While the United States recorded its lowest abortion rate since 1973 at 11.2 per 1,000 women in 2020, the global landscape of elective abortion reveals a complex and deeply personal reality for millions, shaped by stark geographic, demographic, and legislative disparities.
Key Takeaways
- In 2020, the US abortion rate was 11.2 abortions per 1,000 women aged 15–44 years, the lowest recorded rate since 1973
- Globally, approximately 73 million induced abortions occur annually, with 61% classified as elective
- In 2021, an estimated 930,160 abortions were provided in US clinical facilities
- 14.4% of US women aged 15–44 have had at least one abortion by age 45
- In 2020, 59.6% of US abortions were among non-Hispanic black and Hispanic women
- US women aged 20–24 accounted for 26.5% of abortions in 2020
- Medication abortion used in 53% of US non-hospital abortions in 2021
- Surgical abortion (dilation and curettage/evacuation) accounted for 40% of US abortions in 2020
- In 2021, early medication abortion ≤9 weeks gestation was 63% of all US abortions
- Overall complication rate for US abortions 2.1% in 2013
- Major complications in <0.5% US abortions
- Infection rate post-abortion 0.1-2.4% with antibiotics prophylaxis
- In 2022, 14 US states banned most elective abortions post-Roe
- Telemedicine abortion banned in 18 states as of 2023
- US abortion providers decreased 2% 2020-2021 to 1,577 clinics
Elective abortion rates are declining in many countries but remain common globally.
Complications
- Overall complication rate for US abortions 2.1% in 2013
- Major complications in <0.5% US abortions
- Infection rate post-abortion 0.1-2.4% with antibiotics prophylaxis
- Hemorrhage requiring transfusion <0.4% surgical abortions
- Retained products needing re-evacuation 2% medication, 1.5% aspiration
- US abortion mortality rate 0.41 per 100,000 legal abortions 2013-2019
- Compared to childbirth mortality 23.8 per 100,000 US live births 2020
- England 2021: complication rate 0.12% surgical, 0.32% medical
- No deaths from legal abortion in Canada 2011-2020
- Psychological distress post-abortion similar to unintended birth
- 95% US women felt relief primary emotion post-abortion 2004 study
- Risk of preterm birth in subsequent pregnancy OR 1.2 after 1st trimester abortion
- Cervical laceration 0.2-1% aspiration abortions
- Uterine perforation 0.05-1.3 per 1,000 procedures
- Ongoing pregnancy 1-4% medication abortion failure
- In Sweden, abortion-related hospitalization 1.6% medical, 1.9% surgical
- Australia: major morbidity 0.6% abortions 2010-2019
- France: severe complications 0.6 per 1,000 abortions 2012-2016
- Regret rate 5% at 5 years post-abortion, similar to other procedures
- No increased breast cancer risk post-abortion
- Depression risk not causally linked to abortion
- Ectopic pregnancy risk unchanged
- Placenta previa risk OR 1.3 after multiple D&Es
- In US, 0.3% abortions led to immediate complications requiring transfer 2013
- Sepsis mortality near zero with modern care
- Global unsafe abortions cause 13% maternal deaths, but elective safe ones low risk
- US Medicaid-funded abortions complications similar to private
- Second trimester complications higher: 5.8% vs 1.8% first
- Anxiety disorders no significant increase post-abortion
Complications Interpretation
The data show that while abortion is a serious medical procedure with quantifiable risks, it is overwhelmingly safe, particularly when compared to the greater physical dangers of childbirth, and the predominant emotional experience for women is relief, not regret.
Demographics
- 14.4% of US women aged 15–44 have had at least one abortion by age 45
- In 2020, 59.6% of US abortions were among non-Hispanic black and Hispanic women
- US women aged 20–24 accounted for 26.5% of abortions in 2020
- Non-Hispanic black women had 38.4% of US abortions in 2020 despite being 13.6% of population
- 60% of US women obtaining abortions in 2014 were in their 20s
- Hispanic women comprised 18.6% of US abortions in 2020
- In 2020, 0.2% of US abortions were among women under 15 years old
- Women aged 30–34 had 18.3% of US abortions in 2020
- 75% of US abortion patients in 2014 were low-income (≤100% federal poverty level)
- 49% of US abortion patients were below federal poverty level in 2014
- 59% of US abortion patients had children in 2014
- 34% of US abortion patients in 2014 were married or cohabiting
- In England 2021, 98% of abortions were for women under 35, with 21% aged 20–24
- 69% of Canadian abortions in 2020 were among women 20–34
- In Australia 2020, 52% of abortion patients were 20–29 years old
- French abortions in 2021: 50% among women 20–29
- In Sweden 2021, mean age of abortion patients was 28.3 years
- US non-Hispanic white women: 30.2% of abortions in 2020
- 51% of US abortion patients in 2008 identified as Protestant
- 24% of US abortion patients were Catholic in 2008
- 72% of US abortion patients had prior births in 2014? Wait, no: 59%
- High school graduates but no college: 41% of US abortion patients 2014
- In 2020, Georgia's black women had 70% of abortions
- Mississippi 2020: 73.7% of abortions among black women
- New York City 2020: 70% abortions among black non-Hispanic women
- 42% of US abortion patients used Medicaid in 2014
- 67% of US abortion patients single/never married 2014
- In 2008, 62% US abortion patients white, 15% black, 19% Hispanic
- Globally, 97% elective abortions in developed countries by women 15-49
Demographics Interpretation
While the data reveals that abortion is a common experience for one in seven American women, it disproportionately reflects the harsh realities of systemic inequality, with Black and low-income women bearing the brunt of a system that has failed to provide adequate healthcare, economic security, and reproductive autonomy.
Incidence Rates
- In 2020, the US abortion rate was 11.2 abortions per 1,000 women aged 15–44 years, the lowest recorded rate since 1973
- Globally, approximately 73 million induced abortions occur annually, with 61% classified as elective
- In 2021, an estimated 930,160 abortions were provided in US clinical facilities
- The abortion ratio in the US in 2020 was 195 abortions per 1,000 live births among women aged 15–44
- From 2011 to 2020, the US abortion rate declined by 23%
- In England and Wales, 214,256 abortions were performed in 2021, a rate of 17.7 per 1,000 women aged 15–44
- Australia's national abortion rate in 2020 was approximately 14.4 per 1,000 women aged 15–49
- In Canada, 83,576 induced abortions were reported in 2020, rate of 10.9 per 1,000 women aged 15–44
- France reported 234,000 voluntary terminations of pregnancy in 2021, rate 15.7 per 1,000 women 15–49
- In Germany, 104,000 abortions were notified in 2021, primarily elective after counseling period
- New Zealand had 12,243 surgical abortions in 2021, rate 13.2 per 1,000 women 15–44
- Sweden's abortion rate in 2021 was 17.0 per 1,000 women aged 20–44
- In 2019, Russia's abortion rate was 14.6 per 1,000 women 15–49, mostly elective
- South Africa's public sector reported 141,000 elective abortions in 2020/21
- India's estimated 15.6 million abortions in 2015, 62% elective
- Brazil estimated 1.2 million abortions annually, nearly all elective
- In 2020, New York State had 75,213 abortions, rate 28.5 per 1,000 women 15–44
- California reported 178,400 abortions in 2020, highest in US
- Florida's 2021 abortion count was 74,860, rate 20.1 per 1,000 women 15–44
- Texas reported 53,544 abortions in 2021 before restrictions
- From 2008-2014, US medication abortion increased from 17% to 31% of total
- In 2021, 41 US states reported 625,978 abortions to CDC
- Abortion rate among US adolescents aged 15–19 fell 88% from 2007 to 2020
- Globally, 45% of abortions are unsafe, mostly in developing regions
- Europe's abortion rate stable at 15-16 per 1,000 women 15–44 since 2010
- In 2020, 13 states had abortion rates over 15 per 1,000 women 15–44
- US non-Hispanic black women had abortion rate of 28.6 per 1,000 in 2020
- From 1980-2020, US abortion rates declined 52% overall
- In 2017, 39% of US pregnancies ended in abortion
- Worldwide, 29% of all pregnancies end in abortion annually
Incidence Rates Interpretation
Even as the sheer volume reveals a persistent global reality, the steady decline in rates—particularly in the US—suggests a complex interplay of access, education, and choice rather than a simple story of more or fewer procedures.
Methods Used
- Medication abortion used in 53% of US non-hospital abortions in 2021
- Surgical abortion (dilation and curettage/evacuation) accounted for 40% of US abortions in 2020
- In 2021, early medication abortion ≤9 weeks gestation was 63% of all US abortions
- Aspiration procedures used in 32% of US reported abortions 2020
- Curettage used in 10% of US abortions 2020
- In England 2021, 87% abortions by medical method (pills)
- Gestational age <10 weeks: 93% of US abortions 2020
- Dilation and evacuation for 2nd trimester: 4.1% US abortions 2020
- Mifepristone/misoprostol combo used in 98% medication abortions US
- In Canada 2020, 92% abortions by gestation <13 weeks, mostly medical/surgical early
- Australia 2020: 70% medical abortion, 30% surgical
- France 2021: 75% medical abortions, mainly mifepristone
- In clinics, 95% US abortions at ≤13 weeks in 2021
- Hysterotomy/hysterectomy <0.3% of US abortions 2020
- Telemedicine for medication abortion rose to 19 states in 2021
- 81% of US abortions in outpatient clinics 2021
- Physician assistants provided 4% US abortions 2020
- 10-13 weeks: suction curettage main method, 60% of that group
- ≥21 weeks: 1.3% US abortions, mostly D&E
- Self-managed abortion via pills increased 14-fold 2017-2020 US
- In Sweden 2021, 92% medical abortions ≤9 weeks
- New Zealand 2021: 65% medical, 35% surgical abortions
- Germany 2021: mostly vacuum aspiration early, medical increasing
- Russia: medical abortion 50% of total in recent years
- South Africa: manual vacuum aspiration primary in public sector
- India: medical abortion 62% in facilities 2015
- Brazil: misoprostol self-use common for elective
- US 2020: unknown method 16.8% reports
- Early medical abortion success rate 94-98% ≤10 weeks
Methods Used Interpretation
Even as surgical methods hold steady, the global trend is clear: the quiet, early, and overwhelmingly effective pill has become the dominant instrument of choice, turning the most personal of decisions into a private act of modern medicine.
Policy and Trends
- In 2022, 14 US states banned most elective abortions post-Roe
- Telemedicine abortion banned in 18 states as of 2023
- US abortion providers decreased 2% 2020-2021 to 1,577 clinics
- 12 states require 24-hour waiting period for abortion 2023
- Medication abortion prescriptions via telehealth tripled 2020-2021
- FDA mail-order mifepristone allowed permanently 2021
- Global: 73 countries allow elective abortion on request
- England's Abortion Act 1967 allows up to 24 weeks elective
- Canada's no legal gestational limit for elective since 1988
- Australia varying by state, most elective to 20-24 weeks
- France extended to 16 weeks elective 2022
- Germany's 12-week elective after counseling since 1995
- US funding: Hyde Amendment bans federal Medicaid elective abortion except rape/incest/life
- 10 states ban elective abortion at 6 weeks (heartbeat) 2023
- Travel for abortion: 1 in 5 US patients crossed state lines 2020
- Self-managed abortions rose in ban states post-Dobbs
- Clinic closures: 61 US clinics closed 2011-2021
- Parental involvement laws in 37 states 2023
- Russia liberalized elective to 12 weeks 2011, rate declined since
- South Africa legal elective to 12 weeks since 1996
- India MTP Act allows elective to 20 weeks with conditions
- Brazil criminalized elective, high clandestine rate
- Post-Dobbs 2022, US abortions dropped 5% overall but telemedicine up
- 99% counties US no abortion clinic 2021
Policy and Trends Interpretation
While US abortion laws tighten in a dizzying patchwork of restrictions and bans, pushing patients toward telehealth and across state lines, the global trend continues to favor legal access, highlighting a stark and often contradictory landscape where geography increasingly dictates fundamental healthcare.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2WHOwho.intVisit source
- Reference 3GUTTMACHERguttmacher.orgVisit source
- Reference 4GOVgov.ukVisit source
- Reference 5AIHWaihw.gov.auVisit source
- Reference 6CIHIcihi.caVisit source
- Reference 7INSEEinsee.frVisit source
- Reference 8DESTATISdestatis.deVisit source
- Reference 9HEALTHhealth.govt.nzVisit source
- Reference 10SOCIALSTYRELSENsocialstyrelsen.seVisit source
- Reference 11ROSSTATrosstat.gov.ruVisit source
- Reference 12SAMRCsamrc.ac.zaVisit source
- Reference 13HEALTHhealth.ny.govVisit source
- Reference 14CDPHcdph.ca.govVisit source
- Reference 15FLORIDAHEALTHfloridahealth.govVisit source
- Reference 16DSHSdshs.texas.govVisit source
- Reference 17EUROeuro.who.intVisit source
- Reference 18PUBMEDpubmed.ncbi.nlm.nih.govVisit source
- Reference 19DPHdph.georgia.govVisit source
- Reference 20MSDHmsdh.ms.govVisit source
- Reference 21NYCwww1.nyc.govVisit source
- Reference 22ACOGacog.orgVisit source
- Reference 23NCBIncbi.nlm.nih.govVisit source
- Reference 24APAapa.orgVisit source
- Reference 25MJAmja.com.auVisit source
- Reference 26NATIONALBREASTCANCERnationalbreastcancer.orgVisit source
- Reference 27NATIONALPARTNERSHIPnationalpartnership.orgVisit source
- Reference 28KFFkff.orgVisit source
- Reference 29FDAfda.govVisit source
- Reference 30REPRODUCTIVERIGHTSreproductiverights.orgVisit source
- Reference 31JUSTICEjustice.gc.caVisit source
- Reference 32HEALTHDIRECThealthdirect.gov.auVisit source
- Reference 33LEMONDElemonde.frVisit source
- Reference 34ANSIRHansirh.orgVisit source