TL;DR: Based on 2014 rates, it’s true that 1 in 4 women in the United States has an abortion by the age of 45.
Many of our preconceptions about who gets abortions are not true. The majority of women having abortions are already mothers, in their 20s, have some college or a college degree, and report a religious affiliation.
Age
Most women who report having abortions are in their late 20s. A common misconception is that teens account for most abortions. This is not true. Only 4% of abortions occur under the age of 18. Women over 30 are much more likely than teens to access abortion services, comprising 25% of abortions.
Religion
Women of all religions access abortion care. The majority of abortion patients self-report a religious affiliation. Around one in four of those who access abortion self-identify as Roman Catholic and one in three self-identify as Protestant. Those who report no religious affiliation represent less than half of all abortions.
Race
No single racial or ethnic group makes up the majority of abortion patients. Of the most frequently reported groups, 40% are white, 28% are black, and 25% are Hispanic. When compared with overall demographics in the US, black women are overrepresented among abortion patients. It is known that there are significant disparities in reproductive health outcomes by race. This overrepresentation likely reflects broader barriers in reproductive health care, which is a subject of increasing concern.
Prior Births and Parenting Status
The majority of abortion patients are already mothers. 60% of women who have an abortion have at least one child. While decisions about pregnancy are complex, the impact on existing children is a frequently cited reason for terminating a pregnancy. These concerns are not unfounded. The Turnaway Study found that when women are unable to access a desired abortion, their other children are 4 times more likely to live in poverty.
Previous Abortions
Most women who have an abortion have never had one before. A common misconception suggests that abortion is used “as a form of birth control”. This is not the case. Standard counseling regarding pregnancy termination also includes conversations about contraception. There are high rates of contraception use immediately following abortion, including highly effective long-acting methods like IUDs and implants.
Income and Education Level
Almost half of abortion patients have household incomes below the federal poverty line. The proportion of low-income women accessing abortion has been growing in recent decades. There are numerous proposed reasons for this. Higher-earning women have experienced a decreasing abortion rate as they have secured improved access to the most effective contraception options. Meanwhile, lower-income women continue to face many barriers in obtaining many of these methods. Additionally, the growing costs of raising children disproportionately impact lower-income women and families. Despite having lower income, most abortion patients have a college degree (22%) or some college education (41%).
Gestational Age
The vast majority of abortion patients seek care early in pregnancy, with almost all (92%) of abortions in the US occurring in the first trimester. While much of the emotionally-fueled and political discussions around reproductive health focus on later gestational ages, these cases are in the minority. The women who receive abortions later are more likely to be young and poor, with complex social concerns, or to have significant health concerns. Of the 1% of abortions that occur after 20 weeks of pregnancy, nearly all are due to severe maternal or fetal health conditions.
Where do these data come from?
As you might imagine, data on abortion care is sensitive. Since 1987, the Guttmacher Institute has run periodic surveys of women receiving abortions at a nationally representative sample of abortion clinics. These surveys allow us to understand the age, income, and other characteristics of women receiving abortions. This survey does not include hospital-provided abortions, but this only excludes 4% of all abortions. Guttmacher also surveys abortion providers each year to get estimates of the overall number of abortions performed. Getting data directly from abortion providers is likely more reliable than surveys of the general population, where abortion may be underreported due to stigma or privacy concerns.
The estimate that 1 in 4 American women will have an abortion by age 45 is based on data from 2014, and thus is a snapshot of rates at that time. It doesn’t necessarily predict what will happen to younger women. Abortion rates have been consistently decreasing over the last few decades, as access and coverage of contraception have steadily increased. Rates have continued to decline since 2014, so this estimate would likely be somewhat lower today. Looking forward, future trends are particularly difficult to predict due to rapidly changing laws directly impacting abortion access and reproductive health care.
BOTTOM LINE: While rates are decreasing, abortion is not uncommon among American women. Many of the stereotypes of women seeking abortions are not true– most are already mothers, not teenagers, and have not received a previous abortion.
Further Reading
Comprehensive database for national and international abortion data
Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014
From Turnaway Study- Effects of Carrying an Unwanted Pregnancy to Term on Women’s Existing Children
