A Planned Parenthood clinic
A new report analyzing 30-year trends in abortion rates finds that fewer and fewer U.S. women are choosing abortion overall, but that the rate of decline differed significantly between populations. Abortion decreased more among white women and white teenagers, for example, compared with women of Latina or African-American descent.
The study, released Tuesday by the non-profit Guttmacher Institute, which specializes in research on reproductive and sexual health, examined abortion rates in the U.S. from 1974 — the year after Roe v. Wade deemed abortion a "fundamental right" — through 2004. The total number of abortions has dropped over the last two decades, from nearly 1.6 million in 1984 to 1.2 million in 2004. The abortion rate hit its peak in 1980 at 29 abortions per 1,000 women ages 15 to 44; in 2004, that number had dropped to 20 per 1,000 women.
Statistically one in three U.S. women will have an abortion in her lifetime, the study found, but that risk does not apply to all women equally. Women who choose abortion are more likely to be in their 20s or 30s than in their teens or 40s; they're more likely to have children already; and they're also more likely to be black or Hispanic than white. The abortion rates in 2004 were 50 abortions per 1,000 black women and 28 abortions per 1,000 Hispanic women, compared with 11 out of every 1,000 white women.
"This is the first time that somebody's really sat down and said, in this 30-year time period, what have been some of the changes in characteristics of women obtaining abortions?" says Rachel Jones, a senior research associate at the Guttmacher Institute and the project manager for the new study.
In 2004, 60% of women who had abortions had already given birth to at least one child, an increase from 50% in 1989, while 47% of women who had an abortion had already undergone the procedure at least once before (the study's authors point out, however, that the trend in multiple abortions may already be declining). Between 1974 and 2004, the percentage of abortions performed among women in their 20s increased from 50% to 57%; the percentage among women in their 30s increased from 15% to 24%. Meanwhile, the proportion of abortions sought by patients under 20 fell from 33% in 1974 to 17% three decades later.
"The shift in age, more women who already have children — this really does paint a different picture of women having abortions than the way it's portrayed in popular culture," Jones says, in reference to the popular notion that unintended pregnancy happens to careless teens and college kids.
The trend also points to a gap in outreach and education, says Jones: "We've devoted a lot of effort to preventing teen pregnancy and we haven't done very much for older women. So, what you see is that teenagers are doing a better job, over the 30-year time period, of avoiding unintended pregnancies and avoiding abortions."
Economics may also have something to do with it. Single motherhood has become increasingly common over the past 30 years, which may have affected the number of women who already have children who opt for abortions. "A single mom, if she's already got kids and she finds herself pregnant, just has fewer resources to raise another child," Jones says.
Health officials are struggling to educate women who have had an abortion about avoiding additional unwanted pregnancies. "People in the family planning and abortion community are trying to deal with this head on," Jones says. "We have an obligation to women who are experiencing multiple unintended pregnancies to do what we can to help them avoid subsequent unintended pregnancies."
That is no easy task. Jones points out that the population at hand is sexually active and of child-bearing age — at the start, that makes birth control a trickier issue. Also, says Jones, many women who get abortions may not have access to good health care or reliable contraception, or they may not have partners who are willing to use condoms or to use them consistently. "All of these risk factors combined lead to an increased vulnerability to having multiple unintended pregnancies," Jones says.
One interesting finding is that in recent years, there has been a marked trend toward early abortions — in particular, abortions within 7 weeks of pregnancy — something Jones attributes to more accurate home pregnancy tests and more choices in abortion methods, including the introduction of mifepristone, the miscarriage-inducing drug also known as the RU-486 that was approved by the Food and Drug Administration in 2000.
Despite a reduction in access to abortion providers — the Guttmacher Institute conducts a regular census, which has consistently shown a decline in abortion care, Jones says — the increase in early termination of pregnancies suggests that women are still able to find providers and find them quickly. While this marks progress, Jones stresses that there is still a lot of ground to cover toward giving women more control over their family planning. "It's not just about preventing pregnancies," Jones says. "It's about having children when you're ready, and when you want to."