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INTRODUCTION: The overturning of Roe v Wade will result in a patchwork of abortion laws that vary based on where a person lives; however, the current association between geographical region in the United States and abortion is poorly understood. Our objective was to define the effect geographic location has on the incidence of in-hospital pregnancy terminations in the United States. METHODS: The U.S. Nationwide Inpatient Sample (NIS) database was queried for all patients who underwent an in-hospital abortion (termination of pregnancy) from 1997 to 2014. The cohort was divided based on what region in the United States the procedure was performed: Northeast, Midwest, South, and West. ANOVA statistical analysis was used to compare the four groups across the study period. RESULTS: We identified a total of 37,600 patients who underwent an in-hospital pregnancy termination with a significant decrease from 4,113 abortions in 1997 to 1,059 in 2014 (P <.001). Compared to the rest of the United States, the Northeast region experienced a significantly higher incidence of abortions (P <.01), with a mean of 878 abortions per year, and the Midwest experienced a significantly lower incidence of abortions (P <.01), with a mean of 261 abortions per year. CONCLUSION: Our study found that the Northeast and Midwest regions of the United States experience the highest and lowest rates of abortion, respectively. With Roe v Wade overturned, an even higher discrepancy between abortion rate and U.S. region might ensue; however, further study is needed to investigate the etiology of these differences. [ABSTRACT FROM AUTHOR]