How has the annual number of abortions in the US changed since the 1973 Roe v. Wade decision?
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Executive summary
Since Roe v. Wade reported U.S. abortions rose rapidly, peaking in the late 1980s–1990s (commonly cited peak ~1.6 million in 1990 and a peak rate of 29.3 per 1,000 women in 1980–81), then fell steadily for decades to rates and counts lower than early post‑Roe levels; recent years show upticks after Dobbs with Guttmacher and other projects estimating roughly 1.0–1.14 million clinician‑provided abortions in 2023–24 [1] [2] [3] [4] [5]. Available sources show different datasets and methodologies that complicate direct year‑to‑year comparisons [1] [6] [7].
1. Rise after Roe: a sharp post‑legalization increase
After Roe legalized abortion nationwide in 1973, the total number and rate of reported abortions increased rapidly, reaching the highest measured levels in the 1980s; the abortion rate rose almost 80% from 1973 to 1980 and peaked at 29.3 abortions per 1,000 women of reproductive age in 1980–81 [1] [6]. Historical series show the annual count climbing into the hundreds of thousands and—by some sources—into the low millions around the late 1980s and 1990s [2] [8].
2. Decline over decades: a long, steady fall from the peak
From the early 1980s into the 2010s, both the abortion rate and total abortions declined substantially. Guttmacher and CDC data show that by 2012 the rate had fallen below the 1973 rate, and by 2017 the rate stood at 13.5 abortions per 1,000 women aged 15–44—reported as the lowest since 1973 [1] [2]. Analysts characterize this as a long‑term decline that continued at a “slow yet steady pace” after the 1980s [6] [9].
3. Different data sources, different counts — know your numerator
There are two main sources cited in current reporting: CDC surveillance and the Guttmacher Institute. Guttmacher surveys providers directly and produces national estimates; CDC relies on state reporting and typically reports fewer abortions because its dataset omits some jurisdictions at times [1] [9] [6]. That methodological difference explains many discrepancies in total counts and why single‑year comparisons can be misleading [1].
4. The 1990s high‑water mark and contested totals
Some sources cite a peak of roughly 1.6 million abortions around 1990; other reconstructions put the high point somewhat lower but agree the late 1980s–early 1990s were the maximum era for annual abortion counts [2] [10]. Different organizations and advocacy groups also produce cumulative tallies since 1973 that vary widely because they apply different adjustments for missing providers or undercounting [11] [10] [12].
5. The post‑Dobbs era: legal change, shifting patterns, rising clinician‑provided counts
The Supreme Court’s Dobbs decision overturned Roe and triggered a patchwork of state bans. Despite reduced access in many states, several monitoring projects recorded an increase in clinician‑provided abortions nationally in the years immediately after Dobbs: Guttmacher’s Monthly Abortion Provision Study estimated about 1,037,000 abortions in 2023, and the Society for Family Planning and KFF reported national totals rising to roughly 1.05–1.14 million into 2024 [3] [5] [4]. Researchers note these are likely undercounts because they include only abortions in formal health‑care settings and generally do not capture self‑managed medication abortions outside those systems [3] [5].
6. Why numbers can climb even as access is restricted
Reporting projects and analysts explain that bans in some states pushed patients to travel to other states, increased telehealth and mailed medication abortion provision from protected states, and spurred “shield law” protections—factors that can keep national counts steady or rising even as local access falls [13] [5] [4]. Source data therefore reflect not only demand but also shifts in where and how care is delivered [13] [3].
7. Limits, disagreements and what the sources do not say
Sources agree on broad directional trends (rise after Roe, long decline, recent post‑Dobbs increases) but disagree on exact annual totals and on whether recent increases will persist [1] [3] [4]. Available sources do not mention comprehensive counts of self‑managed abortions outside the health system; several warn their published totals are almost certainly undercounts for that reason [3]. Some advocacy and partisan outlets publish cumulative totals since 1973 that conflict with research organizations’ estimates; those differences stem from methodological choices about missing data and adjustments [11] [10].
8. Bottom line for readers
The evidence from CDC, Guttmacher and post‑Dobbs monitoring projects shows a clear arc: rapid rise after Roe, a long multi‑decade decline from peaks in the 1980s–1990s, then a reversal to higher clinician‑provided counts in 2023–24 amid legal upheaval. Exact annual numbers vary by data source and method; readers should treat single figures as estimates tied to the reporting system that produced them [1] [6] [3] [4].