Abortion in the United States of America

According to the Guttmacher Institute, the abortion rate in 2023 was 15.9 abortions per 1,000 women aged 15–44 ¹. As of 2024, abortion bans are in place in 14 states, representing 28% of the country. Meanwhile, 6 states (12%) enforce gestational limits between 6 and 12 weeks LMP, and 5 states (10%) limit abortion between 15 and 22 weeks LMP. Another 16 states (32%) have limits set at or near viability, and 9 states plus Washington D.C. (18%) have no gestational limits at all ². Telehealth abortions now account for nearly 1 in 5 procedures in the U.S., with thousands being accessed monthly, It’s important to mention that Telehealth has come as a service offering protection to individuals in states with abortion bans or restricted access to care³.

Law and Policy: 3/5

Abortion is partially decriminalized but faces significant restrictions in various states, such as waiting periods, gestational limits, and third-party consent requirements. There are some protections for sexual and reproductive health rights (SRHR), but access varies widely by state, especially affecting marginalized communities.

Accessibility: 3/5

Access to abortion services is moderate. While some areas have reasonable access, many states have enacted laws that limit the availability of clinics and impose waiting periods, resulting in significant barriers, particularly for low-income individuals and those in rural areas especially from Black, Latine and Native American communities.

Provider Training: 4/5

Providers generally receive good training in modern methods of abortion care, and many professional organizations advocate for adherence to WHO guidelines. However, there can be regional disparities in training quality and availability.

Public Opinion: 3/5

Public opinion on abortion is divided, with some acceptance but significant stigma still present. Discourse is often influenced by moral judgments and misinformation, though there is a growing acceptance of data and human rights perspectives in some areas.

Support Services: 4/5

Many organizations provide accurate information and counseling services related to abortion care. There are good linkages to additional healthcare services, although gaps exist in some regions.

Data: 4/5

There is adequate data on abortion services, updated regularly, although gaps in comprehensive reporting can still be identified. Many NGOs and government sources provide accessible information.

International Standards: 3/5

The U.S. has ratified several international human rights treaties, but compliance with abortion rights varies significantly at the state level, often undermined by local laws that contradict these commitments.

Adherence to Health Standards in Abortion Care: 4/5

Generally, abortion care practices align well with WHO guidelines, particularly in more progressive states. However, restrictions in some states can compromise adherence to best practices.

In June 2022, the US Supreme Court overturned Roe v Wade, ruling against abortion as a constitutional right. In doing so it gave individual states the power to severely restrict or completely ban abortion care ⁴.

Since Roe has been overturned, 14 US states have banned abortion, 26 states ban abortion after a specific gestational period, 12 states impose specific waiting time on abortion seekers and 22 states need some form of parental involvement for minors. In other states abortion is conditionally legal with various degrees of protection and restrictions. Let’s take a look at the situation of abortion rights across US states post Roe v Wade. Depending on the extent of the laws to guarantee abortion rights, we have divided states according to banned, highly restrictive, restrictive, partly restrictive, protective, highly protective and most protective. Abortion is banned and criminalized in states like Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Texas, West Virginia⁵.

Abortion Bans

In the aftermath of the overturning of Roe v. Wade, abortion access is in crisis in the USA. It has led to increased restrictions across several states and complete ban in many with no exception for rape or incest. According to the abortion law in Alabama, all abortion is banned from the time the person is known to be pregnant’ with no exceptions. In several states without total ban like Florida, Ohio, Iowa, and South Carolina, there are legally enforced restrictions to prohibit abortion after 6 weeks, a time that is not enough time for people to identify pregnancy⁶.

Amnesty International gives us insightful historical context to the overturning of Roe, which has its roots in anti-choice activism since 1973 and was brought to fruition by the Donald Trump administration appointing two anti-choice judges to the Supreme Court. Anti-choice activists in the USA have been making abortion access increasingly precarious since 1973 through TRAP laws⁷. TRAP (Targeted Regulation of Abortion Providers) laws are state-imposed regulations on abortion clinics intended to make it impossible for them to run and eventually cause them to shut down.

A 2023 study by the Guttmacher Institute shows that over 1 million abortions occurred in the US healthcare system, with a rate of 15.7 abortions per 1,000 women of reproductive age; this is the highest number in a decade and a 10% increase from 2020⁸.

Key Findings:

• States next to those with abortion bans saw a 37% increase in abortions⁹.

• States without total bans saw a 25% increase¹⁰.

• This shows that medical facilities in some states had to expand services due to bans in other states¹¹.

The study did not include self-managed abortions outside formal healthcare, such as those using medication sent to people in states with bans. Evidence shows that these self-managed abortions have significantly increased, meaning the total number of abortions is likely much higher than reported¹².

Medication abortions accounted

Abortion Provider Census and Monthly Abortion Provision Study. (2024). Guttmacher Institute

A survey conducted in March 2022, before the overturning of Roe v. Wade, revealed that over half of U.S. adults believed women should have a greater role in shaping abortion policies¹³. 

Factors such as the timing of the abortion, whether the pregnancy is life-threatening, or if the fetus has serious health issues significantly influence people’s opinions on abortion. Gallup polls reveal that public support for abortion varies by trimester, with approval decreasing in the second and third trimesters. The survey conducted among U.S. adults found that 62% support the legalization of abortion in all or most cases¹⁴. This opinion has remained consistent post-Roe, as seen in the widespread disapproval of the Supreme Court’s decision to overturn it¹⁵. Religion plays a significant role in shaping views on abortion in the U.S., with 72% of White evangelicals opposing it. The intersection of religion and politics is also evident, as Catholic Republicans are much more likely to oppose abortion compared to Catholic Democrats.

Factors such as the timing of the abortion, whether the pregnancy is life-threatening, or if the fetus has serious health issues significantly influence people’s opinions on abortion. Gallup polls reveal that public support for abortion varies by trimester, with approval decreasing in the second and third trimesters. The survey conducted among U.S. adults found that 62% support the legalization of abortion in all or most cases¹⁶. This opinion has remained consistent post-Roe, as seen in the widespread disapproval of the Supreme Court’s decision to overturn it¹⁷. Religion plays a significant role in shaping views on abortion in the U.S., with 72% of White evangelicals opposing it. The intersection of religion and politics is also evident, as Catholic Republicans are much more likely to oppose abortion compared to Catholic Democrats.

A national survey on the experiences of transgender, nonbinary, and gender-expansive individuals in the US included 1,694 respondents from four census regions. Of these, 12% reported a total of 433 pregnancies, with 92 (21%) ending in abortion. Another survey by the same researchers, possibly involving the same participants, revealed that 1 in 3 trans, nonbinary, or gender-expansive individuals had considered medically unsupervised, unsafe abortion methods, and 1 in 5 had attempted it. Participants cited numerous barriers to accessing medical care, including insurance issues, gestational limits, transphobic healthcare providers, comorbidities, and personal concerns, such as fear of being discovered¹⁸.

Abortion Opinions Across Religious Groups

Religious affiliation plays a significant role in shaping views on abortion legality in the U.S. Among white evangelical Protestants, 73% oppose abortion in all or most cases, reflecting a conservative interpretation of religious teachings. In contrast, 71% of Black Protestants and 64% of white non-evangelical Protestants support legal abortion, suggesting that cultural factors influence more moderate perspectives¹⁹.

Catholics are divided, with 59% favoring legal abortion, indicating a shift toward individual choice within traditional beliefs. The highest support for legal abortion comes from the religiously unaffiliated, at 86%, highlighting the alignment of secular beliefs with pro-choice views²⁰.

Overall, while many religious groups uphold restrictive views, there is notable variation, especially among less conservative affiliations, underscoring the complexity of the relationship between faith and abortion rights²¹.

Abortion Perspectives Across Political Affiliations

Political affiliation strongly influences views on abortion legality in the U.S., with Republicans and Democrats exhibiting a stark divide. Among Republicans and those who lean Republican, only 41% support legal abortion in all or most cases, while a majority—57%—oppose it, favoring restrictions. This stance aligns with the party’s conservative platform, which often emphasizes traditional values and the protection of unborn life. In contrast, Democrats and Democratic-leaners overwhelmingly support legal abortion, with 86% favoring it in all or most cases. This widespread support reflects the party’s prioritization of reproductive rights and individual choice, underscoring a commitment to personal autonomy over state intervention in healthcare decisions. The significant gap between these groups demonstrates how deeply abortion rights are intertwined with political ideologies in the U.S., making it a divisive issue that continues to influence voter alignment and legislative priorities across party lines²².

Perspectives on Abortion by Race and Ethnicity

The data on abortion attitudes by race and ethnicity reveals notable differences in opinion, highlighting the need to consider demographic factors in discussions on reproductive rights. A higher percentage of Black (73%) and Asian (76%) adults support the legality of abortion compared to White (60%) and Hispanic (59%) adults. These differences may stem from cultural, historical, and social influences on perspectives about reproductive health. Notably, Black adults report the highest support for legal abortion, which may align with social justice movements advocating for bodily autonomy. Meanwhile, White and Hispanic adults show more divided views, with 38% in each group opposing legal abortion. These variations underscore the complexity of the abortion debate and the importance of addressing racial and ethnic differences when forming policies²³.

Views on abortion by age in the U.S

The data on abortion views by age group in the U.S. reveals a clear trend of younger adults showing higher support for legal abortion compared to older adults, reflecting generational differences in attitudes toward reproductive rights. Among those aged 18-29, 76% believe abortion should be legal in all or most cases, a significant majority compared to the 61% of adults aged 30-49 and 57% of those aged 50-64 who share this view. As age increases, opposition to abortion grows, with 40% of adults aged 50-64 and 39% of adults aged 65+ believing abortion should be illegal in most or all cases. This pattern suggests that younger generations are more likely to prioritize reproductive autonomy, perhaps influenced by greater access to information and evolving societal norms. In contrast, older generations may hold more conservative views, influenced by long-standing cultural and religious beliefs. These generational differences highlight the need for policymakers to consider changing public opinion on abortion, particularly as younger generations become a more significant political force²⁴.

Abortion seekers encompass a diverse demographic that includes women, transgender individuals, nonbinary, and gender-expansive people in the United States, reflecting a range of race, class, ability, religion, and ethnicity. Due to the cisnormative lens prevalent in abortion studies, surveys, and, in some instances, activism, comprehensive data on the accurate demographic of abortion seekers across genders is lacking²⁵.

Most abortion seekers in the U.S. are in their twenties (61%), identify as Black or Latino (59%), are low-income (72%), unmarried (86%), and undergo the procedure between six and twelve weeks of pregnancy (73%)²⁶.

A majority of abortion patients (55%) have already given birth to one or more children, while 57% are undergoing their first abortion. Among patients aged 20 and older, 63% have attended at least some college. The vast majority of abortions (91%) are performed during the first trimester. Abortions performed at or after 21 weeks of pregnancy, often referred to as “late-term abortions,” are extremely rare, accounting for less than 1% of all abortions in the U.S²⁷.

The abortion rate is disproportionately higher among certain groups. For example, in 2014, the abortion rate among women living in poverty was 36.6 abortions per 1,000 women of reproductive age, compared to 14.6 abortions per 1,000 women among the general population. This disparity underscores the greater impact of restricted access to reproductive healthcare on low-income communities ²⁸.

Abortion Bans

Black women are more likely to seek abortions than any other race in the U.S. 

Abortions per 1,000 women in the U.S. in 2019

According to 2019 statistics, Black people have an abortion rate of 23.8 per 1,000 women, which is significantly higher than that of people from other racial groups, such as those categorized as “Other race” (13), Hispanic women (11.7), and White women (6.6), this suggests that Black women face unique social, economic, and healthcare challenges that influence their higher abortion rate. While Black population seeks abortions at higher rates than White population, the factors contributing to these disparities—such as access to healthcare, socioeconomic status, and systemic inequalities—are complex and cannot be attributed to race alone²⁹.

The overturning of Roe v. Wade disproportionately impacts Black women, who not only seek abortions at higher rates but also face significant risks of maternal mortality. Black populations are more likely to live in areas with limited access to contraception and healthcare, further hindering their ability to control their reproductive health. Historically, systemic racism, poverty, and lack of access to comprehensive sex education have contributed to higher rates of unintended pregnancies among Black women³⁰.

State-level abortion bans, particularly in Southern states with large Black populations, will trap many in cycles of poverty. Black people are already at a higher risk of pregnancy-related complications and maternal mortality—rates that will likely rise without access to safe abortions. For instance, in Mississippi, Black women accounted for 74% of all abortions in 2019, and the state has some of the highest maternal mortality rates in the country³¹.

Furthermore, Black women face disproportionately higher rates of sexual violence and domestic abuse, which is related to reproductive coercion. Denying them access to abortion exacerbates their vulnerability to intimate partner violence and increases psychological trauma. The cycle of poverty created by unwanted pregnancies affects not only Black women but also their children, who are at higher risk for developmental delays, poverty, and lower educational achievement³².

Ultimately, the lack of reproductive autonomy for Black people in the U.S. perpetuates economic hardship, health risks, and social inequalities for generations.

Abortion can be performed using various methods, depending on the gestational age and the individual circumstances of the patient. The most common methods include medication abortions and in-clinic procedures.

Financial Barriers and Insurance Coverage for Abortion Services

The cost of abortion services varies based on the method and timing, with second-trimester procedures generally being more expensive than first-trimester ones. In 2021, out-of-pocket costs were around $568 for medication abortions and $625 for procedural ones in the first trimester, rising to $775 in the second trimester³³. Many people, especially those with low incomes, face challenges affording these costs. Following the Dobbs decision* State restrictions have also made access challenging, often requiring travel and additional non-medical expenses. Although abortion funds provide financial help, they are limited³⁴.

*Dobs decision: The Supreme Court’ ruling in Dobbs v. Jackson Women’s Health Organization weakened the constitutional right to privacy and bodily autonomy by allowing states to impose restrictions on abortions, but it did not establish a nationwide ban on the procedure.

Cost of Abortion Services in the US 2021

Insurance coverage for abortion is highly restricted, especially in states with tight regulations. Public programs like Medicaid, due to the Hyde Amendment, only cover abortions in limited cases. Before the Dobbs ruling, 60% of patients paid out of pocket, with fewer relying on Medicaid or private insurance³⁵. High deductibles, lack of coverage, and other barriers can lead to delays in obtaining care, which increases costs and reduces access to providers. In some cases, these barriers result in unplanned and unwanted births, leading to long-term financial difficulties for patients³⁶.

Abortion with pills

Medication abortions involve the use of pharmaceutical drugs to terminate a pregnancy, typically up to 10 weeks of gestation.

Mifepristone + Misoprostol

This method combines two medications: mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which is necessary for the pregnancy to continue. Misoprostol is taken later to induce contractions and expel the pregnancy tissue. Access to medication abortion has expanded significantly due to changes in FDA regulations that now allow for prescriptions to be filled at retail pharmacies and via telehealth services.

Which abortion pills are available in USA?

Mifepristone and Misoprostol

Cytotec 200 mcg by Pfizer Ltd

Misoprostol 200 mg by Ani Pharmaceuticals Inc

Misoprostol 200 mg by Micro Labs Ltd

Mifepristone

Mifeprex 200 mg by Danco Laboratories

Mifepristone 200 mg by GenBioPro

Visit -Medical Abortion Commodities Database

Manual Vacuum Aspiration

Manual Vacuum Aspiration (MVA) is usually performed during the first trimester. MVA is less invasive and has a shorter recovery time than other in-clinic methods.

Other Methods

In addition to clinical and medication-based options, there are alternative methods to access abortion services.

Abortion methods in the USA outside of the tradicional health care system?

In the United States, various methods exist outside traditional health care frameworks for obtaining abortion care, particularly in response to restrictive laws and access barriers.

Tele-abortion

Telehealth has become a crucial method for providing abortion services, particularly medication abortions, which can now be accessed remotely following FDA policy changes in 2021 and 2023. Patients complete an online questionnaire, and if eligible, medications are mailed to them³⁷. 

However, some states impose restrictions that limit telehealth access, with 12 out of 36 states allowing abortion having specific limitations as of March 2024. Legal challenges regarding medication abortion continue, while the SFP’s May 2024 #WeCount report indicates that 19% of abortions in December 2023 were via telehealth, with over 40,000 individuals accessing services through protective shield laws since July 2023³⁸.

Self-Managed

Self-managed abortions occur without a clinician visit, using medication obtained from online pharmacies or foreign vendors, typically without direct consultations. Tracking these orders can help estimate abortion numbers but is challenging due to data sharing issues and uncertainty about medication use³⁹.

Interstate Travel 

The Guttmacher Institute’s Monthly Abortion Provision Study indicates that before the Dobbs decision, nearly one in ten individuals traveled out of state for an abortion in 2020. In 2023, this rate more than doubled, with about one in five (~171,000) patients seeking care across state lines⁴⁰.

Illinois experienced the largest increase, with an estimated 37,300 patients traveling there for abortions. Other states like North Carolina, New Mexico, Florida, and Kansas also saw rises in out-of-state patients, though new gestational restrictions in Florida and North Carolina may reduce the 9,600 and 15,800 patients previously traveling to those states⁴¹.

The health care system provides information on safe abortion services; however, it is primarily organizations like the Guttmacher Institute and NGOs that research and provide critical data regarding abortion in the United States.

Abortion

In this Google Trends data related to “Abortion,” we observe a variety of topics and searches connected to legal and cultural discussions. The mention of “State” may refer to individual U.S. states’ differing abortion laws. “Project 2025” likely relates to future legislative or political initiatives on abortion rights. The inclusion of Amanda Bynes and Britney Spears, two prominent celebrities, suggests a link to public figures and their personal experiences influencing the conversation around abortion. “Democratic National Convention” may highlight abortion rights as a significant political issue in upcoming elections. Among related searches, queries like “California abortion laws 2024” and “Arizona abortion ban supreme court” point to a strong interest in the evolving legal landscape in specific states, while “Kate Cox” could be a figure involved in abortion activism or legislation.

Overview of Search Trends (09/2023 – 09/2024)

This overview of search trends related to the word “abortion” from September 2023 to August 2024 reveals fluctuations in public interest over time. In late 2023, searches saw a steady increase from 233 in September to 266 in December. However, January 2024 shows a notable drop to 203, possibly reflecting a post-holiday dip in attention. Interest gradually picks up again, peaking at 294 in both March and April 2024. A sharp decline occurs in May with 199 searches, followed by another rise in June (292) and a significant peak in August 2024, reaching 338, indicating renewed public focus, potentially linked to legal or political events.

Abortion pill:

This Google Trends data related to “Abortion Pill” reflects a mix of medical, legal, and practical concerns. The “Clinical sign” topic points to users researching symptoms or effects after taking the abortion pill. “Supreme Court” suggests interest in legal rulings affecting access to abortion medication, while “Carafem” and “Abortion Pill NYC – Abortion Clinic” highlight specific providers offering the pill. “CVS drugstore chain” may be linked to pharmacies providing abortion medications. In related searches, “Abuzz Health” and “Aid access reviews” indicate users looking for reputable abortion pill providers, while “Planned Parenthood abortion payment options” focuses on the financial aspect. Queries like “How long does the abortion pill take to start” and “Do’s and don’ts after abortion pill” reflect concerns about the procedure’s timeline and aftercare.

Overview of Search Trends (09/2023 – 03/2024)

This overview of search trends for “Abortion Pill” from September 2023 to August 2024 shows notable variations in public interest. Starting at 236 in September 2023, searches increased to 259 in October before dipping to 200 in November. Interest peaked at 280 in December, followed by a decrease in January 2024 to 218. After a steady rise in March 2024, hitting 330, there was a dip again in April (222) and May (224). June 2024 saw the highest search volume at 354, indicating significant attention during that time, followed by a slight decline in July (269) and August (289), but still maintaining high interest compared to earlier months.

Misoprostol

In this Google Trends data related to “Misoprostol,” the related topics and searches reflect both educational and medical interests. “Teaching” may point to the use of misoprostol in medical education or training, while “Plan C” is associated with organizations promoting safe access to abortion pills. “Opioid” could indicate interest in the drug’s use alongside other medications, while “Preeclampsia” and “Ovulation” suggest medical applications beyond abortion. In related searches, questions like “How long does misoprostol take to work” and “How long after taking misoprostol do you pass the sac” show concern about the pill’s effects and timing. Other searches, such as “Planned Parenthood abortion payment options” and “Aid access reviews,” indicate interest in cost and service accessibility for abortion care.

Overview of Search Trends (09/2023 – 09/2024)

The search trends for “Misoprostol” from September 2023 to August 2024 show a steady fluctuation in interest. In late 2023, searches start high at 343 in September and rise to 368 by December, with a slight dip in November (302). Early 2024 sees a minor decline, stabilizing around 330 in January and February. A significant spike occurs in March 2024, reaching 432, possibly due to heightened attention or events related to misoprostol. Though interest drops slightly in April and May, searches peak again in June at 414. The year ends with consistently high search volumes, with August 2024 showing 394, reflecting sustained public interest.

In the United States, the maternal mortality ratio of 22.3 deaths per 100,000 live births underscores significant public health challenges. Compounding this issue, 41.6% of pregnancies are unintended, revealing critical gaps in reproductive planning and education. Access to contraception remains inadequate, with only 49% of individuals able to obtain necessary services, which contributes to the prevalence of unintended pregnancies. The poverty rate of 11.6% further highlights socioeconomic barriers that can limit access to healthcare and exacerbate reproductive health disparities. The Global Gender Gap Index score of 0.748 highlights ongoing gender disparities across various sectors, while the Human Rights Index score of 4.30 indicates serious obstacles in securing fundamental rights for all citizens. However, the U.S. maintains a high literacy rate of 99%, suggesting that educational attainment is not the primary barrier to addressing these pressing reproductive health issues. Collectively, these statistics emphasize the urgent need for enhanced healthcare access, comprehensive reproductive education, and targeted policies to reduce maternal mortality and unintended pregnancies in the country.

Native Americans and abortion care 

Indigenous populations are impacted on multiple layers by the overturning of Roe. For Native Americans, abortion has always been inaccessible because of the 1976 federal law, The Hyde Amendment, that prohibits abortions at Indian Health Service facilities, which resulted in abortion seekers having to travel far for abortion care⁴².

‘“Roe has never been accessible for Native women,” said Lauren van Schilfgaarde, a tribal law specialist at UCLA who has studied abortion care in Indigenous communities⁴³. “When you add in the rates of violence and the complete gutting of tribal governments’ abilities to respond, you have a real dangerous recipe in which Native women have a lack of reproductive health⁴⁴’. 

Interestingly, following the overturning of Roe v. Wade states with the highest Indigenous populations, such as Oklahoma and North and South Dakota, also have the most restrictive abortion laws, with complete bans in place. In 20 states housing approximately 2 million Native American residents, abortion is banned at 18 weeks or earlier. Additionally, the already critical situation is exacerbated by alarmingly high rates of sexual violence and unintended pregnancies, as well as hate crimes targeting Indigenous women, transgender, and queer individuals. High maternal mortality rates and significant barriers to preventive care and contraception further hinder access to sexual and reproductive healthcare. The recent legal changes have intensified these challenges, underscoring the urgent need for comprehensive support⁴⁵.

In June and July 2002, the Native American Women’s Health Education Resource Center (NAWHERC) conducted a survey to evaluate Native American women’s access to legal abortions through the Indian Health Service (IHS). The findings revealed that 85% of the surveyed Service Units were noncompliant with the official IHS abortion policy, thereby violating the Hyde Amendment. Furthermore, in 62% of these Service Units, personnel reported that they do not provide abortion services or funding even in cases where the woman’s life is at risk due to the pregnancy⁴⁶.

Abortion Migration

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The post-Roe aftermath has severely impacted abortion access, with 14 states implementing bans on the procedure. Within just six months of the overturning of Roe v. Wade, many of these states saw a significant decrease in available abortion providers. Those still offering care were often restricted by stringent gestational limits, such as six weeks in Georgia and 16 weeks in six other states. This crackdown on access forced many abortion seekers to leave their states—and even the country—to obtain necessary healthcare, a process that was not only costly and fraught with logistical challenges due to surveillance but also dangerous for their health.

Moreover, as Native American organizers have repeatedly pointed out, Roe was never fully accessible to Indigenous people, who have historically faced long distances to access abortion care. The end of Roe has multiplied these challenges, further limiting their options for safe and timely healthcare.

In this precarious context, it is valuable to think of abortion access using Amy Reed Sandoval’s essay, “Traveling for Abortion as a Form of Migration,” where she extends the framework of immigration and border control to the experiences of abortion seekers in the U.S. By framing this journey as migration and those seeking care as migrants, she highlights the abortion crisis and the mobility challenges that exacerbate it. This issue has become even more pronounced in the wake of post-COVID abortion bans, which have intensified inter-state “border control” within the U.S.⁴⁷

Sandoval’s analysis prompts critical questions about how race, class, gender, and ethnicity serve as barriers to abortion access. In border states, immigrant communities often face the additional challenge of traveling for abortion care due to immigration checkpoints⁴⁸. For undocumented immigrants, the intersection of border violence and abortion restrictions creates significant obstacles, making it nearly impossible for them to access necessary healthcare⁴⁹.

‘First, if we think that abortion is a right, then why is often only accessible to those who can travel great distances, often at inordinate personal cost? Second, what mobility barriers are specifically targeting women’s bodies, particularly the bodies of BIPOC and undocumented women/pregnant people? Third, how are some people who migrate for abortion care more vulnerable than others, and how is this vulnerability also multidimensional?’

-Amy Reed Sandoval, ‘Traveling for Abortion as a Form of Migration’

Abortion within transgender, nonbinary and gender- expansive individuals

According to a survey by the Guttmacher Institute, an estimated 462 to 530 transgender and gender-expansive individuals obtained abortions in 2017, primarily at non-specialized clinics, as only 23% of U.S. clinics provide trans-specific care. The survey underscores the challenges posed by institutionalized heteronormativity in collecting accurate national data on transgender abortion experiences⁵⁰.

To generate national estimates, we constructed weights based on facility abortion caseloads and types (e.g., abortion clinics vs. physician offices). In response to the question regarding the number of TGNB (transgender and gender non-binary) individuals who obtained abortions in 2017, 57 facilities (10% of those responding) reported variations of “not applicable/NA,” while 113 (19%) marked “don’t know.” Interestingly, 35 facilities that selected “don’t know” or “NA” did offer trans-specific services⁵¹.

Follow-up calls with facilities marked “not applicable” revealed that this data was not routinely collected in patient files, preventing definitive answers. To address these gaps, we applied two weighting approaches. The more conservative method recorded the 57 “not applicable” responses as “0,” assuming those facilities did not provide abortions to transgender patients. In contrast, the less conservative method categorized both “not applicable” and “don’t know” responses as “missing.” In both approaches, the analysis assumed that non-responding facilities were similar to those that provided complete data⁵² .

This highlights that the data gap is not merely a result of incomplete documentation but rather stems from discrimination within medical institutions. Ignoring this gap would overlook the genuine struggles that trans individuals face in accessing equitable healthcare.

A national survey titled Abortion Experiences and Preferences of Transgender, Nonbinary, and Gender-Expansive People in the United States examined the experiences of 1,694 respondents across four U.S. census regions. Of these, 12% reported a total of 433 pregnancies, with 92 (21%) ending in abortion. Another survey by the same researchers found that one in three trans, nonbinary, or gender-expansive individuals had considered medically unsupervised, unsafe abortion methods and one in five had attempted them. Participants cited various barriers to accessing medical care, including issues with insurance, gestational limits, transphobic healthcare providers, comorbidities, and personal concerns, such as fear of others finding out about the pregnancy. These findings underscore the compounded obstacles that contribute to the material challenges faced by trans people in obtaining safe reproductive healthcare⁵³.

Disability and Abortion

“Policies that restrict access to abortion will drastically exacerbate threats to the autonomy, health, and overall well-being of disabled people.⁵⁴”

American Association of People with Disabilities (AAPD) 

Disabled individuals make up an estimated 12,7% of the U.S. population, with 26% of U.S. adults identifying as having a disability⁵⁵. Among them, a staggering 36% are Black disabled individuals living in poverty⁵⁶. The overturning of Roe v. Wade has had particularly severe consequences for disabled people seeking abortions. Disability rights activists emphasize the urgent need to center disabled individuals in conversations around bodily autonomy. A crucial issue fueling this call is the pervasive desexualization of disabled people, which often leads to their reproductive rights being overlooked or ignored. As Maria Town, president of the American Association of People with Disabilities (AAPD), stated:

We are not seen as sexual beings. In fact, the assumption is that we just don’t have sex when, in reality, disabled people do have sex. We need and deserve accessible, affordable reproductive and informed reproductive health care, and that includes abortion.”

– Maria Town, president of AAPD

Disability rights activist Imani Barbarin highlights how sidelining disabled people in abortion activism perpetuates ableism*, notably when advocates argue that abortion is necessary to avoid having a disabled child⁵⁷. This rhetoric invalidates, dehumanizes, and alienates disabled abortion advocates. The harm is mainly profound in a context where disabled individuals face multiple intersecting barriers:

• Unaffordable healthcare: Disabled people are more likely to live in poverty, making access to reproductive healthcare even more difficult. Health insurance only covers abortion in 15 states, according to the DC Abortion Fund, further restricting access for disabled individuals⁵⁸.

• Ableist discrimination by healthcare providers: Disabled individuals often face prejudice in medical settings, including being outright refused care. For example, Planned Parenthood of Greater New York canceled an abortion appointment for a woman, stating, “We don’t do procedures for people in a wheelchair.⁵⁹“

• Forced sterilization and non-consensual contraception: Disabled people have historically been subjected to forced sterilization and placed on contraception without their consent, stripping them of their reproductive autonomy.⁶⁰

• Higher risk of medical complications: Disabled individuals are more likely to experience serious health risks, including clotting, infection, and bleeding, which makes access to safe abortion services even more critical.⁶¹

These systemic barriers demonstrate the urgent need to center disabled voices and experiences in the fight for reproductive justice.

*Ableism: the discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior.

How did the pandemic influence abortion in US

The COVID-19 pandemic exacerbated the post-Roe abortion crisis in the USA. During this time, state authorities and anti-abortion groups seized the opportunity to impose further restrictions on abortion care. Within a structurally racist society, this resulted in heightened healthcare inaccessibility for Black, Hispanic, and Native American communities, which was compounded by the lack of access to sexual and reproductive healthcare services.

As the pandemic significantly worsened socioeconomic inequalities, the Guttmacher Institute found that one of the early impacts of COVID-19 was on fertility preferences and access to sexual and reproductive healthcare (SRH), which were intensified by the economic fallout. Women already facing systemic inequities related to race, class, and sexuality were more likely to express a desire to postpone childbearing or have fewer children as a result of the pandemic. These pre-existing inequalities led to increased concerns among women regarding their access to SRH services. Many respondents reported delays and cancellations of contraceptives and SRH healthcare. The pandemic further restricted access to SRH services for Black and Hispanic women, queer women, and those living in poverty, perpetuating the inequities rooted in a white supremacist, capitalist society⁶².

Key findings from the 2021 Guttmacher Survey of Reproductive Health Experiences reveal that the COVID-19 pandemic:

• Influenced and shifted fertility preferences⁶³.

• Disproportionately affected the sexual and reproductive health of marginalized groups due to systemic social and health inequities⁶⁴.

• Elevated the importance of telemedicine services, which provided critical support during the pandemic-related SRH crisis, particularly for those facing increased barriers, such as women, trans and gender-expansive individuals from racialized groups, low-income populations, and those with disabilities⁶⁵.

• Caused delays and cancellations of contraceptive and sexual and reproductive health (SRH) services, making them increasingly inaccessible⁶⁶.

The New Trump Administration

In the second Trump administration, it anticipates that abortion rights and reproductive health policies would likely encounter substantial challenges, both within the U.S. and internationally. Guided by the conservative Project 2025 agenda, this administration might reinforce restrictive abortion measures nationwide, potentially limiting access to Mifepristone—a medication used in medical abortions⁶⁷.

Internationally, a reinstatement of the global gag rule is possible. This policy prohibits funding for organizations that provide abortion-related services, which would significantly impact global health initiatives—limiting access to abortion care, family planning, and contraceptive services across numerous regions⁶⁸.

Furthermore, the administration would likely appoint anti-SRHR (sexual and reproductive health and rights) advocates to influential diplomatic roles, positioning the US as a force opposing gender equality and SRHR in global forums like the United Nations; this could include reviving the Geneva Consensus Declaration, promoting policies and statements that undermine human rights, and actively pushing anti-abortion and anti-contraception agendas within international frameworks, further restricting SRHR worldwide⁶⁹.

Such an environment would not only restrict access to healthcare but also fuel misinformation and stigma surrounding abortion. The narratives promoted by this administration could have lasting repercussions, making it essential to foster messages rooted in data and human rights.

Although the healthcare system has some data, non-governmental organizations (NGOs) provide the most critical information; however, to gain a more comprehensive understanding of the situation regarding abortion in the US, further investigation should also focus on the items that are not highlighted on the following chart, as they require more information:

*This page presents abortion data only for women and girls since the information available is usually not separated by gender. However, AbortionData.org acknowledges this limitation.

Many organizations offer support for those seeking information on abortion. General practitioners (GPs) can often be the first point of contact. Additionally, various counseling centers provide free information, such as:

• Aya Contigo

• SisterSong

• The Afiya Center

• National Network of Abortion Funds (NNAF)

• Planned Parenthood

• Aid Access

• Reprocare Healthline

• The Brigid Alliance

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2. Abortion in the United States Dashboard | KFF. (2024, 14 agosto). KFF. www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/
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3. McPhillips, D. (2024). Telehealth abortions now account for nearly 1 in 5 in the US, with thousands accessed under shield laws each month, report says. CNN Health.
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Abortion in the United States of America

• 1Abortion Rating
• 2Law & Abortion Rights
• 3Facts & Numbers
• 4Public Opinion
• 5Abortion Seekers
• 6Accessibility & Methods
• 7Online Abortion Searches
• 8Social & Cultural Context
• 9What we don't know
• 10Points of Contact
• 11Sources