How Many Abortions Per Year? U.S. and Global Data

The United States records roughly a million abortions per year based on the most comprehensive counts, while the global figure is far larger, with researchers estimating about 56 million abortions annually during 2010–2014. Both numbers are harder to pin down than you might expect, because no single tracking system captures every procedure, and in many countries abortions go unreported entirely. The story behind those figures involves shifting legal landscapes, changing technology, and persistent gaps in who gets counted.

How U.S. Abortion Data Is Collected

Two main data sources track abortions in the United States, and they produce different numbers. The CDC’s Abortion Surveillance System requests data from state health agencies, but reporting is voluntary. Several large states, including California, Maryland, and New Hampshire, have not submitted data to the CDC system for years, which means the CDC’s published totals reliably undercount the true number. The Guttmacher Institute, an independent research organization, has periodically conducted its own Abortion Provider Census, collecting information directly from facilities that provide abortions across all fifty states. Because Guttmacher’s survey has historically included continuous reporting from every state, its totals run higher than the CDC’s. Despite the methodological differences, both sources have shown similar trends in abortion rates over the past decade, rising and falling in parallel even when their absolute numbers differ.

This means that when you see a headline citing a specific annual number, you should check which source it comes from. A CDC figure for any given year will be lower than a Guttmacher figure, not because one is wrong, but because the CDC is simply missing data from some of the most populous states. Neither number is perfect, but together they bracket the real figure and confirm the same overall direction.

U.S. Numbers Over Time

Abortion in the United States peaked in the early 1990s. Between 1992 and 1996, the number of abortions fell from about 1.53 million to roughly 1.37 million, while the abortion rate dropped from 26 to 23 per 1,000 women of reproductive age.² That decline continued for roughly two more decades, driven by expanded access to effective contraception, falling teen pregnancy rates, and changing reproductive behavior. By 2017, the national abortion rate had dropped to its lowest point since Roe v. Wade was decided in 1973.

The trend reversed around 2018 and 2019, with abortion numbers ticking upward. The reasons are debated, but researchers point to the growing availability of medication abortion and telehealth services, which made early abortion easier to obtain. By 2020 and into 2021, the total continued to climb. The CDC’s 2021 surveillance report, which still excludes several large states, documented increases in both the number and the rate of abortions across the areas that did report.³ In the most complete counts, the U.S. likely exceeded a million abortions per year by the early 2020s.

How the Dobbs Decision Reshaped the Landscape

The Supreme Court’s June 2022 ruling in Dobbs v. Jackson Women’s Health Organization eliminated the federal constitutional right to abortion and returned regulation to individual states. Within months, more than a dozen states enacted total or near-total bans. The effect on where abortions happen has been dramatic, but the effect on how many abortions happen has been more complicated than many predicted.

Interstate travel for abortion care nearly doubled between 2020 and 2024, with Illinois, North Carolina, New Mexico, and Kansas absorbing the highest volumes of out-of-state patients.¹ The shifts were starkest for people traveling from states that enacted bans. In the year after Dobbs, travelers seeking abortions from Georgia increased by roughly fiftyfold compared to the year before, while travelers from Tennessee increased more than sevenfold. The average daily travel distance for people crossing state lines for an abortion rose from about 156 miles before the ruling to 258 miles after.⁴

Abortions provided to travelers jumped by about 38 additional cases per day nationally after Dobbs, and the increase was concentrated among people in their first trimester and among non-Hispanic Black patients. Researchers did not observe a significant increase in daily abortions for residents of the states that were already providing care, suggesting that the new patients were almost entirely displaced demand from ban states rather than new demand.⁴ The overall national count of abortions has not dropped as sharply as a map full of bans might suggest, because people are traveling farther, using telehealth, or managing abortions on their own.

The Rise of Telehealth and Medication Abortion

One of the biggest shifts in the U.S. abortion landscape has nothing to do with bans and everything to do with pills. Medication abortion, which uses a two-drug regimen of mifepristone and misoprostol, now accounts for the majority of U.S. abortions. The expansion of telehealth has accelerated that trend: patients in states where abortion is legal can have a video consultation, receive pills by mail, and complete the abortion at home without ever visiting a clinic.

The number of virtual clinics offering telehealth abortion nearly doubled in the first year after Dobbs. In September 2022, 11 such clinics operated across 26 states and Washington, D.C. By June 2023, 20 virtual clinics were providing telehealth abortion care in 27 states and D.C.⁵ The provision of medication abortion through telehealth has taken an increasing share of total abortions, offering a more affordable and private option for patients in both restrictive and supportive states.⁶

Demand for telehealth abortion pills spiked in the months after Dobbs. One provider, Aid Access, completed over 16,000 telehealth medication abortion requests across 18 states between late 2021 and early 2023. The average monthly request rate nearly doubled after the ruling, and the increase was steepest among people who lived farthest from brick-and-mortar clinics.⁷ Telehealth has essentially created a parallel access route that partially offsets clinic closures, though it does not reach everyone, particularly those who need later procedures or who lack stable internet and mailing addresses.

Who Gets Abortions in the United States

The demographics of abortion patients reflect broader patterns of economic inequality and reproductive access. According to CDC surveillance data from 2021, non-Hispanic Black women accounted for about 42% of all abortions in reporting areas, despite making up a much smaller share of the reproductive-age population. Non-Hispanic White women accounted for roughly 30%, and Hispanic women for about 22%. Black women had the highest abortion rate at about 29 per 1,000 women of reproductive age, compared with about 6 per 1,000 for White women.³

About 87% of abortion patients in 2021 were unmarried. Roughly 39% of abortions were among women who had never given birth before, while the remaining 61% had at least one prior live birth.³ This challenges the persistent stereotype of abortion as primarily a decision made by young, childless women. The majority of people who have abortions are already parents.

How patients pay also tracks with which type of abortion they get. People who identified as Asian or White, had no prior births or abortions, or were paying out of pocket were more likely to have a medication abortion. Non-Hispanic Black patients, those with incomes at or below the poverty level, and those paying with insurance were more likely to have a procedural (surgical) abortion.⁸ The reasons probably involve geography and clinic type: medication abortion is easier to obtain in settings with telehealth options and early gestational windows, while patients in areas with fewer providers or who present later may be steered toward procedural methods.

When During Pregnancy Abortions Occur

The vast majority of abortions in the United States happen early in pregnancy. CDC data from 2021 show that about 81% of abortions were performed at or before nine weeks of gestation, and about 94% were performed at 13 weeks or earlier. Only about 6% took place between 14 and 20 weeks, and fewer than 1% occurred at 21 weeks or later.³

These numbers are relevant because political debates often focus on later abortions, which are exceedingly rare and usually involve serious medical complications, fetal diagnoses, or barriers to earlier access. The expansion of medication abortion and telehealth is pushing the gestational distribution even earlier, since medication abortion is typically used before 10 or 11 weeks. Not all facilities offer later procedures: a 2012 survey found that while 95% of abortion facilities offered care at 8 weeks, only 34% did so at 20 weeks, and just 16% at 24 weeks.⁹ The scarcity of later-gestation providers is itself a contributor to delayed abortions, creating a feedback loop where people who face barriers early end up seeking care later, at facilities that are harder to find and farther away.

The Global Picture

Worldwide, abortion is far more common than most people realize. Between 2010 and 2014, an estimated 56 million abortions took place each year globally.¹⁰ More recent analyses covering 2015–2019 suggest the number is even higher, though exact global totals depend on modeling assumptions because many countries lack reliable reporting.

Regional trends reveal a split. In developed countries, the annual abortion rate dropped substantially between 1990 and 2014, falling from about 46 per 1,000 women of reproductive age down to about 27. In developing countries, the rate barely moved over that same period, going from about 39 to 37.¹¹ The decline in wealthier nations is largely attributed to better contraceptive access, while the stubbornly high rate in poorer nations reflects ongoing gaps in family planning services and education.

Country-level variation is enormous. Estimated abortion rates in the 2015–2019 period ranged from as low as 5 per 1,000 women in some countries to as high as 80 per 1,000 in others, and the variation was substantial even within the same world region.¹² Sub-Saharan Africa showed the widest spread between countries, underscoring that abortion rates are shaped by local access to contraception, economic conditions, and cultural norms rather than by any single global factor.

Safe and Unsafe Abortion Worldwide

The safety of abortions varies as much as their frequency. Of the roughly 56 million annual abortions in 2010–2014, about 55% were classified as safe, meaning they were performed by a trained provider using a recommended method. About 31% were “less safe,” and 14% were “least safe,” a category that includes procedures using dangerous methods or performed by untrained individuals. Taken together, about 25 million abortions per year were classified as unsafe, and 97% of those occurred in developing countries.¹⁰

The health consequences are severe. Unsafe abortion accounts for an estimated 13% of maternal deaths worldwide, and an estimated 68,000 women die from unsafe procedures annually. Among those who survive, roughly five million experience long-term health complications including chronic infection and infertility.¹³ The overwhelming concentration of these deaths and injuries in low-income countries makes unsafe abortion one of the clearest examples of how reproductive outcomes track with economic inequality.

Harm-reduction programs have tried to narrow this gap by counseling people on the safer use of misoprostol where clinical abortion services are restricted or unavailable. A systematic review of such programs found overall complication rates of about 2%, with serious complications being rare. Only two out of roughly 4,000 participants required hospital admission for infection, and no deaths were reported.¹⁴ These findings suggest that even where legal access is limited, providing accurate information about medication can significantly reduce the mortality toll.

Whether Laws Change the Numbers

One of the most persistent questions in this debate is whether banning or restricting abortion actually reduces how many abortions happen. Research published in the BMJ found that abortion rates are similar in countries where the procedure is legal and in countries where it is restricted.¹⁵ What changes is not the number of abortions but how safe they are. Where abortion is legal and accessible, procedures tend to be safe. Where it is heavily restricted, the proportion of unsafe abortions climbs.

This does not mean laws have zero effect on individual access. In the United States after Dobbs, people in ban states face real and measurable barriers: longer travel distances, later gestational ages at the time of the procedure, and higher costs. People from racial and ethnic minority groups and those with lower incomes are disproportionately affected by these burdens.⁴ The finding that overall national counts have not dropped dramatically after Dobbs is consistent with the global research: restrictions shift where and how abortions happen more than they reduce the total.

What does reliably bring abortion rates down is expanded access to effective contraception. Reducing both the periods when people are not using contraception and the failure rates from improper use lowers unintended pregnancy and, in turn, the demand for abortion.¹⁶ Investments in family planning programs have been shown to reduce unintended pregnancies, total and unsafe abortions, maternal deaths, and child deaths, making them one of the most cost-effective public health interventions available.¹⁷ The steepest abortion rate declines in developed countries from the 1990s through the 2010s coincided with periods of improved contraceptive availability, not with shifts in legal status.

Self-Managed Abortion Outside the Formal System

None of the official counts fully capture abortions that happen outside the health-care system. A nationally representative survey found that an estimated 7% of U.S. women reported having attempted a self-managed abortion at some point in their lifetime, commonly using ineffective methods. The researchers noted that surveys conducted at abortion clinics likely capture only about a third of all self-managed attempts, meaning the real number is substantially underestimated.¹⁸

Self-managed abortion is more common among people who face the steepest barriers to clinical care: people of color, people with lower incomes, and people living in states with restrictive abortion laws.¹⁹ Since Dobbs, the prevalence is widely expected to have grown, though capturing it in data remains inherently difficult because people who manage their own abortions have strong reasons not to report it. This means the headline annual figures for the United States, whether from the CDC or Guttmacher, undercount the true total by an unknown margin. The people most likely to be missing from the data are the same people most affected by abortion restrictions, which makes the gap between reported numbers and reality a health-equity issue in itself.

The Economic Consequences of Being Denied an Abortion

The Turnaway Study, a five-year longitudinal project that followed nearly a thousand women across 30 facilities in the United States, offers some of the strongest evidence on what happens when someone who wants an abortion cannot get one. The study compared women who received a wanted abortion with women who were turned away because they had passed their facility’s gestational limit by a few weeks.²⁰ Women who were denied were more likely to experience poverty, more likely to stay tethered to an abusive partner, and less likely to achieve the financial goals they had identified for themselves. These economic gaps persisted years after the denial.

The study’s design is unusual in reproductive-health research because it created a natural comparison group: the women who just barely made the cutoff versus those who just barely missed it were, on average, very similar in background and circumstances. The differences that emerged over the following years could be more confidently attributed to the denied abortion rather than to pre-existing differences. As more states have restricted or banned abortion post-Dobbs, the Turnaway findings have taken on fresh relevance for estimating the downstream economic and social effects on the roughly one in four women in reproductive age who now live in states with bans or near-bans. The costs ripple outward from the individual to families and communities, which is why economists have increasingly treated abortion access as a labor-market and poverty issue rather than solely a health-care one.²¹

1
KFF. Abortion Trends Before and After Dobbs
2
PubMed. Abortion incidence and services in the United States, 1995-1996
3
Morbidity and Mortality Weekly Report. Abortion Surveillance — United States, 2021
4
JAMA Network Open. Out-of-State Travel for Abortion Care Before and After the Dobbs v Jackson Decision
5
PubMed Central. Virtual Clinic Telehealth Abortion Services in the United States One Year After Dobbs: Landscape Review
6
PubMed. Demand for Medication Abortion Through Telehealth Before and After the Dobbs v. Jackson Supreme Court Decision in States Where Abortion Is Legal
7
JAMA Network Open. Distance to Care and Telehealth Abortion Demand After Dobbs
8
PubMed. Characteristics of people obtaining medication vs procedural abortions in clinical settings in the United States
9
PubMed Central. Secondary measures of access to abortion services in the United States, 2011 and 2012: gestational age limits, cost, and harassment
10
The Lancet. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model
11
PubMed Central. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends
12
BMJ Global Health. Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019
13
PubMed Central. Unsafe Abortion: Unnecessary Maternal Mortality
14
PubMed Central. Reducing the harms of unsafe abortion: a systematic review of the safety, effectiveness and acceptability of harm reduction counselling for pregnant persons seeking induced abortion
15
PubMed. Abortion rates are similar in countries where procedure is legal or restricted
16
PubMed. Epidemiology of unintended pregnancy and contraceptive use
17
PubMed Central. Harmonizing Methods for Estimating the Impact of Contraceptive Use on Unintended Pregnancy, Abortion, and Maternal Health
18
PubMed Central. Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States
19
PubMed Central. Self-Managed Abortion in the United States
20
PubMed Central. Socioeconomic Outcomes of Women Who Receive and Women Who Are Denied Wanted Abortions in the United States
21
PubMed Central. Making sense of the economics of abortion in the United States