Early Medication Abortion Makes Up an Increasing Proportion of All Abortions
The U.S. abortion rate declined to 16.9 abortions per 1,000 women aged 15–44 in 2011, well below the 1981 peak of 29.3 per 1,000 and the lowest since 1973 (16.3 per 1,000), according to "Abortion Incidence and Service Availability in the United States, 2011," by Rachel Jones and Jenna Jerman. Between 2008 and 2011, the abortion rate fell 13%, resuming the long-term downward trend that had stalled between 2005 and 2008. The number of abortions (1.1 million in 2011) also declined by 13% in this time period.
While the study did not specifically investigate reasons for the decline, the authors note that the study period (2008–2011) predates the major surge in state-level abortion restrictions that started during the 2011 legislative session, and that many provisions did not go into effect until late 2011 or even later. The study also found that the total number of abortion providers declined by only 4% between 2008 and 2011, and the number of clinics (which provide the large majority of abortion services) declined by just 1%.
"With abortion rates falling in almost all states, our study did not find evidence that the national decline in abortions during this period was the result of new state abortion restrictions. We also found no evidence that the decline was linked to a drop in the number of abortion providers during this period," says Rachel Jones, lead author of the study. "Rather, the decline in abortions coincided with a steep national drop in overall pregnancy and birth rates. Contraceptive use improved during this period, as more women and couples were using highly effective long-acting reversible contraceptive methods, such as the IUD. Moreover, the recent recession led many women and couples to want to avoid or delay pregnancy and childbearing."
Beginning in 2011, state efforts to restrict abortion have surged, according to Guttmacher research. States enacted 205 abortion restrictions between 2011 and 2013, more than in the entire previous decade combined. "Over the past three years, we have seen an unparalleled attack on abortion rights at the state level, and these new restrictions are making it harder for women to access services and for providers to keep clinic doors open," says Elizabeth Nash, state issues manager at Guttmacher. "As we monitor trends in abortion going forward, it is critical that we also monitor whether these state restrictions are preventing women who need abortion services from accessing them."
While the overall abortion rate continued to decline, the proportion of abortions that were early medication procedures continued to increase. An estimated 239,400 early medication abortions were performed in 2011, representing 23% of all nonhospital abortions, an increase from 17% in 2008. The study estimated that 59% of all known abortion providers offer this service.
"Clearly, the availability of medication abortion does not lead women to have more abortions," says Jones. "However, it has likely helped women obtain abortion care earlier in pregnancy, as evidenced by a shift toward very early abortions."
The study also found that abortion rates dropped in all four U.S. regions and in all but six states during 2008–2011: Declines were steepest in the Midwest (17%) and the West (15%), and less steep yet noteworthy in the South (12%) and Northeast (9%). Notably, the few states in which abortion rates increased had rates lower than the national average to begin with.
This analysis was based on the Guttmacher Institute's 16th census of all known abortion providers in the United States. The study, "Abortion Incidence and Service Availability in the United States, 2011," is available online and will appear in the March 2014 issue of Perspectives on Sexual and Reproductive Health.
Additional materials can be found online:
- Facts on Induced Abortion in the United States — national overview fact sheet
- State Facts About Abortion — state-specific fact sheets
- Data Center — create your own tables, maps and graphs using the most current data available
- An Overview of Abortion in the United States — slide show on the current state of abortion
- Trends in Abortion in the United States, 1973–2008— slide show presenting trends since Roe
- Trends in Abortion by State— slide shows presenting trend data for all 50 states and the District of Columbia
- Abortion in the United States — video on characteristics of U.S. women who have abortions
- Barriers to Abortion Access — infographic on geographic and policy barriers faced by U.S. women who want to access abortion services