Data shows wide variations in access to abortion clinics nationwide

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Graphic by Ramiro Ferrando

With the fewest abortion providers in the U.S. and the highest number of restrictive policies enacted since it became legal, U.S. women’s access to abortion is becoming increasingly limited.

The abortion rate in the U.S. has been constantly declining for the past three decades and it’s now in a record low, according to the Centers for Disease Control (CDC). The abortion rate is the number of abortions per 1,000 women and it has fallen from 29.3 women in 1981 to 11.8 women in 2015.

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CDC data show that the peak number of abortions took place in 1990, with almost 1.43 million. The most recent abortion surveillance report indicates that there were 638,169 in 2015, less than half than in 1990.

Click on the “play” button below to see the data from 1973-2014


Moreover, the deaths of women associated with complications have never been so low.

According to data from the CDC, in 2014, the most recent year for which data are available, six women died as a result of complications from legal abortion, which is hugely less than the about 800 women who die each year in the U.S. from pregnancy or childbirth related causes.

At the same time, the number of abortion providers is at its lowest.

Abortion was legalized in 1973 under the Roe vs. Wade case. The number of providers has gone from a high of 2,908 providers in 1982 to 1671 in 2014, the year from which latest figures are available. That’s about a 42 percent decline.

In addition, since 2011, 33 states enacted more than 400 hundred abortion restrictions.

Click on a state below to see more detailed information.

But nationwide statistics don’t tell the whole story.

The distribution of abortion facilities is highly heterogeneous across the U.S.

California, for example, has 152 abortion clinics, while others as Mississippi, Wyoming, Missouri, Kentucky, North Dakota, South Dakota and West Virginia have just one each.

The issue of access to abortion is starker when considering the number of women living in those states. The most extreme example is in Missouri, where there is one clinic for 1.3 million women of reproductive age. That range is 15 to 49 years old.

Thus, some researchers are studying what they call “abortion deserts.” The expression refers to a city that is farther than 150 miles from an abortion facility.

Dr. Ushma Upadhyay, associate professor in the Department of Obstetrics, Gynecology & Reproductive Science at the University of California San Francisco, is one researcher that also focused on topic of “abortion deserts”.

Upadhyay’s research group identified 27 cities in the U.S. that fit this criterion.

Restrictive laws

The sharp increase in restrictive laws on abortions has shocked pro-choice groups.

“That is unprecedented,” said Elizabeth Nash, the senior state issues manager in the Guttmacher Institute. “Not even in the early 1970s did we see something like this.”

The Guttmacher Institute is pro-choice non-profit research and policy organization.

Nash attributed the restrictions to the legislative and gubernatorial elections of 2010.

“So many very conservative candidates became lawmakers”, she said.

By then, she said, model legislation from pro-life advocates was ready to move forward.

The restrictions included:

  • Limits on or the ending of state funding for abortions;
  • Mandatory counseling requirements;
  • Waiting periods;
  • Parental consent;
  • Refusals rules for providers, both individuals and institutions;
  • Restriction of coverage by private insurance plans;
  • Gestational limits related bans;
  • The need for a second physician in the procedure;
  • Safety standards for buildings.

Some of the restrictions were called by pro-choice activists “Targeted Restrictions on Abortion Providers,” also known as “TRAP” laws.

Their main goal, according to the regulators’ arguments, was to increase the women’s safety. However, a special report by the The American College of Obstetricians and Gynecologists has said the rules  are unnecessary and ultimately aimed to decrease the number of providers.

Critics of the limits also say bans of state funding for abortions affect low-income women  the most and that the situation is exacerbated by distances to abortion clinic.

The average abortion costs about $500 not including travel expenses, days off from work, and other common expenditures, according to researchers.

By Ramiro Ferrando


Abortions still in high demand

In spite of being in an all-time low, abortions are still a highly demanded health service.

According to a study by the American Journal of Public Health nearly one in four in the US women will have an abortion by age 45.

“Statistically this means that everybody knows somebody who had an abortion,” said Jenn Stanley, journalist and host of Rewire’s podcast about abortion called Choice/Less.



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