The U.S. abortion rate has fallen to a 30-year low, reports the Guttmacher Institute, which records the abortion rate by surveying the known abortion providers in the country. Between 2008 and 2011, the number of abortions fell to 1.1 million a year, a drop of 13 percent. Overall, abortion has been in a long-term decline for most of the time it's been legal. In 1981, 29 women per 1,000 ages 15-44 had an abortion. In 2011, it was only 17 per 1,000.
Anti-choicers should avoid congratulating themselves for the decline, however. As the Guttmacher's press release indicates, this descent happened before the most recent wave of abortion restrictions began closing clinics. Instead, it seems that women are just getting pregnant less often. Over the same period, the birth rate was also in decline, hitting a record low in 2012.
And sorry, Mike Huckabee, it's probably not because women have decided they find sexual intercourse to be debasing. In fact, it's pro-choice activists and groups like Planned Parenthood, with their tireless work at making contraception socially acceptable and affordable, that should take the credit. Contraception use, especially highly effective long-term forms like the IUD, is up. Indeed, contraception has become universal, with 99 percent of sexually active women having used contraception before and 62 percent of women reproductive age using contraception now. Also, it's not that the country is being taken over by the urbane single ladies who haunt conservative nightmares—the Sandra Flukes of the world who delay getting married and love their birth control pills. Married women are more likely to use contraception than never-married women.
More women are also getting very early abortions with medication, with nearly 1 in 4 nonhospital abortions being performed with the abortion pill, up from 17 percent in 2008. Unfortunately, efforts to increase access to medication abortion have been stymied in some states that have passed medically unnecessary laws serving no other purpose but to turn what should be an easy way to get an abortion into a major hassle.
Since 2011, which is where this research ends, a lot has changed in the U.S. In the past year, the ability to prevent unintended pregnancy has improved under the Affordable Care Act through the contraception mandate and the Medicaid expansion, which will help reach low-income women who experience the highest levels of unintended pregnancy. Medically unnecessary but draconian state-level regulations in places like Texas have shut down a lot of clinics—so many that the remaining ones can't handle the overflow of demand. (This almost certainly has to reduce the number of abortions counted, if only because the number of people counting them is going down.)
But that brings us to the question of illegal abortion, which 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. Of course, "out of sight, out of mind" is probably good enough for the anti-choice politicians who have created this problem in the first place.
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