U.S. Abortion Rate Ends 30-Year Decline. NewsWire

NewsWire: 7/11/22

• From 2017 to 2020, the number of abortions in the U.S. rose by 8%. This follows three decades of declines, with increases observed in most states. (Guttmacher Institute)
• NH: The Supreme Court’s decision to overturn Roe v. Wade after nearly five decades has pushed the country into a new era of patchwork abortion policies. It’s also thrust into the spotlight the numbers behind the debate. How common are abortions in America?
• The U.S. abortion rate peaked in 1981 after seeing steady increases in the years following Roe v. Wade. For the next 30 years, it declined, eventually hitting a record low in 2017 of 13.5 abortions per 1,000 women ages 18-44.
• But according to the new report from the Guttmacher Institute, that decline has reversed. Both the abortion rate and the number of abortions has ticked up every year since. In 2020, the rate stood at 14.4 abortions per 1,000 women.
  

• Since the number of U.S. births also declined over this period, this means that fewer women were getting pregnant, and of those who did, a larger share chose to have an abortion. From 2017 to 2020, the abortion ratio (the number of abortions per 100 pregnancies) rose from 18.4 to 20.6, or +12%.
• Increases were seen in 33 states and in every region of the country. The largest increases were in Oklahoma (where the abortion rate rose +100%), District of Columbia (+62%), Mississippi (+41%) and Illinois (+28%).
• The likelihood of abortion is greater for certain groups of women. Abortions are more common among women who live below the poverty line, are unmarried, and already have at least one child. Abortion rates also differ considerably by race and ethnicity. In 2019, the abortion rate among black women was 23.8 per 1,000. For Hispanic women, it was 11.7. For white women, it was 6.6.
• Despite the recent increases, the abortion rate remains near its record low. Americans are having half as many abortions as they did 30 years ago, largely due to more contraceptive use and declines in sexual activity, especially among more risk-averse youth. (See “U.S. Abortion Rate Falls to Lowest Rate Ever.”)
• What’s behind the reversal? According to the report, there “were no clear patterns” in the states where abortion rates increased or decreased. Women in poverty are more likely to get abortions than higher-earning women, and some states expanded Medicaid coverage for abortion during this period. Financial distress and high unemployment during the first year of the pandemic is thought to have contributed to the rise as well.
• Another contributing cause may have been fewer contraceptive services available to low-income families. The Trump administration prohibited federally funded family planning clinics that serve low-income people from referring patients for abortions. Many of these clinics chose to reject the funding rather than follow this policy, which by one estimate nearly halved the number of patients they were able to serve with other services like free or low-cost contraception.
• The Dobbs ruling will probably result in fewer abortions than would otherwise occur. Abortion is now banned in at least nine states, with more bans or restrictions set to take effect in the coming months that will affect around half of the country. Many women in affected states will still get abortions anyway, some by traveling out of state to receive care or by using medication. But these routes are not accessible to everyone.
• In general, we expect one of two responses to Dobbs. Some women will lean more heavily on preventative measures. Sales of emergency contraception soared so high after the ruling that Walmart, Amazon, CVS, and Rite Aid put purchase limits on Plan B. Anecdotally, urologists around the country are reporting that the number of men requesting vasectomies has spiked.
• Other women will give birth to children that they otherwise would not have had. While no single outcome will be true for all of these women, it’s almost certain that this new reality will have huge implications for social services, mental health, fertility rates, and maternal death rates--with very different consequences depending on the state.