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Rebecca Wind
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U.S. ABORTION RATE CONTINUES LONG-TERM DECLINE, FALLING TO LOWEST LEVEL SINCE 1974; MORE EFFORT STILL NEEDED TO REDUCE UNINTENDED PREGNANCY

Increased Use of Medication Abortion Stems Decline in Providers

In 2005, the U.S. abortion rate declined to 19.4 abortions per 1,000 women aged 15–44, continuing the downward trend that started after the abortion rate peaked at 29.3 in 1981, according to a new Guttmacher Institute census of U.S. abortion providers. The abortion rate is now at its lowest level since 1974. The number of abortions declined as well, to a total of 1.2 million in 2005, 25% below the all-time high of 1.6 million abortions in 1990.

Despite these declines, slightly more than one in five pregnancies ended in abortion in 2005, an indicator of how much still needs to be done to help women and their partners avoid unintended pregnancy. “Our policymakers at the state and federal levels need to understand that behind virtually every abortion is an unintended pregnancy, so we must redouble our efforts towards prevention, through better access to contraception,” says Sharon L. Camp, president and CEO of the Guttmacher Institute.

Even as the long-term decline in the U.S. abortion rate continued, the new study also found that early medication abortion services expanded substantially between 2000 and 2005, as growing numbers of providers offered the service, including some that previously did not offer surgical abortion services. Fifty-seven percent of all known abortion providers now offer medication abortion services, compared with 33% in early 2001. Medication abortion accounted for 13% (161,000) of all abortions performed in 2005, and 22% of all eligible abortions (those performed prior to nine weeks’ gestation). According to recent government reports, abortions are occurring earlier, when the procedure is safer; increased access to medication abortion can help accelerate that trend.

“For a long time, nearly 90% of abortions in the U.S. have taken place in the first trimester, but in recent years, women having an abortion have been able to do so earlier and earlier in the first trimester. Currently, more than six in 10 abortions occur within the first eight weeks of pregnancy, and almost three in 10 take place at six weeks or earlier,” says Rachel Jones, lead researcher on the new survey. “Medication abortion, which provides women with an additional option early in pregnancy, clearly reinforces this very positive trend.”

The decline in the number of U.S. abortion providers, which had been substantial over the past decade, slowed dramatically between 2000 and 2005: The number of providers declined just 2% over this period, partly because of a surge in the number of providers that offer only medication abortion services. Without them, the number of providers would have declined by 8%. Overall, the number of providers declined in 26 states and the District of Columbia, increased in 15 states and remained stable in nine.

This analysis is based on the Guttmacher Institute’s 14th census of all known abortion providers in the United States. The study, “Abortion in the United States: Incidence and Access to Services, 2005,” will appear in the March 2008 issue of Perspectives on Sexual and Reproductive Health.

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