By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
This is hugely important and as we look not only backwards but forward, let’s see what the data tells about why the number of abortions, the abortion rate, and the abortion ratio all declined.
Birth Control, Birth Rates, and the Economy
Let’s tackle one bundle of claims right away – that something, such as an economic recession, triggered a sudden surge in the use of birth control, leading to fewer abortions. This is one of the theories put forward by Guttmacher’s Rachel K. Jones and Jenna Jerman in the just released study.
Let us stipulate up front that anything reducing the population of women becoming pregnant – abstinence, birth control, disease, or just ordinary population shifts – would, all other things being equal, reduce the number of abortions. It is not out of the question that some of that could have been involved here, at least to a certain degree. But there is other data that leads us to believe that this is not the best explanation for the decline, or even the bulk of it. (Contraception is not an NRLC issue and what is offered here is an examination of whether this or some other factors offer the best explanation for what took place between 2008 and 2011.)
At the onset, we should note that the appeal to the economy is somewhat strange. More than a few pro-abortion sources have traditionally argued that poor economic circumstances lead to more, not fewer abortions. The thinking is that pregnant women turn to abortion when the economy turns sour and they determine that they cannot afford to care for the child. This is, in fact, one of the chief reasons women have historically given to Guttmacher and others when asked why they are having abortions.
There was a definite economic downturn during the period under examination, yet what we find are not more, but considerably fewer abortions—1.06 million, a drop of 13% since 2008. Guttmacher suggests that this may have resulted because there were fewer pregnancies overall due to the use of long acting reversible contraceptive (LARC) birth control methods (this would involve things like intra-uterine devices, or transdermal implants like Implanon).
They turn to LARCs because they admit that “little improvement in contraceptive nonuse [an awkward construction that effectively means more rather than less use] among all women at risk of unintended pregnancy has been seen in recent years.” Though they argue that there was a 3% decline in “nonuse” among younger women, it does not appear that this would be sufficient to account for the 13% decline in abortions. Guttmacher appears to pin its explanatory hopes on women switching to LARC methods which do not require immediate or daily management.
This explanation is problematic, at best. While Guttmacher notes that the number of contraceptive users who use the LARC method rose from 2% to 9%, it has this change occurring over a period of seven years (between 2002 to 2009). Though Guttmacher projects that there was some decline in the number of abortions from 2008 to 2009– a drop of about 60,000 women–it claimed that the decline in abortions had largely “stalled” in the years leading up to that.
Guttmacher estimated there were 1,269,000 abortions in 2002, but only about 56,000 fewer in 2008, when there were 1,212,400. This works out to fewer than 9,500 per year. While hugely important because lives were saved, this does not represent the sort of factor that can explain a drop of 150,000 abortions in just three years–unless all the switching to LARCs occurred in that last year, which is highly unlikely.
DECLINE IN BIRTH RATES
There was an overall drop in birthrates in the U.S. between 2008 and 2011 of about 11.2%, and this would likely involve some of the same factors that lead to some of the drop in abortions. But this is the back side of a “birth rate bubble” that occurred between 2002 and now may be evening out.
If there were a close correspondence between birth rates and abortion, one would have expected to see a large increase in abortions between 2002 and 2007. Yet this was the period where Guttmacher saw abortions largely “stall,” though, dropping slightly, and saw abortion rates show a modest decline. It means that pregnancies were more likely during this period, but not abortions.
In other words, whatever other factors are involved, the data tell us that more pregnant women were choosing life. Declining abortion ratios (for Guttmacher, the number of abortions per 100 pregnancies ending in abortion or live birth), seen both before and after 2008, bear this out. Different things may have led to the expansion and shrinkage of the universe of pregnant women from 2002 to 2011, but whatever size that population might have been and whatever the reasons, it was clearly a much more pro-life group at the end of this arc than it was at the beginning, and less likely to abort than any population of pregnant women since 1973.
Shutting Down the Mills
Jones and Jerman tells us that “Abortion incidence [the number of abortions] is inherently affected by service availability” and also tell us that the number of abortionists declined over the study period. But they then say, “[T]he scale of the decline in providers does not appear to account for the considerable drop in abortion incidence nationally.”
The number of abortion “providers” dropped from 1,793 “providers” in 2008 to 1,720 in 2011, a drop of 4%. Though chemical abortion has added a number of new abortionists to the rank since RU486’s approval in 2000 (more on this later in the series), the long term trend for many years has been a shrinkage in the number of abortionists.
There were in fact 1,819 “providers” in 2000 and 2,582 as recently as 1988. The peak was 2,918 in 1982.
The drop does indeed correspond to the declining number of abortions, prompting worries in the industry about “access” ;we see the familiar refrain in this report about “89% of counties” lacking an abortion clinic. But even Guttmacher admits that the closure of clinics, at least in some states, may reflect reduced demand rather than closure due to any particular legal barriers.
A loss of just 73 “providers,” four percent less than what it found in its 2008 report, though, is not enough, according to Jones and Jerman, to account for 13% fewer abortions in 2011.
A closer examination of the data, though, seems to indicate that the closing of these particular “providers” may have had more of an impact than Guttmacher lets on.
Guttmacher’s survey covers all sorts of “providers” – giant abortion mills, “family planning” clinics that do a hefty abortion business, hospitals, as well as private practice physicians that may do a few occasional abortions on the side. Guttmacher sorts these out according to the type of establishment these are and caseloads : Those performing fewer than 30 abortions a year, those doing between 30 and 399 a year, those doing 400 or more and less than a thousand, those performing between a thousand and 4,999 abortions, and those doing 5,000 abortions a year or more.
Here’s some information that may surprise you if you didn’t realize how much consolidation has taken place in the abortion industry. Though those “providers” performing a thousand or more abortions a year made up just 20% of the total number of “providers” in 2011, they performed 78% of the total number of abortions.
When you go further and compare the distributional data from 2011’s “providers” with that from the 2008 survey, you find some very interesting changes.
The numbers of abortions done by “providers” in the lower volume categories was roughly the same for each year : 232,490 abortions done by the “providers” with caseloads under a thousand a year in 2008, 233,060 for abortionists in the same category in 2011.
Where was the huge drop-off in business? In the categories of abortionists doing between a thousand and 4,999 abortions and those doing five thousand or more.
In 2008, 31 “providers” did five thousand or more abortions a year, performing 206,550 abortions as a group. But by 2011, there were just 20 in this category of providers, performing 134,330 abortions.
There were 365 “providers” performing between 1,000 and 4,999 abortions in 2008, but just 329 in this group in 2011. And their total caseloads dropped from 773,320 abortions in 2008 to 691,100 in 2011.
All told, these two groups of “providers”–all the abortionists performing a thousand or more abortions a year–did 154,440 fewer abortions in 2011 than 2008. That would appear to be responsible for virtually all of the drop from 2008 to 2011.
It wasn’t, from anything we can tell, that this group suddenly grew a conscience, nor does not appear, from the available data, that any of these large clinics suddenly slashed its workload to become a medium sized ‘provider.” Instead their ranks thinned, with 47 of these major abortion mills for some reason simply going out of business.
Nothing here tells us why this happened, whether an abortionists simply retired, whether there were financial problems, whether they were bought out and consolidated with another mega-clinic, etc. The stories are probably different for each one.
One of those who may have been on the 2008 list but would have been missing from the one in 2011 was Kermit Gosnell, the “high volume, high profit” late abortionist from Philadelphia whose license was suspended in 2010 and who was convicted last year of murdering babies born alive.
That alone could have impacted some of these statistics. It is interesting to note that in 2011, the year after Gosnell’s license was suspended in nearby Delaware (where he had worked one day a week at a Wilmington area abortion clinic), abortion rates (the number of abortions per 1,000 women of reproductive age) in that state dropped by 22%!
Guttmacher admits that the closure of even a single clinic can have considerable consequences. When just a handful of clinics were temporarily closed in Louisiana in 2010, Guttmacher speculates that the “disruption in services” may have contributed to the 19% decline in abortions seen between 2008 and 2011. Later, Guttmacher speculates that the closure of a single clinic in Kansas and Oklahoma may have been part of the reason for larger than average abortion declines there.
See you Monday for Part Three.
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