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Incarceration Status Among Individuals Obtaining Abortion in the United States, 2020

Marielle Kirstein, Guttmacher Institute Liza Fuentes, Boston Medical Center Carolyn Sufrin, Johns Hopkins School of Medicine

First published on American Journal of Public Health:

| DOI:
Abstract / Summary

Objectives. To examine the abortion frequency among incarcerated people before Dobbs v Jackson Women’s Health Organization was decided.

Methods. We used data from the 2020 Abortion Provider Census to examine the number and distribution of facilities that provided abortions to incarcerated patients.

Results. Sixty-seven clinics across 25 states and the District of Columbia provided more than 300 abortions to incarcerated patients in 2020. Eleven of these clinics are in states that now have total or near-total abortion bans.

Public Health Implications. People in jails and prisons face many structural barriers when seeking an abortion, especially with increased state abortion restrictions and an inability to travel out of state. If they cannot obtain desired care, people may be forced to continue pregnancies in harsh conditions. To address abortion access inequities, policy and research must consider incarcerated individuals. (Am J Public Health. 2023;113(12):1352–1355.)

After the Supreme Court’s decision in Dobbs v Jackson Women’s Health Organization (Dobbs) eliminated federal protections for abortions in the United States, research and reporting have continued to document adverse effects on people’s health and well-being. Abortion restrictions in 15 states resulted in 66 clinics ceasing abortion services within 100 days of Dobbs and more than 25 000 people unable to access abortion within the first 9 months of the decision. Still, we do not fully understand the effects of Dobbs, including for people in jails and prisons—who have the fewest resources to overcome barriers and categorically cannot travel out of state. Mass incarceration and maternal health outcomes are both characterized by structural racism and racial disparities, raising concerns that abortion bans will have a distinctly negative effect on incarcerated people.

In the United States, 3% to 4%, or roughly 38 000, of incarcerated women are pregnant at intake based on the most recent data on admissions of women to prisons and jails. Before Dobbs, the courts consistently ruled that incarcerated individuals retained their constitutional right to abortion. However, carceral institutions implemented inconsistent policies: some expressly prohibited abortion; some allowed it, albeit sometimes with restrictions out of step with state law; and others’ self-pay requirements made abortion functionally inaccessible. The only existing study of abortion occurrence among incarcerated individuals collected data from carceral facilities and reported 44 abortions among 1040 pregnancies. We examined the incarceration status of abortion patients using data from a census of clinics providing abortion care in 2020.


United States