State-level variation in abortion rates, including out-of-state abortions, pre-Dobbs

Photos: Pro-abortion rights activists protesting on Oct. 3, 2021, by Gayatri Malhotra via Unsplash (left) and anti-abortion activists protesting on Feb. 12, 2019, by Maria Oswalt via Unsplash (right).

by CRAIG HELMSTETTER

Washington D.C., Florida, and Illinois had the nation’s highest rates of abortion in 2020, while D.C., Kansas and New Mexico saw the highest proportion of abortions obtained by out-of-state residents. 

These findings are from the most recent data currently available on abortion from the Centers for Disease Control and Prevention (CDC), which tracks data on numerous public health concerns. The 2020 data is well before last year’s pivotal Dobbs case, in which the Supreme Court overturned the national right to abortion that it had established in 1973’s Roe v. Wade decision, effectively returning the issue to the states. Still, the data reveal some notable state-level variations, based on both the cultural and legal differences that predated Dobbs. 

The CDC’s state-by state database has had three holes for the past several years, due to either inadequate reporting or failure to report: California, Maryland, and New Hampshire, the nation’s 1st, 19th, and 41st largest states, respectively. The remaining states include 86% of the nation’s population.  

The CDC’s data documents over 620,000 officially reported abortions in 2020, ranging from nearly 75,000 in Florida to 91 in Wyoming. Since states vary widely in population – Florida’s population was 21.5 million in 2020 compared to Wyoming’s 577,000 –the raw number of abortions is less telling of state-level variation than are rate-based comparisons.  

Perhaps the most telling rate is the proportion of abortions per female of child-bearing age; generally defined as 15 to 44.[1] Looking at the data this way, Florida and Wyoming maintain their respective top and bottom rankings with Florida’s second highest-in-the-nation rate of 19 abortions per 1,000 women age 15 to 44 and Wyoming next to the bottom with a rate of 0.8 per 1,000. 

Washington D.C. had the highest rate by far at 24 abortions per 1,000 women age 15 to 44, followed by Florida and then Illinois. At the low end, South Dakota, Wyoming and Missouri each had rates lower than 1 per 1,000.  

The CDC’s abortion database also tracks the number and proportion of abortions provided to out-of-state residents. In raw numbers, Illinois, Georgia and North Carolina lead that list (9,686; 6,411, and 5,117, respectively). Alaska reported providing only eight abortions to out-of-state residents in 2020. 

Proportionally, however, the District of Columbia leads the list once again, with 71% of its abortions provided to people living outside of the district. While not nearly that high, it is still notable that over half of Kansas’ abortions were provided to out-of-state residents—likely attributable to the restrictive environment in neighboring Missouri.  

The differences in abortion statistics by state, even pre-Dobbs, partly reflects the divisive nature of the issue among the public at large. According to our analysis of data provided by YouGov as part of the McCourtney Institute for Democracy’s May 2022 Mood of the Nation Poll, Americans are close to evenly divided on the legality of abortion:

  • 53% indicate that abortion should be legal, including the 23% who indicate that it should be legal “most of the time.”

  • 36% indicate that abortion should be illegal, “except in cases of rape, incest and to save the mother’s life.”

  • 12% indicate that abortion should be illegal in all circumstances.

This split opinion among the American public differs from state to state, with some states more heavily favoring abortion protections and residents of others favoring abortion restrictions. Thus, the state-to-state variation in both abortion rates and the provision of abortions to out of state residents, are likely to be further magnified in the rapidly evolving legal environment since the Dobbs decision. 

[1] While a small fraction of people who give birth identify as nonbinary or male, the CDC data explicitly refers to “women age 15 to 44.”

Note: Map originally appeared in a story for Minnesota Public Radio News, published June 23, 2023

Craig Helmstetter