Washington Bucks Trend as U.S. Abortion Rate Reverses Long-Term Decline


Washington is among 18 states where the abortion rate fell in 2020, according to new data from the Guttmacher Institute, a New York-based abortion-rights research organization. Nationally, the abortion rate increased, reversing a 30-year period of decline.

In 2020, there were 930,160 abortions performed in the United States, an 8% increase from 862,320 abortions in 2017. Similarly, the abortion rate rose from 13.5 abortions per 1,000 women ages 15-44 in 2017 to 14.4 in 2020, a 7% increase.

There was also a small uptick in the number of abortions performed in Washington, from 17,740 in 2017 to 17,980 in 2020. But when you account for the population of women ages 15-44 increasing over that period, the rate of abortions fell from 12.1 to 11.7 per 1,000 — that's a 3% decline.

Every three years, the Guttmacher Institute requests data from all known facilities providing abortions in the U.S. Their most recent Abortion Provider Census, completed in May 2022, covers 1,687 facilities.

The new data release comes after a U.S. Supreme Court draft opinion in the Dobbs v. Jackson Women's Health Organization case was leaked last month. The draft showed a majority of justices ready to overturn the landmark Roe v. Wade decision, which legalized access to abortion in 1973. It is unclear if the draft represents the court's final decision.

Because there were many more births (3.6 million) than abortions in 2020, the data shows fewer people were getting pregnant and, among those who did, a larger proportion had abortions. About 1 in 5 pregnancies ended in abortion in 2020, according to the institute. However, the data only includes abortion procedures overseen by a clinician. Self-managed abortions using medication, which accounted for nearly one-third of all abortions in 2014 (the most recent figures available), were not included in the data.

In all regions of the U.S., the rates of abortion rose in 2020. The West, along with the Midwest, saw the largest increases, both up 10%. In the South, the rate went up 6%, and in the Northeast, 3%.

Even so, there was a tremendous degree of variation between states. Oklahoma and Missouri represent the two extremes.

Oklahoma's abortion rate doubled, jumping from 6.2 per 1,000 women aged 15-44 in 2017 to 12.4 in 2020. The number of abortions also doubled, from 4,780 to 9,690.

At the other end of the spectrum, in Missouri, the rate plummeted from 4 to .1 per 1,000 women aged 15-44. The number of abortions in Missouri fell from 4,710 in 2017 to just 170 in 2020.

The abortion rate increased in 28 states and the District of Columbia, fell in 18, and was unchanged in four.

What accounts for such a dramatic difference in the abortion trends among the states?

The Guttmacher Institute explains that a number of developments in the 2017-2020 period may have impacted states in different ways.

For example, some states expanded Medicaid coverage of abortion care, affecting people who would have otherwise been unable to afford the procedure. Also, the Trump administration's "domestic gag rule" severely reduced the capacity of the Title X family planning network, which provides contraceptive care. This may have resulted in a greater number of unintended pregnancies.

Twenty-five states enacted various types of abortion bans and restrictions between 2017 and 2020, which could partially explain the decline in abortion rates in some states. Additionally, the pandemic may have disrupted access to abortion services in 2020 as health care providers dealt with early outbreaks.

Even so, the Guttmacher Institute said there were no clear patterns that could help explain the increases in abortion rates in some states and the decreases in others. Some state saw an increase one year and a decrease the next, or vice versa.

This happened in Washington. The abortion rate increased slightly from 2017 to 2019, going from 12.1 to 12.2, before it dropped to 11.7 in 2020.