By Rob Stein
Washington Post Staff Writer
Thursday, January 17, 2008
The number of abortions performed in the United States dropped to 1.2 million in 2005 -- the lowest level since 1976, according to a new report.
The number of abortions fell at least in part because the proportion of women ending their pregnancies with an abortion dropped 9 percent between 2000 and 2005, hitting the lowest level since 1975, according to a nationwide survey.
At the same time, the long decline in the number of abortion providers appears to be stabilizing, partly a result of the availability of the French abortion pill RU-486, the report found, because some physicians who do not perform surgical abortions provide it to their patients.
The report did not identify reasons for the drop in abortions, but the researchers said it could be caused by a combination of factors.
"It could be more women using contraception and not having as many unintended pregnancies. It could be more restrictions on abortions making it more difficult for women to obtain abortion services. It could be a combination of these and other dynamics," said Rachel K. Jones of the Guttmacher Institute, a reproductive-health research organization, which published the report in the March issue of the journal Perspectives on Sexual and Reproductive Health.
Whatever the reasons, the trend was welcomed by abortion opponents and abortion rights advocates.
"This study shows that prevention works, and that's what we provide in our health centers every day," said Cecile Richard of the Planned Parenthood Federation of America. "At the end of the day, Americans of all stripes believe that we need to do more to prevent unintended pregnancy and make health care affordable and accessible."
Said Randall K. O'Bannon of the National Right to Life Committee: "It's still a massive number, but it's moving in the right direction." He added that at least some of the drop may be the result of changing attitudes.
"Even look at Hollywood," he said, citing the hit movie "Juno," about a pregnant teenager who decides to have her baby. "More and more people are starting to reconsider their positions."
Suzanne T. Poppema of Physicians for Reproductive Choice and Health speculated that wider availability of the morning-after pill also might be playing a role.
"I would like to say that it's at least partially due to increased availability of emergency contraception, which is a really good addition to reproductive health care in this country," she said. The emergency contraceptive known as Plan B, a high dose of standard birth control pills, can prevent pregnancy if taken within 72 hours of unprotected sex.
The report was based on a survey, conducted regularly since the 1970s, of all abortion providers known to the Guttmacher Institute. It is considered one of the most authoritative sources of data on abortions in the United States. The latest survey, of 1,787 providers, was conducted in 2005 and was the first since 2000.
The new data were released less than a week before the 35th anniversary of the Supreme Court's Roe v. Wade decision, which struck down many state restrictions on abortion, triggering a surge in the procedures. Supporters and opponents of the decision are planning numerous events to mark the anniversary, including three days of activities in Washington, involving thousands of antiabortion activists, beginning this weekend.
The total number of abortions among women ages 15 to 44 declined from 1.3 million in 2000 to 1.2 million in 2005, an 8 percent drop that continued a trend that began in 1990, when the number of abortions peaked at more than 1.6 million, the survey found. The last time the number of abortions was that low was 1976, when slightly fewer than 1.2 million abortions were performed.
The abortion rate fell from 21.3 per 1,000 women ages 15 to 44 in 2000 to 19.4 in 2005, a 9 percent decline. That is the lowest since 1974, when the rate was 19.3, and far below the 1981 peak of 29.3.
The abortion rate varies widely around the country, tending to be higher in the Northeast and lower in the South and Midwest. The rate in the District dropped 20 percent but remained higher than that of any state at 54.2. Virginia's rate fell 9 percent, to 16.5, while Maryland's rate rose 8 percent, to 31.5.
The proportion of pregnancies ending in abortion also declined, falling from 24.5 percent in 2000 to 22.4 percent in 2005 -- a 9 percent drop and down from a high of 30.4 in 1983.
The sharp fall came despite a comparatively tiny decline in the number of abortion providers. There were 2 percent fewer providers than in the previous survey, but that drop was much smaller than in prior studies.
Jones attributed the slower decline to the introduction of RU-486, also known as mifepristone. The drug, which was approved in 2000, allows women to terminate their pregnancies without the need for a surgical procedure.
"We found that there were providers who previously didn't offer surgical abortions and are now only providing early medical abortions," Jones said. "If it wasn't for those providers, the number of providers would have declined by far more."
By 2005, 57 percent of abortion providers were offering the drug, accounting for 13 percent of abortions, the report found.
That trend was troubling to O'Bannon, who questioned the safety of the drug.
"It disturbs me that there are clinics that may not have been doing abortions before and are doing them now, and that there are doctors who may not have been doing abortions before but are now," he said.
But advocates said they were encouraged by the increased availability of mifepristone, which they said has been shown to be highly effective and safe.
"One of the objections to the abortion pill was that it was going to cause the abortion rate to go sky-high. But this shows that didn't happen," Poppema said.
Nevertheless, 87 percent of U.S. counties, accounting for 35 percent of women ages 15 to 44, do not have an abortion provider, the report found.