National Background and Context

Each year, a broad cross section of people in the United States obtain abortions. In 2017, 862,320 abortions were provided in clinical settings in the United States.

The U.S. Supreme Court recognized the constitutional right to abortion in the 1973 Roe v. Wade decision and has reaffirmed that right in subsequent decisions.

However, since 2010, the U.S. abortion landscape has grown increasingly restrictive as more states adopt laws hostile to abortion rights. Between January 1, 2011 and July 1, 2019, states enacted 483 new abortion restrictions, and these account for nearly 40% of all abortion restrictions enacted by states in the decades since Roe v. Wade. Some of the most common state-level abortion restrictions are parental notification or consent requirements for minors, limitations on public funding, mandated counseling designed to dissuade individuals from obtaining an abortion, mandated waiting periods before an abortion, and unnecessary and overly burdensome regulations on abortion facilities.

Abortion Incidence

•Approximately 862,320 abortions occurred in the United States in 2017. The resulting abortion rate of 13.5 abortions per 1,000 women of reproductive age (15–44) represents an 8% decrease from the 2014 rate of 14.6.[1]

•In 2017, 17,210 abortions were provided in Virginia, though not all abortions that occurred in Virginia were provided to state residents: Some patients may have traveled from other states, and some Virginia residents may have traveled to another state for an abortion. There was a a 18% decline in the abortion rate in Virginia between 2014 and 2017, from 12.5 to 10.2 abortions per 1,000 women of reproductive age. Abortions in Virginia represent 2.0% of all abortions in the United States.[1]

Where Patients Obtain Abortions

•In 2017, there were 1,587 facilities providing abortion in the United States, representing a 5% decrease from the 1,671 facilities in 2014. Sixteen percent of facilities in 2017 were abortion clinics (i.e., clinics where more than half of all patient visits were for abortion), 35% were nonspecialized clinics, 33% were hospitals and 16% were private physicians' offices. Sixty percent of all abortions were provided at abortion clinics, 35% at nonspecialized clinics, 3% at hospitals and 1% at physicians' offices.[1]

•There were 32 facilities providing abortion in Virginia in 2017, and 16 of those were clinics. These numbers represent an 11% decline in clinics from 2014, when there were 34 abortion-providing facilities overall, of which 18 were clinics.[1]

•In 2017, 89% of U.S. counties had no clinics providing abortions. Some 38% of reproductive-age women lived in those counties and would have had to travel elsewhere to obtain an abortion.[1] Of patients who had an abortion in 2014, one-third had to travel more than 25 miles one way to reach a facility.[2]

•In 2017, some 93% of Virginia counties had no clinics that provided abortions, and 80% of Virginia women lived in those counties.[1]

Restrictions on Abortion

In Virginia, the following restrictions on abortion were in effect as of September 1, 2019:

  • Most patients must receive state-directed counseling that includes information designed to discourage them from having an abortion, and then wait 24 hours before the procedure is provided. Counseling must be provided in person for women within 100 miles of the provider and must take place before the waiting period begins, thereby necessitating two trips to the facility.
  • Health plans offered in the state’s health exchange under the Affordable Care Act can only cover abortion in cases of life endangerment, or in cases of rape or incest.
  • Abortion is covered in insurance policies for public employees only in cases of life endangerment, rape, incest or fetal impairment.
  • The parent of a minor must consent and be notified before an abortion is provided.
  • Public funding is available for abortion only in cases of life endangerment, rape, incest or fetal impairment.
  • A patient must undergo an ultrasound at least 24 hours before obtaining an abortion; the provider must offer the patient the option to view the image.
  • An abortion during the third trimester may be performed only if the patient's life or health is endangered.


References

1. Jones RK, Witwer E and Jerman J, Abortion Incidence and Service Availability in the United States, 2017, New York: Guttmacher Institute, 2019.

2. Fuentes L and Jerman J, Distance traveled to obtain clinical abortion care in the United States and reasons for clinic choice, Journal of Women’s Health, 2019, https://doi.org/10.1089/jwh.2018.7496.