Abortions Down but So Are Births, and Cause Is Unknown
A new report shows a 13% decrease in the rate of abortions, but whether the drop is caused by a decline in abortion providers, shifts in public opinion or the increase in long-acting contraceptives is under dispute.
BY PETER JESSERER SMITH
| Posted 2/21/14 at 7:56 AM
WASHINGTON — The U.S. abortion rate is as low as it has been since 1973. But the reasons for the downward trend are unclear and in dispute, as the birth rate also continues to drop, raising questions as to whether the United States is actually shifting in a pro-life direction or is instead becoming ever more reliant on contraception.
The Guttmacher Institute, an abortion research firm with historical ties to Planned Parenthood, reports that the abortion rate dropped 13% over a period of three years to 16.9 abortions in 2011 for every 1,000 women between the ages of 15-44. The annual number of children aborted in the U.S. dropped to under 1.06 million in 2011 from 1.21 million in 2008, when the rate was 19.4 abortions per 1,000 women.
The study shows the abortion ratio has declined, but only slightly. In 2011, 21.1 women out of 100 opted for abortion instead of birth. It shows that at least one more woman out of 100 pregnancies (not ending in miscarriage) is choosing giving birth instead of abortion than in 2008, when the abortion ratio was 22.5 women out of 100.
While the abortion decline revealed in Guttmacher’s latest report has been hailed by the pro-life community as a positive sign, the reasons for why the abortion rate is going down are not clear. Guttmacher’s researchers point out that U.S. women had fewer pregnancies in 2011 than 2008: Not only did the abortion rate decline 13%, but the birth rate dropped by 9%.
Rachel Jones, the lead researcher on the Guttmacher report, said her team was surprised to find that abortion rates were decreasing in all regions of the country — Midwest (17%), West (15%), South (12%) and Northeast (9%) — including states with liberal abortion laws and more restrictive ones. Only six states (Wyoming, Alaska, New Hampshire, Missouri, Maryland and West Virginia) showed zero or positive abortion rate increases. But Jones doesn’t think the drop is necessarily an indication that people are choosing life instead.
“If it was just a drop in abortions, and the birth rate hadn’t changed or gone up, then that would have suggested that fewer women had access to abortion services or, if they got pregnant, were choosing not to have an abortion,” Jones said. “But the birth rate went down, which suggested fewer women were getting pregnant. And it went down so much that it was impossible that all, or even most of those abortions, were converted to unintended births.”
Out on a LARC?
Jones said this evidence led her team to believe that the most plausible hypothesis for the general decline in abortion was if the 9% uptick observed in 2009 in use of long-acting reversible contraceptives (LARCs), such as intra-uterine devices (IUDs) and implants, (particularly among women younger than 25, the demographic that experiences the most abortion) continued through the study period.
The Guttmacher report pointed to studies that showed contraceptive use increased 3% among women in their 20s during 2007-2009, putting the percentage of women in this group not using any birth control at 12%. LARC use among low-income women accessing publicly funded contraception jumped from 4% to 11%, while use of condoms and over-the-counter birth control for this same abortion-vulnerable group fell from 25% to 17%.
“So that seemed to us, because those are highly effective contraceptive methods that leave not any room for user error, that even small increases in reliance on these methods can have a measurable effect on pregnancy, birth and abortion rates,” Jones said.
The Guttmacher study period missed the explosion of pro-life laws that were passed or began taking effect in 2011, and Jones said the next study will take that into account. Right now, she said, the data between 2010-2011 was “not conclusive” that pro-life laws impeding access to abortion or the decline of providers were responsible for the across-the-board decline. Jones said researchers in Texas are finding that those laws are having an impact on reducing abortions, but new legislative restrictions are not at play in New York, which has also seen a decline in providers, possibly due instead to a lack of demand.
Michael New, a U.S. political scientist and research associate at Reproductive Research Audit, said the country is experiencing a decline in the fertility rate that coincides with the Guttmacher study. The total fertility rate dropped from 2.12 in 2007, the rate needed to replace the population, to 1.89 in 2011. But New said the reasons are unknown.
However, he did not believe increased contraception or the post-2008 economic slowdown were persuasive reasons for the abortion decline.
“If contraceptive use really drives the abortion decline, you’d see the unintended pregnancy rate fall. But the unintended pregnancy rate is not falling,” he said.
Instead, New believes that cultural changes and shifts in public opinion may also be at work. He pointed to research showing that the rate of repeat abortions has stayed stable, but first-time abortions are down, implying that the current generation of women doesn’t “see abortion as a contraceptive backup method” like the older generation.
“If unintended pregnancy rates are the same, and abortion numbers are falling, it seems the only logical conclusion is that a higher percentage of women facing unwanted pregnancies are not choosing abortion and are choosing to carry the pregnancy to term,” he said.
New added, “We’ve seen a shift in public opinion, and I think that deserves some consideration.”
Gallup’s surveys show an upward trend among Americans who identify themselves as “pro-life,” starting in 2008 and coinciding with Guttmacher’s survey of abortions of 2010-2011. A majority of Americans described themselves as “pro-choice” briefly around 2010, but the trend reversed. By 2012, 50% identified themselves as “pro-life,” and a record-low 41% identified themselves as “pro-choice.”
At the same time, Gallup’s polls show the number of people who said abortion is “morally wrong,” regardless of legality, spiked to a high of 56% in 2009 and dipped to 51% by 2012, when 38% responded that abortion was “morally acceptable.”
Richard Doerflinger, associate director of the Secretariat for Pro-Life Activities for the U.S. Conference of Catholic Bishops, argued in an essay on The Public Discourse website that the Guttmacher report could actually be under-appreciating how the 4% decline in abortion providers since 2008 could actually account for the substantial drop in the abortion rate.
“Closing even one such [facility] could have a significant impact,” said Doerflinger, noting that Guttmacher’s data shows a 13% decline of 49 abortion facilities from 2008 to 2011, which correlates with the 13% abortion decline. He said the average facility performs between 1,000 and 5,000 abortions per year (Guttmacher’s report stated the majority have an average abortion caseload upwards of 1,000). Multiplying Doerflinger’s per-facility numbers by 49, and assuming abortion-minded women didn’t go to other facilities, that could mean between 49,000 to 245,000 unborn children were spared from abortion by the closures.
Cheryl Sullenger, senior policy adviser for Operation Rescue, said the organization has been tracking the number of abortion facilities closing. They found the total number of surgical abortion providers dropped 12% in 2013, as the closing of 87 facilities left the total remaining in operation in the United States at 582, by their count.
Sullenger believed that both cultural trends against abortion as backup for contraception, coupled with the new generation growing up with ultrasound technology and the exposure of abortion centers’ questionable conduct, are all reasons for abortion businesses closing.
“We know that when clinics close, it puts a real dent in the abortion numbers,” she said, pointing to her report that focused on abortion in Kansas, where the greatest declines in abortion rates coincided with closures.
The state’s health department reports that the clientele for Kansas abortion facilities is split between out-of-state women and in-state women, so it makes it difficult to know if women just went other places outside of Kansas. But Sullenger said that when Operation Rescue bought a former Wichita abortion facility as its office headquarters, about 30 women came looking for an abortion, and they referred them to the nearby crisis-pregnancy center.
“Not a single one of them ever got an abortion,” she said. “They all were able to get the help they needed, stop and think about things a little more long term, and every single one of them kept their babies or released them for adoption; but I think the majority kept their babies.”
She said when another facility closed in Wichita the requests for adoption placement increased 20%-40%.
Filling the Void
In a recent interview with the Register, Abby Johnson, a former Planned Parenthood director, told the Register the pro-life community has to be forward-thinking and fill in the gap left when abortion centers close. While the pro-life community has been very pro-active in setting up crisis-pregnancy centers, she said they need to have the goal of creating pro-life women’s medical centers that are able to compete with the abortion industry flagship, Planned Parenthood, by offering the same basic women’s services. She says this would take away a key factor Planned Parenthood uses to hook abortion clients.
“You have to provide services that people can’t get at Planned Parenthood, and the services they can get you have to provide with better quality,” said Johnson. “So, ideally, that’s what we have to start doing. And it is happening.”
She pointed to Stanton Healthcare in Idaho and Guiding Star, which is helping her set up a pro-life women’s clinic in Bryan/College Station, Texas, as excellent examples.
“Being able to be competitive with Planned Parenthood (down the street or next door to them or whatever) is going to be more important than any initiative that’s on their list right now,” Johnson said.
“The problem is that women walk into a Planned Parenthood clinic,” she said. “If we can get them to never walk into a Planned Parenthood clinic, then we’ve won half the battle.”
Peter Jesserer Smith is a Register staff writer.
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