The ranks of abortion providers have decreased slightly, by 4 percent, between 2008 and 2011. Most of that change is not about abortion clinics closing. The number of providers working in those stand-alone facilities only declined by 1 percent over the three-year period, meaning most of the decrease came from abortion providers who work in more general practices or in hospitals. The Midwest, notably, was the one region of the country where the number of abortion clinics increased between 2008 and 2011, by 8 percent (most of this is due to a surprisingly high number of abortion clinics opening in Iowa, increasing their ranks from 10 in the state to 17).
Taking all of that together, researchers don’t think it’s the 44 abortion restrictions passed between 2008 and 2011 that have led to the decrease in the abortion rate. Instead, they point a finger at more widespread contraceptive use.
One pro-life group, however, is confident that its message is responsible:
The National Right to Life pushed back on the authors’ reasons for the decline, suggesting that the debate over pro-life legislation had an effect on women’s behavior even before the surge of abortion restrictions (according to Guttmacher, 205 laws passed in the period between 2011 and 2013).
Americans United For Life president Charmaine Yoest says the report doesn’t give a complete picture:
It’s also important to recognize that the abortion data in this country is deeply flawed. There is no standardized reporting to the Centers for Disease Control. And this report from Guttmacher is based on survey data that they collect themselves. Women are often told by abortionists to use emergency rooms if they experience complications — and furthermore to conceal the abortion by claiming it’s a spontaneous miscarriage. This kind of deception from the abortion industry is extremely dangerous to women’s health.
But Marcotte points out that if risky, undocumented abortions are on the rise, the pro-life movement is partially to blame:
[I]llegal abortion… is notoriously hard to document yet seems to be rising in response to the shutdown of abortion clinics in red states. As Lindsay Beyerstein reported in the New Republic, one doctor in the relatively small town of Harlingen, Texas, reports having worked with about 100 patients since November who needed help with incomplete miscarriages, most of whom almost surely self-aborted with an ulcer medication available over the counter in Mexico. Since the medication is pretty effective at aborting a pregnancy entirely without a doctor’s help, the number of women in the area who have resorted to this is likely many times that. An unintended consequence of shutting down abortion clinics is that it’s going to be harder to assess what the actual abortion rate is in the U.S.
Sally Kohn brings up another contributor to lower abortion rates: better sex education:
According to the National Survey of Family Growth, teens who received comprehensive sex education were 50 percent less likely to experience pregnancy than those who received abstinence-only education. And yet conservatives have been pushing abstinence-only education for a generation, prioritized—and funded—by the federal government under President George W. Bush. Why? Out of some puritanical idealism that if you tell teens not to have sex, they won’t—instead of basing policy on the reality that teens will have sex either way, and so better to equip them with information to be safe and healthy.
James Taranto pulls out an old theory, “the Roe effect,” to explain the long-term decline:
We argue that Roe v. Wade had the unanticipated political consequence of elevating the topic of abortion and polarizing public opinion around it and the unanticipated demographic consequence of reducing fertility unevenly and thereby intergenerationally diminishing support for abortion, as well as the proclivity to have abortions. In other words, the women deciding whether to have abortions now are disproportionately the daughters of women who opposed abortion. Of course parents don’t always convince their offspring of their views, but surely they have some influence in the aggregate.
Kilgore wishes pro-life activists would embrace contraceptives:
According to the Guttmacher Institute, as of 2010 5.6 percent of contraception-using women in the U.S. relied on an IUD, representing over two million women. If you are of the point of view that most of these women are actually having hidden abortions, then the abortion rate is actually skyrocketing, notwithstanding the fact that outside the antichoice ranks the idea that preventing the implantation in the uterine wall of a microscopic zygote is an “abortion”—just as bad morally as anything going on in Gosnell’s butcher shops— is considered, well, crazy.
That’s the reason for a lot of the heat around the contraceptive coverage mandate issue, and more generally, why compromises on abortion policy are so difficult. If one group of people thinks making it easier and cheaper to gain access to IUDs is the best way to reduce the need for abortions, and another thinks IUD use threatens a great Holocaust of baby-killing, they are going to have a bit of trouble finding common ground, eh?
Dan Savage also zeroes in on pro-life opposition to contraceptives:
So… the abortion rate is now where it was before abortion was legalized. And if we continue to back contraception—by, say, including contraception coverage in the health insurance policies that people are obligated to purchase under Obamacare—we could conceivably drive the abortion rate down further. To pre-Roe levels. Unfortunately American conservatives and anti-abortion crusaders are waging a war on contraception and access to contraception. Because what they oppose is sex. And female sexuality. It’s women having sex in the absence of potentially dire or life-altering/life-threatening consequences that drives them mad. That’s why they oppose abortion and the one thing that has been proven to bring down the abortion rate: greater access to contraception.
Nora Caplan-Bricker looks ahead:
It’s hard to predict how long this rate of decline will last. As the economy ticks back up, the decline may slow. Then again, the implementation of the Affordable Care Act may depress the rate further still. Patrick Whelan, a member of the pediatric faculty at Harvard, studied the impact of Massachusetts’ universal health care system in an effort to predict Obamacare’s effects, and found that the rate of abortion went down. “My own strong feeling is that giving girls and women access to care plugs them into the system,” Whelan told me. “They have someone reminding them about contraception. It helps them be more attentive to their health.” The ACA, like the Massachusetts law, mandates insurance coverage of contraception.