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Who are the 1 in 4 American women who choose abortion?

One important group’s voice is often absent in the debate: the women who choose abortion.

The abortion debate is at the center of U.S. political dialogue. Voices from both sides flood social media feeds, newspapers, radio and television programs.

In the last year, attacks on reproductive rights sharply increased. In 2019, Georgia, Missouri, Ohio, Kentucky and Mississippi successfully passed so-called “heartbeat” bans to prohibit abortion as early as 6 to 8 weeks. Alabama is the first state to pass a complete abortion ban without exceptions for rape or incest. Due to ongoing legal challenges, these bans have yet to go into effect.


One important group’s voice is often absent in this heated debate: the women who choose abortion. While 1 in 4 women will undergo abortion in her lifetime, stigma keeps their stories untold. As an obstetrician/gynecologist who provides full-spectrum reproductive health care, I hear these stories daily.

Unintended pregnancy

In 2011, nearly half of pregnancies in the U.S. were unintended. This reflects a 6% drop in unintended pregnancies since 2008, largely due to Title X family planning programs and easier access to birth control.

Unintended pregnancy remains most common among poor women, women of color and women without a high school education. Women living in poverty have a rate of unintended pregnancy five times higher than those with middle or high incomes. Black women are twice as likely to have an unintended pregnancy as white women.

Barriers to contraception play a major role. Among women with unintended pregnancies, 54% were using no birth control. Another 41% were inconsistently using birth control at the time of conception.

Forty-two percent of women with unintended pregnancy choose to end their pregnancies.

The women who choose abortion

Abortion is a routine part of reproductive health care. Approximately 25% of women in the U.S. will undergo an abortion before the age of 45. The Guttmacher Institute, a research and policy institute in New York City, has been tracking these data for the last 50 years.

American women have abortions with similar frequency to women living in other developed nations. The bulk of abortion patients are in their 20s.

Women of all races and ethnicities choose abortion. In 2014, 39% of abortion patients were white, 28% were black and 25% were Latinx. Similarly, women of all religious affiliations choose to end their pregnancies at similar frequencies.

Most of these women understand what it means to parent a child. More than half of abortion patients in 2014 were already mothers.

Poor women account for the majority of abortion patients. Fifty-three percent of women pay out-of-pocket for their abortion. The rest use private or state-funded insurance plans.

Women choose abortion for multiple reasons. The most common reason cited is that pregnancy would interfere with education, work or ability to care for dependents.

Financial stress also plays a major role in women’s decision-making. Seventy-three percent of women reported that they could not afford a baby at the time. Nearly half cited relationship difficulties or wanting to avoid single motherhood. More than a third of women felt their families were complete.

The following categories were chosen by fewer than 0.5 percent of respondents and are not shown: "Was a victim of rape", "Husband or partner wants me to have an abortion", "Parents want me to have an abortion", "Don’t want people to know I had sex or got pregnant" Chart: The Conversation, CC-BY-ND Source: Guttmacher Get the data

Twelve percent chose abortion due to their own health problems. For example, one of my patients and her husband were thrilled to find out she was pregnant for the first time. Then she received the diagnosis of metastatic breast cancer. She had to choose between lifesaving chemotherapy and radiation or her pregnancy.
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