How have abortion rates for Black infants changed in the U.S. over the past 20 years?
Executive summary
Over roughly the past two decades Black women in the U.S. have continued to have substantially higher abortion rates than White women, even as overall abortion rates fell; CDC- and Guttmacher-era reporting shows racial disparities persisting and, in many periods, widening [1] [2]. Recent research also ties post‑Dobbs state abortion bans to increased births and higher infant mortality concentrated among Black infants — an 11% relative rise in Black infant deaths was reported in analyses of 2012–2023 vital statistics for states with bans [3] [4].
1. A long-running racial gap: rates fell, disparity stayed large
Abortion rates in the U.S. have been declining for decades, but the decline has not erased racial differences: in mid‑2010s CDC reports the non‑Hispanic Black abortion rate (25.1 per 1,000 women age 15–44 in 2016) was roughly 3.8–5 times the non‑Hispanic White rate, depending on the data window and measurement [1] [2]. Scholarly summaries and surveillance reports make clear the absolute Black rate fell in many recent years while the White rate often fell faster, meaning the relative disparity persisted or increased in some intervals [1].
2. Measurement caveats: gaps, reporting differences and hidden geography
National figures come from multiple systems — the CDC’s abortion surveillance and independent estimates such as from Guttmacher — and they use different collection methods and coverage. The CDC’s surveillance excludes some reporting areas in some years (California, New York, Texas and others at times), which complicates trends by race because those states account for a large share of abortions and diverse populations [5] [1]. Analysts warn that incomplete state reporting and the overlap of race/ethnicity categories mean headline ratios mask data uncertainty [6] [7].
3. Why the disparity exists: structural drivers, not simple explanations
Researchers and public‑health commentators attribute higher abortion rates among Black women to systemic inequalities — lower access to consistent contraception and health care, greater levels of economic hardship and stress, differential timing of care, and broader social determinants — rather than a single proximate cause [8] [2]. The literature explicitly rebuts claims that provider targeting alone explains the pattern, pointing instead to socioeconomic and healthcare access drivers [2].
4. Timing and risk: later abortions and unequal health consequences
Several sources note Black women are more likely to obtain abortions later in pregnancy, which carries higher medical risk and greater cost; later timing is linked to access barriers and contributes to disparities in abortion‑related outcomes [9] [8]. Analysts connect later abortions and reduced post‑pregnancy care access to potential increases in adverse maternal and infant outcomes when care is delayed or blocked [8].
5. Recent policy shock: bans, more births, and worse infant outcomes for Black infants
Newer studies of the post‑Dobbs policy landscape find that states enacting strict bans saw increases in live births and higher than expected infant mortality; the relative increase in infant mortality was larger for Black infants — reported as an ~11% higher rate than expected in states with bans, equivalent to an observed rise from 10.66 to 11.81 deaths per 1,000 live births among non‑Hispanic Black infants in the affected states [4] [10] [3]. Authors link some of this increase to a higher share of births with congenital anomalies continuing to term after bans eliminated termination as an option [3] [4].
6. Competing perspectives and contested narratives
Advocacy groups interpret the same numbers differently: public‑health scholars and reproductive‑rights analysts frame disparities as the product of structural inequities that pandemic‑era and post‑Dobbs policy changes have worsened [8] [3]. Anti‑abortion organizations emphasize the raw magnitude of racial differences to argue against abortion on moral or demographic grounds; such groups’ claims often rely on historical ratios but sometimes omit the socioeconomic context emphasized by public‑health research [11] [1]. The scientific literature explicitly calls out political uses of the statistics and notes media and scholarly communities do not always engage the complexity [1].
7. What the sources do and do not say
Available reporting and peer‑reviewed analyses document that Black women’s abortion rates remained higher than White women’s over recent decades and that post‑2022 state bans are associated with increased Black infant mortality in affected states [1] [4]. Available sources do not present a single, clean 20‑year time series that uniformly covers all states and racial categories without caveats; the CDC and academic studies both warn about missing state reports and methodological differences that limit straightforward national trend claims [5] [6].
8. Bottom line for readers
The empirical picture is consistent: Black women have borne a disproportionate share of abortions for decades even as overall rates dropped, and recent policy shifts that reduce abortion access are associated with increased live births and higher infant mortality concentrated among Black infants — outcomes explained in the research by structural barriers and changes in which pregnancies continue to term [2] [4]. Policymakers and commentators should use these data with care: missing reporting, differing methodologies, and political agendas complicate simple interpretations [5] [1].