Understanding Abortion Care

An Overview of Abortion Care

Nearly half of pregnancies in the U.S. are unintended.¹ The U.S. Department of Health and Human Services established a national goal to change that through its Healthy People initiative², calling family planning “one of the 10 great public health achievements of the 20th century.”³ Efforts toward meeting the Leading Health Indicator that sexually active females receive reproductive health services (including family planning and pregnancy options counseling) will reduce the need for abortion.

There is some good news, however:

• The rate of unintended pregnancy in the U.S. took a promising turn between 2008 and 2011: 51% of pregnancies were unintended in 2008, and that rate declined to less than half (45%) in 2011.
• Disparities across population groups are narrowing, although they persist, with higher rates among girls 15 to 17 years of age, patients who were cohabiting, with low income, and Hispanics.⁴
• The percentage of unintended pregnancies that end in abortion has remained stable⁵ but the abortion rate has recently hit record lows.
• In 2014, an estimated 926,200 abortions were provided in the U.S., a rate of 14.6 per 1,000 patients aged 15 to 44, down 14% from 16.9 per 1,000 in 2011.⁶

The CDC has been conducting abortion surveillance since 1969, and regularly publishes Abortion Surveillance Reports.

Although there is a constitutional right to abortion, states have enacted hundreds of restrictions on abortion that make it difficult or impossible for patients to exercise this right.  For instance, as discussed in detail in State Abortion Laws and their Relationship to Scope of Practice, “physician-only” laws impede access to abortion care by denying appropriately trained advanced practice clinicians the opportunity to serve their patients’ needs.⁷

Other barriers include:

• Laws requiring biased counseling of abortion patients;
• Laws requiring abortion providers to narrate an ultrasound image, even against the patient’s wishes;
• Laws mandating that a patient delay her abortion by a minimum period of time (typically 24, 48, or 72 hours) after receiving state-mandated counseling information;
• “TRAP” laws (Targeted Regulation of Abortion Providers), which single out abortion providers for medically unnecessary, politically motivated regulations—often forcing clinics to shut down; and
• Decline in the number of abortion clinics: The vast majority of abortions are provided by abortion and nonspecialized clinics, and 6% fewer clinics⁸ provided abortions in 2014 than in 2011. Today, 90% of counties in the U.S. lack an abortion provider.