National Background and Context

Each year, a broad cross section of U.S. women have abortions. As of 2014, 60% of women having abortions are in their 20s; 59% have one or more children; 86% are unmarried; 75% are economically disadvantaged; and 62% report a religious affiliation.[1] No racial or ethnic group makes up a majority: 39% of women obtaining abortions are white non-Hispanic, 28% are black non-Hispanic, 25% are Hispanic and 9% are of other racial backgrounds.[1]

Contraceptive use is a key predictor of whether a woman will have an abortion. The very small group of American women who are at risk of experiencing an unintended pregnancy but are not using contraceptives account for more than half of all abortions.[2] Many of these women did not think they would get pregnant or had concerns about contraceptive methods.[2] A minority of abortions occur among the much larger group of women who were using contraceptives in the month they became pregnant. Many of these women report difficulty using contraceptives consistently.[3]

Abortion is one of the safest surgical procedures for women in the United States. Fewer than 0.05% of women obtaining abortions experience a complication.[4]

In the 1973 Roe v. Wade decision, the U.S. Supreme Court ruled that a woman, in consultation with her physician, has a constitutionally protected right to choose abortion in the early stages of pregnancy–that is, before viability. In 1992, the Court upheld the basic right to abortion in Planned Parenthood v. Casey. However, it also expanded the ability of the states to enact all but the most extreme restrictions on women's access to abortion.[5] The most common restrictions in effect are parental notification or consent requirements for minors, limitations on public funding, and unnecessary and overly burdensome regulations on abortion facilities.

Pregnancies and Their Outcomes

•The 63 million U.S. women of reproductive age (15–44) had six million pregnancies in 2011. Sixty-seven percent of these pregnancies resulted in live births and 18% in abortions; the remaining 15% ended in miscarriage.[6]

•In Iowa, 52,100 of the 578,778 women of reproductive age became pregnant in 2011. Some 73% of these pregnancies resulted in live births and 11% in induced abortions.[7,8]

•In 2011, 1.06 million American women obtained abortions, producing a rate of 16.9 abortions per 1,000 women of reproductive age. The rate is a decrease from 2008, when the abortion rate was 19.4 per 1,000.[9]

• In 2011, 5,640 women obtained abortions in Iowa, producing a rate of 9.7 abortions per 1,000 women of reproductive age. Some of these women were from other states, and some Iowa residents had abortions in other states, so this rate may not reflect the exact abortion rate of state residents. The rate was 14% lower in 2011 than in 2008, when it was 11.3 per 1,000. Abortions in Iowa represent 0.5% of all abortions in the United States.[9]



Where Women Obtain Abortions

•In 2011, there were 1,720 abortion providers in the United States. This is a slight (4%) decrease from 2008, when there were 1,793 abortion providers. Thirty-five percent of providers in 2011 were hospitals, 19% were abortion clinics (clinics where more than half of all patient visits were for abortion), 30% were clinics where fewer than half of all visits were for abortion, and 17% were private physicians’ offices. Sixty-three percent of all abortions were provided at abortion clinics, 31% at other clinics, 4% at hospitals and 1% at private physicians’ offices.[9]

•In 2011, there were 18 abortion providers in Iowa, and 17 of those were clinics. This represents a 64% increase in overall providers and a 70% increase in clinics from 2008, when there were 11 abortion providers overall, of which 10 were clinics.[9]

•In 2011, 89% of U.S. counties had no abortion clinics. The 38% of American women who lived in these counties would have to travel outside their county to obtain an abortion.[9] Of women obtaining abortions in 2008, one-third traveled more than 25 miles.[10]

•In 2011, 85% of Iowa counties had no abortion clinic, and 50% of Iowa women lived in these counties.[9]

Restrictions on Abortion

In Iowa, the following restrictions on abortion were in effect as of September 1, 2016:

  • The parent of a minor must be notified before an abortion is provided.
  • Public funding is available for abortion only in cases of life endangerment, rape, or incest. The governor must approve each Medicaid-funded abortion.


References

1. Jerman J, Jones RK and Onda T, Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008, New York: Guttmacher Institute, 2016.

2. Sonfield A, Hasstedt K and Gold RB, Moving Forward: Family Planning in the Era of Health Reform, New York: Guttmacher Institute, 2014.

3. Frost JJ, Darroch JE and Remez L, Improving contraceptive use in the United States, In Brief, New York: Guttmacher Institute, 2008.

4. Weitz TA et al., Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver, American Journal of Public Health, 2013, 103(3):454–461.

5. Boonstra HD et al., Abortion in Women's Lives, New York: Guttmacher Institute, 2006.

6. Special tabulations of data from Finer LB and Zolna MR, Declines in unintended pregnancy in the United States, 2008–2011, New England Journal of Medicine, 2016, 374(9):843–852.

7. National Center for Health Statistics (NCHS), Vintage 2011 bridged-race postcensal population estimates, 2013, http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2011.

8. Special tabulations of data from Martin JA et al., Births: final data for 2011, National Vital Statistics Reports, 2013, Vol. 62, No. 1, and Jones RK and Jerman J, Abortion incidence and service availability in the United States, 2011, Perspectives on Sexual and Reproductive Health, 2014, 46(1):3–14.

9. Jones RK and Jerman J, Abortion incidence and service availability in the United States, 2011, Perspectives on Sexual and Reproductive Health, 2014, 46(1):3–14.

10. Jones RK and Jerman J, How far did US women travel for abortion services in 2008? Journal of Women’s Health, 2013, 22(8):706–713.