Long-Term Decline in Abortions Has Stalled; Medication Abortion Becoming More Common
The steady decline in the U.S. abortion rate since 1981 appears to have stalled, new Guttmacher Institute research finds. The 2008 rate stood at 19.6 abortions per 1,000 women aged 15–44, significantly below the 1981 peak (29.3 abortions for every 1,000 women). However, the 2008 abortion rate was virtually unchanged from the 2005 rate (19.4 abortions). Likewise, the total number of abortions in 2008 (1.21 million) was essentially unchanged from 2005.
"In this time of heightened politicization around abortion, our stalled progress should be an urgent message to policymakers that we need to do more to increase access to contraceptive services to prevent unintended pregnancy, while ensuring access to abortion services for the many women who still need them," says Sharon Camp, president and CEO of Guttmacher.
The new study further found an increase in the use of early medication abortion, which uses a combination of two drugs in lieu of surgery: The number of such procedures performed in nonhospital facilities rose from 161,000 to 199,000 between 2005 and 2008, and the proportion of all nonhospital abortions that were early medication procedures increased from 14% to 17%. Early medication abortion has become an integral part of abortion care; 59% of all known abortion providers now offer this service.
"That early medication abortion is becoming more widely available is good news," says Rachel Jones, lead author of the new study. "U.S. government reports have shown that abortions are increasingly occurring earlier in pregnancy, when the procedure is safest. Increased access to medication abortion is helping to accelerate that trend."
According to the new study, the number of abortion providers changed little—from 1,787 to 1,793—between 2005 and 2008. And as before, 87% of U.S. counties had no abortion provider, and 35% of women of reproductive age lived in those counties. There was a disturbing increase in the proportion of large nonhospital providers (those offering 400 abortions or more) reporting antiabortion harassment—from 82% in 2000 to 89% in 2008. Harassment was particularly common among providers of all sizes in the Midwest and South. Picketing was the most common form of harassment (reported by 55% of providers), followed by picketing combined with blocking patient access to facilities (21%).
The survey on which the study is based was the Guttmacher Institute’s 15th census of all known abortion providers in the United States. The study, "Abortion Incidence and Services in the United States, 2008," has been published online and will appear in the March 2010 issue of Perspectives on Sexual and Reproductive Health.
Note on the state-level data: Although the numbers and rates of abortion vary substantially at the state level—both between states and over time—it is important to note that these data are calculated by state of occurrence, not by state of residence. Therefore, they do not distinguish abortions provided to nonresidents of a state, who may account for some of the changes in incidence in neighboring states (for example, the decrease in New Jersey and the parallel increase in Pennsylvania).
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
- Rebecca Wind