Half of the Clinics That Provided Abortions to Incarcerated Individuals in 2020 Were in States Hostile to Abortion

New analysis emphasizes that barriers to abortion in jails and prisons will be exacerbated post-Dobbs

The full study is available here. 

More than 300 abortions were provided by 67 clinics to incarcerated individuals in the United States in 2020, according to a new study from the Guttmacher Institute and Johns Hopkins University School of Medicine. The number of abortions, which is most likely an underestimate, is the most recent and reliable count of abortions among incarcerated individuals.

The study found that 52% of clinics providing abortion care to individuals in the carceral system were located in states hostile to abortion—many of which have added additional restrictions since the period under study, including six states where abortion has since been banned or is now unavailable beyond six weeks. It is estimated that nearly 38,000 women were pregnant upon intake to US jails and prisons in 2020, representing 3-4% of all females who were incarcerated. The number of women who were incarcerated increased in 2021, indicating that the need for abortion services among people in jails and prisons will continue, but post-Dobbs restrictions will make abortion care even more difficult to obtain. 

“Even when Roe was in effect, incarcerated individuals struggled to get the abortion care they needed,” says Marielle Kirstein, a coauthor formerly with the Guttmacher Institute. “But the Dobbs decision has introduced more barriers to care. People being held in jails and prisons in states with abortion bans cannot travel for care or self-manage a medication abortion.”  

Incarceration Status among Individuals Obtaining Abortion in the U.S., published in the American Journal of Public Health, used data from the 2020 Abortion Provider Census* to analyze clinics that provided abortions to incarcerated patients. The paper, which is only the second published study on abortion occurrence among incarcerated individuals, underscores the devastating impact that the Dobbs decision will have on those in carceral institutions.   

Key findings from the analysis: 

  • Sixty-seven clinics across 25 states and the District of Columbia provided more than 300 abortions to patients in jail or prison. 

  • All clinics that provided abortion to incarcerated individuals were located in metropolitan or urban areas. 

  • Fifty-two percent of clinics providing abortion care to individuals in the carceral system were located in states hostile to abortion, including six states where abortion has since been banned or is unavailable beyond six weeks. 

“Abortion bans and restrictions will force more incarcerated individuals to continue pregnancies and experience birth against their will,” says coauthor Liza Fuentes, director of health equity research at Boston Medical Center. “Because mass incarceration is characterized by structural racism, this will have a disproportionate impact on Black and Brown people and further exacerbate the racial disparity in access to reproductive health care services.” 

To address the abortion access crisis among incarcerated individuals, the authors recommend: 

  • Further research on abortion access and provision to incarcerated patients. 

  • Institution- and state-level policies and groups that facilitate access to abortion care, such as abortion funds, must explicitly consider the needs and unique barriers to care faced by incarcerated abortion seekers. 

  • Eliminating the exclusion of incarcerated people from Medicaid and eliminating the Hyde Amendment, which prohibits federal funds from covering abortion services for people enrolled in Medicaid, Medicare and the Children’s Health Insurance Program. 

  • Standardization and oversight of carceral medical care, especially in states that are hostile to abortion. 

The full study is available here. 

*The Guttmacher Institute’s Abortion Provider Census (APC), which collects data about abortion from all healthcare facilities known or suspected to provide abortion care, is the most comprehensive data collection effort on abortion provision in the United States. The 19th iteration of the APC, from which this analysis is based, collected data for 2019 and 2020 from facilities across the country.