While most of the media coverage of late regarding reproductive rights is touching on this exotic new battle over contraception, American women are increasingly facing a dramatic drop-off in access to safe, legal abortion. The Guttmacher Institute has released its annual report on new abortion restrictions, and the news is not good. While state-level attacks on abortion are fewer in number in 2014 than in the three years before—down to 21 from a high of 80 in 2011—it appears that it's because anti-choicers have learned to work smarter, not harder.
Targeted regulations of abortion providers—nicknamed TRAP laws, which are laws that single out abortion clinics for medical regulations no other clinics that provide similarly low-risk services need to obey—are on trend, and they are much more efficient at wiping out safe abortion access than rules like mandatory ultrasounds or legislation banning insurance coverage of abortion services.
There are two types of TRAP laws that Guttmacher recorded: facility requirements and admitting privilege requirements. The former refers to regulations that insist abortion clinics be outfitted with all these medically unnecessary but expensive building requirements. Forcing clinics to meet ambulatory surgical center standards, even if they only do first-trimester abortions that can be done in a one-minute procedure or with a pill, is a popular one. The other TRAP law sweeping the land is requiring that abortion providers have hospital admitting privileges, even though many hospitals refuse to give them. This regulation has been particularly devastating for rural communities, since there are so few hospitals that are willing to work with these doctors. Guttmacher provided a map to show how dramatic the expansion of TRAP laws has been in the past 14 years.
Fifty-nine percent of women in the country now live in a state that has a TRAP law designed specifically to reduce their access to safe abortion. These laws are incredibly effective. According to the New York Times, Texas has seen the number of clinics offering abortion drop from 44 to 24 since 2011, just with the hospital admitting privileges law. When the requirement that clinics meet ambulatory surgical standards goes into effect in September, there will only be six left.
Of note is the fact that the abortion rate was already declining pretty dramatically prior to the attacks on legal abortion clinics, but in spite of, not because of, anti-choice efforts. The abortion rate actually declined between 2008 and 2011 by a whopping 13 percent, most likely because of improved contraception use. That the attacks on contraception and abortion access happened to kick into high gear just as women were gaining more control over their fertility could be a coincidence, but if so, it's a pretty big one.