Guttmacher survey results for 2013 and for 2014 find U.S. abortions drop to well under one million

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

For the first time since 1974, the number of abortions performed in the United States has dropped below one million–926,190 for 2014. Even better news, longer term, is that abortion rates and ratios, which measure the general frequency of abortion and the likelihood that a pregnant woman will abort, are down to levels below what they were in 1973, when Roe v. Wade first made abortion on demand the law of the land.

In “Abortion Incidence and Service Availability In the United States, 2014″ (Perspectives on Sexual and Reproductive Health, March 2017), Guttmacher authors Rachel Jones and Jenna Jerman estimate that there were 926,190 abortions performed in the U.S. in 2014.

Guttmacher also says that there were just 14.6 abortions for every thousand women aged 15-44 as of July 1st of that year (Guttmacher’s abortion rate) and indicates that there were 18.8 abortions for every 100 pregnancies ending in abortion or live births (their abortion ratio).

The U.S. Centers for Disease Control (CDC) has reported similar declines in the number of abortions over the past couple of decades. These latest numbers from Guttmacher are a strong confirmation of a significant and enduring change in abortion practice and opinion in the U.S. [1]

There were 12.5% fewer abortions in 2014 than there were just three years earlier, when there were 1,058,490. The most recent figure of 926,190 represents a drop of 42.4% from the all time peak of 1,608,600 in 1990.

Guttmacher found that abortion rates and ratios fell 13.6% and 11.3%, respectively from their last report (2011). Both figures are way down from their peaks of a 29.3 abortion rate in 1980 and 1981 and an all time high abortion ratio of 30.4 reported for 1983.

Abortion was down in nearly every state and region

States in the South and the West saw the biggest drops (13.7% and 13.6%, respectively), but nearly every region saw decreases of nearly 10% (Midwest states down 9.4%, Northeast states down 11.7%).

In the handful of states that saw modest increases, these may have been statistical anomalies caused by heavy recent promotion of RU-486 chemical abortions or the opening of a new clinic.

Overall, and in the longer term, abortion is down everywhere.

Drop in the number of abortion clinics

Nationwide, there were 49 fewer abortion performing facilities in 2014 than there were in 2011, continuing another long term, significant trend. There were 2,918 abortion “providers” in 1982. That had dropped to 2,042 by 1996.

As of 2014, there were just 1,671. Jones and Jerman indicate that some of those they identified as performing at least one abortion in 2014 may have closed by year’s end.

In this report, like Guttmacher’s last for 2011, the most significant decline was found in larger abortion mills–those responsible for 1,000 to 4,999 abortions a year. There were 329 such facilities in 2011, but just 269 in 2014.

If each of those clinics performed just a thousand abortions a year, rather than the maximum, their elimination alone would make these “providers” responsible for at least 60,000 fewer abortions.

Offered Explanations

One explanation given for the decline in the last several reports is the improved use of contraceptives, particularly to the increased use of LARCs (long acting reversible contraceptives such as the IUD and implants). This time, however, the authors also conceded that “abortion restrictions” may have been a factor.

Given what we mentioned earlier about the diminishing number of abortion “facilities,” it is hardly surprising that the issue of clinic closures was a major concern of the report. Guttmacher ties these to what it calls “TRAP laws” (the abortion industry’s clever acronym for “Targeted Regulation of Abortion Providers”).

They argue these requirements (not specified, but things such as requiring them to have sanitary tools, unexpired drugs, pass safety inspections, etc.) make it more difficult for clinics to stay in business. Guttmacher says, “Abortion incidence can also decline if women who want abortions are unable to obtain them; abortion restrictions have the potential to reduce abortion incidence by impeding access to services.”

In a 1/17/17 press release from Guttmacher, Rachel Jones went further. After citing “improved contraceptive use” as a reason for the decline in unintended pregnancy and thus a “decreased need for abortions,” Jones said “the wave of abortion restrictions passed at the state level over the last five years could also have contributed to the decline by making it more difficult for women to access needed services in highly restrictive states.”

There are a number of assumptions here that deserve some unpacking. There does appear to have been some increase in LARC use because of heavy promotion by the “family planning” lobby and then support from the Obama administration, but this fails to explain how and why the huge fall off in abortions has been going on for 24 years!

Guttmacher, Planned Parenthood, and the abortion lobby have been pushing contraceptives for longer than that, but have only recently been claiming to see any significant increase in usage.

Furthermore, though states have passed many new laws regulating abortion and abortion clinics in the past few years, this has been the case for the past few decades. Some of the recent laws addressed safety and sanitation issues at clinics and dangerous butchers like Kermit Gosnell. But others merely gave mothers a chance to see live ultrasounds of their unborn children, to learn about practical alternatives available in their area, gave parents a voice in their minor child’s decisions, or offered protection to pain-capable unborn children.

If those latter “restrictions” lessened the number of abortions, it was primarily by decreasing the demand for abortion, not by closing clinics directly.

After going on and on about these requirements , Guttmacher finally comes to the conclusion that abortions dropped in both states that did and didn’t have these “TRAP” laws: “In some states, increased abortion restrictions likely contributed to the decline in abortions, but in others, the decline may have been driven by a drop in demand.”

In looking at the internal features of every state, legitimately noting the number of clinics and new laws, Guttmacher may have missed the overall educational impact of these laws, advances in technology, and their impact on the national discussion.

For example, part of the decrease may be fewer women getting pregnant. But one thing that is certain is that fewer women are having abortions.

Chemical abortions continue to increase

While there was plenty of good news in the latest numbers, there would have been even fewer clinics and perhaps even fewer abortions if not for the proliferation of chemical abortions.

Guttmacher says that there were 272,400 “early medication abortions” performed in 2014, about 29.4% of the total. This represented an increase of 13.8% in just the three years since Guttmacher’s last study.

Almost all of these (Guttmacher says 97%) were done with mifepristone (RU-486), typically used in combination with the prostaglandin misoprostol. The remaining 3% were done either with the anti-cancer drug methotrexate, or with misoprostol alone.

Most of the places offering chemical abortions offered surgical abortions as well. However Guttmacher says that “23% of all nonhospital facilities offered only early medication abortions.”

New Jersey was one of the very few states that saw an increase in abortion clinics from 24 in 2011 to 41 in 2014. Most of these were clinics that started offering chemical abortions.

Guttmacher picks up claims advanced by abortion advocates fighting Texas clinic regulations that clinic closures were leading many women to turn to drugs and other means to self-abort. We have refuted this study elsewhere (see here).

Guttmacher doesn’t give actual numbers at this point, but claims that “Overall, 12% of nonhospital facilities had seen at least one patient who had attempted to end her pregnancy on her own in 2014.” Whether this involved the actual ingestion of some dangerous chemical substance or just some concoction of juice and soda rumored (falsely) to have abortifacient effects, is not specified.

Where we go from here

Additional data from this survey will likely be released in the coming months, fleshing out our understanding of the nature and depth of this welcomed decline. That this decline has gone on so long and so deep makes it clear that this is no statistical glitch or aberration and not simply the response to some new medical policy or some recent legislative or judicial happening.

Any of these things may have contributed, but what is now evident, with more than two decades of data pointing in the same direction, is that America more and more is turning away from abortion. Fewer and fewer people believe abortion is simply a morally neutral surgical procedure to remove “tissue.” Old talking points about abortion as an “answer” for unwed pregnancy, or poverty, or collapsing relationships, are no longer convincing.

There are fewer abortions because more and more women just aren’t buying it anymore.

[1] Unlike the Centers for Disease Control (CDC), Guttmacher does not rely on reports from state health departments for its figures, but surveys abortion clinics, hospitals, and private physicians’ offices directly, following up with phone calls if multiple attempts by mail are unsuccessful to contact them. So though it does not survey and publish data every year the way the CDC does, its numbers, when published, are thought more accurate. (This is especially so, given that a few states, including the country’s most populous, California, report no data at all to the CDC and are left off of their count.)