By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Over the Thanksgiving holidays, the government released its latest report on abortion in America, confirming a welcomed long term downward trend in the numbers of abortions.
According to the U.S. Centers for Disease Control (CDC), the number of abortions fell 2% from 2015 to 2016, dropping from 638,169 to 623,471. As has been the case for some years now, this number does not include any abortion data from California, the nation’s most populous state, nor any numbers from Maryland, New Hampshire, and for 2016, the District of Columbia. Data from California, New Hampshire, and at least one other state have been missing from every CDC surveillance report since 1998.
The private abortion industry research group, the Guttmacher Institute, does have data from DC and all states and reported 874,100 for 2016. Guttmacher’s number is thought to be more accurate because it surveys abortion clinics directly rather than relying on reports from state health departments like the CDC does.
Though Guttmacher only conducts its surveys every few years, while the CDC reports annually (though taking a couple of years to process data), Guttmacher has reported an estimated figure of 862,320 for 2017, further evidence the drop in the number of abortions is continuing.
The value of the CDC’s figures, despite its deficiencies, is that it has data for every year and reports that data with regularity, giving a good read on abortion’s demographic trends.
The abortion rate and ratio reported by the CDC for 2016 are the lowest it has recorded since the Supreme Court declared abortion on demand legal in the U.S. in 1973.
According to the CDC, there were just 11.6 abortions for every 1,000 women aged 15-44 in U.S.. The abortion rate in 1973 was 14 abortions for every thousand women of reproductive age. It was more than double that – 25 abortions per thousand – in 1980.
With respect to the abortion ratio, the CDC says it found that there were 186 abortions for every thousand live births in 2016 (so that everyone is clear, that would be 186 abortions out of a total of 1,186 abortions and births). The abortion ratio was 196.3 in 1973, the first year Roe was in operation. That ratio reached a peak of 364.1 in 1984.
All these are very encouraging numbers. It is very important to understand that It is not just that there are fewer abortions, but that fewer pregnant women are turning to abortion. It also means that abortion is becoming a less common occurrence in our country.
Type and Timing of Those Abortions
Relying on state reports means that the CDC not only misses data from big states like California, but also means that the data it does receive and report varies from state to state. Some state reports include gestation, method of abortion, racial and demographic details, etc., while others don’t. This means while the overall total reflects abortions reported from 47 states, gestational data may only be available from 40 states (or “reporting areas”) or data on abortion methods from just 43 states or fewer.
Despite the rapid proliferation of chemical abortions, surgical abortions still make up the majority of procedures in the U.S., the CDC reports. About six in ten (59.9%) were surgical abortions performed at 13 weeks gestation or less. Another 8.8% were surgical procedures performed at greater than 13 weeks. This means that more than two-thirds (68.7%) of those abortions in the U.S. (in the 43 reporting areas) in 2016 were surgical.
The CDC no longer separates these out by individual surgical method. But it does say that this includes “aspiration curettage, suction curettage, manual vacuum aspiration, menstrual extraction, sharp curettage, and dilation and evacuation procedures.”
The CDC still reports on the number of hysterotomies (in which both the baby and the uterus are removed) as a separate category, but these were extremely rare. Only New Jersey appears to have reported any by name, with 34, and only 51 are reported for the entire U.S.
The abortions that the CDC classifies as “medical” are typically (but not always) those chemical abortions involving mifepristone (RU-486) and a prostaglandin (some abortions use misoprostol, a prostaglandin, alone, or in combination with another drug, methotrexate).
About a third of the abortions reported to the CDC for 2016 were chemical [“medical”] abortions. Most of them–27.9% of all abortions– were reported at or earlier than 8 weeks gestation. An additional 3.4% were those chemical abortions reported at more than 8 weeks.
The CDC’s chemical abortion accounting is complicated by a decision made by the U.S. Food and Drug Administration (FDA) in 2016. The FDA extended the cut off point for mifepristone abortions from 49 days after a woman’s last menstrual period to 70 days. Some of the abortions recorded by the CDC as after 8 weeks obviously cross the old barrier.
The CDC also reports 129 “intrauterine instillation” abortions, ones in which chemicals like prostaglandins, urea, or saline are introduced into the placenta to stimulate contraction to expel the child from the uterus.
As made clear above, most abortions continue to be performed in the first trimester, with 90.9% being performed at or earlier than 13 weeks gestation. As has increasingly been the case since the advent of chemical abortions, more than a third (37.7% for 2016) of all abortions are done at six weeks gestation or less. Nearly two-thirds (65.3%) are performed at 8 weeks gestation or less.
About 9% of abortions are performed at 13 weeks gestation or more — meaning in the second (or third) trimester. The CDC reported that 7.7% percent of abortions were performed somewhere between 14 and 20 weeks gestation. A little over one percent (1.3%) were at 21 weeks gestation or more.
Details on Demographics
By far, the largest percentage of abortions were those performed on women in their twenties: a total of 58.5% on women 20-29. Of these 30% were performed on women aged 20-24, 28.5% for women 25-29. About a third (28.3%) were to women in their thirties and just a small percentage (3.5%) were to women aged 40 and older.
Those aged 19 and younger were responsible for less than one in ten (9.7%) of all abortions. Two-thirds of those (according to a separate CDC table) were performed on the oldest teenagers–18 or 19. The CDC shows that the portion of abortions going to younger teens has been decreasing in the last ten years along with their rates and ratios, demonstrating the continued impact of parental involvement laws.
Race and Ethnicity
Race and ethnicity are difficult for the CDC to measure precisely. States categorize and report these differently, resulting in data charts with competing sets of numbers.
By one data set from 36 reporting areas, whites accounted for 46.7% of abortions, blacks for 42% and 11.3% from other. On a separate chart, Hispanic abortions (which may include women of white, black, and other races) were reported by the CDC to reflect 17.5% of total U.S. abortions, though another CDC data set put these at 18.8%.
Because all CDC data sets are missing data not only from California, but also, in this case, Florida, which have a significant Hispanic population, it is expected that these percentages may be low. This is especially so if Hispanic abortion rates and ratios in those states are at all comparable with those from states that did report. (CDC reported an abortion rate of 11.3 abortions per thousand women of reproductive age for Hispanic women from 36 reporting areas and a ratio of 151 abortions for every 1,000 live births for that same group in 2016.)
Marital Status, Previous Births and Abortions
As would be expected, the vast majority (85.9%) of abortions were to unmarried women. It has been above 80% every year with the CDC since at least 1994.
One shockingly stubborn statistic is that 59% of aborting women report at least one previous live birth. Nearly a third of women (32.7%) reported having already given birth to two children, or more. The CDC does not tell us whether these previous children were still living with their mothers, but owing to the relative dearth of domestic U.S. infant adoptions, it is expected that many do.
Though for most women in 2016, her abortion was her first, a substantial percentage (43.1%) of women reported having at least one prior abortion. Nearly one in nine (10.9%) reported having two previous abortions and more than one in 13 said she had had three abortions or more.
CDC analysts say that increased contraceptive use among adolescents and “Changing patterns of contraceptive use may have contributed to this decrease in unintended pregnancy.” But it is clearly the case that many women are still using abortion as a means of birth control.
How far have we come?
The number of abortions has been coming down, falling substantially in the past three decades. There were 1.6 million abortions in 1990, meaning that the number has dropped by almost half (using Guttmacher’s higher, more complete totals) by 2016.
Data from the CDC confirm that downward slide. The number of abortions has fallen across the country, particularly dropping among teens, but with rates and ratios falling among nearly all groups.
Still, much higher rates for minorities persist, as do percentages of repeat abortions. Chemical abortions keep rising, and later abortions continue to be performed.
Clearly there is more work to do, and there will be as long as abortions are legal and desperate women seek them out.
But real progress has been made. There is tangible evidence that what we are doing has been working. Not just in the smaller numbers, but in the babies alive today that have been spared the knife or the poison pill of the abortionist.