Chemical abortions now make up 63%
By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
On the basis of new monthly estimates based on reports of some of the clinics in its database, Guttmacher is now estimating that there were 1,026,690 abortions in the United States in 2023, the first full year after Dobbs. This is more than a 10% increase over Guttmacher’s last formal estimate of 930,160 for 2020, but still substantially lower than its all time peak of more than 1.6 million in 1990, when the nation’s population was considerably lower.
The frequency of abortion is also up, according to Guttmacher, reaching 15.7 abortions per thousand women of reproductive age (ages 15-44), itself a 9% jump over the 14.4 recorded by Guttmacher in 2020. The last time the abortion rate was this high was in 2012, when it was 16.1, although it had reached as high as 29.3 per thousand in 1980 and 1981.
In a separate report, Guttmacher says that chemical abortions now account for 63% of all abortions performed in the U.S., approaching two thirds. The increased prevalence of chemical abortions, particularly via telemedicine, is one of the possible reasons Guttmacher gives for the reported increase.
A certain level of uncertainty in the numbers
There is reason to be skeptical of the precision of Guttmacher’s latest numbers, but it may well be that the trends are in that direction.
Unlike previous Guttmacher surveys, these are based on selected samples of “providers” rather than full national surveys of all known clinics. This is why the monthly estimates in their new data set are expressed in ranges (e.g., November of 2023 is said with 90% certainty to be somewhere between 79,300 and 82,300; the median estimate used for counting is 80,700).
While this new method allows Guttmacher to estimate more quickly based on data from “providers” with whom they have had regular contact for a number of years, it may skew the data towards more active, aggressive members of their trade. These are ones who are most likely to capitalize on post-Dobbs trends by advertising services in neighboring states, working with abortion funds to handle women traveling from pro-life states, managing high volume abortion mega-clinics or utilizing marketing novelties such as mobile abortion clinics operating just across state lines.
Those abortion clinics would very likely see increases, picking up travelers from other states whose travel expenses and sometimes even abortions are paid for by others. But it is unknown whether the surge at those big clinics necessarily indicates increased traffic at some of the other less strategically positioned providers for which Guttmacher is also projecting increases.
Reasons given for the increase
We have hinted at them above, but Guttmacher explicitly mentions several of these factors as possible reasons for the increase they saw.
Guttmacher is forthright in attributing much of the post-Dobbs increase to abortion industry aggression and innovation. Explaining large shift to states where abortion has been welcome, Guttmacher says:
In part, this is because the drastic loss of access in states with more protective law has been counterbalanced by monumental efforts on the part of clinics, abortion funds and logistical support organizations to help women in those states access care through financial and practical support.
Abortion friendly states that were neighbors to states with protections for the unborn saw enormous increases, Guttmacher says. For example, Illinois saw 72% more abortions in 2023 than 2020, an increase of more than 38 thousand abortions, with more than two thirds of that from out of state patients. Virginia’s abortions increased 76%, North Carolina’s 41%, and New Mexico’s 257%!
Guttmacher alludes to the role played by national “abortion funds,” charitable groups helping many women pay for travel or abortions (or both). The National Network of Abortion Funds (NNAF) says that in the year following Dobbs, they disbursed nearly $37 million to more than a hundred thousand women seeking abortions.
This funding clearly fueled the increase, but the NNAF reported that donations have dramatically slowed in recent months. Guttmacher does not say so directly, but this may be one reason why its monthly numbers show consistently lower estimates for the last four months of 2023.
The precise impact is still unclear at this point, but Guttmacher believes that it is possible that COVID had some impact on personal decisions about childbearing.
One thing COVID did clearly impact was the increased availability of abortion by telemedicine. This is where women order abortion pills online or by smart phone and picked them up at the clinic or had them mailed to their homes.
Telemedical abortion fuels the increase
Most of Guttmacher’s report on the increase of chemical abortions is clearly part of a media prep for the Alliance for Hippocratic Medicine v. U.S. Food & Drug Administration (AHM v. FDA) case slated to be heard at the Supreme Court March 26th, rehashing discredited claims about the abortion pill’s safety and efficacy. There is, however, some new data on the role chemical abortions played in the national abortion increase.
In a separate release, Guttmacher says, on the basis of their most recent monthly abortion surveys, that chemical abortions now account for 63% of abortions in the U.S., essentially two out of every three.
This is after chemical abortions crossed the halfway point in Guttmacher’s 2020 survey with 53% for that year.
Though Guttmacher says it is unable to count the number of “self-managed abortions” where women order drugs from unauthorized sources over the internet, the group does say that it has clear evidence of telemedical abortion’s growth.
Telabortion, or telemedical abortion, is one where women seeking chemical abortions consult with a “provider” by video, phone call, text, or some other online platform to be screened and, if they qualify (and pay their money), to have abortion pills shipped in the mail to their homes.
The pills’ effectiveness decreases, and associated complications increase, the farther along a woman is in her pregnancy. The pills do not work in situations of ectopic pregnancy. It is unclear how well or how carefully these phone operators or online prescribers check the gestational age of a woman’s child or determine whether the child is implanted safely in her uterus.
While just 7% of U.S. “providers” prescribing abortion pills offered the telemedical option in 2020, 31% did in 2022. Virtual clinics, which exist only online and have no physical locations for patient visits, Guttmacher says accounted for 8% of all abortions in the first six months of 2023.
Expect the abortion industry to invest more heavily in telabortions and on-line clinics. Not only does it greatly reduce overhead, allowing for easier profits, but it enables them to sell abortions in areas where there is insufficient interest in or demand for abortion dedicated clinics.
This not only opens up large portions of less populated suburban and rural environments, but also specifically states where current laws have closed many traditional abortion clinics. ‘
This is also clearly part of what appears to be the recent abortion increase.
Soft numbers, but hard truths
Guttmacher admits that its most recent numbers are a bit mushier than the ones they reported before Dobbs–when they surveyed all know abortion “providers” in the country– but these latest estimates do appear to show some sort of increase occurring the months after the June 2022 Dobbs decision.
It is too early to tell, but the same monthly report they use to generate these numbers also seems to show abortions dropping off after the summer months in 2023, averaging about 81,850 a month from September on. Projected for a year, that would be 982,200, still an increase over 2020, but considerably less than the 1,026,690 Guttmacher is now reporting for 2023.
So abortions may be up, but perhaps not as much as Guttmacher would have us believe.
The abortions reported by these big box abortion clinics, Guttmacher’s most reliable reporters, are real, however, and thus probably a lot of their abortion increases too.
Rather than doubt the overall national estimates, which may be off by several thousand, the takeaway is that these latest numbers are clear evidence that the abortion industry has prepared for this day and is using every resource at its disposal to keep their bloody business going.
While Guttmacher wants people to know that Dobbs has “forced” thousands of women to “flee” their home states to seek abortions elsewhere, it also admits that “many others were unable to obtain care in the formal health care system, and some were forced to continue their pregnancies.”
This means that while abortions may have increased due to aggressive marketing and paying for many abortions, pro-life protections were still able to save many lives.
The fight for life continues.