Better Prevention or Changing Attitudes?

Teenagers aside, contraceptive use may not have increased among American women as a whole. A 2002 CDC study found that older women had actually started forgoing birth control in greater numbers. And, says Gandy, "there definitely are fairly concerted efforts in some areas to discourage the use of birth control or to refuse to provide it in pharmacies."

Lack of Provider Access
Overall, the United States has fewer abortion providers now that it did in the first half of 2001, according to Guttmacher's numbers. Since 2001 the number of providers has dropped by 2 percent. However, that decline appears small compared with previous Guttmacher studies. From 1996 through that first half of 2001, Guttmacher's data shows that the number of abortion providers dropped by 11 percent. And in the four-year period prior to that (1992-1996), there was a 14 percent decline.

But there has been one trend that may be counteracting the drop in traditional abortion providers: a rise in the number of new clinics that offer only "early medication abortion services," or RU486, a medication that terminates a pregnancy (in the first trimester) by blocking the effects of progesterone. Since the drug was introduced in the United States in September 2000, more than 840,000 women have taken it, and the Guttmacher study estimates that it is now used in 14 percent of all abortions (up from 6 percent in 2001). Clinics that offer only RU486—not surgical abortions—are growing in popularity. An increase in such clinics may explain why the overall drop in providers was as little as 2 percent in this report. When the RU486-only clinics are taken out of the equation, the drop in abortion providers since 2000 is in fact a much steeper 8 percent.

One thing is clear, at least: access to abortion is uneven nationwide. "In some states," says NOW's Gandy, "abortion has simply become more difficult to come by." Even Jones, the co-author of the Guttmacher study—who is reluctant to pinpoint a single cause nationwide—says the unevenness factor is playing a crucial role in driving down abortion rates in some parts of America. "Mississippi has a low abortion rate, and there we're pretty sure the drop is due to decreased access," she says. "They had two abortion clinics last time we did this study. Now they have only one." Several other states in the South, where restrictions on abortion are often toughest, showed substantial declines in abortion in the new study, and a surprising number of counties—87 percent—nationwide have no abortion provider at all.

More Babies by Choice
Randall K. O'Bannon, director of education and research for National Right to Life, says more women are choosing to go forward with their pregnancies because they're "better informed" about abortion and more familiar with fetal biology, thanks to technologies such as 4-D ultrasound. "There's been a lot of pro-life education and outreach, and a lot of people out there providing women with positive alternatives to abortion," says O'Bannon. "This data tells you that attitudes have changed."

Not so fast, says Jones, the Guttmacher researcher. Yes, more women are carrying to term, she says, but if that's because they've changed their political views she doesn't know. "We don't have any recent data on that, either," she says. Perhaps that's one thing both sides can agree on: the need for more statistics on pregnancies and abortion.

© 2008