By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Everyone knew that the pandemic, the shutdowns, the anxiety were likely to affect the number of abortions, but the question was how and by how much? Would keeping everyone indoors for months on end lead to more or fewer pregnancies? Would women be more afraid of visiting the clinic or the hospital? Would the idea of giving birth to a child and raising him or her during a pandemic prove an unconquerable fear?
It might be different for everyone and we may never know all the reasons. But it appears that more women aborted their babies in 2020 than they did just three years earlier, jumping 7.9% from Guttmacher’s last survey in 2017. Altogether, based on surveys of abortion providers in every U.S. state and the District of Columbia, Guttmacher says it record just 862,320 in the same survey, the lowest figure it had reported since 1973, the first year after Roe was decided.
The 2017 figure was part of a longer term drop that had been going on for some 27 years, when Guttmacher showed abortions peaking at 1.6 million for 1990. It now appears that the trend has reversed and is, at least for now, heading in the other direction.
Abortions increased in all areas of the country, Guttmacher claims. The increase was largest in the West (12%) and lowest in the Northeast (2%). Guttmacher says abortions rose 10% in the Midwest and 8%in the South.
Abortion rates also showed a reversal in the latest Guttmacher report, going from 13.5 abortions per thousand women of reproductive age (15-44) to 14.4, an increase of 7%.
About one in five pregnancies ended in abortion, Guttmacher says, with the abortion ratio (the number of abortions per 100 pregnancies) increasing from 18.4 abortions to 20.6 abortions .
Guttmacher notes that births dropped by 6% during this period. Taken together with the data from its own survey, Guttmacher says the overall trend shows fewer women getting pregnant between 2017 and 2020, and a greater proportion of those who did choosing abortion.
These new numbers reflect a clear and troubling increase, but assessing the causes is difficult.
COVID and Chemical Abortions
Part of that was surely COVID, though the precise impact of how that affected the dynamic is probably complicated, as everything was with the virus. But another trend revealed by the survey—an increase in the number of “medical” [chemical] abortions that Guttmacher has reported elsewhere was also probably responsible and perhaps even related to the reversal. Earlier this year, Guttmacher revealed that data, likely from the same survey, showed that 54% of all abortions are now “medical,” most of those involving mifepristone, the “abortion pill.”
This increase coincided with a time when the abortion industry was heavily pushing the abortion pill, promoting “self-managed” abortions with pills shipped by mail. Guttmacher shows that a lot of the increase was in 2018 and 2019 while this promotion was going on.
During the pandemic, however, the abortion industry in several states were specifically offering these pills as a way to avoid a trip to the clinic and the contact involved in a surgical abortion. Some of these states were already trying a telemedical version of the protocol being “studied” by Gynuity from 2016 to 2021. When COVID shut down traffic to many abortion clinics, in some states Planned Parenthood was offering to let patients do their screening online and simply drive by and have someone bring pills out to the car.
It wasn’t entirely safe, and it wasn’t the protocol recommended by the Food and Drug Administration (FDA) at the time. But it did offer women scared at the prospect of having a child during a pandemic a way to have an abortion without spending much time in a public space or social situation.
With fear of COVID, if not risk of the virus, on the wane, this may turn out to be less of a motivation for abortion in the years after 2020. But the rise in these chemical abortions is likely to continue since the FDA authorized pharmacy distribution and a telemedical protocol for mifepristone in December of 2021.
So long as women are swayed by false but largely unchallenged assurances of mifepristone’s safety and efficacy, and prescribers are not held accountable for their deaths and injuries, more of these shady online pseudo-medical entrepreneurs will take advantage of the market and exploit these women for an easy, quick buck.
Guttmacher speculates that some of the increase may be due to some states expanding “Medicaid coverage of abortion care” arguing that “this coverage meant that many who would not otherwise have been able to afford an abortion could get care.” It does not identify these states or show how they expanded that care in this report, so this is hard to evaluate.
Guttmacher also asserts that “Local and national abortion funds increased their capacity and helped even more people pay for their abortion.” Again, translating this into direct numbers is difficult, but the role of these private funds in covering the traveling and medical costs that would be faced by aborting women should not be minimized. Just such abortion funds played a major role in shipping women out of state to abortion clinics in neighboring states when Texas’ Heartbeat law went into effect in September of 2021.
Another factor that Guttmacher mentions is the effort of many states to expand the list of qualified abortionists to include nurse practitioners, physician assistants, or certified nurse midwives. Some states have done this explicitly, such as allowing lower level clinicians to perform surgical procedures, but others would have been affected by an FDA decision in 2016 to allow any “certified healthcare provider” to prescribe the abortion pills.
With a shortage of surgically trained abortionists and only limited number of doctors signing up to offer abortion pills, this broadening of authorized prescribers obviously expanded the availability of these deadly pills.
Variations in State Data
Individual state data given by Guttmacher is hard to interpret without further context. Many states showed increases for all three years, not really surprising given the overall result. But some states showed large increases for a year or two but then declines for the other. A couple of states showed big drops or big increases for the full period.
Mississippi was a state which showed increases across the board (+40% from 2017-2020), which Guttmacher attributes to more women deciding to have abortions there at the state’s lone abortion clinic. It neglects to mention that that clinic, up until a federal district court blocked it in March of 2017, had been fighting a law passed by Mississippi in 2012 critics called a “clinic shutdown law” requiring abortionists have admitting privileges at local hospitals for patients experiencing complications.
Some are easier to understand than others. Illinois added five clinics between 2017 and 2020 and added more than 10,000 abortions (+25%). Washington, DC showed a huge jump of 76% in the number of abortion in 2018-2019 after Planned Parenthood opened a giant, glamorous new megaclinic in September of 2016.
According to Guttmacher’s count, Virginia showed a jump in 2020 of 14% after a 4% decline in 2018 and 2019. Notably, in April of 2020, Gov. Ralph Norman signed legislation rolling back previous abortion limits (waiting periods, informed consent, clinic safety) in the commonwealth. Kentucky showed an increase of 28% from 2017 to 2020 after a federal district court struck down a law in 2018 that threatened to close the states only functioning abortion clinic
Maine was one place that saw abortion rise 16% over the three years the survey studied. Guttmacher attributes this to the states allowing state funds to cover abortions and requiring private insurance plans to cover the procedure, which may well have played a role. However they neglect to mention that Maine was one of the states where a state abortion chain – Maine Family Planning – began offering chemical abortions by telemedicine in 2016.
Pro-life laws and policies did have an impact. Missouri, where abortion clinics were mired in dispute with the state over licensure and safety issues, dropped from 4,710 abortions in 2017 to just 170 in 2020. Guttmacher notes that most women in Missouri went out of state for abortion . They don’t specify, but it seems likely that many went to Planned Parenthood megaclinics just across the state border in Overland Park, Kansas or Fairview Heights, Illinois – states which saw 20% and 25% increases over the period of the survey.
Where does this leave us?
Once Guttmacher releases the full data and report, it will be much easier to track and see all the causes and factors. But whatever the full explanation, it is clear that abortion advocates have, with their money, their media control, their political power, and their promotion of chemical abortion been able to sway more women to use their deadly product.
None of this should be surprising to those in the pro-life movement who have seen these trends playing out over the last few years. The abortion movement saw their industry in decline and invested in new clinics, new abortion products and packaging, new advertising and political campaigns.
But we have also seen what works. Thirty years ago, when abortions were at their peak, we began educating the public as to the humanity of the unborn child, and began providing life affirming alternatives for those mothers who felt they had no “choice” other than abortion.
We began passing parental involvement, informed consent, funding limits, laws exposing the horrors of partial birth and dismemberment abortions and the pain that the unborn child feels when abortionists rip their limbs from their sockets.
We set in motion the legislation that today compels the Supreme Court to consider the constitutionality of abortion and the rights of the unborn.
We know that the other side won’t just stop or go quietly. This latest increase is proof of that. But our efforts have borne fruit before, and if we persist in doing good, doing what is right, we can expect those numbers to turn around once again.
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