What are state‑by‑state cumulative abortion counts since 1973 when adjusted for underreporting?
Executive summary
Public, auditable state‑by‑state cumulative abortion counts since 1973 that incorporate a uniform, accepted adjustment for underreporting do not exist in the public record; researchers instead rely on two primary sources with different methods — the Guttmacher Institute’s provider surveys (national and state series through 1973–2020 and ongoing monthly estimates) and CDC surveillance, which is known to undercount because state reporting is voluntary and incomplete [1] [2] [3]. Competing tallies — advocacy groups’ cumulative totals (for example, a 65.5 million figure circulated by pro‑life groups) — are recalculations built on Guttmacher or CDC inputs plus additional assumptions about “missing providers” and post‑Dobbs shifts, not on a single, independently verified state‑level adjusted ledger [4] [5].
1. What the authoritative sources actually provide
Guttmacher offers the most complete publicly documented dataset for 1973–2020 at national and state levels and explains that its totals come from direct surveys of known abortion providers and follow-up estimation where providers did not respond [1] [6]. The institute also publishes a Monthly Abortion Provision Study that produced a national estimate of about 1,037,000 abortions in 2023 and warns those annual estimates exclude abortions obtained entirely outside formal health systems and therefore are almost certainly undercounts [2].
2. Why the CDC numbers differ and why “adjusted” totals are controversial
CDC abortion surveillance has been published annually since the 1970s but depends on voluntary reporting from state health departments; several large jurisdictions have been absent or incomplete in different years which produces a systematic undercount compared with Guttmacher [3] [7]. Because the CDC’s coverage of all 52 reporting areas varied across decades and some states did not submit data consistently, many researchers prefer Guttmacher’s provider‑level methodology for estimating state totals — but even Guttmacher must impute missing responses, a process that creates uncertainty around any “adjusted” cumulative total [8] [1].
3. What the advocacy tallies claim and the limits of those claims
National Right to Life and allied outlets have publicized cumulative totals (for example, roughly 65,464,760 abortions since 1973) that are explicitly based on Guttmacher and other datasets with proprietary or publicly un‑specified adjustments for “undercounts” and “missing providers,” plus extrapolations for 2021–2024 using various proxies [4] [5]. Those figures produce headline‑grabbing state and national aggregates but rest on methodological choices — which years to adjust, how to allocate estimated missing abortions among states, and how to account for abortions occurring outside the formal system post‑Dobbs — that are not universally accepted or reproducible from the public sources cited.
4. The practical answer to the question posed
A defensible, reproducible state‑by‑state cumulative count since 1973 adjusted for underreporting can be approximated only by using Guttmacher’s state series through 2020 as the baseline and then applying clearly documented, transparent adjustment rules for subsequent years and for nonresponding providers — a process the available public reporting describes but does not publish as a single state‑level “adjusted cumulative” table that covers 1973–present [1] [2]. The CDC’s published state counts may be used as a secondary check, but they are known to undercount and omit jurisdictions in some years [3] [7]. No provided source supplies a universally accepted, fully adjusted state‑by‑state cumulative total from 1973 to 2025/2026.
5. How a researcher should proceed to build a transparent adjusted series
Start with Guttmacher’s 1973–2020 state dataset and its documentation, clearly record which provider nonresponse rates and imputation methods were applied, incorporate the Guttmacher Monthly Abortion Provision Study for 2021–present with explicit assumptions about telemedicine and out‑of‑system medication abortion undercounts, and cross‑validate against CDC surveillance and independent compilations while flagging where large jurisdictions (historically California, New York City data status, etc.) create gaps [1] [2] [7]. Any final state‑by‑state cumulative figure must publish the adjustment algorithm and uncertainty bounds; absent that transparency, competing cumulative claims (including the 65 million+ tallies) should be treated as estimates built on contestable assumptions [4] [5].