US Abortion Rates Continue to Decline

Larissa Puro/USC Institute for Global Health

Abortion rates in the United States have reached a historic low since the Supreme Court legalized the procedure in the landmark 1973 Roe v. Wade decision.

The Guttmacher Institute, a non-profit dedicated to advancing sexual and reproductive health through research and policy, released data last week demonstrating that the estimated 862,320 abortions performed in the US in 2017 represent a 7 percent decline since the last study in 2014. The national abortion rate―abortions per 1,000 women aged fifteen to forty-four―fell by 54 percent since its peak in 1980.

Anti-choice groups wasted no time taking credit for the nationwide decline in pregnancy terminations.

The Charlotte Lozier Institute said in their statement:

This fact reveals the success that the pro-life movement has had in working to shift public opinion, to better assist pregnant women and their families, and to pass protective laws.

The group 40 Days for Life used the results of the study to promote their upcoming campaign:

 

And the National Right to Life Committee’s president, Carol Tobias, said this:

The pro-life movement’s efforts to educate American’s [sic] about the humanity of the unborn child and pass protective pro-life legislation are having an impact and our nation is moving away from the deadly U.S. Supreme Court decisions of Roe v. Wade and Doe v. Bolton.

Despite what anti-abortion groups claim, Guttmacher could not identify a clear correlation nationally between abortion rates and increased restrictions on abortion clinics and women’s healthcare facilities. While there are certainly exceptions like Texas and Ohio, where legal restrictions that result in clinic closures directly affect the abortion rate, 57 percent of the nationwide decline occurred in states that did not enact any new restrictions. Guttmacher attributed the decline nationwide to an increase in self-managed abortions and decreasing pregnancy rates, coupled with improvements in contraceptive use.

According to the Centers for Disease Control and Prevention (CDC), in 2017 the fertility rate fell to 60.2 births per 1,000 women aged fifteen to forty-four. The teen birth rate fell 39 percent between 1991 and 2009 and is now at a record low for all race groups. Additionally, data shows a decline in the percentage of sexually active teenagers coupled with an upward trend of the use of contraceptives during first-time sex. Between 2014 and 2016, the number of women (age fifteen to forty-four) using long-acting reversible contraceptive methods increased by 23 percent. Increasing access to affordable and effective methods of birth control reduces the number of pregnancies and the need for abortions.

While this data speaks in part to the success of reproductive education and access to contraceptives, Guttmacher’s study does have a number of shortcomings. Due to incomplete data, 9 percent of their findings estimated when, how, where, and even if abortions occurred, and the study only measured abortions in clinical settings. The study is missing data from a number of facilities and did not account for individuals crossing state lines to obtain abortions. Additionally, in our ever-changing landscape of abortion facilities and providers, information becomes outdated quickly.

Nonetheless, this conversation comes at an important time as the Trump administration continues its crusade to restrict access to contraception and abortion. At a meeting of the United Nations General Assembly on Monday, Health and Human Services Secretary Alex Azar called on UN member nations to oppose efforts to promote access to abortion internationally:

We do not support references to ambiguous terms and expressions such as ‘sexual and reproductive health and rights’ in UN documents, because they can undermine the critical role of the family and promote practices like abortion in circumstances that do not enjoy international consensus and which can be misinterpreted by UN agencies.

“There is no international right to an abortion, and these terms should not be used to promote pro-abortion policies and measures,” Azar added. “Further, we only support sex education that appreciates the protective role of the family in this education.”

This follows a letter Azar and US Secretary of State Mike Pompeo released in July requesting foreign leaders to “join the United States in ensuring that every sovereign state has the ability to determine the best way to protect the unborn and defend the family as the foundational unit of society vital to children thriving and leading healthy lives.”

Also on Monday, an eleven-judge panel from the Ninth Circuit heard arguments addressing whether a Title X rule rolled out over the summer should be taken into account during court challenges brought by twenty-two states and Planned Parenthood. The regulation changes prevent medical organizations that provide or refer patients for abortions from receiving Title X funds. Under the rule, health centers across the country are at risk of closure even if they don’t provide abortion care—ultimately limiting access to STD prevention, cancer screening, and contraception. Since the rule went into effect, 20 percent of grantees have left the program, including Planned Parenthood, which served 40 percent of Title X patients in 2017.

Despite the hyper-polarized framing of the abortion debate, 77 percent of Americans support Roe v. Wade. Guttmacher’s study on declining abortion rates has its limitations, but the response by anti-abortion groups coupled with the Trump administration’s continued assault on basic, preventative health care makes clear the need to prioritize an accurate and full gathering of data on abortion in the United States in order to wholly understand the effects of access and restrictive laws on those seeking care.