Abortions in the U.S. rose for the first time in more than 30 years, with 8 percent more abortions in 2020 than in 2017, according to new data published on June 15 by the Guttmacher Institute, an abortion advocacy group.
All four regions of the U.S. experienced an increase in abortions, with the West and Midwest experiencing the largest jump — 12 percent and 10 percent, respectively.
The Guttmacher Institute says that while abortion increased nationally, there was variation across and within states, with “no clear patterns to explain why some had increases or decreases.” States like Illinois, Mississippi and Oklahoma experienced considerable growth in the number of abortions, while Missouri, Oregon and South Dakota had substantially fewer abortions in 2020.
“It hasn't been a uniform increase. You look at Missouri, for example, and certainly restrictions are having a huge impact,” Elizabeth Nash, a state policy expert with the Guttmacher Institute, tells Yahoo Life. “But what we have seen is more support for abortion access even in some of the more hostile states.”
This new data comes just as the Supreme Court is poised to overturn Roe v. Wade, according to a leaked Supreme Court draft opinion, which would not outlaw abortion, but allow states to individually determine the right; it's why many states are passing so-called “trigger laws,” ready to severely limit or ban abortion if the landmark abortion rights decision is overturned.
“I don't think we have all the answers as to why abortion has been going up,” Nash says. “What we have been seeing over these past few years is that abortion access in some ways has been increasing — either through some state policies, or by additional funding made available, or by people simply moving heaven and Earth to ensure that they get the care they need.”
Here are four possible reasons from the Guttmacher Institute as to why, despite some state-level restrictions on abortion access, there was an overall national increase in abortions between 2017 and 2020:
1. There’s been more funding for abortions
A majority of people seeking abortions are poor or low-income, and over the past decade more money has been available to help people pay for abortion care.
“Between state and local abortion funds, there’s just more of them now, and it's because people have been recognizing the need to help others pay for abortion,” Nash says. “And as those funds have been created, they have been able to reach out and build a base of supporters who provide donations. And that base has been growing.”
Some states also expanded Medicaid to include coverage for abortions, meaning people who otherwise may not have been able to afford an abortion could access abortion care. Abortions in Illinois, for example, increased 25 percent between 2017 and 2020, and the Guttmacher Institute notes that a likely contributing factor is that Illinois allowed the use of state Medicaid funds to pay for abortion in January 2018.
2. There have been more protections placed around abortion access
Between 2017 and 2020, 75 provisions to protect abortion rights were enacted. These included abortion coverage in public and private health plans, expanding the types of clinicians who can provide abortion care and protecting access to abortion clinics.
“One of the things we've been seeing a huge increase in is harassment outside of abortion clinics,” Nash says, “so [people have been] passing laws that provide criminal penalties for people who harass those going into and out of a clinic.”
3. Many people lost access to low-cost or no-cost contraceptives
In 2019, changes to the Title X federal family planning program resulted in many people losing access to contraceptive services — potentially affecting 1.6 million female contraceptive patients — which likely resulted in more unwanted pregnancies.
“[Title X] is designed to help low-income individuals pay for family planning services,” Nash says. “So it's really reaching populations that don't have the financial resources to pay for health care, and those patients are low-income but also disproportionately Black and brown individuals, young people, LGBTQ people.”
A “domestic gag rule” implemented by the Trump administration in 2019 prohibited Title X providers from referring patients for abortion care, meaning many providers like Planned Parenthood were compelled to pull out of the program.
The Biden administration reversed the gag rule in November 2021.
“With the gag rule reversed, clinics will rejoin the program and again provide services, hopefully getting people better access to contraceptive care, which could prevent unwanted pregnancy and the need for abortion,” Nash says.
4. COVID-19 may have led to more demand for abortion
The Guttmacher Institute notes that the COVID-19 pandemic disrupted abortion access across the U.S. While some states opposed to abortion rights attempted to ban the procedure by claiming it wasn’t essential health care, other states supportive of abortion rights also experienced disruptions in abortion services because health care systems were overwhelmed by COVID-19 outbreaks. In New York, for example, at least 10 percent of clinics reported that they paused or stopped abortion in 2020, according to the Guttmacher Institute.
Still, Florida experienced a 7 percent increase in abortions from 2019-2020, with more people from other states obtaining abortions in Florida “potentially because they lived in neighboring states that imposed restrictions on abortion care as ‘nonessential’ under COVID-19 orders,” according to the Guttmacher Institute.
When the COVID-19 pandemic began in early 2020, disease, unemployment and an uncertain future were top of mind for many — and Nash says that may have discouraged some people from having children.
“I think when the pandemic hit, people might have reconsidered continuing a pregnancy, simply saying, ‘Now’s not the right time for me to have a child,’” Nash says. “So it became more important for them to find abortion care. And if their state had an emergency order barring abortion, they may have gone to another state to access care.”
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