Abortion in the United States

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Abortion availability in the U.S. by fetal gestational age
Abortion laws in the U.S. before Roe

Abortion is legal throughout the United States and its territories, although restrictions and accessibility vary from state to state. Abortion is a controversial and divisive issue in the society, culture and politics of the U.S., and various anti-abortion laws have been in force in each state since at least 1900.

Quotes[edit]

In a brief to the supreme court, the United Nations special rapporteur on the right to health warned that overturning Roe v Wade and banning or criminalizing abortion would be “irreconcilable” with international human rights laws. ~ Jessica Glenza
  • Kawana Ashley, an unwed, pregnant teenager, had reasons for wanting to terminate her pregnancy. Unfortunately for Ashely, she was twenty-five weeks pregnant and could no longer obtain a legal abortion because the fetus was viable. So, on March 27, 1994, she obtained a gun and shot herself across the abdomen in an attempt to terminate her pregnancy. Ashely was rushed to the hospital and survived her self-inflicted gunshot wound. Her fetus, however, had been struck by the bullet and died fifteen days later. Ashley was prosecuted for manslaughter and third-degree murder, but the Florida Supreme Court held that a pregnant woman cannot be charged with these crimes for self-aborting. The court held that, under Florida law, Ashley could self-abort at any time during her pregnancy, even when the fetus was viable.
  • Americans without any religious affiliation registered stronger opposition in the poll than people of specific faiths to abortion restrictions (72 percent) and stronger support than people of specific faiths for government action to shield people who are lesbian, gay, bisexual or transgender from discrimination (83 percent).
  • Evidence abounds that a high proportion of women become pregnant unintentionally, in both developed and developing countries. In the United States and in some Eastern European countries for which data are available, about one-half to three-fifths of all pregnancies are unintended, and a large proportion of these are resolved through abortion.
    • Bankole; et al. (1998). "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries". International Family Planning Perspectives. 24 (3): 117–27, 152. doi:10.2307/3038208. JSTOR 3038208. Archived from the original on 17 January 2006.
  • Contraceptive use does not necessarily provide complete protection against pregnancy; each method can fail, even when it is used perfectly. U.S. data from the late 1980s, for example, show that the estimated first-year failure rate for the pill is 8%, while that for the condom is 15%. (Failure rates for less effective methods, such as periodic abstinence, are even higher—e.g., 26%.).
    • Bankole; et al. (1998). "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries". International Family Planning Perspectives. 24 (3): 117–27, 152. doi:10.2307/3038208. JSTOR 3038208. Archived from the original on 17 January 2006.
  • Results: During 1988-1997, the overall death rate for women obtaining legally induced abortions was 0.7 per 100000 legal induced abortions. The risk of death increased exponentially by 38% for each additional week of gestation. Compared with women whose abortions were performed at or before 8 weeks of gestation, women whose abortions were performed in the second trimester were significantly more likely to die of abortion-related causes. The relative risk (unadjusted) of abortion-related mortality was 14.7 at 13-15 weeks of gestation (95% confidence interval [CI] 6.2, 34.7), 29.5 at 16-20 weeks (95% CI 12.9, 67.4), and 76.6 at or after 21 weeks (95% CI 32.5, 180.8). Up to 87% of deaths in women who chose to terminate their pregnancies after 8 weeks of gestation may have been avoidable if these women had accessed abortion services before 8 weeks of gestation.
    Conclusion: Although primary prevention of unintended pregnancy is optimal, among women who choose to terminate their pregnancies, increased access to surgical and nonsurgical abortion services may increase the proportion of abortions performed at lower-risk, early gestational ages and help further decrease deaths.
  • Upon learning of the negative side effects of Thalidomide Sherri Finkbine decided she wanted to have an abortion rather than risk having a severely deformed fetus. The Finkbines scheduled an abortion at the hospital though her physician warned her that they were in murky legal territory as the state of Arizona only allowed therapeutic abortions at that time and there was no reason to believe that the pregnancy posed a threat to Sherri Finkbine's health.
    Sherri Finkbine contacted a friend at the Arizona Republic to tell her story so that other women who had taken or were taking Thalidomide might be made aware of the legal and ethical obstacles they potentially faced. The reporter promised Sherri Finkbine that her anonymity would be protected but because of her celebrity as a children's show host the newspaper decided to use her name.
    The hospital where Finkbine planned to have the abortion did not want to risk prosecution, and when the district attorney threatened to prosecute the institution and the staff members who participated in the procedure, the hospital cancelled the surgery. The Finkbine's physician requested a court order to proceed with the abortion, arguing that it was therapeutic, but it was denied. Judge Yale McFate ruled to dismiss the physician's request because he felt he couldn't exercise authority in this matter.
    The media coverage of this ordeal made Sherri Finkbine, already a minor celebrity, a major name in the news. The Finkbines began to receive death threats and the FBI had to step in to offer them protection. Bob Finkbine was suspended from his job as a high school teacher and Sherri was fired from her job as the host of "Romper Room".
  • The US Supreme Court has struck down a 2013 Texas abortion law that imposed restrictive regulations on the procedure.
    The law requires doctors who perform abortions to have admitting privileges at nearby hospitals and clinics to maintain hospital-like conditions.
    Republicans contended the law protects women while advocates argued the measure restricts access to abortions.
    The key decision is the first major abortion ruling since 2007.
    Justice Anthony Kennedy sided with the court's liberals in the 5-3 decision, which marked the first time the High Court has limited state abortion legislation in more than 15 years.
  • "By striking down politically motivated restrictions that made it nearly impossible for Texans to exercise their full reproductive rights, the court upheld every woman's right to safe, legal abortion, no matter where she lives," Democratic presumptive nominee Hillary Clinton said in a statement after the ruling.
    But Russell Moore, president of the Ethics & Religious Liberty Commission of the Southern Baptist Convention, said the decision came "at the expense of children, women, and families".
    "Keeping abortion providers accountable should not be a political wedge issue. This ruling is further proof how much more work the pro-life movement has to do in the cause of life and human dignity." he said.
  • This note focuses on the issue of the state's application of the criminal law as a sanction against women who choose to have abortions. History reveals that pre-Roe criminal-abortion law-both by its terms and in its application-expressed an incoherent attitude toward the culpability of these women. While criminal-abortion laws treated the abortionist as a serious felon, sending him to prison for up to twenty years,' the same statutes either did not cover the woman seeking an abortion, or, if the statutes did deem her a criminal, prosecutors and courts refused or neglected to hold her liable criminally. The law instead cast women as victims of the criminal conduct of others and sometimes, paradoxically, of themselves.
  • The bill allows women to get abortions after 24 weeks if their life or health is threatened by the pregnancy in addition to permitting women to have an abortion at any time if the fetus is not viable, according to syracuse.com.
    The law also regulates abortion under public health law, rather than criminal law, and allows licensed nurse practitioners, physician assistants and licensed midwives to conduct abortions, syracuse.com reported.
  • In a statement, Cuomo praised the passage of the legislation, calling it a “giant step forward.”
    “Today we are taking a giant step forward in the hard-fought battle to ensure a woman’s right to make her own decisions about her own personal health, including the ability to access an abortion,” he said.
    “With the signing of this bill, we are sending a clear message that whatever happens in Washington, women in New York will always have the fundamental right to control their own body,” he added.
  • The US abortion rate is at an all-time low.
    While the dip is partially due to more women using more effective, long-term birth control, like IUDs, it's also because there are fewer abortion clinics in the United States than there were a decade ago.
    In 2008, 851 clinics provided abortions across the US. By 2014, the number had dropped to 788, a 7% decrease. And the stats get even slimmer when you look at state-by-state totals. Five states are down to a single abortion clinic.
  • Twenty-five states have enacted Targeted Restrictions on Abortion Providers —or TRAP — laws imposing strict requirements on abortion clinics and providers that the Guttmacher Institute, a reproductive rights research group, says "go beyond what is necessary to ensure patients’ safety." Reproductive rights activists also call them "clinic shutdown laws," because they say the laws are often written with the intent of closing abortion clinics in the state.
  • A TRAP law was at the heart of a major case decided by the Supreme Court in 2015, Whole Woman's Health v. Hellerstedt. The law in question required abortion clinics in Texas to meet strict standards, from the exact size of the examination rooms to admission privileges doctors had to secure for admitting patients to local hospitals.
    In June, SCOTUS ruled in a 5-3 decision that the law "provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions, and constitutes an 'undue burden' on their constitutional right to do so."
    But similar laws are still on the books in half of the states in the country, and can cause clinics to close, forcing women who need abortions to travel farther in order to get the care they need. After Texas' law went into effect in 2013, the number of clinics providing abortions in the state dropped in half, from 41 to 22.
  • Death from illegal abortion was once common in the United States. In the 1940s, more than 1,0000 women died each year of complications from abortion. In 1972, 24 women died of complication of legal abortion and 39 died from known illegal abortions. In 2000, the last year for which complete data are available, there were 11 deaths from legally induced abortion, and no deaths from illegal abortion (abortion induced by a nonprofessional) in the entire United States. The American Medical Associations Council on Scientific affairs has reviewed the impact of legal abortion and attributes the decline in deaths during the country to the introduction of antibiotics to treat sepsis; the widespread use of effective contraception beginning in the 1960s, which reduced the number of unwanted pregnancies; and, more recently, the shift from illegal to legal abortion. The United States has a serious problem with teenage pregnancy. Without legal abortion, there would be almost twice as many teenage births each year.
    • Sacheen Carr-Ellis, Nathalie Kapp; "10. Family Planning". In Berek, Jonathan S. (ed.). "Novak's Gynecology” (14 ed.). (2007) Lippincott Williams & Wilkins. pp.295-296
  • The number of abortion reported each year in the United States-1,313,000 in 2000 according to the Alan Guttmacher Institute-has been decreasing since the 1980s (260). In 2001, the national abortion rate was 16 per1,000 women aged 15 to 44 years. Most women who obtain abortions are unmarried (82% in 2001), and the ratio of abortion to live births s 9 times higher for unmarried women than for married women (261). Use of abortions varies markedly with age. In 2001, 18% of women obtaining abortions were 19 years of age or younger, and 51.3% were 24 years of age or younger. IN 2001, the abortion ratio for women younger than 15 years of age was 744 per 1,000 live births, almost as many abortions as births (Fig. 20.2). The Lowest abortion ratio, 147 per 1,000 live births, is for women aged 30 to 34 years. Legal abortion rates and ratios reached their highest in the early 1980s as they replaced illegal abortions, and both have declined since, especially for the youngest women (Fig. 10.20) (258).
    • Sacheen Carr-Ellis, Nathalie Kapp; "10. Family Planning". In Berek, Jonathan S. (ed.). "Novak's Gynecology" (14 ed.). (2007) Lippincott Williams & Wilkins. p.296
  • In the United States, about 50% of pregnancies are unintended, and about 40% of unintended pregnancies are ended by elective abortion, making it one of the most common surgical procedures done.
  • The mortality and morbidity of women who terminated their pregnancy before the 1973 Supreme Court decision in Roe v Wade are compared with post—Roe v Wade mortality and morbidity. Mortality data before 1973 are from the National Center for Health Statistics; data from 1973 through 1985 are from the Centers for Disease Control and The Alan Guttmacher Institute. Trends in serious abortion-related complications between 1970 and 1990 are based on data from the Joint Program for the Study of Abortion and from the National Abortion Federation. Deaths from illegally induced abortion declined between 1940 and 1972 in part because of the introduction of antibiotics to manage sepsis and the widespread use of effective contraceptives. Deaths from legal abortion declined fivefold between 1973 and 1985 (from 3.3 deaths to 0.4 death per 100 000 procedures), reflecting increased physician education and skills, improvements in medical technology, and, notably, the earlier termination of pregnancy. The risk of death from legal abortion is higher among minority women and women over the age of 35 years, and increases with gestational age. Legal-abortion mortality between 1979 and 1985 was 0.6 death per 100 000 procedures, more than 10 times lower than the 9.1 maternal deaths per 100 000 live births between 1979 and 1986. Serious complications from legal abortion are rare. Most women who have a single abortion with vacuum aspiration experience few if any subsequent problems getting pregnant or having healthy children. Less is known about the effects of multiple abortions on future fecundity. Adverse emotional reactions to abortion are rare; most women experience relief and reduced depression and distress.
  • ABSTRACT: In the United States, more than one half of pregnancies are unintended, with 3 in 10 women having an abortion by age 45 years. In 2008, 1.2 million abortions occurred in the United States, of which 6.2% took place between 13 weeks of gestation and 15 weeks of gestation, and 4.0% took place at 16 weeks of gestation or later. Only 1.3% of abortions are performed at 21 weeks of gestation or later. The proportion of abortions performed in the second trimester, usually defined as between 13 weeks of gestation and 26 weeks of gestation (as calculated from the last menstrual period), has remained stable during the past two decades. The purpose of this document is to provide evidence-based guidelines for the medical and surgical methods of second-trimester termination as well as for the management of associated complications.
  • Abortion is legal in every state in the USA and there are clinics in every state. We do understand that in many states one must travel quite far to find a clinic.
    To find a clinic, you can check National Abortion Federation here or Planned Parenthood here. Clinics listed at these sites may be able to give you a small grant to help pay for your abortion through the Justice Fund. They can also tell you if Medicaid can help cover the cost of abortion in your state. If you need financial help, there are funds throughout the US that may be able to give you a loan or grant for part of the costs. Go to National Network of Abortion Fund to find the fund in your state, or call the National Network of Abortion Funds at 617-267-7161. You can also call the helpline at the National Abortion Federation for referrals and funding. The number is 1-800-772-9100 and the best times to call are between 6 and 11:00 PM EST Mon-Friday, noon-9:00 PM EST on Saturdays, or anytime on Sunday 9 AM -9:00 PM EST.
    If you choose to self-manage your abortion, please see www.abortionpillinfo.org for information about how you might be able to find the medicines. If you have the medicines and have any questions before, during or after using them, we are available at this website to support you. For emotional support, you can also call the All-Options Talkline at 1-888-493-0092 (M-Fri 10-1am, Sa-Su 10-6 EST).
  • Recent findings: In recent years, there has been an alarming rise in the number of antiabortion laws enacted across the United States. In total, various states in the union enacted 334 abortion restrictions from 2011 to July 2016, accounting for 30% of all abortion restrictions since the legalization of abortion in 1973. Data confirm, however, that more liberal abortion laws do not increase the number of abortions, but instead greatly decrease the number of abortion-related deaths. Several countries including Romania, South Africa and Nepal have seen dramatic decreases in maternal mortality after liberalization of abortion laws, without an increase in the total number of abortions. In the United States, abortions are incredibly safe with very low rates of complications and a mortality rate of 0.7 per 100 000 women. With increasing abortion restrictions, maternal mortality in the United States can be expected to rise over the coming years, as has been observed in Texas recently.
    • Conti, Jennifer A.; Brant, Ashley R.; Shumaker, Heather D.; Reeves, Matthew F. (November 2016). "Update on abortion policy". Current Opinion in Obstetrics and Gynecology. 28 (6): 517–521. doi:10.1097/GCO.0000000000000324. PMID 27805969. S2CID 26052790.
  • The use of contraception reduces the probability of having an abortion by 85%. In states which allowed emergency contraceptives without a prescription prior to the FDA's move earlier this year, the abortion rate dropped by over 1/3. Some 70% or 42 million American women today of reproductive age are sexually active and do not want to become pregnant. Only 5% of women aged 15-44 in the U.S. use no contraception during sex and they account for 50% of the nation's abortions.
  • While mental health advocates have had to fight to have mental illness treated on a par with physical illness in the insurance context, parity between physical and mental health has been a central feature of abortion jurisprudence for almost 30 years (TGR, Vol. 1, No. 6, December 1998). Under Roe v. Wade, women have a constitutional right to choose an abortion, but after the fetus reaches viability, states may restrict or even prohibit abortion except when necessary to protect a woman's life or health. Roe's companion case, Doe v. Bolton, clarified that "health" must be broadly defined to include both physical and mental health concerns: "Medical judgment may be exercised in the light of all the factors—physical, emotional, psychological, familial, and the woman's age—relevant to the well-being of the patient. All these factors may relate to health."
    In light of these rulings, any attempt to qualify the health exception—or, more specifically, to exclude mental health—would appear to conflict directly with the current state of constitutional law. The health exception, however, has long been a target of abortion foes, who claim it is so broad as to allow women to obtain "late" abortions for any reason. In fact, a 1996 ad sponsored by the National Conference of Catholic Bishops claims that the health exception can be defined "as just about anything," including a psychological crisis caused when a teenager realizes that she "won't fit into a prom dress" or "hates being 'fat.'"
  • In PLANNED PARENTHOOD OF CENTRAL MISSOURI V. DANFORTH(1) (1976) and COLAUTTI V. FRANKLIN(2) (1979), the Supreme Court made clear that viability is a medical determination, which varies with each pregnancy, and that it is the responsibility of the attending physician to make that determination.
    These principles are embodied in the laws of most states. Forty states have enacted legislation severely limiting abortions after fetal viability. Laws in 32 states limit abortions after viability to cases in which the woman's life at serious risk or her health is endangered, although five of the 32 also permit abortions in cases of fetal defect. Laws in seven states permit abortions after viability only when the woman's life is endangered; California is the only state where laws ban late abortions for any reason.
  • Abortions after fetal viability are extremely rare. Half of the 1.5 million abortions in the U.S. each year take place within the first eight weeks of pregancy; nine in 10 occur within the first 12 weeks. Less than 1 percent are performed after 20 weeks. Some 300-600 abortions -- or up to four one-hundredths of 1 percent -- are performed after 26 weeks.
  • Eight in 10 Americans surveyed consistently say that abortion should be legal in cases of fetal defect. Severe fetal defects often are not diagnosed until late in pregnancy. Amniocentesis, which can be used to diagnose hundreds of these serious fetal conditions, may not produce results until after 20 weeks of gestation. Consequently, locating a physician who will perform the abortion, making travel arrangements, and securing the necessary funds may be a time-consuming process.
    Other tragic circumstances sometimes turn a wanted pregnancy into a potential medical disaster. In some cases, a preexisting medical condition, such as heart or kidney disease, may be so severely exacerbated by pregnancy that the woman's life is threatened. In other cases, a pregnant woman who had thought she was completely healthy may be diagnosed with a serious medical condition such as breast cancer. In these cases, an abortion becomes medically indicated, since continuing the pregnancy would make treatment impossible. In still other cases, pregnancy itself may cause some dangerous conditions, such as preeclampsia -- which do not become severe until late in pregnancy.
    In addition to abortions for medical indications such as these, abortions after viability also are sought by a very small number of women in extremely difficult life situations, such as very young girls who conceal their pregnancies or who may be victims of incest; women who abuse alcohol or other drugs; or women who suffer severe mental or emotional impairments.
  • Though serious infection after induced abortion is rare, infections account for one third of abortion-related deaths in the United States. Most fatal cases of infection after induced medical abortion have involved clostridial species. These reported cases share important clinical features that may guide clinicians to earlier recognition and institution of therapy.
  • At one time before H.B. 2 was passed, Texas had some forty clinics providing abortions throughout the state. About half of those closed after the provision requiring hospital admitting privileges for abortion clinic doctors went into effect, and clinic operators had told the Court that the number would drop to eight or nine clinics if both provisions were upheld and went fully into effect. It is unclear how many, if any, of the closed clinics will now reopen in the wake of the Court’s decision.
  • The Austin boycott is yet one more unconventional tactic used by the pro-life movement in the ongoing debate. For decades, the media have been chronicling the drama unfolding outside of clinics around the nation ranging from routine protest to violence. Pro-choice activists, media pundits, and pro-choice politicians typically discuss these tactics in terms of personal acts of harassment, completely devoid of any political implications. When explaining the magnitude of anti-abortion activity at clinics, pro-choice activists contextualize the debate as a question of women’s rights: the pro-life movement does not believe in a woman’s right to choose. Conversely, pro-life activists see their unconventional activities at clinics as stemming from their belief that abortion is murder and they are simply trying to prevent the wholesale slaughter of innocent children. Both camps draw on simplistic explanatory frames to make sense of the saliency of the abortion issue and breadth of activities occurring at clinics. However, the abortion controversy is anything but simple.
  • The abortion decline between 2008 and 2011 was driven by a steep drop in unintended pregnancy, which in turn is most plausibly explained by more and better contraceptive use.
    * New evidence contradicts arguments by abortion opponents that the 2008–2011 abortion decline resulted from more women carrying unintended pregnancies to term because of state abortion restrictions or because they chose to do so of their own accord.
    * These findings have major implications for the U.S. abortion debate as, among other things, they validate that supporting and expanding women’s access to contraceptive services leads to a lower incidence of abortion.
    • Dreweke, Joerg (March 18, 2016). ["New Clarity for the U.S. Abortion Debate: A Steep Drop in Unintended Pregnancy Is Driving Recent Abotion Declines". Guttmacher Institute. Retrieved January 22, 2021.
  • Who gets abortions in America? The portrait of abortion has changed with society. Today, teenagers are having far fewer abortions. The typical patient is most likely already a mother, poor, unmarried, in her late 20s, has some college education and is very early in pregnancy.
    The politics are complicated. Americans are not as neatly divided on abortion as politicians and activists. Overall, 26 percent of voters hold a different view on abortion than the presidential candidate they supported in 2020, one poll found.
  • If the experience among affiliates of the Planned Parenthood and sales figures from the US manufacturer, Danco Laboratories, LLC, (personal communication, Danco Laboratories, LLC) are indicative, use of medical abortion continues to grow in numbers and as a percentage of first-trimester abortions in the United States. By the end of 2007, about 50% of medically-eligible Planned Parenthood patients up to 56 days of gestation chose medical abortion (representing 26% of all first-trimester abortions), despite the loss of a critical week of eligibility when medical abortion with buccal misoprostol could be provided only through 56 days of gestation. The officially mandated switch from vaginal to buccal misoprostol resulted in no reduction in uptake of the method and no reduction in effectiveness. In February 2008, based on results of a recent clinical trial, Planned Parenthood resumed offering medical abortion from 57 through 63 days of gestation, employing the buccal route.
  • Since 1977 there have been eight murders, 17 attempted murders, 42 bombings, and 186 arsons targeted at abortion clinics and providers across the United States. In some cases, a small group of clinics have been targeted multiple times.
  • About half of American women will face an unplanned pregnancy, according to the nonprofit Guttmacher Institute, and at current rates more than one-third will have an abortion by the time they are 45. Since Roe v. Wade legalized the procedure in 1973, no other issue has so contorted U.S. politics or confounded values. When does life begin? Who should decide? And is there anything that can be agreed on to make the hard choices less painful?
  • In the past 10 years, as public funding for family planning has stalled, unplanned pregnancy rates have jumped 29% among poor women; they are now more than four times as likely to have abortions as richer ones.
  • Despite restricted access, abortion remains one of the most common surgical procedures in the U.S. for women and, according to the Guttmacher Institute, fewer than 0.3% of patients experience a complication serious enough to require hospitalization. First-trimester abortions in particular are considered extremely safe. After years of debate about breast cancer and abortion, the U.S. National Cancer Institute in February 2003 gathered the world's leading experts to review the data and assess the risk. They stated that their conclusion that "induced abortion is not associated with an increase in breast cancer risk was "well established," the institute's highest rating for research findings.
  • In court briefs and reports, defense attorneys, prosecutors, judges, international human rights experts and academics have begun to unpick what a return to illegal abortion might look like in a country with a vast law enforcement apparatus, with the world’s largest incarcerated population, and with women as America’s fastest growing imprisoned demographic.
    “It’s like a thought experiment – to think about what ‘Call Jane’ would look like,” in the modern era, said Cynthia Conti-Cook, a technology fellow with the Ford Foundation. Her work in gender, racial and ethnic justice explores how law enforcement could use the data produced by digital infrastructure – phones, internet browsers, social media – to prosecute people who seek or aid abortions, should Roe v Wade be overturned, and the procedure become illegal in some states once again.
    A single mobile phone could reveal the entire collective, Conti-Cook warned. Just one encounter with law enforcement – a traffic stop, a search, an arrest – could expose the entire network “through digital connections”.
  • Other American historians, such as Leslie J Reagan, the author of When Abortion Was a Crime, have warned of Ceausescu-like regimes where prenatal care becomes about ensuring “all pregnancies are progressing to term”, and authorities monitor menstrual cycles. In Missouri, health department officials have admitted to monitoring periods to identify “failed medical abortions”, part of a bid to close the state’s last abortion clinic.
    In a brief to the supreme court, the United Nations special rapporteur on the right to health warned that overturning Roe v Wade and banning or criminalizing abortion would be “irreconcilable” with international human rights laws. Even so, some states have already instituted bans, such as Texas, which banned the vast majority of abortions.
  • In America, the debate about abortion is often reduced to binary categories. Religious versus secular. Misogynists versus murderers. Even “Christian theocracy” versus, presumably, everyone else.
  • In the 1973 Roe v. Wade decision, the Supreme Court ruled that women, in consultation with their physician, have a constitutionally protected right to have an abortion in the early stages of pregnancy—that is, before viability—free from government interference.
    In 1992, the Court reaffirmed the right to abortion in Planned Parenthood v. Casey. However, the ruling significantly weakened the legal protections previously afforded women and physicians by giving states the right to enact restrictions that do not create an "undue burden" for women seeking abortion.
  • “I’m proud of my town for standing up for what they believe in," Misty Collins says. "That’s on God’s values and that’s what our country is based on.”
    Reproductive rights advocacy group Naral Pro-Choice Texas and the Lilith Fund for Reproductive Equity are the two non-profits responsible for the billboards.
  • Analysis of 2 recent surveys of the attitudes of US women on the morality and legality of abortion and the political implications of those attitudes, and on the characteristics of women who report having had abortions. About 70% of women surveyed believed legal abortion should be available for any woman who wants 1, but only 1/3 believed abortion to be morally justified under all circumstances. Only a minority believed that abortion was wrong under the most commonly given reasons for abortion, and a substantial majority believed it is justified for reasons of health or in cases of rape or incest or a defective fetus. Because there was no single circumstance among the 10 choices which were held to be immoral by a majority of the women, a legal restriction which would not violate the consciences of a majority of women would be difficult to construct. While opponents of abortion are more likely than supporters to support political candidates solely on the abortion issue, supporters so far outnumber opponents that single issue voters are twice as likely to be prochoice than antiabortion. Little differences were found among Catholics and non Catholics in the proportions that support legal abortions, although Catholics were more likely to have moral reservations. Strongest support for legal abortion was found among women who had had abortions, blacks, and from women who attend religious services less than once a month. Majorities in opposition to legal abortions were found in none of the subgroups. Comparison with surveys of abortion providers showed that the truthfulness with which women reported their abortion experience in these polls was greater among younger women: 80% and 60% of women under age 25 reported truthfully, while 32% and 53% of those aged 25-44 underreported abortion experience. Among other findings of the polls: at least 4 million US women now living have had illegal abortions; Catholic and Protestant women are about as likely to obtain an abortion; women who attend religious services regularly are relatively less likely to obtain them; older women of higher socioeconomic status were more likely to have obtained an abortion during the period when they were illegal; the overwhelming majority of women who had abortions believed it to have been right to do so and that they are better off for having done so.
  • Hispanic women are 60 percent more likely than non-Hispanics to have an unintended pregnancy that they terminate by abortion, but they are less likely than nonwhites to do so. Women who profess no religion have a higher abortion rate than do women who report some religious affiliation; among the latter, Catholics are about as likely to obtain an abortion as are all women nationally, while Protestants and Jews are less likely to do so. One in six abortion patients in 1987 described themselves as born-again or Evangelical Christians; such women are half as likely as other American women to obtain abortions. Unmarried cohabiting women are nine times as likely as married women living with their husbands to have an abortion, and separated women are also at high risk. Other characteristics associated with an above-average likelihood of abortion are current school enrollment, current employment, low income, Medicaid coverage, intention to have no more children and residence in a metropolitan county. Half of all abortion patients in 1987 were practicing contraception during the month in which they conceived, and a substantial proportion of those who were not doing so had stopped using a method only a few months before becoming pregnant. The majority of abortion patients who had stopped using a method prior to becoming pregnant said they had most recently used the pill. Nonuse of a method of birth control among abortion patients is greatest for those who are young, poor, black, Hispanic or less educated.
  • Results of a 1994-1995 national survey of 9,985 abortion patients reveal that women who live with a partner outside marriage or have no religious identification are 3.5-4.0 times as likely as women in the general population to have an abortion. Nonwhites, women aged 18-24, Hispanics, separated and never-married women, and those who have an annual income of less than $15,000 or who are enrolled in Medicaid are 1.6-2.2 times as likely to do so; residents of metropolitan counties have a slightly elevated likelihood of abortion. When age is controlled, women who have had a live birth are more likely to have an abortion than are those who have never had children. Catholics are as likely as women in the general population to have an abortion, while Protestants are only 69% as likely and Evangelical or born-again Christians are only 39% as likely. Since 1987, the proportion of abortions obtained by Hispanic women and the abortion rate among Hispanics relative to that for other ethnic groups have increased. The proportion of abortion patients who had been using a contraceptive during the month they became pregnant rose from 51% in 1987 to 58%. Nonuse is most common among women with low education and income, blacks, Hispanics, unemployed women and those who want more children. The proportion of abortion patients whose pregnancy is attributable to condom failure has increased from 15% to 32%, while the proportions reporting the failure of other barrier methods and spermicides have decreased.
  • Roe v. Wade, the 1973 Supreme Court decision that legalized abortion, “gave my profession an almost unlimited license to kill,” Dr. Jefferson testified before Congress in 1981.
    Dr. Jefferson, a surgeon, was speaking in support of a bill, sponsored by Senator Jesse Helms, Republican of North Carolina, and Representative Henry J. Hyde, Republican of Illinois, that sought to declare that human life “shall be deemed to exist from conception.” Had it passed, it would have allowed states to prosecute abortion as murder.
    “With the obstetrician and mother becoming the worst enemy of the child and the pediatrician becoming the assassin for the family,” Dr. Jefferson continued to testify, “the state must be enabled to protect the life of the child, born and unborn.”
  • In a 2003 profile in The American Feminist, an anti-abortion magazine, Dr. Jefferson said, “I am at once a physician, a citizen and a woman, and I am not willing to stand aside and allow this concept of expendable human lives to turn this great land of ours into just another exclusive reservation where only the perfect, the privileged and the planned have the right to live.”
  • Roe v. Wade, the landmark Supreme Court decision that established a woman’s legal right to an abortion, is decided on January 22, 1973. The Court ruled, in a 7-2 decision, that a woman’s right to choose an abortion was protected by the privacy rights guaranteed by the Fourteenth Amendment to the U.S. Constitution. The legal precedent for the decision was rooted in the 1965 case of Griswold v. Connecticut, which established the right to privacy involving medical procedures.
    Despite opponents’ characterization of the decision, it was not the first time that abortion became a legal procedure in the United States. For most of the country’s first 100 years, abortion as we know it today was not a criminal offense.
  • In the 1700s and early 1800s, the word “abortion” referred only to the termination of a pregnancy after “quickening,” the time when the fetus first began to make noticeable movements. The induced ending of a pregnancy before this point did not even have a name–but not because it was uncommon. Women in the 1700s often took drugs to end their unwanted pregnancies.
    In 1827, though, Illinois passed a law that made the use of abortion drugs punishable by up to three years’ imprisonment. Although other states followed the Illinois example, advertising for “Female Monthly Pills,” as they were known, was still common through the middle of the 19th century.
  • Abortion itself only became a serious criminal offense in the period between 1860 and 1880. And the criminalization of abortion did not result from moral outrage. The roots of the new law came from the newly established physicians’ trade organization, the American Medical Association. Doctors decided that abortion practitioners were unwanted competition and went about eliminating that competition. The Catholic Church joined the doctors in condemning the practice.
    By the turn of the century, all states had laws against abortion, but for the most part they were rarely enforced and women with money had no problem terminating pregnancies if they wished. It wasn’t until the late 1930s that abortion laws were enforced. Subsequent crackdowns led to a reform movement that succeeded in lifting abortion restrictions in California and New York even before the Supreme Court decision in Roe v. Wade.
  • Until the late 19th century, abortion was legal in the United States before “quickening,” the point at which a woman could first feel movements of the fetus, typically around the fourth month of pregnancy.
    Some of the early regulations related to abortion were enacted in the 1820s and 1830s and dealt with the sale of dangerous drugs that women used to induce abortions. Despite these regulations and the fact that the drugs sometimes proved fatal to women, they continued to be advertised and sold.
    In the late 1850s, the newly established American Medical Association began calling for the criminalization of abortion, partly in an effort to eliminate doctors’ competitors such as midwives and homeopaths.
    Additionally, some nativists, alarmed by the country’s growing population of immigrants, were anti-abortion because they feared declining birth rates among white, American-born, Protestant women.
    In 1869, the Catholic Church banned abortion at any stage of pregnancy, while in 1873, Congress passed the Comstock law, which made it illegal to distribute contraceptives and abortion-inducing drugs through the U.S. mail. By the 1880s, abortion was outlawed across most of the country.
    • History.com Editors, "Roe v. Wade". HISTORY. (Updated: May 15, 2019 Original: Mar 27, 2018)
  • During the 1960s, during the women’s rights movement, court cases involving contraceptives laid the groundwork for Roe v. Wade.
    In 1965, the U.S. Supreme Court struck down a law banning the distribution of birth control to married couples, ruling that the law violated their implied right to privacy under the U.S. Constitution. And in 1972, the Supreme Court struck down a law prohibiting the distribution of contraceptives to unmarried adults.
    Meanwhile, in 1970, Hawaii became the first state to legalize abortion, although the law only applied to the state’s residents. That same year, New York legalized abortion, with no residency requirement. By the time of Roe v. Wade in 1973, abortion was also legally available in Alaska and Washington.
    • History.com Editors, "Roe v. Wade". HISTORY. (Updated: May 15, 2019 Original: Mar 27, 2018)
  • While American women with the financial means could obtain abortions by traveling to other countries where the procedure was safe and legal, or pay a large fee to a U.S. doctor willing to secretly perform an abortion, those options were out of reach to McCorvey and many other women.
    As a result, some women resorted to illegal, dangerous, “back-alley” abortions or self-induced abortions. In the 1950s and 1960s, the estimated number of illegal abortions in the United States ranged from 200,000 to 1.2 million per year, according to the Guttmacher Institute.
    • History.com Editors, "Roe v. Wade". HISTORY. (Updated: May 15, 2019 Original: Mar 27, 2018)
  • Recent estimates find that approximately 1.29 million abortions were performed in the United States in 2003, a 2% decrease from 1.31 million in 2000. Each year in the United States, 2% of women of reproductive age (15 to 44 years) terminate a pregnancy legally. Given the current rate, it is estimated that over one third of women in the United States will have had an abortion by age 45. The abortion rate in 2000 was about 21.3 per 1,000 women. This rate has decreased from 27.4 abortions per 1,000 women in 1990. While nearly all women in the United States have used some form of contraceptive at some point in their lives and contraceptive use has increased considerably since the legalization of abortion, about half of the 6 million pregnancies occurring each year are reportedly unplanned. Roughly half of these unplanned pregnancies, one in five pregnancies overall, are terminated by induced abortion. Women who opt for abortion tend to be never married, in their 20s, live below the federal poverty level, and are mothers of at least one child. Over half of women who have had an abortion used some form of contraception during the month that they became pregnant. Since legalization in 1973, abortion in the United States has become very sage. Yet, worldwide, 19 of the 46 million abortions performed annually are done so illegally. Illegal abortion remains very unsafe and account for some 68,000 deaths globally each year.
  • The landmark 1973 Supreme Court decision in “Roe v. Wade” effectively legalized abortion in the United States. Since that time, federal and state legislators have proposed or enacted hundreds of pieces of legislation aimed at restricting access to abortion or challenging the Court’s “Roe” decision, making induced abortion the most actively litigated and highly publicized area in medicine.
  • Antiabortion legislation seeks to chip away at access to abortion through a variety of means. The federal so-called “partial-birth abortion” ban of 2003 attempted to abolish certain late-second-trimester abortion procedures, but due to its vague language, it would have further reaching effects; at the time of this writing, a Supreme Court case challenging the ban awaits a decision. A number of states have mandated parental notification or consent before a minor is able to obtain an abortion. In some states, women seeking abortions must undergo a waiting period of at least 24 hours or receive state-sanctioned counseling beforehand; in some cases, this counseling contains ideologically charges or scientifically disputed information that s meant to discourage women from ultimately choosing abortion. A handful of states, most notably South Dakota in 2006, have attempted ot pass bans on almost all abortions with the express purpose of challenging “Roe”.
  • Claiming that abortion can cause breast cancer, social conservatives have pushed for laws across the country that require doctors to provide “counseling” about this alleged risk to all women seeking abortions. As these efforts advanced last year, the Bush Administration distorted the science on this issue to misleadingly portray abortion as a risk factor in breast cancer when there is a scientific consensus that it is not.
    Until the summer of 2002, the National Cancer Institute posted an analysis on its web site concluding that the current body of scientific evidence does not support the claim that abortions increase a woman’s risk of breast cancer. The analysis explained that after some uncertainty before the mid-1990s, this issue had been resolved by several well-designed studies, the largest of which was published in the New England Journal of Medicine in 1997, finding no link between abortion and breast cancer risk.
    In November 2002, however, the Bush Administration removed this analysis and posted new information about abortion and breast cancer on the NCI web site. The new fact sheet stated:
    [T]he possible relationship between abortion and breast cancer has been examined in over thirty published studies since 1957. Some studies have reported statistically significant evidence of an increased risk of breast cancer in women who have had abortions, while others have merely suggested an increased risk. Other studies have found no increase in risk among women who have had an interrupted pregnancy.
    This new fact sheet erroneously suggested that whether abortion caused breast cancer was an open question with studies of equal weight supporting both sides. The New York Times called the NCI’s new statement “an egregious distortion of the evidence.” According to the director of epidemiology research for the American Cancer Society, “This issue has been resolved scientifically . . . . This is essentially a political debate.”
    After members of Congress protested the change, NCI convened a three-day conference of experts on abortion and breast cancer. Participants reviewed all existing population-based, clinical, and animal data available, and concluded that “[i]nduced abortion is not associated with an increase in breast cancer risk,” ranking this conclusion as “well-established.” On March 21, 2003, the NCI web site was updated to reflect this conclusion.
  • [J]ust last year, the US passed at least 106 abortion restrictions, making it the single worst year for reproductive health care access in the country’s history — but one that’s growing. In states like Missouri, lawmakers are pushing the envelope with legislation intended to expand abortion restrictions even outside of the state.
  • The argument for these anti-abortion laws hinges on the belief that a fetus should be considered a functioning human because its heartbeat can be heard on ultrasound (Texas’s SB 8 bill is also referred to as “the heartbeat law” by its proponents). But this claim has been repeatedly debunked by medical professionals, who explain the term “fetal heartbeat” is misleading. Any activity captured in an early gestation ultrasound is “actually electrical activity, and the sound that you ‘hear’ is actually manufactured by the ultrasound machine,” not a human heartbeat.
  • The political weight behind such measures is relatively new: As recently as 1984, data suggests, a person’s political affiliation was not closely tied to their position on abortion. But by 2020, the gap between pro-choice Democrats and anti-abortion Republicans had widened tremendously, reaching a 59 point-difference among “strong partisans, the group most likely to vote in primary elections.”
  • The choice to have an abortion was hers until the opening of the cervix to the uterus, was dilated; after dilation, emptying the uterus became inevitable. In those days, I saw little mind-changing; women had their decision firmly made, usually, and were eager to get on with the abortion. Frequently, they hoped I might do it then and there; women were unaccustomed to being told anything much about what was to be done to us--often the woman’s attitude was, "don't tell me any(more)thing, just get on with it". But we insisted that SHE KNOW; that the abortion was something we were going to be doing together, that this was her decision and she could, should, and must know all about it.
  • We told women: you're a part of this not an object of this; this is an ensemble production. Abortion was to be a matter of informed choice; decision-making is a revolutionary act. And we talked ~ along, giving information, asking and answering questions, a woman at the pregnant woman's shoulders holding her hand or maybe wiping her forehead. Those women who said they didn't want to know what was happening were told why we thought it important to know, why it is important not to detach oneself from one's body or to submit to anyone else, even to someone who is helping, who you have chosen to help, even to us.
  • Most often we aborted pregnancies by dilation and curettage (D&c). By about 1972, the technique of manual vacuum aspiration was available, and we used it, too, frequently for women six weeks pregnant or less, though curettage always completed those abortions. The aspiration was less uncomfortable but then we felt it was not always entirely reliable when used alone. For women 6-12 weeks pregnant, we always did the D&C.
    For women 12-16 weeks pregnant, or beyond, labor was induced, most commonly by breaking the amniotic sac with forceps. Both laminaria and luenbach paste, which separate the placenta from the uterine wall, were available during some of those years, but their presence is clinically detectable while a broken amniotic sac, drained fluid, and a dilated os can all be attributed to natural process. The os dilated, the sac broken, labor induced, the pregnancy comes out.
  • Results: The abortion rate declined 8.0% between 2000 and 2008, from 21.3 abortions per 1,000 women aged 15-44 to 19.6 per 1,000. Decreases in abortion were experienced by most subgroups of women. One notable exception was poor women; this group accounted for 42.4% of abortions in 2008, and their abortion rate increased 17.5% between 2000 and 2008 from 44.4 to 52.2 abortions per 1,000. In addition to poor women, abortion rates were highest for women who were cohabiting (52.0 per 1,000), aged 20-24 (39.9 per 1,000), or non-Hispanic African American (40.2 per 1,000). If the 2008 abortion rate prevails, 30.0% of women will have an abortion by age 45.
    Conclusion: Abortion is becoming increasingly concentrated among poor women, and restrictions on abortion disproportionately affect this population.
  • Although modern induced abortion is one off the safest medical procedures available, it is regulated like no other area of medicine in the USA. The procedure is currently subject to a multitude of federal and state laws and regulations. This situation was not always the case. From the country’s inception up through the first half of the 19th century, abortion prior to “quickening” was legal and largely unregulated in the USA.
  • This paper examines the content of Post Abortion Syndrome (PAS) claims, the social actors involved and how this social diagnosis bypassed professional dissent and diffused into public policy in the United States. Previous works on the spread of PAS focus on almost exclusively on anti-abortion think tanks and policymakers. Missing from these analyses, however, is an emphasis on the grassroots-level actions undertaken by evangelical crisis pregnancy center (CPC) activists in introducing and circulating PAS claims. The CPC movement introduced PAS claims and provided the fodder for anti-abortion think tanks to construct evidence of pro-life claims. Despite dissent from health professionals and academic researchers, CPC PAS claims successfully diffused into federal and state abortion policy. I draw upon Brown et al.’s social diagnosis framework and Armstrong's five-stage model of diagnosis development to frame this account.
  • Much has changed in the twenty-plus years since “Roe”. Although abortion is not illegal it is available in less than 20 percent of the counties in this country. The ban on federal Medicaid funding and the restrictions imposed by many states, including parental consent laws, waiting periods, and mandatory counseling on fetal development, do not make abortion a realistic option for some women and girls. Many of these restrictions stem from the belief that woman are not responsible decision-makers. They follow from ‘Roe”, which codified both the state’s right to regulate abortion and the physician’s responsibility for it. Within the medical profession itself, doctors who perform abortions are stigmatized. To compound these problems of access and attitude, abortion providers are being driven out by the high costs of protecting their clinics, their staffs, and themselves from violent attacks by abortion foes. The situation could hardly be worse for beleaguered clinics.
  • Abortion clinics operate in a siege situation, and that mentality is not conducive to change. But that hostile climate could be used to create a community, a partnership, between clinic staff and the women who seek their services, much as we in Jane were able to use our illegality to build solidarity. An emphasis on health and reproductive education in abortion counseling would give women the tools they need to act responsibly. Training professional staff to respond to each woman as a full person not only benefits women but also makes the practitioners’ work more rewarding and positively affects morale. Substituting responsive care for a reliance on drugs improves health outcomes and women’s emotional recovery. Although we cannot expect provider associations to police their members, they could promote examples of quality care. In major cities, where a variety of abortion services exists, feminists could evaluate these services and make that information available to women.
  • More than 25 years have elapsed since Dr. Bourne, an eminent London obstetrician, was found not guilty after having performed an abortion on a 14-year-old girl who had become pregnant after a particularly brutal rape. In this country no state has specifically legalized an abortion for pregnancy resulting from rape or incest. It is extremely likely, however, that many victims of such crimes have been aborted upon the medical, or more accurately psychiatric, opinion that the operation is necessary to preserve the patient's life. Our society tends to express vigorous condemnation of criminal abortion until confronted with a personally or socially unacceptable pregnancy.
  • A sea change in attitudes toward abortion occurred during the five years before “Roe v Wade”. By 1971 over half the people questioned in opinion polls favored legalizing abortion. Lawyers challenging abortion statutes, who had previously emphasized the effects of unconstitutionally vague language on medical practitioners, began in the early 1970s to argue on behalf of women’s right to decide when to have a child, Organizations that had been working to reform abortion laws changed their goals, strategies, and often their names to reflect the new movement for repeal of all state abortion statutes, and after 1970 state courts began ruling in favor of women’s right to abortion.
  • In 1982, a French pharmaceutical company announced that it had developed a pill that would end a pregnancy if taken within seven weeks of conception. Advocates of reproductive freedom hailed the news, because the pill, known as RU-486, meant that abortions could be induced soon after conception in a doctor's office, without surgery. By the early 1990's, RU-486 was available in France, Britain and Sweden. But protests by antiabortionists were driving its European manufacturers to quit making it, and opponents in the United States helped block its introduction here by threatening to boycott the products of any drug company that sold it. In the face of such intimidation, virtually no American company was willing to supply it in commercial quantities. Since its approval for sale by the Food and Drug Administration last fall, RU-486 has been distributed in the United States by a pharmaceutical company specializing in women's health that gets it from a producer in China.
  • “I don’t think the most damaging issue in this country is poverty, as important as the issue is,” Land said, agreeing that the country needs to work to alleviate poverty and that the government has a measure of responsibility in the effort.
    “Yet not a single day has gone by in the last 32 years that I have not personally grieved and prayed for the 4,000 babies -- disproportionately African American -- who have been aborted,” Land continued. “I believe government has a responsibility to protect life. That includes unborn life. I personally will not rest until they are protected.”
    The most dangerous place an American has been over the past 32 years is his or her mother’s womb, Land said, noting there is a 33 percent chance of a child being killed between conception and birth.
  • Sam Lau, senior director for advocacy media at the Planned Parenthood Action Fund, believes more Americans are recognizing this moment as a crisis for abortion access.
    "I think what we have seen is absolutely an increase in awareness, an increase in urgency, an increase in the need to fight back," he said. "But I still actually think that huge swaths of this population still don't quite believe that the access to abortion and the 50-year precedent that is Roe v. Wade is really hanging in the balance."
  • Chances are, you know someone who has had an abortion. Statistically, it’s a near-certainty: In the U.S., one in three women will have an abortion by the age of 45. But despite how incredibly common abortion is, it remains mired in stigma and misinformation.
  • Even though 23 states currently regulate the provision of ultrasound by abortion providers in some way, viewing an ultrasound doesn’t stop women from having an abortion. Not even close. According to a recent study featured in the Obstetrics and Gynecology Journal, of the 40 percent of women who chose to view their ultrasound, 98.4 percent still went through with their abortion.
  • Under a law that went into effect in July, physicians in South Dakota must tell any woman seeking an abortion that she is terminating the life of “a whole, separate, unique, living human being” with whom she has an “existing relationship,” that her relationship “enjoys protection under the United States Constitution and under the laws of South Dakota,” and that abortion terminates that relationship along with “her existing constitutional rights with regards to that relationship.”
  • The purported increased risks of psychological distress, depression, and suicide that physicians are required to warn women about are not supported by the bulk of the scientific literature. By requiring physicians to deliver such misinformation and discouraging them from providing alternative accurate information, the statute forces physicians to violate their obligation to solicit truly informed consent.
  • PIP: In "Roe," the Supreme Court found that the privacy right in the 14th amendment's view of "personal liberty" encompasses a woman's right to choose an abortion. The Court found that "abortion is a fundamental right." These conclusions are mistaken. The Court's analysis of "the history of abortion regulation" had a lot of errors and did not consider the state of technology in which abortion evolved. Sir Edward Coke, a 16th and 17th century jurist, said that abortion was a "great misprison." Quickening, the point at which a woman feels life, was used to determine fetal viability. State courts, therefore, viewed "abortion after quickening as common law crime." By the end of 1868, 30 to the then 37 states had passed laws restricting abortion. The Supreme Court said that the 19th century laws were passed to guard the mother's health "against the dangers of unsafe operation." In the 15 months before "Roe," 5 state courts said that their abortion laws were constitutional. They said that this was "intended to protect the lives of unborn children." Therefore, the Court's belief that "the state courts focused on the State's interest in protecting "the health of the mother" was unexplainable. The Court said that in many states the woman couldn't "be prosecuted for self-abortion." 17 states did "incriminate the woman's participation in her own abortion," but the Court did not note this. The Court's premise about the greater hazards of late abortions is mistaken. The states were concerned, in the late 19th century, about whether the attempted abortion caused the death of a child. The "right to an abortion" can only be seen as "fundamental" if it is "implicit" in the "ordered liberty" concept or "deeply rooted" in US tradition and history. "Roe" struck down the abortion laws of all 50 states and should be overturned.
  • Existing as a woman in America means watching a parade of state legislators stand up every year and debate bills that restrict your body and therefore how much say you have over the direction of your life. These bills are argued in courts, online, in classrooms and on opinion pages. Our bodies are not simply our bodies. They are the part of the discourse.
  • Compared to other advanced industrialized societies, the contemporary USA is the extreme example of a society inwhich an antiabortion movement arose in response to legalization and ultimately managed to become a leading force in domestic politics.
  • Notwithstanding involvement on the part of Catholic and Protestant clergy and others, physicians were the leading force in the campaign to criminalize abortion in the USA. The American Medical Association (AMA), founded in 1847, argued that abortion was both immoral and dangerous, given the incompetence of many practitioners at that time. According to a number of scholars, the AMA’s drive against abortion formed part of a larger and ultimately successful strategy that sought to put “regular” or university-trained physicians in a position of professional dominance over the wide range of “irregular” clinicians who practiced freely during the first half of the 19th century.
    What followed was a “century of criminalization” characterized by a widespread culture of illegal abortion provision. Thousands of women died or sustained serious injuries at the hands of the infamous “back alley butchers” of that period, and encountering these victims in hospital emergency rooms became a nearly universal experience for US medical residents. However, safe abortions were available to some women, performed by highly skilled laypersons and physicians with successful mainstream practices who were motivated primarily by the desperate situations of their patients. These “physicians of conscience” were instrumental in convincing their medical colleagues of the necessity to decriminalize abortion. By 1970, the AMA reversed its earlier stance and called for the legalization of abortion.
  • Freestanding clinics remain the dominant form of abortion delivery in the USA, while in Europe and Canada, abortions are more evenly spread between clinics and hospitals. Notwithstanding the many benefits of the freestanding clinic model, it also has contributed to the marginalization of abortion services from mainstream medicine in the USA and left clinics more vulnerable to attacks from antiabortion extremists. In contrast, those European countries where abortions are delivered as part of national health care systems have experienced less difficulty in finding providers and far less antiabortion activity at service sites.
  • Liebel and other anti-abortion activists contend that mifepristone is not safe for women to take unsupervised at home and argue that it’s led to many rushing to emergency rooms. But of nearly 4 million women who have taken the drug since 2000, the FDA said, there were reports of 24 associated deaths as of 2018, including two cases of ectopic pregnancy and several cases of severe sepsis. Those deaths, however, could not be causally linked to the drug with certainty because of the patients' use of other drugs or receipt of medical or surgical treatments, or their co-existing medical conditions and information gaps about their health status, the agency said.
  • “Storer himself, for example, believed that abortion was indicated where there was fear of transmitting insanity or epilepsy to the offspring. Thus, “physicians agreed that the embryo’s rights were conditional. What was at the core of their movement, therefore, was a reallocation of social responsibility for assessing the conditional rights of the fetus against the woman’s right to life, both narrowly and broadly defined. From the late nineteenth century until the late 1960s, it was doctors, not women, who held the right to make that assessment.”
    • Luker, Abortion and the Politics of Motherhood, p.35
  • The latest war on abortion is being fought less over women's bodies than over their minds. In the past few years, under the banner of "a woman's right to know," a number of states have passed laws mandating that women seeking abortions be told that going ahead with the procedure would expose them to mental health risks, including post-traumatic stress and a greater danger of suicide.
    Such warnings might sound like a good idea. The decision to terminate a pregnancy can be difficult, and some women end up regretting it. It's commendable to help women make an informed choice. But an informed choice requires accurate information. And these laws mandate that women be misled.
    Rigorous U.S. scientific studies have not substantiated the claim that abortion, compared with its alternatives, causes an increased incidence of mental health problems. The same conclusion was reached in 2008 by an American Psychological Association task force, which I chaired, as well as by an independent team of scholars at Johns Hopkins University. As recently as September, Oregon State University researchers announced the results of a national study showing that teenagers who have an abortion are no more likely to become depressed or to have low self-esteem one year or five years later, compared with their peers who deliver.
    Even so, the claim that abortion harms women's mental health persists. According to research by the Guttmacher Institute, counseling on the negative psychological effects of abortion is mandatory in Mississippi, Nebraska, South Carolina, South Dakota, Texas, Utah and West Virginia. Promoting this claim is part of a political strategy aimed at dissuading women from terminating a pregnancy and at making abortions difficult, if not impossible, to obtain. It is a strategy that distorts scientific principles, even as it uses the umbrella of scientific research to advance its aims.
  • State lawmakers in Nebraska willfully ignored the difference between correlation and causation in April, when they passed a law requiring that health-care providers inform women seeking abortions if they have any characteristics - such as being poor or having low self-esteem - shown to be related to mental health problems following an abortion. If a woman experiences certain difficulties after an abortion, she can file a civil lawsuit against her physician claiming that she wasn't screened adequately for those characteristics. It's an option sure to discourage doctors from offering the procedure, if they aren't already disinclined.
    The law ignores the fact that the very characteristics that predispose women to emotional or mental health problems following an abortion also predispose them to postpartum depression if they deliver or to mental health problems in general, even if they do not become pregnant.
    Following the logic of this purportedly protective law, women wanting to deliver a child should likewise be screened to ascertain that they are not predisposed to poor mental health afterward.
  • More than four decades after Roe v. Wade legalized abortion nationwide, most Americans (57%) are supportive of legal abortion, according to a 2017 Pew Research Center survey. But a substantial minority (40%) says abortion should be illegal in all or most cases, and within some U.S. denominations and religious groups, this figure is much higher.
  • Among those who do identify with a religion, the majority view about abortion among members of a particular group often mirrors that group’s official policy on abortion. This is the case with the Church of Jesus Christ of Latter-day Saints (the Mormon church) and the Southern Baptist Convention – both churches oppose abortion, as do most members of those churches. And the Presbyterian Church (U.S.A.), Unitarian Universalist Association, and Reform and Conservative Judaism, for example, all support abortion rights, in line with most of their adherents.
    There are, however, cases where the views of a church’s members don’t align with its teachings on abortion. For instance, while the Roman Catholic Church is an outspoken critic of abortion, U.S. Catholics were divided on the issue in the 2014 survey, with 48% supportive of legal abortion and 47% opposed.
  • Unitarian Universalists (90%) and American Jews (83%) in the 2014 survey were much more supportive of legal abortion than the general population. And most people who have no religious affiliation – particularly atheists and agnostics (87% each) – also support abortion rights.
  • [L]ittle progress has been made in reducing rates of unintended pregnancy. More than one-third of the 205 million pregnancies that occur annually worldwide are unintended, as are nearly half of all pregnancies in the USA. In contrast to the trend toward liberalization of abortion laws worldwide, women’s reproductive rights in the USA have suffered major setbacks in recent years. The clinic protesters of the 1990s have been joined by pharmacists who refuse to dispense birth control or emergency contraception, the US Supreme Court justice who upheld a federal ban on certain abortion procedures without regard for women’s health, pseudo-scientists who allege that abortion causes long-lasting psychological trauma despite incontrovertible evidence to the contrary, and a conservative White House administration that has left a legacy of hostility to women’s rights that will take many years to undo. Indeed, these countercurrents embody one of the great moral contradictions of our time: that is, while we have simple, safe, and effective technologies to provide women with the means to control their fertility, millions of women across the globe lack access to family planning services and one woman continues to die every 8 minutes from an unsafe abortion.
  • In the early 1960s, abortion was illegal in Arizona, as it was in every state after more than a century of anti-abortion legislation. Arizona, like some other states, provided exceptions in limited circumstances, but abortion was otherwise restricted throughout the United States. However, the 1960s also ushered in a change in the public perception of abortion, a change that was conducive to the Supreme Court’s decisions in Roe v. Wade and Doe v. Bolton to overturn many state and federal restrictions on abortion.
    The women’s movement played a big part in that change, as well as a rubella epidemic that raised widespread concern about fetal deformities and strengthened support for therapeutic abortions. However, if there was one person whose story had the biggest impact, it was a Phoenix-area woman named Sherri Finkbine. An abortion she had 50 years ago Saturday reminds us of the importance of keeping abortion safe and legal.
  • Finkbine had been promised anonymity, but her identity was exposed and her story created a media firestorm. Limited by abortion laws and fearing the publicity, hospitals in the United States denied Finkbine abortion services. She asked the Arizona Superior Court for immunity from prosecution if she obtained an abortion in Arizona. At that time, Arizona law allowed abortions only if the mother’s life was in danger. Judge Yale McFate dismissed Finkbine’s case, arguing that there was no legal controversy and that he didn’t have the authority to make a decision on the matter. Finkbine was finally able to obtain an abortion in Sweden on August 18, 1962. It was confirmed at the time of the abortion that her child would have been severely deformed.
    Highly publicized at the time, Finkbine’s story is seen now as a pivotal moment in the history of abortion laws in the United States. In her book The Pig Farmer’s Daughter and Other Tales of American Justice: Episodes of Racism and Sexism in the Courts from 1865 to the Present, Dr. Mary Frances Berry wrote that Finkbine’s story “helped change public opinion [on abortion]. Fifty-two percent of respondents in a Gallup poll thought she had done the right thing.” Berry adds that by 1965, “most Americans, 77 percent, wanted abortion legalized ‘where the health of the mother is in danger'”; in that same year, The New York Times called for reform of abortion laws.
    Dr. Lee Epstein, a professor of law and political science at the University of Southern California, wrote that “Finkbine’s situation evoked sympathetic reactions from various organizations and in essence, led to the creation of an American abortion reform movement.”
  • “Mifepristone is the only medication that they require you to receive in the clinic, but then you can self administer it at home. That doesn't make any medical sense,” she said of the FDA requirements under review. “If it is safe for you to take it home, it should also be safe for you to receive it at home and then consume it at home.”
  • Most Americans see abortion as morally wrong, yet most also want it to be legal some of the time. And that’s because Americans see what these women’s lives don’t show — that there are imaginable occasions when a pregnancy is not, in fact, a blessing. And that we might serve the world equally well by supporting policies that care for the children who live here already.
  • It should be obvious why, if the Supreme Court had upheld the law at issue in Whole Woman’s Health, that could have been the death knell for abortion rights. If states can enact regulations whose sole purpose is to drive up the cost of performing abortions, they eventually would be able to drive all abortion clinics out of business. Perhaps Texas might have required all abortion clinics to be built out of solid gold.
    And yet, even in a world of 24-karat surgical centers, the Supreme Court could have claimed that Roe and Casey remain good law. States still would be forbidden from writing a law that states explicitly that “no one may perform an abortion.” But those states would still be free to ban abortion as long as they were sufficiently dishonest about what they were up to.
  • Ever since Roe, the Court has held that the state may impose stricter restrictions on abortions later in pregnancy than it can early in the fetus’s development. Roe divided pregnancy up into trimesters, permitting greater regulation of abortion in the latter two-thirds of the pregnancy. Casey abandoned this framework to focus on “viability,” giving the government broader authority over abortion once a fetus can survive outside of the womb.
    If the Court permits states to impose the same kind of restrictions on pre-viability abortions that those states may currently impose on post-viability abortions, that would severely hobble abortion rights and allow states to forbid most abortions — even if the Court does not explicitly overrule Roe or Casey.
  • The rate declined to 16.9 abortions per 1,000 women between the ages of 15 and 44 in 2011, the latest year studied, which was well below the 1981 peak of 29.3 per 1,000 and the lowest since 1973 when the rate was 16.3 per 1,000, the study from Guttmacher Institute showed.
    “With abortion rates falling in almost all states, our study did not find evidence that the national decline in abortions during this period was the result of new state abortion restrictions. We also found no evidence that the decline was linked to a drop in the number of abortion providers during this period,” says Rachel Jones, lead author of the study.
    The decline in abortions coincided with a drop in overall pregnancy and birth rates, and contraceptive use and methods improved during the period, Jones said.
  • The study also found that the total number of abortion providers declined by only 4 percent between 2008 and 2011, and the number of clinics, which provide the large majority of abortion services, declined by just 1 percent.
    While the overall abortion rate declined, the proportion of abortions that were early medication procedures continued to increase, according to the study.
    An estimated 239,400 early medication abortions were performed in 2011, representing 23 percent of all nonhospital abortions, an increase from 17 percent in 2008. The study estimated that 59 percent of all known abortion providers offer this service.
  • As the 40th anniversary of the Roe v. Wade Supreme Court decision takes place on Tuesday, a majority of Americans – for the first time – believe abortion should be legal in all or most cases, according to a new NBC News/Wall Street Journal poll.
    What’s more, seven in 10 respondents oppose Roe v. Wade being overturned, which is the highest percentage on this question since 1989.
    “These are profound changes,” says Republican pollster Bill McInturff, who conducted this survey with Democratic pollster Peter D. Hart and his colleagues.
    McInturff adds that the abortion-related events and rhetoric over the past year – which included controversial remarks on abortion and rape by two Republican Senate candidates, as well as a highly charged debate over contraception – helped shaped these changing poll numbers.
    “The dialogue we have had in the last year has contributed … to inform and shift attitudes.”
  • According to the poll, 54 percent of adults say that abortion should be legal either always or most of the time, while a combined 44 percent said it should be illegal – either with or without exceptions.
    That’s the first time since this poll question was first asked in 2003 that a majority maintained that abortion should be legal. Previously (with just one exception in 2008), majorities said abortion should be illegal.
    In addition, a whopping 70 percent of Americans oppose the Roe v. Wade decision being overturned, including 57 percent who feel strongly about this.
    That’s up from the 58 percent who said the decision shouldn’t be overturned in 1989; the 60 percent who said this in 2002; and the 66 percent who said this in 2005.
    By comparison, just 24 percent now want the Roe v. Wade decision overturned, including 21 percent who feel strongly about this position.
    Much of this change, the NBC/WSJ pollsters say, is coming from African Americans, Latinos and women without college degrees -- all of whom increasingly oppose the Supreme Court decision being overturned.
  • Freestanding clinics remain the dominant form of abortion delivery in the United States, whereas in Europe and Canada abortions are more evenly apportioned between clinics and hospitals. Notwithstanding the many benefits of the freestanding clinic system in the United States, it has contributed to the marginalization of abortion services from the rest of the medical establishment and has been vulnerable to attacks from anti-abortion extremists.8 In contrast, in European countries where abortions are delivered as part of national health care systems, there has been less difficulty finding abortion providers and far less anti-abortion activity at sites of abortion provision.
  • Members of the National Abortion Federation (NAF) reported an escalation of hostility and targeted activity in 2017. With anti-abortion extremists feeling emboldened by the current political environment, trespassing more than tripled, death threats/threats of harm nearly doubled, and incidents of obstruction rose from 580 in 2016 to more than 1,700 in 2017. We also continued to see an increase in targeted hate mail/harassing phone calls, and clinic invasions, and had the first attempted bombing in many years.
    There were again no acts of extreme violence, with no murders or attempted murders. While we recorded a decrease in burglary, vandalism and general online hate speech, we also recorded a significant increase in activities aimed at disrupting services, intimidating providers and patients, and preventing women from obtaining the health care they need.
  • NAF has been tracking incidents of violence and disruption against abortion providers since 1977. Our comprehensive violence and disruption statistics are an invaluable resource that enables us to detect patterns and trends in anti-abortion criminal activities and report incidents to law enforcement. NAF members submit monthly reports on the violence and disruption they experience.
  • Much of the academic literature that analyzes U.S. state-level restrictions on abortion focuses on parental involvement laws and the extent to which abortion is publicly funded through Medicaid. However, one shortcoming common to all of these studies is that they fail to analyze informed consent laws and other types of anti-abortion legislation that received constitutional protection through the U.S. Supreme Court's decision in Planned Parenthood of Southeastern Pennsylvania v. Casey (1992). In this study, a series of regressions on a comprehensive time series cross-sectional data set provides evidence that several types of state-level anti-abortion legislation result in statistically significant declines in both the abortion rate and the abortion ratio. Furthermore, a series of natural experiments provide further evidence that abortion restrictions are correlated with reductions in the incidence of abortion.
  • In the present day too, as a consequence of a Supreme Court decision, crusades for and against abortion have reached passionate intensity. Forces of total good are arrayed against total evil, the sure sign of a dogma encased in the struggle for absolute power. On both sides what once existed in the shadows of convention and ordinary adjustment is now bathed in the pitiless glare of the apocalyptic.
  • Regardless of their views about the legality of abortion, most Americans think that having an abortion is a moral issue. By contrast, the public is much less likely to see other issues involving human embryos – such as stem cell research or in vitro fertilization – as a matter of morality.
    Asked whether abortion is morally acceptable, morally wrong or not a moral issue, only about a quarter of U.S. adults (23%) say they personally do not consider having an abortion to be a moral issue, according to a survey by the Pew Research Center. Twice as many Americans (46%) say this about using in vitro fertilization. Asked about the morality of medical research that uses embryonic stem cells, more than a third of U.S. adults (36%) say they do not consider such research to be a moral issue. Roughly four-in-ten (42%) say the same about stem cell research that does not involve human embryos.
    The percentage of U.S. adults who consider abortion to be morally wrong (49%) far exceeds the percentage who express this view about in vitro fertilization (12%), non-embryonic stem cell research (16%) or embryonic stem cell research (22%).
    Only 15% of the public thinks that having an abortion is morally acceptable. By comparison, about a third of U.S. adults say they personally view IVF and both forms of stem cell research as morally acceptable practices.
  • There are sizable differences in opinions about the moral acceptability of abortion by partisanship, political ideology and education, but few differences when it comes to gender and age.
    About two-thirds of Republicans and independents who lean toward the Republican Party consider having an abortion morally wrong (64%), compared with 38% of Democrats and Democratic-leaning independents. Similarly, conservatives (67%) are more inclined than either self-described moderates (40%) or liberals (31%) to view having an abortion as morally wrong.
    Those with fewer years of formal schooling also are more inclined to consider abortion morally wrong. A majority of those with a high school degree or less education (58%) say they personally believe having an abortion is morally wrong. This compares with 47% among those with some college education and 39% among those with at least a college degree.
  • In Texas, the medically unnecessary mandates on admitting privileges and building requirements have been eliminated. That means the abortion providers left standing after Texas’ anti-abortion law passed (about half of the approximately 40 providers that existed beforehand) were allowed stay open. The decision also made it possible for some of the health centers that Texas's HB2 shuttered to reopen. Overall, it was a win for abortion access in Texas.
    Beyond Texas, efforts to enforce similar abortion restrictions in three other states —Alabama, Mississippi, and Wisconsin— were thwarted less than 24 hours after the ruling.
    The Whole Woman’s Health v. Hellerstedt ruling set a precedent that, at the time, was expected to strengthen constitutional protections for abortion access in the long-term.
  • The decision in Whole Woman's Health was a huge triumph for abortion access. However, the Texas law that the Supreme Court struck down in 2016 was nearly identical to a law at the center of a 2020 Louisiana case, which threatened to flout that precedent. Fortunately, on June 29, 2020 — in June Medical Services v. Russo — the Supreme Court struck down Louisiana's medically unnecessary law that would have made abortion virtually inaccessible in the state. It was another win for abortion access, but the fight isn't over.
    But right now, in states across the country, far too many people still face insurmountable barriers to safe, legal health care. A person’s right to make their own decisions about abortion shouldn’t depend on who they are or where they live. It’s time to pass state laws to protect the constitutional right to abortion, and repeal ones that block it.
  • In the United States, more than one half of pregnancies are unintended, with 3 in 10 women having an abortion by age 45 years. In 2008, 1.2 million abortions occurred in the United States, of which 6.2% took place between 13 weeks of gestation and 15 weeks of gestation, and 4.0% took place at 16 weeks of gestation or later. Only 1.3% of abortions are performed at 21 weeks of gestation or later. The proportion of abortions performed in the second trimester, usually defined as between 13 weeks of gestation and 26 weeks of gestation (as calculated from the last menstrual period), has remained stable during the past two decades.
  • Second-trimester abortion is an important component of comprehensive women’s health care, and women seek termination later in pregnancy for a variety of medical and social reasons. Circumstances that can lead to second-trimester abortion include delays in suspecting and testing for pregnancy, delay in obtaining insurance or other funding, and delay in obtaining referral, as well as difficulties in locating and traveling to a provider. Poverty, lower education level, and having multiple disruptive life events, have been associated with higher rates of seeking second-trimester abortion. In addition, major anatomic or genetic anomalies may be detected in the fetus in the second trimester and women may choose to terminate their pregnancies (47-95%). The identification of major anatomic or genetic anomalies in the fetus through screening and diagnostic testing most commonly occurs in the second trimester, although first-trimester screening and chorionic villus sampling can enable first-trimester diagnosis of aneuploidy. Some obstetric and medical indications for second-trimester termination include preeclampsia and preterm premature rupture of membranes, among other conditions. Additional indications for uterine evacuation in the second trimester are pregnancy failure before 20 weeks of gestation and fetal demise. In 2005, the U.S. fetal mortality rate was 6.22 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, and this rate was higher for teenagers; women aged 35 years and older; and among non-Hispanic black, Hispanic, and American Indian or Alaska Native women.
  • In 1974 and 1975 the Senate Judiciary Committee held hearings on two variants of a proposal called the Human Life Amendment to the Constitution designed to effect reversal of the Supreme Court’s decision on abortion. Prolife forces, the advocates of the Human Life Amendment, were unable to secure more than a committee hearing from the Senate and not even that from the House of Representatives. Undeterred, they turned their attention to the prospective presidential candidates as the 1976 campaign drew near.
    Jimmy Carter, former governor of Georgia, shed the status of a dark horse regional candidate by virtue of his showing the Iowa primary in which he succeeded in identifying himself with the pro-life cause. Thereafter he had to exercise considerable ingenuity obscuring his position on the Human Life Amendment, a proposal he could not endorse without forfeiting the hope of nomination by a Democratic National Convention. In an editorial the Jesuit weekly ‘’America’’ accused Cater of “indifference” to the issue of abortion manifested by a “response . . . [that] has shifted constantly from the Iowa primary through the platform hearings to the post-convention maneuverings (America 1976, 42). Such criticism led Carter, complaining that he was “in trouble with the Catholics,” to seek advice from the president of the University of Notre Dame, Theodore Hesburgh, who urged him to sidestep the question by pointing out that the Constitution gave the president no part in the process of amending the constitution (Hesburgh 1990, 271-72).
  • “I think Alabama has gone too far," Robertson said Wednesday on his long-running TV program, "The 700 Club," referring to the hefty prison sentence for anyone who performs an abortion -- 99 years or life behind bars.
    The bill, awaiting a signature by Republican Gov. Kay Ivey, is further reigniting a debate over Roe v. Wade, the 1973 Supreme Court decision that legalized abortion across the nation, and it could have justices rethinking that landmark ruling, but Robertson has his doubts about putting forth this case as a test case.
    "It’s an extreme law, and they want to challenge Roe vs. Wade, but my humble view is that this is not the case we want to bring to the Supreme Court because I think this one will lose," he said.
  • State Rep. Terri Collins, a Republican, who sponsored the bill, told The Washington Post that although she has sympathy for survivors and agrees “that rape and incest could be an exception in state law,” she has purposefully crafted the bill with a hard-line stance on abortion in hopes that it will make its way to the Supreme Court.
    “What I’m trying to do here is get this case in front of the Supreme Court so Roe v. Wade can be overturned,” she said.
  • Voters remain as divided as ever on the issue of abortion.
    A new Rasmussen Reports telephone survey finds that 50% of Likely U.S. Voters consider themselves pro-choice, while 40% say they are pro-life, the same split found over three years ago.
    However, that does not mean half of U.S. voters are abortion advocates. Fifty-three percent (53%) of voters consider abortion morally wrong most of the time, while just 32% say it is morally acceptable most of the time. Fifteen percent (15%) are undecided.
    A closer look finds that; 22% of pro-choice voters agree with 91% of pro-lifers that abortion is morally wrong most of the time, and another 24% of those who are pro-choice are undecided. But most pro-choice voters (54%) say abortion is morally acceptable most of the time.
  • With Texas and Wisconsin the latest states to attempt limits on abortion, fewer voters than ever are calling themselves pro-choice, and the gap between pro-choice and pro-life voters is the narrowest yet.
    A new Rasmussen Reports national telephone survey finds that 46% of Likely U.S. Voters now consider themselves pro-choice, the lowest finding in three years of regular surveying. Forty-three percent (43%) say they are pro-life, matching the highest finding to date. Eleven percent (11%) are undecided.
  • Results: The abortion-related mortality rate in 2000-2009 in the United States was 0.7 per 100,000 abortions. Studies in approximately the same years found mortality rates of 0.8-1.7 deaths per 100,000 plastic surgery procedures, 0-1.7deaths per 100,000 dental procedures, 0.6-1.2 deaths per 100,000 marathons run and at least 4 deaths among 100,000 cyclists in a large annual bicycling event. The traffic fatality rate per 758 vehicle miles traveled by passenger cars in the United States in 2007-2011 was about equal to the abortion-related mortality rate.
    Conclusions: The safety of induced abortion as practiced in the United States for the past decade met or exceeded expectations for outpatient surgical procedures and compared favorably to that of two common nonmedical voluntary activities. The new legislation restricting abortion is unnecessary; indeed, by reducing the geographic distribution of abortion providers and requiring women to travel farther for the procedure, these laws are potentially detrimental to women's health.
  • Results: The pregnancy-associated mortality rate among women who delivered live neonates was 8.8 deaths per 100,000 live births. The mortality rate related to induced abortion was 0.6 deaths per 100,000 abortions. In the one recent comparative study of pregnancy morbidity in the United States, pregnancy-related complications were more common with childbirth than with abortion.
    Conclusion: Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion.
  • The recent surge of new legislation regulating induced abortion in the United States is ostensibly motivated by the desire to protect women's health. To provide context for interpreting the risk of abortion, we compared abortion-related mortality to mortality associated with other outpatient surgical procedures and selected nonmedical activities.
  • Results
    The abortion-related mortality rate in 2000–2009 in the United States was 0.7 per 100,000 abortions. Studies in approximately the same years found mortality rates of 0.8–1.7 deaths per 100,000 plastic surgery procedures, 0–1.7deaths per 100,000 dental procedures, 0.6–1.2 deaths per 100,000 marathons run and at least 4 deaths among 100,000 cyclists in a large annual bicycling event. The traffic fatality rate per 758 vehicle miles traveled by passenger cars in the United States in 2007–2011 was about equal to the abortion-related mortality rate.
    Conclusions
    The safety of induced abortion as practiced in the United States for the past decade met or exceeded expectations for outpatient surgical procedures and compared favorably to that of two common nonmedical voluntary activities. The new legislation restricting abortion is unnecessary; indeed, by reducing the geographic distribution of abortion providers and requiring women to travel farther for the procedure, these laws are potentially detrimental to women's health.
  • 1994-5: The Roper Center for Public Opinion Research: Researchers S.K. Henshaw & K. Kost used a different measurement of abortion data: the "abortion index." For a given group, an abortion index of 1.0 indicates that women in the group have an per-capita number of abortions equal to the U.S. average; a value of 2.0 indicates that they are twice as likely to have an abortion.
    They sampled women at a group of abortion clinics and determined that the abortion index by religion was for:
    *Protestants: 0.69;
    *Followers of a religion other than Judaism and Christianity: 0.78;
    *Roman Catholics: 1.01;
    *Jews: 1.08;
    * Women who do not follow an organized religion: 4.02.
    The researchers found that only 18.0% of abortion patients identified themsleves as "Born-again/Evangelicals," This compares to 46% of the general population. Also, 82% of abortion patients identified as other than "Born-again/Evangelicals" compared with 54% of all Americans. Born-again/Evangelicals are thus very much under-represented among those seeking an abortion.
  • Interpreting abortion data relating to religion:
    These data need to be interpreted carefully. The abortion index is influenced by many variables, including:
    The percentage of women in the religious group who are sexually active.
    The percentage of sexually active women who do not use an effective contraceptive method.
    The frequency of their sexual activity.
    The type of sexual activity -- whether it is liable to result in pregnancy.
    The percentage of pregnant women who wish to terminate the pregnancy.
    The percentage of pregnant women who choose to have an abortion.
    Truthfullness: These data show what the women say, not necessarily what they do or are. For example, twice as many adults "say" that they go to religious services regularly than actually do go.
    For example, the average Roman Catholic teenager might be less likely to have access to accurate and comprehensive birth control information. All other factors being equal, this would increase the index for Roman Catholics. Similarly, conservative Protestant denominations (fundamentalist and other evangelicals) composed largely of born-again members, are very actively involved in reducing abortion access in the U.S. Their members might be too ashamed or embarrased to admit that they belong to these groups,
  • A diversity of views exists within the U.S. and Canada concerning abortion access. Many pro-life and pro-choice groups have been organized with opposing goals. Surprisingly, they agree on a few very important points.
    *They both want to see the abortion rate decline.
    * In those cases where they feel that an abortion is acceptable, they are both concerned that it present a minimal health risk to the woman.
    * Once human personhood is attained by the embryo or fetus, both pro-life and pro-choice supporters are concerned that his/her life be preserved, except in very unusual circumstances.
    Unfortunately, the two sides cannot agree on when personhood is attained. Most pro-life groups believe it happens at conception and are thus generally opposed to all elective abortions. Pro-choice groups typically believe that it happens later in gestation or at birth, and are thus generally supportive to a woman’s access to affordable, safe, elective abortions.
    • Religious Tolerance, [www.religioustolerance.org/abo_hist1.htm "Current beliefs by various religious and secular groups"]
  • Since there appears to be no possibility of compromise on abortion access, the conflict among pro-life, anti-abortion, and pro-choice groups in the U.S. will probably continue into the foreseeable future. This will inspire anti-abortion radicals to continue attacks on people and facilities.
  • In the United States, legislation regarding abortion has varied with the times. Before 1800, no statutes addressed the subject of abortion. The first antiabortion legislation appeared in the 1820s; the preservation of pregnant women's health was the motivating force. During this time, the mortality rate from abortion was high, while the mortality rate from childbirth was less than 3%. By 1900, abortion in the United States at any time during pregnancy was a crime, with the exception of therapeutic abortion performed to save the mother's life.
    During the 1950s, the practice of medicine came under increasing scrutiny, and guidelines were set to define the indications for therapeutic abortion. The guidelines allowed therapeutic abortion if (1) pregnancy would "gravely impair the physical and mental health of the mother," (2) the child born was likely to have "grave physical and mental defects," or (3) the pregnancy was the result of rape or incest (Mcfarlane, 1993). In the United States, the legalization of abortion by Roe v Wade in 1973 upheld the fundamental right of a woman to determine whether to continue her pregnancy.
    • Roche, Natalie E. (28 September 2004). "Therapeutic Abortion". eMedicine. Archived from the original on 14 December 2004. Retrieved 19 June 2011.
  • US statistics indicate that the vast majority of abortions are elective. Therapeutic abortion is rare. The ability to define therapeutic abortion performed for maternal indications is difficult because of the subjective nature of decisions made about potential morbidity and mortality in pregnant women. A variety of medical conditions in pregnant women have the potential to affect health and cause complications that may be life threatening.
    Prenatal screening in the form of prenatal diagnostic screening continues to improve the antepartum diagnosis of fetal anomalies. The decision to continue or terminate a pregnancy complicated by fetal anomalies is a difficult decision. The most difficult decisions are associated with anomalies that are unpredictable or highly variable in their expression.
    • Roche, Natalie E. (28 September 2004). "Therapeutic Abortion". eMedicine. Archived from the original on 14 December 2004. Retrieved 19 June 2011.
  • Abortion, it's beautiful, it's beautiful abortion is legal. I love going to an abortion rally to pick up women, 'cause you know they are fucking. . . When a woman gets pregnant, it's a choice between the woman and her girlfriends. One girlfriend goes, 'Child, you should have that baby — that man got some good hair.' And the other girlfriend says, 'Child, why we even talking about this — ain't we supposed to go to Cancun next week? Get rid of that baby!' [That] is how life is decided in America.
    • Chris Rock, comedian, in his stand-up comedy routine, February 2005 [1].
  • "Heartbeat laws," which have been enacted in six states thus far in 2019, along with even more restrictive policies in three others, are putting abortion back in the forefront of national discussion and encouraging both sides to gear up for an anticipated legal battle at the Supreme Court.
    Even as 60% of Americans say abortion should either not be legal at all or only legal in a few circumstances, a majority don't support laws that would outlaw abortion once a fetal heartbeat can be detected. This was defined in the question as occurring "usually around the sixth week of pregnancy."
    Fifty-eight percent of Americans say they would oppose a ban on abortions after a fetal heartbeat can be detected while 40% are in favor. Notably, this conforms with Americans' views on first trimester abortions more generally. According to a May 2018 Gallup survey, 60% think abortion should generally be legal in the first three months of pregnancy while most oppose it in the later months.
  • A similar percentage of Americans, 60%, does not want the Supreme Court to overturn Roe v. Wade, the landmark decision that defined a woman's constitutional right to abortion. This is on par with the 64% found in 2018, as well as the 58% Gallup recorded in 1989 with slightly different wording.
    Just one third of Americans favor overturning Roe v. Wade, including similar proportions of men, women and all age groups. Sharper differences are seen by party identification, with most Democrats and independents opposed to reversing Roe but nearly half of Republicans in favor.
  • Despite Americans' aversion to strong anti-abortion legislation, they remain closely split in their self-identification as "pro-life" or "pro-choice" on the abortion issue.
  • No one is thinking about these hardships when they put these bans on. People have other children, people have health issues, people have all types of things and they are spending every dime just to go somewhere else because this basic need isn’t accessible in their own state. But there are people fighting for them, no matter what laws are being passed or what the restrictions are, and we are doing everything we can to be able to service these patients. They need to know that we're going to continue to fight for them.
  • Efforts to ban abortion in America have been given considerable momentum by the powerful involvement of militant fundamentalists’ who have made an alliance with conservative political groups. Evangelical moral and religious fervor has been combined with sophisticated political strategies, influential television programming, marketing expertise, and extensive funding.
  • In a 34-second video titled "Abortion is Murder," Alabama Lieutenant Governor Will Ainsworth told voters to reach out to representatives and urge them to pass the bill.
    "Abortion is murder," Ainsworth says in the video that was posted on YouTube Sunday and shared on Twitter. "Those three simple words sum up my position on an issue that many falsely claim in a complex one." He added on Twitter that there should be no amendments, which appeared to be a reference to exceptions for rape or incest.
  • Alabama's proposed legislation is just one of more than 300 anti-abortion measures that have been introduced this year by state politicians. Four states — Georgia, Mississippi, Ohio and Kentucky — passed bills this year that outlaw abortions after a fetal heartbeat is detected, which is typically five to six weeks into a pregnancy. Many, like Alabama's, are in direct conflict with the Supreme Court's Roe v. Wade decision, which protects a woman's right to an abortion.
    If it passes, it would be the most restrictive anti-abortion law approved since Roe. The bill's primary sponsor, Representative Terri Collins, has previously called the legislation a "direct attack" on the Supreme Court's ruling, and anticipates that the bill will be contested by abortion rights advocates and potentially make its way to the high court.
    "The heart of this bill is to confront a decision that was made by the courts in 1973 that said the baby in the womb is not a person," Collins said last week when the Alabama House debated the legislation. "This bill addresses that one issue. Is that baby in the womb a person? I believe our law says it is."
  • Abortion was common in the United States and everywhere else, as it is today. It is a universal of women’s experience and always has been. Evidence of abortion dates back to the beginnings of recorded history. But the numbers of abortions have waxed and waned in response to the availability of contraceptives and social circumstances that encouraged or discouraged childbearing. During the Great Depression, when childbearing was unthinkable for many, abortions skyrocketed. One large study found that white middle-class married women aborted one in every four pregnancies in the 1930s the number dropped during World War II, when birth control devices (condoms, diaphragms, vaginal foam) circulated widely, but in the late 1950s, the rate started to climb.
    For doctors and medical workers, the woman bleeding from a botched abortion was a familiar figure in hospital emergency rooms in the 1950s and ‘60s. Entire wards were given over to patients suffering from septic abortions. Women tried to abort themselves with abortifacients or irritants administered as douches: Lysol, soap, kerosene, vinegar, powdered mustard, bleach, among others. They used, or others used on them, garden hoses, syringes, telephone wire, coat hangers, nut picks, pencils, catheters, and chopsticks.
  • Some abortion policies in the U.S. are based on the notion that abortion harms women’s mental health. The American Psychological Association (APA) Task Force on Abortion and Mental Health concluded that first-trimester abortions do not harm women’s mental health. However, the APA task force does not make conclusions regarding later abortions (second trimester or beyond) and mental health. This paper critically evaluates studies on later abortion and mental health in order to inform both policy and practice.
  • Hawaii this week becomes the first state in the Union to legalize abortion on request, leaving the decision about the operation to the woman herself and her physician. The legislature completed passage of the bill last week and sent it to Governor John A. Burns. A Roman Catholic, Burns said he would not sign it but neither would he veto it. Unsigned, it becomes law in ten days.
    The Hawaiian law is essentially what many physicians have been urging—so far, unsuccessfully—in several mainland states. It includes only minimal restrictions: the operation must involve a fetus that cannot live outside the womb (usually meaning less than 20 weeks of gestation); it must be performed by a licensed physician or surgeon (M.D. or doctor of osteopathy), and in a Government-licensed hospital. By comparison, the "liberalized" abortion laws passed by ten states, led by Colorado in 1967, require that each abortion must be approved by two or more disinterested physicians. All specify some medical need, such as the mother's physical or mental health, or a likelihood that the baby will be defective. Britain is somewhat more lenient than these states, but still stipulates pre-operation approval by more than one doctor. The District of Columbia is now in a legal limbo, since Federal Judge Gerhard A. Gesell declared the restrictive District code unconstitutional because it was too vague. Gesell's ruling is subject to reversal on appeal. Meanwhile, abortion is available in the District, but many residents complain that it is difficult to obtain.
  • Like every other jurisdiction that has liberalized its abortion law, Hawaii was fearful of becoming an "abortion capital." So the legislators wrote in a 90-day residency requirement. Some concede that this may be unconstitutional, but they worded it so that the rest of the statute is unassailable. Hawaii thus becomes the first major jurisdiction in the Western world in which abortion is treated as an exclusively medical matter. Any woman over 20 can have one for the asking if she can find a doctor willing to perform it.
  • As pro-choice advocates prepare to honor the 40th anniversary of Roe v. Wade, the Supreme Court decision has been getting decidedly ambivalent coverage in the press. In today’s paper, New York Times columnist Gail Collins puzzles over Americans’ discomfort with the issue of abortion, emphasizing their contradictory responses to questions about abortion on public opinion surveys:
    Gallup polls suggest support for abortion rights is fading, particularly among young Americans, and that more people now regard themselves as “pro-life” than “pro-choice.” On the other hand…the polls depend on the question. According to the Quinnipiac poll, if you ask Americans whether they agree with the Roe decision, nearly two-thirds say yes.
    This apparent incongruity is thrown into even starker relief in a 2011 PRRI survey, which allowed respondents to identify as both “pro-life” and “pro-choice.” The results showed that these labels don’t encompass the complexity of Americans’ attitudes toward abortion: 7-in-10 Americans said that “pro-choice” describes them somewhat or very well, while nearly two-thirds said the same of the “pro-life” label. Fully 43% of respondents identified as both “pro-choice” and “pro-life.”
  • How to explain this contradiction? In the survey, a majority of respondents reported that abortion should be legal, but a similar number also agreed that it was immoral. Nearly 6-in-10 (58%) also agreed that at least some health care professionals in their community should provide legal abortions. And Americans’ perspectives on when abortion should be permissible vary widely: strong majorities agree that a woman should be able to obtain a legal abortion if the women’s physical health (86%) or mental health (74%) is seriously endangered by the pregnancy, if she became pregnant as the result of rape (79%), or if there is a strong chance of defect in the baby (66%). They are decidedly more divided on other circumstances, as the accompanying chart shows.
    Support for legal abortion hasn’t wavered much over the past four decades, but it also hasn’t increased. Compare this to the dramatic shift in public opinion on same-sex marriage over the past ten years, and recent claims that “pro-choice” advocates are losing the war over abortion start to make sense. On the other hand, as Collins, who is herself pro-choice, points out, Americans continue to reject extreme positions on abortion at the ballot box. The doomed Senate campaigns of Todd Akin and Richard Mourdock serve as blunt reminders for public officials who take such stands.
    Analyzing Americans’ perspectives on abortion inevitably lead to contradictions, and we’re frequently distracted by allegiance to the “pro-choice” and “pro-life” labels. If the polling data shows us anything, it’s that Americans’ complex attitudes toward abortion can’t be answered in one question. Maybe it’s time to stop trying.
  • Most respondents to a survey of abortion patients in 1987 said that more than one factor had contributed to their decision to have an abortion; the mean number of reasons was nearly four. Three-quarters said that having a baby would interfere with work, school or other responsibilities, about two-thirds said they could not afford to have a child and half said they did not want to be a single parent or had relationship problems. A multivariate analysis showed young teenagers to be 32 percent more likely than women 18 or over to say they were not mature enough to raise a child and 19 percent more likely to say their parents wanted them to have an abortion. Unmarried women were 17 percent more likely than currently married women to choose abortion to prevent others from knowing they had had sex or became pregnant. Of women who had an abortion at 16 or more weeks' gestation, 71 percent attributed their delay to not having realized they were pregnant or not having known soon enough the actual gestation of their pregnancy. Almost half were delayed because of trouble in arranging the abortion, usually because they needed time to raise money. One-third did not have an abortion earlier because they were afraid to tell their partner or parents that they were pregnant. A multivariate analysis revealed that respondents under age 18 were 39 percent more likely than older women to have delayed because they were afraid to tell their parents or partner.
  • In Lubbock, the focus was on abortion and the ordinance that reads: “It shall be unlawful for any person to procure or perform an abortion of any type and at any stage of pregnancy in the City of Lubbock, Texas.”
    Those arguing against the local ordinance say it is unconstitutional and unenforceable. The Lubbock City Council said it was unconstitutional when the seven members unanimously voted it down. It’s on the ballot by way of a citizen-led petition. Many local officials there believe that if it passes, lawsuits will follow.
    Proponents of the ordinance view it as the new tool in their efforts to ban abortions. They say the abortion debate — long a heated discussion in national and state politics — is now a local issue.
  • Planned Parenthood opened again in Lubbock last year, and abortion services are being made available at the Lubbock clinic. Planned Parenthood also offers in-person and telemedicine services such as breast and cervical cancer screenings, birth control, annual wellness checks, HIV and STI tests, and other healthcare services.
    The ordinance says it shall be an affirmative defense to the unlawful acts if an abortion was in response to a life-threatening physical condition arising from a pregnancy. There are no exemptions for instances of rape or incest.
  • Jack Qu’emi Gutiérrez was a 20-year-old college student in a self-described “shitty relationship” when they found out they were pregnant.
    It was 2011 and Gutiérrez, a nonbinary person who uses the pronouns they/them, had to pool all their money at the time to pay the $500 to get the abortion pill. Even though Gutiérrez chose to have a medication abortion (“I didn’t want a bunch of people in my crotch”), they were still forced to undergo two trans-vaginal ultrasounds before obtaining the abortion pill.
    “I felt very, very much alone,” Gutiérrez told HuffPost. “I didn’t have any frame of reference for what an abortion would be like, period. Not to mention what an abortion would be like as a nonbinary person.”
    Although Gutiérrez went to Planned Parenthood, they were constantly misgendered and there was no option for preferred pronouns or name on the intake form.
  • Make no mistake: The abortion bans are absolutely an attack on cis women. It’s part of a larger war on women that’s been raging for decades, and it’s deeply rooted in misogyny and sexism. But these bans also affect transgender, intersex and other gender-nonconforming people.
    Cazembe Murphy Jackson, a transgender man, said his abortion experience was similar to Gutiérrez’s. Jackson was raped his junior year in college and, six weeks later, had to take out a loan to get an abortion at a Planned Parenthood in Texas.
    “It was awkward because people were not competent around trans masculine folks getting abortions. One of the first questions I got was, ‘Is this [abortion] for your partner?’” he said.
  • No issue since the Vietnam conflict or maybe since Prohibition, has so plagued the American moral conscience as has abortion. The 1973 Supreme Court ruling on Roe v. Wade has plunged this county into what seems to be an endless-and nearly hopeless-polarization of extreme positions such that the American public has begun to lose confidence that any moral middle ground can be found. Many in society are numbed by the frequent revision of abortion laws at the federal and state levels, congressional proposals to prevent legal constraints on abortion, Republican executive attempts to establish “gag rules,” and the latter’s recent reversal by President Clinton. We are told in nearly every survey that a majority of the American people believes that the Supreme Court went too far when it granted a Fourteenth Amendment right to abortion. The abortion of 1.6 million fetuses each year becomes even more complex and debatable when public funds are used to finance these medical procedures.
  • In 2014, abortion rates were the lowest they’d been since abortion became legal nationwide in 1973. Still, 2.8 million US women confronted unintended pregnancy in 2011, and 42% of them chose to terminate those pregnancies. If the low 2014 abortion rate holds steady, 1 in 4 American women will have an abortion before menopause. Calling the vast majority of these procedures elective is a cavalier way to dismiss the aspirations and disparage the judgment of the almost 1 million American women who ask for this procedure every year.
  • When the Republican national convention convened in Kansas City in 1976, the party's pro-choice majority did not expect a significant challenge to their views on abortion. Public opinion polls showed that Republican voters were, on average, more pro-choice than their Democratic counterparts, a view that the convention delegates shared; fewer than 40 percent of the delegates considered themselves pro-life.1 The chair of the Republican National Committee, Mary Louise Smith, supported abortion rights, as did First Lady Betty Ford, who declared Roe v. Wade a “great, great decision.” Likewise, Vice President Nelson Rockefeller, who had taken a leading role in the fight for abortion rights in New York in the late 1960s and early 1970s, was solidly pro-choice. Even some of the party's conservatives, such as Senator Barry Goldwater, supported abortion rights. But in spite of the Republican Party's pro-choice leadership, the GOP adopted a platform in 1976 that promised an antiabortion constitutional amendment. The party's leadership viewed the measure as a temporary political ploy that would increase the GOP's appeal among traditionally Democratic Catholics, but the platform statement instead became a rallying cry for social conservatives who used the plank to build a religiously based coalition in the GOP and drive out many of the pro-choice Republicans who had initially adopted the platform. By 2009, only 26 percent of Republicans were pro-choice.
  • The Catholic campaign against abortion legalization in the United States began as a human rights cause that was rooted in the assumptions of New Deal liberalism. At the time of the New Deal, abortion was illegal throughout the nation except when it was necessary to save a woman’s life, and the sale of contraception was still illegal in some states. Although the laws against abortion and contraception had been passed in the late nineteenth century, long before the rise of New Deal liberalism, Catholics viewed this legislation as evidence of a concern for human life that they thought accorded well with the principles of the New Deal social welfare state. Thus, when a few non-Catholic doctors began calling for the liberalization of abortion laws in the 1930s, and when a much larger number of Protestants and Jews advocated the repeal of the laws against birth control, Catholics reacted against both campaigns by appealing to the values of New Deal liberalism.
  • Because the initial abortion law liberalization campaigns of the mid-to-late 1960s sought only modest changes in state abortion laws in order to allow abortion in cases of rape and incest, suspected fetal deformity, and dangers to the health of the mother, few Protestants—and even fewer evangelicals—joined the right-to-life campaign to lobby against these early liberalization proposals. Having recently rejected the Catholic position on contraception (evangelicals had once opposed birth control, but they generally accepted it after the early 1960s), they were reluctant to endorse a Catholic-led antiabortion campaign that seemed to rely on the same natural-law arguments that Catholics had used against contraceptives.
  • When abortion law reformers ceased calling for a modest liberalization of existing abortion laws and began demanding a repeal of almost all restrictions on abortion, some evangelicals reacted in horror and decided that the right-to-life movement was worthy of more consideration than they had initially thought. The removal of almost all legal restrictions on first and second-trimester abortions in New York in 1970 was particularly troubling, since it quickly led to nearly 200,000 legal abortions per year in New York’s hospitals. Two months after the enactment of New York’s new abortion policy, Christianity Today published an editorial titled, “War on the Womb,” which argued, for the first time, that human personhood probably began “at the very moment or very soon after the sperm and egg meet” [97]. In previous editorials, Christianity Today, like other evangelical magazines, had avoided taking the Catholic position that human life began at conception, but its outrage over “abortion on demand” pushed it closer to the Catholic view. The magazine no longer published editorials endorsing abortion in exceptional circumstances. In 1971, it encouraged readers to join right-to-life organizations—even though these organizations, at the time, were overwhelmingly Catholic.

"Blue Hill is second Nebraska town to outlaw abortion in city limits" (April 15, 2021)[edit]

"Blue Hill is second Nebraska town to outlaw abortion in city limits". www.1011now.com. (April 15, 2021).

  • The City of Blue Hill, Nebraska (population 941) has become the 25th city in the nation, and the second city in Nebraska, to pass an enforceable ordinance outlawing abortion within their city limits. The vote of the Blue Hill City Council was a unanimous 3-0 vote. One council member was absent for part of the meeting and missed the actual vote, but he says he was supportive of the decision of the City Council, and proud to stand with the council’s three “Yes” votes. The ordinance, which immediately outlaws abortion, also declares the abortion pill contraband in Blue Hill, Nebraska.
    Blue Hill City Council member say the vote lives up to the phrase on the official seal of the City of Blue Hill, which reads, “Preserving Our Heritage for Future Generations.”
  • “When someone brought this issue to my attention, and I was urged to ‘Add us to the list.’ I wasn’t sure it was necessary for small-town Blue Hill. Would anyone ever open an abortion clinic here? Probably not, but I’ve learned being proactive is much easier than being reactive. Today, more than ever, we must strive for a better tomorrow, or society will suppress and surpass us. I think the future of Blue Hill is in good hands with a council that unanimously votes to prohibit abortion within their city limits.”
    Blue Hill Mayor Keri Schunk
  • The vote to outlaw abortion came one day after the Food and Drug Administration’s Acting Commissioner Janet Woodcock sent a letter to the American College of Obstetrics and Gynecology indicating that the FDA intends to “exercise enforcement discretion” in the dispensing of the abortion pill by mail during the COVID-19 pandemic.
    The pro-abortion American College of Obstetrics and Gynecology praised the FDA announcing in a press release, “ACOG applauds the U.S. Food and Drug Administration (FDA) for acknowledging the strong safety and efficacy profile of mifepristone for termination of early pregnancy. By halting enforcement of the in-person dispensing requirement during the COVID-19 pandemic, the FDA is recognizing and responding to the available evidence—which has clearly and definitively demonstrated that the in-person dispensing requirement for mifepristone is unnecessary and restrictive.” The press release goes on to say that “ACOG has for years advocated for the FDA to remove the in-person dispensing requirement for mifepristone.”
  • “Nebraska is a pro-life state, and communities are working to recognize and protect innocent life in a variety of ways. The Biden-Harris Administration is pushing a radical, pro-abortion agenda, and Nebraska must do everything we can to stand against the abortion lobby.”
    Governor Pete Ricketts (Ne-R)

“Providing abortion pills before patients need them could enable earlier care” (December 6, 2021)[edit]

“Providing abortion pills before patients need them could enable earlier care”, (December 6, 2021)

  • ANSIRH researchers Katherine Ehrenreich, M. Antonia Biggs, and Daniel Grossman authored an editorial in BMJ Sexual & Reproductive Health exploring the potential for clinicians to provide medication abortion pills to patients before they are pregnant, a model called “advance provision.” Doing so would enable patients to have the pills on hand when necessary, enabling earlier access to care.
    The authors believe the model holds potential and merits further study—particularly considering the United States’ current political environment. The model would effectively shorten the time between the decision to have an abortion and obtaining care to zero days.
  • The authors note that state legislatures have implemented restrictions, including Texas’ recent SB 8, that have increased the distance to the nearest provider for many people, sometimes requiring hundreds of miles of travel. Hurdles posed by travel are often compounded by additional concerns, such as childcare, job obligations, and mandatory waiting periods. These, in turn, lengthen the delay between a patient’s initial need for an abortion and their treatment. But even in settings where there is good access to care in the United States, there is inevitably some time between the first call to the clinic and the in-person appointment to obtain medication abortion.
    The authors outline a potential approach to the advance provision model, with clinicians screening patients for some contraindications to medication abortion prior to pregnancy in addition to providing any necessary education. The research team sees advance provision as a “complete care model,” which would also include access to necessary follow-up care in case of complications, ongoing pregnancy, or incomplete abortion.
  • At the same time, the researchers acknowledge possible challenges with the model, including self-administration at inappropriate times and medication diversion. It is unlikely, too, that advance provision could be adopted in all U.S. states.
    Still, studies on its safety and how patients can use the medications with limited clinician oversight could provide contributory evidence toward an eventual move toward over-the-counter availability of mifepristone and misoprostol for medication abortion.
  • Ehrenreich, Biggs, and Grossman write:
    "While a future landscape of medication abortion may include telemedicine and mail-order pharmacy dispensing, advance provision may be a preferable option for those who would continue to face barriers to care, including those travelling to areas with limited options for safe abortion."

"The Right to Choose at 25: Looking Back and Ahead"[edit]

"The Right to Choose at 25: Looking Back and Ahead". www.aclu.org. Retrieved October 5, 2015.

  • On January 22, 1973, the United States Supreme Court announced its landmark rulings that legalized abortion, Roe v. Wade and Doe v. Bolton. Two days later, a New York Times editorial predicted that the decisions offered "a sound foundation for final and reasonable resolution" of the abortion debate. Yet, in fact, the struggle that had resulted in the Supreme Court victories was far from over. Few in 1973 could have anticipated how explosive the issue of abortion would become and how difficult the right would be to retain. Nor could anyone then have known how much the availability of safe legal abortion would contribute to women's social, economic, and political advancement in the next quarter of a century.
  • Abortion was not, in fact, illegal in most states until the second half of the nineteenth century. Before then, medical experts and other commentators believed that abortion was commonly sought and widely available. By their estimates, there was one abortion for every four live births.
    But from the mid-nineteenth century, opposition to abortion began to emerge from several directions. Physicians charged their competitors -- mid- wives and folk healers -- with performing too frequent and unsafe abortions; the newly formed professional organizations of physicians sought criminal bans. A vocal group of native-born, white Americans condemned abortion as "race suicide" because it lowered their birth rate at a time when they feared being outnumbered by immigrants. Still others, reacting to the new movement for women's suffrage and other rights, worried that continuing access to abortion would permit women to stray from their traditional roles as wives and mothers. As a result of these converging sentiments, by the end of the century every state had enacted a law criminalizing abortion. Most made an exception only for abortions undertaken to preserve a woman's life.
    These laws did not end abortion but merely sent it underground. The unsafe and unsanitary practice of illegal abortion maimed and killed thousands of women. Finally, in the 1960s, an outcry arose to make abortion legal again. The outcry came from doctors, legal reformers, clergy, and women themselves. The ACLU was in the forefront of this movement.
  • Led into the struggle by board members like Dorothy Kenyon, a feminist lawyer and judge, the ACLU was the first organization to call for a woman's right to choose abortion. Kenyon began pressing the issue as early as 1958, and she persisted until 1967, when the board affirmed "the right of a woman to have an abortion." She also brought the issue to the public, appearing on television talk shows and in print, where she called for an end to "cruel and unconstitutional abortion laws."
    In 1965, the ACLU filed a friend-of-the-court brief in a landmark case that paved the way for the legalization of abortion. That case, Griswold v. Connecticut, challenged Connecticut's ban on the prescription, sale, or use of contraceptives, even for married couples. In a major legal breakthrough, the Supreme Court decided that restrictions on birth control violated the right to privacy protected by the Constitution.
  • Griswold greatly encouraged the activists who were waging a two-pronged campaign to legalize abortion. On one front, doctors, lawyers, clergy, and women called for the reform or repeal of state abortion laws. In the mid-1960s, the New York Civil Liberties Union helped organize a campaign to repeal New York's abortion law. In 1970, New York, Hawaii, Alaska, and Washington became the first states to repeal their abortion laws, making abortion more widely available, although some restrictions remained in effect in all four states.
    On a second front, legal reformers brought test cases against criminal abortion laws in federal and state courts all over the nation, in the hope that one case would reach the Supreme Court. In 1971, the high court issued its first decision about abortion in U.S. v. Vuitch, a case argued by the ACLU's general counsel, Norman Dorsen. Police had arrested Dr. Milan Vuitch in Washington, D.C., claiming that he had violated the District's law permitting abortions only to preserve a woman's life or health. Dr. Vuitch argued that only a physician, not a prosecutor, could judge when an abortion was necessary to protect a woman's life or health. The Supreme Court did not overturn the statute as Vuitch sought, but it held that the burden of proof should be on a prosecutor who brought charges, not on a doctor. The Court also concluded that "health" should be understood to include considerations of psychological as well as physical well-being.
  • The Supreme Court's decisions in Roe v. Wade and Doe v. Bolton had nationwide impact. After the Court ruled the Texas and Georgia abortion laws unconstitutional, no other states could enforce similarly restrictive laws. When the Court made its landmark rulings, it was in step with public opinion. Public attitudes had shifted as a result of the decade-long campaign to legalize abortion. In 1968, only 15 percent of Americans favored liberalizing abortion laws; by 1972, 64 percent did.
  • The legalization of abortion has dramatically improved women's health. Abortion services moved from the back alleys into hygienic facilities staffed by health professionals. High-quality training, the ability of professionals openly to share their expertise with one another, and the development of specialized clinics all enhanced the safety of abortion services. In the early part of this century, an estimated 800,000 illegal abortions took place annually, resulting in 8,000 - 17,000 women's deaths each year. Thousands of other women suffered severe consequences short of death, including perforations of the uterus, cervical wounds, serious bleeding, infections, poisoning, shock, and gangrene. After legalization, deaths as a result of abortion greatly declined. In 1991, for example, 11 women died as the result of complications arising in legal abortions. Today, one death occurs in every 167,000 legal abortions, compared with one in every 30,000 in 1973.
    Once Roe made it possible to obtain safe legal abortions, women have been having abortions earlier in their pregnancies when the health risks are the lowest. In 1973, only 38 percent of abortions were performed at or before eight weeks of pregnancy; in 1997, this percentage has risen to 52, and 89 percent of all abortions occur in the first 12 weeks. Only one percent takes place after 21 weeks. Today, abortion is one of the most commonly performed surgical procedures and is ten times safer than carrying a pregnancy to term.
  • Since the landmark decisions of 1973, the ACLU Reproductive Freedom Project and our sister organizations have worked continuously to defend and expand reproductive rights. Our greatest challenge has been to try to assure that the right to choose extends to those whose lack of political power makes them easy targets for lawmakers: low-income women and young women. The Supreme Court held in 1980 that the federal constitution permits the government to withhold Medicaid funds for virtually all abortions, while continuing to fund all other medically necessary services, including prenatal care and childbirth. Yet bans on public funding for abortion rob low-income women of the right to choose by depriving them of the means to exercise their choice. We therefore turned to the state constitutions in an effort to restore low-income women's rights. A case won on state constitutional grounds provides strong protection for choice because it is insulated from federal constitutional review and is therefore unaffected by any erosion of the federal right to choose. Because the ACLU and its allies have succeeded in forestalling or overturning a number of funding bans in key states, 40 percent of Medicaid-eligible women once again have abortion coverage.
  • In 1997, for the second time, the anti-choice majority in Congress passed the so-called "Partial-Birth Abortion Ban Act." For the second time, President Clinton vetoed it. Congress is again set to attempt to override the President's veto.
    By making physicians fearful of performing safe, common methods of abortion, the ban would seriously endanger women's health.
  • Every year, anti-choice legislators in Congress target the appropriations bills that fund the various agencies of the federal government and attach amendments that largely prohibit the use of federal funds for abortions. As a result, millions of people who rely on the government for their health care have been denied abortion coverage. They include most Medicaid recipients, federal employees and their dependents, military personnel and their dependents, Native American women, federal prisoners, and low-income residents of Washington, D.C.

"Report of the APA Task Force on Mental Health and Abortion" (13 August 2008)[edit]

"Report of the APA Task Force on Mental Health and Abortion" (PDF). Washington, DC: American Psychological Association. 13 August 2008. Archived (PDF) from the original on 15 June 2010.

  • Although the U.S. Supreme Court legalized abortion in the United States more than 35 years ago (Roe v. Wade, 1973), it continues to generate enormous emotional moral, and legal controversy. Over the last two decades, one aspect of this controversy has focused on the effects of abortion of women’s mental health. Public debate on this issue can be traced to 1987, when then President Ronald Reagan directed then-Surgeon General C. Everett Koop to prepare a Surgeon General’s report on the public health effect (both psychological and physical) of abortion. After conducting a comprehensive review of the scientific literature, Dr. Koon declined to issue a report; instead, he sent a letter to President Reagan on January 9, 1989, in which he concluded that the available research was inadequate to support any scientific findings about the psychological consequences caused by abortion. In subsequent testimony before Congress, Dr. Koop stated that his letter did not focus on the physical health risks of abortion because “obstetricians and gynecologists had long since concluded that the physical sequelae of abortion were no different than those found in women who carried to term or who had never been pregnant”. Dr. Koop also testified that although psychological responses following abortion can be “overwhelming to a given individual,” the psychological risks following abortion were “miniscule” from a public health perspective.
    • p.5
  • Almost all abortions (92% according to the 2002 National Survey of Family Growth) in the United States are of unintended pregnancies, pregnancies that are not induced for therapeutic reasons. A late term induced abortion of an intended pregnancy may have very different implications for mental health than a first-trimester induced abortion of an unintended pregnancy.
    • p.7
  • ”How prevalent are mental health problems among women in the United States who have had an abortion?” This question focused attention on the extent to which abortion poses a threat to women’s mental health, i.e., is associated with a clinically significant mental disorder (see Wilmoth et al., 1992 for a discussion of this issue). In order to answer this question, research must have several key characteristics. First, the research must be based on samples of women representative of the women to whom one wants to generalize. Thus, to address whether abortion poses a threat to the mental health of women in the United States requires a study based on a nationally representative sample of women in the United States. Highly selected samples, biased samples, samples with considerable attrition or underreporting, or samples of women in other cultures and social contexts are not appropriate for answering this question. As will be discussed below, sampling problems are a serious concern in abortion research. Second, an adequate answer to the prevalence question also requires a clearly defined and agreed-ipon definition of a “mental health problem” and a valid, reliable, and agreed-upon measurement of that problem. Feelings of sadness or regret with the normal range of emotion are not clearly defined and agreed-upon mental health problems. Mental health outcomes that meet established criteria for clinically significant disorders are. Third, researchers must know the prevalence of the same mental health problem in the general population of U.S. women who share characteristics similar to the abortion group, e.g., women who are of a similar age and demographic profile. Such information is essential for interpreting the significance of findings. For example, if 15% of women in a nationally representative sample who had an abortion were found to meet diagnostic criteria for depression, the meaning of this would be more a cause for concern is the base rate for clinical depression among women in the general population f a similar age and demographic profile was 5% than if it was 25%.
    • p.8
  • Women obtain abortions for different reasons. The vast majority of abortions are of unintended pregnancies-either mistimed pregnancies that would have been wanted at an earlier or latter date or unwanted pregnancies that were not wanted at that time or at any time in the future. Approximately half of women in the United States will face an unintended pregnancy during their lifetime, and about half of those who unintentionally become pregnancy resolve the pregnancy through abortion. The reasons that women most frequently cite for terminating a pregnancy include not being ready to care for a child (or another child) at that time, financial inability to care for a child, concern for or responsibility to others (especially concerns related to caring for a future child and/or for existing children), desire to avoid single parenthood, relationship problems, and feeling too young or immature to raise a child. Some pregnancies are terminated because they are a consequence of rape or incest. Very few (<1%) women cite coercion from others as a major reason for their abortion. A very small percentage of abortion are of planned and wanted pregnancies. Women who terminate wanted pregnancies typically do so because of fetal anomalies or risks to their own health.
    • p.9
  • Unwanted pregnancy and abortion do not occur in a social vacuum. The current sociopolitical climate of the United States stigmatizes some women who have pregnancies (e.g., teen mothers) as well as women who have abortions. It also stigmatizes the nurses and physicians who provide abortions. From a sociocultural perspective, social practices and messages that stigmatize women who have abortions may directly contribute to negative psychological experiences post abortion.
    The psychological implications of stigma are profound. Experimental studies have established that stigmatization can create negative cognitions, emotions, and behavioral reactions that can adversely affect social, psychological, and biological functioning. Effects, and behavioral reactions that can adversely affect social, psychological, and biological functioning. Effects of perceived stigma include cognitive and performance deficits, increased alcohol consumption, social withdrawal and avoidance, increased depression and anxiety, and increased physiological stress responses. Societal stigma is particularly pernicious when it leads to “internalized stigma associated with abortion (e.g., who see themselves as tainted, flawed, or morally deficient) are likely to be particularly vulnerable to later psychological distress.
    • pp.11-12

"Maine expands list of abortion providers" (June 10, 2019)[edit]

"Maine expands list of abortion providers". Associated Press. June 10, 2019. Archived from the original on June 11, 2019.

  • AUGUSTA, Maine (AP) — Maine is making it easier to get an abortion with the governor’s signing of a bill Monday to allow medical professionals who are not doctors to perform the procedure.
    The bill, which Democratic Gov. Janet Mills introduced herself, will go into effect 90 days after the Legislature adjourns, which is expected in mid-June.
    Maine is now set to allow nurse practitioners, physician assistants and certified nurse-midwives to provide abortion medication and perform in-clinic abortions, which typically involve suction.
    Maine joins other Democrat-led states moving to protect and in some cases expand abortion rights as GOP-led states push tighter restrictions .
  • “Maine is defending the rights of women and taking a step toward equalizing access to care as other states are seeking to undermine, rollback, or outright eliminate these services,” Mills said.
  • Maine will be the second state after California with a law allowing non-doctors to perform in-clinic abortions, according to Maine’s Office of Policy and Legal Analysis. Nearly two dozen states, including Vermont and New Hampshire, have expanded their list of abortion-medication providers following court or agency rulings.
  • Abortion rights groups including Planned Parenthood for years have fought against physician-only laws. This year, groups are trying to strike down the bans in Idaho, Virginia, Maine, Wisconsin and Arizona.
    Critics said they are concerned that some non-doctors lack the training to handle rare but major complications from abortion procedures, such as hemorrhages.
    “Expanding who is allowed to perform an abortion does not expand the safety of the procedure,” Republican state Sen. Stacey Guerin has said.
    But supporters have argued that abortion is one of the safest medical procedures. Nurse practitioners and physician assistants testified that Maine’s restriction is outdated.

“Thy Kingdom Come” (June 26, 2006)[edit]

Randall Herbert Balmer, “Thy Kingdom Come”, (June 26, 2006)

  • Why, then, is the Religious Right, which claims allegiance to the scriptures, not working to outlaw divorce?
    The answer, I suspect, is that the issue of abortion has served the Religious Right very effectively for more than two decades. Although the Religious Right was slow to pick up on abortion as a political issue, it proved to be a potent one for them during the 1980s, in part because Reagan championed the pro-life cause-despite the fact that as governor of California, he had signed into law a bill legalizing abortion. Reagan kept the antiabortion rhetoric alive throughout his presidency, repeatedly promising an amendment to the Constitution that would outlaw abortion. He never delivered on that promise: nor did his vice president and successor as president, George H.W. Bush, who in 1980 has campaigned against Reagan for his party’s presidential nomination as a pro-choice Republican. Although both men coveted the support of the Religious Right, neither made good on his promise to outlaw abortion.
    • Chapter One: Strange Bedfellows, p.11
  • The real question for the Religious right and the Republican party is how serious they are about reducing (and even eliminating) abortion itself, especially when everyone acknowledges that legal sanctions will not work. Wouldn’t the energies of the Religious right be more productively directed toward campaigns to encourage abstinence, contraception, and adoption, similar to campaigns directed against smoking or alcohol and spousal abuse? Even better, the Religious Right want to consider the links between abortion rates and the availability of contraception or the economic plight of mothers-to-be facing medical and child-care costs. Surely such initiatives would do more than a legal ban to make abortion rare and unthinkable. The Religious Right might also want to consider the fat that by the time Bill Clinton, a defender of reproductive choice, left office, the abortion rate had fallen to its lowest level since 1974, a year after the Roe decision.
    Curiously although the leaders of the Religious Right have been advocating a legal ban on abortion at least since 1980, they have been remarkably silent about the details of their proposals. Will gynecologists be required to report every fertilized egg implanted in the uterus to some government registry so that each pregnancy can be monitored? Which agency would be responsible for such oversight-the federal Bureau of Investigation or some new entity? (Given the Religious Right’s professed aversion to government, the latter option seems unlikely). Will the government require that a law-enforcement official be present at every obstetrics examination, or merely somewhere on the premises? Will it be a federal, state, or local official? What about miscarriages? How will officials determine whether or not a miscarriage occurred naturally?
    • pp.19-20
  • My party, the Democratic Party, has utterly botched the abortion issue, I’ll not deny that. In their efforts to assert the importance of women’s rights and prerogatives, many Democrats have elevated abortion to an intrinsic entitlement and, in so doing, have refused to acknowledge the moral implications of abortion itself. This imperious position has alienated key constituencies once associated with the Democratic Party, especially Roman Catholics. It has also functioned to marginalize many evangelical voters in the Democratic Party-on that issue alone.
    • p.21

"Supreme Court to review ruling on Louisiana abortion law" (October 4, 2019)[edit]

Barnes, Robert (October 4, 2019). "Supreme Court to review ruling on Louisiana abortion law". The Washington Post.

  • The Supreme Court said Friday that it will review a restrictive Louisiana abortion law, providing the first opportunity for a conservative majority reinforced by President Trump’s two appointees to begin reconsidering the court’s abortion rights landscape.
    In the coming months, the court will examine whether the state’s 2014 law requiring doctors at abortion clinics to have admitting privileges at nearby hospitals unduly burdens women’s access to abortion. Practitioners have said the law would force most of Louisiana’s abortion clinics to close, leaving only one doctor eligible to perform the procedure.
    It is almost identical to a Texas law struck down by the Supreme Court in 2016. Now-retired justice Anthony M. Kennedy joined the court’s four liberals to form a majority in what was its most important endorsement of abortion rights in 25 years.
  • “The Supreme Court now has a chance in this case to reconsider, reverse, and return Roe v. Wade and the issue of abortion to the American people, which is long overdue,” Students for Life of America President Kristan Hawkins said in a statement. “States should absolutely have the right to pass their own health and safety standards designed to protect women inside abortion vendors.”
  • “Access to abortion is hanging by a thread in this country, and this case is what could snap that thread,” Alexis McGill Johnson, acting president of Planned Parenthood Federation of America, said in a statement. “There’s only one reason the court would not strike down the Louisiana law and that is because Justice Kennedy, who voted to protect abortion access just three years ago, has been replaced with Justice Kavanaugh. This is what we’ve warned about.”
  • The court’s 2016 decision in the Texas case, Whole Woman’s Health v. Hellerstedt, said the admitting-privileges requirement “provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions, and constitutes an ‘undue burden’ on their constitutional right to do so.”
    Hospitalization after an abortion is rare, all sides agree, and the lack of admitting privileges by the doctor who performed the procedure is not a bar to the woman getting needed medical care. The court’s opinion said there are numerous reasons doctors might not be able to attain admitting privileges at a nearby hospital, including the fact that it is so rare for their clients to need hospitalization.
  • Judge Jerry E. Smith, writing for the majority, said that the court complied with the Supreme Court’s decision in Whole Woman’s Health by taking a painstakingly close look at the details.
    “Unlike in Texas, the [Louisiana law] does not impose a substantial burden on a large fraction of women,” he concluded.
    He said that the closing of some clinics in Louisiana, as opposed to Texas, would not dramatically increase driving distances and that it was easier for doctors in Louisiana to procure admitting privileges. He said that “at most, only 30 percent of women” seeking abortions in Louisiana would be affected.
  • The full 5th Circuit declined to reconsider the panel’s decision, and dissenting judges said their colleagues seemed more intent on giving the Supreme Court a chance to reverse its 2016 ruling than complying with it.
    “I am unconvinced that any justice of the Supreme Court who decided Whole Woman’s Health would endorse our opinion,” Judge Stephen A. Higginson wrote in his dissent. “The majority would not, and I respectfully suggest that the dissenters might not either.”
  • “Louisiana has tried everything under the sun to decimate access to abortion care,” said Kathaleen Pittman, clinic administrator at Hope Medical Group, one of the plaintiffs. “The situation here is already dire and this law would be the last straw for most of the remaining clinics. We’re hopeful that the court will recognize how devastating this law would be for women in our state.”
  • Louisiana Attorney General Jeff Landry (R) had also asked the court to review the decision. He wants the justices to decide that abortion providers don’t have the legal standing to challenge laws such as the one the Louisiana legislature passed.
    “The evidence of Louisiana abortion clinics’ poor safety records, inadequate credentialing practices, and questionable efforts to undermine health and safety regulations shows that the abortion clinics’ interests are directly adverse to the interests of Louisiana women,” Landry said in a statement. “Incompetent and unsafe providers should not be allowed to challenge health and safety standards designed to protect women from those very providers.”

"Justice Department sues Texas to block six-week abortion ban" (September 9, 2021)[edit]

Barrett, Devlin; Marimow, Ann E. (September 9, 2021). "Justice Department sues Texas to block six-week abortion ban". The Washington Post.

  • The suit filed by the Justice Department in federal court in Austin asks a judge to “protect the rights that Texas has violated” by declaring the abortion law unconstitutional and issuing an injunction blocking its enforcement. At a news conference, Attorney General Merrick Garland said the ban “is clearly unconstitutional under long-standing Supreme Court precedent.”
    “This kind of scheme to nullify the Constitution of the United States is one that all Americans, whatever their politics or party, should fear,” said Garland, warning that what he called the “bounty hunter” element of the law may become “a model for action in other areas by other states and with respect to other constitutional rights or judicial precedents.” The U.S. government, Garland added, has a responsibility “to ensure that no state can deprive individuals of their constitutional rights.”
  • A spokeswoman for Texas Gov. Greg Abbott (R) defended the law and accused the Biden administration of acting for political reasons — to distract Americans from the U.S. withdrawal from Afghanistan and the influx of migrants at the U.S.-Mexico border.
    “We are confident that the courts will uphold and protect that right to life,” press secretary Renae Eze said in a statement.
  • The Biden administration’s suit argues that the Texas law violates the 14th Amendment’s due process clause, saying the measure deprives women in Texas of the right to an abortion and imposes an “undue burden” — and that the Constitution generally takes precedence over state laws.
    The suit also says the measure interferes with the federal government’s constitutional obligation to provide access to abortion, including in cases of rape or incest, to people in the custody or care of federal agencies or government contractors, including at prisons.
  • In its 5-to-4 decision last week, the Supreme Court’s conservative majority said abortion providers and civil rights groups had “raised serious questions regarding the constitutionality of the Texas law.” But the court allowed the ban to take effect while the legal battle plays out, saying the abortion providers and advocates who had challenged the law could not show they were suing the right people.
    Their lawsuit targeted state court judges and court clerks, who would have to accept lawsuits alleging violations of the ban for those suits to go forward. The majority said it was premature for the court to step in because it is “unclear whether the named defendants can or will seek to enforce the Texas law.”
  • Garland said Monday that his agency would do all it could to guarantee access to abortion in Texas. But advocates said the pledge lacked specifics; they urged a direct challenge.
    Asked Thursday about the intense pressure from Democrats to take action, Garland said the department “does not file lawsuits based on pressure. We carefully evaluated the law and the facts, and this complaint expresses our view of the law and the facts.”
    The lawsuit seeks to stop not only the state but also private individuals who would bring civil lawsuits to enforce the Texas law.
    In response, Texas Attorney General Ken Paxton (R) tweeted, “Today the Biden Administration sued every individual in Texas” and said Biden should not meddle in a state’s “sovereign rights.”
  • Steve Vladeck, a constitutional law professor at the University of Texas law school, called the lawsuit “an ambitious and powerful” effort “to protect the constitutional rights of citizens.” The question, he said, is whether citizens who try to enforce the law are “agents of the state and therefore subject to the injunction the government is seeking.”
    “That’s a very broad request for relief,” said Vladeck, who has been publicly critical of the way the law was designed to avoid judicial review, “but also perhaps necessary given the novel and cynical procedural traps Texas created.”
  • Biden “is a puppet of the radical abortion agenda, and his DOJ will quickly find that they do not have jurisdiction to stop the Texas Heartbeat Act,” said Elizabeth Graham, vice president of Texas Right to Life.
    The law is already having an effect. Abortion clinics in Texas say they are abiding by the six-week ban and sending women who are further along in their pregnancies across state lines to seek the procedure.
    Texas Right to Life, which backed the law, was collecting anonymous tips on its website about potential violations of the law, but so far no lawsuits have been filed against abortion providers in state court.

"U.S. Abortion Rate Hits Lowest Point Since 1973" (February 2, 2014)[edit]

Bassett, Laura (February 2, 2014). "U.S. Abortion Rate Hits Lowest Point Since 1973". Huffington Post.

  • The U.S. abortion rate dropped significantly from 2008 to 2011 and hit its lowest point since 1973 (the year Roe v. Wade was decided), according to a new report by the Guttmacher Institute. The big drop occurred just prior to an unprecedented wave of state anti-abortion restrictions going into effect.
    The rate declined to 16.9 abortions per 1,000 women of reproductive age in 2011, a 13 percent drop from 2008. The rate had peaked in 1981 at 29.3 abortions per 1,000 women -- roughly twice the 2011 rate -- and plateaued at about 19.4 abortions per 1,000 women from 2005 to 2008.
  • Researchers found no evidence that the drop in abortions was related to new legal restrictions on the procedure. The total number of abortion clinics declined only 1 percent between 2008 and 2011, and the number of providers dropped by 4 percent. Rachel Jones, lead author of the study, said the decline had more to do with an increase in contraceptive use.
    "The decline in abortions coincided with a steep national drop in overall pregnancy and birth rates," she said. "Contraceptive use improved during this period, as more women and couples were using highly effective, long-acting reversible contraceptive methods, such as the IUD. Moreover, the recent recession led many women and couples to want to avoid or delay pregnancy and childbearing.”
  • According to the latest Guttmacher data, more than half of pregnancies in the United States are unintended, and about 40 percent of unintended pregnancies end in abortion. About three-fourths of women who have abortions say they can't afford a child; three-fourths say having a child would interfere with work, school or the ability to care for other dependents; and half say they do not want to be a single parent or are having problems with their husband or partner.
    While the overall abortion rate was declining, the Guttmacher study found that the percentage of medication-induced abortions was increasing relative to surgical abortions among women in their first trimester of pregnancy. Nearly a quarter of nonhospital abortions were early medication procedures in 2011 -- a 6 percent increase from 2008.
    “Clearly, the availability of medication abortion does not lead women to have more abortions,” said Jones. “However, it has likely helped women obtain abortion care earlier in pregnancy, as evidenced by a shift toward very early abortions.”
  • State legislatures enacted a record number of anti-abortion laws in 2011, including mandatory waiting periods, mandatory ultrasound laws, strict new building requirements for clinics, gestational limits on abortion and requirements that abortion providers have admitting privileges at local hospitals. The study notes that most of these restrictions were passed in the second half of 2011, and because there is typically a lag between a law's passage and its implementation, they would not have affected the 2011 abortion rate.
    The Guttmacher study concluded that further research is needed to determine what effect the new laws will have on the abortion rate and access to services.
    "Although we found no evidence that new abortion restrictions affected abortion incidence or services at the national level during the study period, this does not mean these laws are not problematic," the study authors wrote. "Some of the new regulations undoubtedly made it more difficult, and costly, for facilities to continue to provide services and for women to access them."

"Five men outlaw abortion in a Texas town, declaring a 'sanctuary city for the unborn'" (06/13/2019)[edit]

Isaac Stanley-Becker. "Five men outlaw abortion in a Texas town, declaring a 'sanctuary city for the unborn'". The Washington Post. (06/13/2019)

  • The municipal prohibition, which plainly contradicts the judgments of the U.S. Supreme Court, joins statewide bans on abortion sweeping the country in the wake of the solidification of a conservative majority on the nation’s top court. In Texas, abortion has already been banned after 20 weeks. Now in the state, a bill awaiting the governor’s signature would require doctors to treat “a child born alive after an abortion,” which happens rarely.
  • The legislation was modeled on a measure embraced 7 to 1 in March by the city council of Roswell, N.M., which is best known as the site of a purported UFO crash in 1947. Roswell’s move to declare its support for “fetal life” was accompanied by a measure characterizing itself as a “Second Amendment Sanctuary City,” in opposition to legislation advanced by the state legislature that expands background checks for private gun sales.
    Waskom residents said they were unconcerned by the prospect of a costly legal fight over the abortion measure because, according to local media, “they say God will take care of them.”
  • City officials said they included exceptions for rape and incest, and cases where the mother’s life is at risk, to force a reckoning with the procedure of abortion itself, preventing a judgment based only on the absence of exceptions.
    Lobbying for the ordinance was led by Right to Life of East Texas, whose director, Mark Lee Dickson, celebrated the unanimous vote in posts on Facebook.
    He quoted from the measure, which states that “the Supreme Court erred in Roe v. Wade when it said that pregnant women have a constitutional right to abort their pre-born children.” It further describes the 1973 opinion as a “lawless and illegitimate act of judicial usurpation, which violates the Tenth Amendment by trampling the reserved powers of the States, and denies the people of each State a Republican Form of Government by imposing abortion policy through judicial decree.”
  • Dickson, who is a pastor at the Baptist Sovereign Love Church in Longview, Tex., added his interpretation of the measure, saying it meant that all organizations that provide abortions or assist others in obtaining the procedure “are now declared to be criminal organizations in Waskom, Texas.”
    The antiabortion activist has thrown his weight behind some of the most sweeping efforts to outlaw the procedure, including by assigning criminal liability to women, and not just the doctors they seek out to end their pregnancies.
    In April, he went to Austin to advocate for a bill that would have criminalized abortion without exception, making it possible to convict women who undergo the procedure of homicide, which can carry the death penalty in Texas. The measure, which earned a hearing before the state House Committee on Judiciary and Civil Jurisprudence, was introduced by state Rep. Tony Tinderholt, a Republican from Arlington, Tex., who argues that the measure is necessary to make women “more personally responsible.”
  • In a statement on Thursday, the executive director of Naral Pro-Choice Texas, Aimee Arrambide, called the ordinance a “dangerous attempt to undermine Roe v. Wade," and affirmed that, “abortion remains legal in all 50 states.”
    “We will not be intimidated,” Arrambide pledged.
  • Before the Tuesday vote, Waskom’s mayor told council members that the city lacked the resources to engage in a lengthy legal battle over the legislation, the instigation of which is the professed aim of the ordinance.
    “Most likely we will wind up getting sued if this is passed,” the mayor, Jesse Moore, said. “It could go to the Supreme Court.”
    That prospect would present fiscal challenges for the city, lawmakers acknowledged.
    “We don’t have the possible millions of dollars that it would take to take it to that level,” said alderman Jimmy Dale Moore, who nevertheless voted for the ordinance. “We can’t pay those kind of attorney’s fees. The city don’t have the money.”
    Pointing to a member of the crowd gathered to watch the proceedings, the mayor advised, “Save your nickels and pennies,” eliciting chuckles from the public.
    “We may need them,” he said.

"Texas town bans abortion in all-male council vote" (June 13, 2019)[edit]

"Texas town bans abortion in all-male council vote". BBC News. June 13, 2019. Retrieved January 23, 2020.

  • All five members of the entirely male Waskom city council have declared their East Texas town a "sanctuary city for the unborn".
    The unanimous vote prohibits abortion within Waskom's city limits, leaving exceptions in the case of rape, incest or serious risk to the mother's life.
    There are no abortion clinics in Waskom but councilmen told local media the ban was a necessary preventative measure.
  • Local media footage of the vote showed Mayor Jesse Moore caution other council members that they may be sued for passing the ban.
    "It could go to the Supreme Court," he said.
    Mark Lee Dickson, director of Right to Life of East Texas and an advocate for the ban, wrote on Facebook that the measure was "history in the making".
    "It is good to see the men of Waskom rise up to protect women and children," he wrote.
  • Nearly 30 states have introduced some form of restriction on abortion so far this year.
    Fifteen of these bans, in states such as Louisiana and Georgia, forbid abortion as early as six weeks into a pregnancy - before many women even know they are pregnant.
    Anti-abortion supporters have dubbed these six-week bans "heartbeat bills" as they outlaw abortion as soon as what they describe as a foetus' heartbeat is detectable. But the American College of Obstetricians and Gynaecologists says that name is misleading, as what is being detected is "a portion of the foetal tissue that will become the heart as the embryo develops".
  • According to the Guttmacher Institute, a group that researches sexual and reproductive health, 19 states have laws that could be used to restrict abortion, while 10 states have laws that protect abortion rights.

“The Oxford companion to United States history” (2006)[edit]

Boyer, Paul S., ed. (2006). “The Oxford companion to United States history”. Oxford: Oxford Univ. Press.

  • The legal status of abortion in the United States has undergone dramatic shifts but its practice has been consistent. Throughout American history, many women have relied on abortion to control their fertility. Before the mid-nineteenth century, abortion induced prior to quickening (the moment when the pregnant woman feels fetal movement) was a legal and accepted practice, especially for young, unmarried women. Y midcentury, the commercialization of abortion gave greater visibility to its prevalence among married, white, native-born women. This increased visibility coincided with growing agitation by women for fuller inclusion in public life and with increased “immigration of ethnically diverse people, both of which provoked concern about the nation’s changing character. Thus when physicians pursued the criminalization of abortion in an effort to stabilize their professional standing through laws restraining their competitors, especially midwives, their proposals resonated with legislators’ gender, ethnic, and nationalist fears. In the twenty years between 1860 and 1880, with little public debate, every state made abortion illegal, except when performed by a licensed physician to save the life of the pregnant woman. In this same period, federal and state laws also prohibited the distribution of contraceptive information and devices.
  • At times during the one hundred years when abortion was illegal, police allowed its practice to continue undisturbed, at times it was repressed. Throughout the period, many women continued to procure abortions despite the risks, and juries often refused to convict abortionists, indicating continued public acceptance of the practice. During the 1930s, abortion clinics run by licensed physicians operated quite openly contributing to an estimated 800,000 abortions a year. However, the procedure was still quite risky; induced abortions accounted for 14 percent of maternal mortality. After World War II, hospitals tightened the practice o therapeutic abortion by establishing physician review boards, leading to a dramatic reduction in hospital abortions. Police raids on the illegal clinics that had thrived in the 1930s made abortion even more difficult and dangerous to obtain. Abortion death rates doubled between 1951 and 1962, with the risk falling most heavily on women of color who were four times more likely than white women to die from abortion.
  • Political challenges to abortion laws were rare before the 1960s. The birth control movement led by Margaret Sanger did not contest abortion restrictions, instead pointing to the high rates of injury and death from criminal abortion as a compelling reason to decriminalize contraception. As repression of abortion increased through the 1950s, leading women to take more desperate risks, physicians and women began to seek reform of abortion laws. By 1973, through legislative and court actions, the abortion reform/repeal movement won changes in nineteen state laws. At the same time, networks were organized to provide women with access to safe and affordable illegal abortions. In California, the Society for Humane Abortion inspected facilities, bargained over fees, and referred thousands of women to clean and inexpensive illegal abortions in Meico. In Chicago, self trained women organized an abortion service called Jane that performed twelve thousand abortions between 1969 and 1973 without a single fatality. These referral networks were part of the resurgent women’s movement, which also pushed beyond reform to seek repeal of abortion laws. They argued that the decision to abort a pregnancy involved the fundamental right of women to control their bodily process.
  • This activism ended in 1973 with the “Supreme Court’s “Roe v. Wade” landmark decision. Grounded in the 1965 decision “Griswold v. Connecticut”, which had established the right to privacy in contraceptive decision-making, ‘’Roe’’ established a fundamental right to abortion. Under ‘’Roe’’, except to ensure maternal health, stataaes could not restrict abortion before fetal viability. (Viability is the point in pregnancy when the fetus is “capable of meaningful life outside the womb,” roughly the end of the second trimester.) After ‘’Roe’’, the maternal mortality rates dropped by almost one half.
  • Efforts to undercut ‘’Roe’’ began almost immediately. Small groups opposed to abortion reform blossomed into the “pro life” movement, arguing that abortion violated the fetus’s right to life. Initially led by the American Roman Catholic church, the movement expanded as social conservatives and Protestant fundamentalists (some intent on rebuilding the ‘Republican party after Watergate) took up the issue. Early successful restrictions centered on ending federal funding of abortion for poor women and requiring parental consent and notification lws for teenagers. Outside the courtroom and legislature, organized efforts emerged to disrupt the practice of abortion. Harassment of clinic patients and abortion providers became common. IN the late 1980s and early 1990s, Operation Rescue, led by Randall Terry, blockaded abortion clinics in cities nationwide. The goal of this activity was to publicize the pro-life cause and make abortion difficult, if not impossible, to obtain. Between 1982 and 1998, there were more than 150 bombings and 5 murders associated with anti-abortion activity.
  • While not recriminalizing abortion, the Supreme Court in 1992 retreated from its holding in ‘’Roe’’. In the Casey v. Planned Parenthood’’ decision, which upheld mandatory waiting periods and state mandated counseling, the Court ruled that the State’s interest in protecting potential life permitted some restrictions on abortion throughout pregnancy, as long as the restrictions did not impose an undue burden on women. Thus, abortion was no longer a fundamental right; the lower standard of “undue burden” gave legislators greater leeway to limit abortion. At the twentieth century ended, abortion remained legal, but practical access was increasingly problematic. Harassment, violence, and restrictions led many hospitals nad practitioners to stop providing abortion. An estimated 83 percent of U.S. counties had no abortion provider. At the same time, however, federal and state laws protecting women’s access to clinics, and the innovative use of anti racketeering laws against organizers of clinic blockades, continue to hinder efforts to stop abortion completely.

“The Church and abortion: a Catholic dissent” (30 September 2010)[edit]

O'Brien, George Dennis (30 September 2010). “The Church and abortion: a Catholic dissent”. Rowman & Littlefield. ISBN 978-1-4422-0577-2. Retrieved 5 January 2012.

  • It might have been less divisive politically if abortion had moved toward legal permission through legislative debate in the states. One should not be deluded, however, into thinking that if abortion were once again before state legislatures, we would be in the same situation legally or socially as in 1973 when Roe was handed down. The fact that history cannot be simply reversed has been made by various justices in their opinions resisting the overturn of Roe. For more than thirty-five years women have assumed that legalized abortion was possible in the United States. Whether their decisions to have an abortion during that time were moral or wise, the deed was done legally. What would be the social dynamic if abortion were again prohibited?
    • p.23
  • I do not believe that the question of criminal law can be evaded; specific laws raise further moral issues beyond the immorality of abortion itself. If, after reversing Roe, abortion were to be banned by any means nationally, or, more plausibly, locally in the states, legal penalties would have to be enacted against those who violated the law. What would be an appropriate and effective law? The ultimate “realism” of anti-abortion legislation hinges on the plausibility of solving the lord high executioner’s “object all sublime”: to make the punishment fit the crime. Failure to match crime and punishment undermines law: too harsh a penalty and juries will not convict, too lenient and the crime disappears from public perception and the docket.
    • pp.24-25
  • Simple realism suggests that even modest anti-abortion laws are unlikely to be enacted in the United States. If two conservative states like South Dakota and Colorado could not muster majorities for anti-abortion statutes, what are the chances in other states? There may be a few states, probably in the so-called Bible belt, that would pass anti-abortion laws in the absence of Roe, but even there it is unlikely that the laws would match the foundational rhetoric of the Catholic oral crusaders. The reason that even conservatives and prudent Catholic bishops pull back from highly punitive law stems from quite appropriate moral assessment that seldom strays into the anti-abortion rhetoric. I will examine these moral assessments in the next chapter, but before I do I want to point out one more reason why abortion should not be the trump card in politics.
    • p.32

=== "New York Dems Flex Muscles, Pass Reproductive Health Act"]. (January 22, 2019) === "New York Dems Flex Muscles, Pass Reproductive Health Act". CBSNewYork. January 22, 2019.

  • NEW YORK (CBSNewYork) -- A re-write of New York abortion laws had been held up by Republicans for more than a decade.
    On Tuesday, the 46th anniversary of the Roe v. Wade decision, Senate Democrats passed the Reproductive Health Act, 38-24. Gov. Andrew Cuomo hoped to sign the bill later in the evening, CBS2's Tony Aiello reported.
    Critics call the legislation a radical over-reach that benefits people who harm pregnant women.
    All the power in Albany is now in the hands of Democrats and they quickly moved to pass an abortion rights bill.
    "We're saying here in New York, women's lives matter. We're saying here in New York, women's decisions matter," Senate Majority Leader Andrea Stewart-Cousins said.
  • [C]ritics say the Reproductive Health Act goes beyond codifying -- to expanding.
    Timothy Cardinal Dolan spoke about it Tuesday on his radio show.
    "Any, any, any limit on the unfettered, unquestioned absolute right to abortion, they want none of it," Dolan said.
  • Provisions in the bill include dropping most restrictions on abortions after 24 weeks, allowing midwives and nurse practitioners to perform abortions and ending criminal charges for harming children in the womb.
    Livia Abreu of the Bronx lost her baby in a 2018 domestic violence attack. Charges against her ex-boyfriend, Oscar Alvarez, include abortion in the first degree.
    "The passing of RHA will exonerate him from those charges. I cannot imagine living in a world where harming or killing an unborn child is not a crime," Abreu said.

"CDCs Abortion Surveillance System FAQs" (November 21, 2012)[edit]

"CDCs Abortion Surveillance System FAQs". Center for Disease Control and Prevention. November 21, 2012. Retrieved August 8, 2013.

  • CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. Many states and reporting areas conduct abortion surveillance. CDC compiles the information these reporting areas collect to produce national estimates. CDC’s surveillance system compiles information on legal induced abortions.
  • Preparation of the Abortion Surveillance report is based on the data available from the states and reporting areas that voluntarily provide this information for a given calendar year. After CDC receives the data, additional time is required to perform the analyses that produce the tables, the figure, and the narrative describing methods and trends. Please view the abstract and methods portion of the most recent Abortion Surveillance report for more information on compilation of the report.
  • This report is used for many purposes in the field of public health, including to:
    Evaluate the success of programs aimed at promoting equitable access to patient-centered quality contraceptive services in the United States
    Calculate pregnancy rates, on the basis of the number of pregnancies ending in abortion, in conjunction with birth data and pregnancy loss estimates
    Monitor changes in clinical practice patterns related to abortion, such as changes in the types of procedures used and weeks of gestation at the time of abortion
    Calculate the national legal induced abortion case-fatality rate
  • In addition to the data available in the annual Abortion Surveillance report, data from 2010 to 2019 are also available for abortions distributed by state/area of residence and state/area of clinical service. These data are consistent with data reported to CDC for each year’s Abortion Surveillance report. No additional data are available for public use.
  • In 2019, 629,898 legal induced abortions were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2010–2019, in 2019, a total of 625,346 abortions were reported, the abortion rate was 11.4 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 195 abortions per 1,000 live births.
    From 2010 to 2019, the number, rate, and ratio of reported abortions decreased 18%, 21%, and 13%, respectively. However, compared with 2018, in 2019, the total number increased 2%, the rate of reported abortions increased by 0.9%, and the abortion ratio increased by 3%.
  • Similar to previous years, in 2019, women in their twenties accounted for the majority of abortions (56.9%). The majority of abortions in 2019 took place early in gestation: 92.7% of abortions were performed at ≤13 weeks’ gestation; a smaller number of abortions (6.2%) were performed at 14–20 weeks’ gestation, and even fewer (<1.0%) were performed at ≥21 weeks’ gestation. Early medical abortion is defined as the administration of medications(s) to induce an abortion at ≤9 completed weeks’ gestation, consistent with the current Food and Drug Administration labeling for mifepristone (implemented in 2016). In 2019, 42.3% of all abortions were early medical abortions. Use of early medical abortion increased 10% from 2018 to 2019 and 123% from 2010 to 2019. MMWR Surveill Summ 2021;70(No. SS-9):1–29.

"Click - Debating Reproductive Rights - Reproductive Rights and Feminism, History of Abortion Battle, History of Abortion Debate, Roe v. Wade and Feminists"[edit]

"Click - Debating Reproductive Rights - Reproductive Rights and Feminism, History of Abortion Battle, History of Abortion Debate, Roe v. Wade and Feminists". www.cliohistory.org. Retrieved December 2, 2017.

  • Even though single women won wider access to birth control in the 1960s and 1970s, sexual activity could still result in unplanned pregnancies, which brought the nation’s abortion laws under scrutiny. The first laws explicitly prohibiting abortion were passed in the late nineteenth century, often restricting abortion to cases where the life of the mother was at risk. As the modern medical profession continued to lay claim to all aspects of women’s reproductive health during the first half of the twentieth century, doctors and hospital review boards became the gatekeepers who decided whether a woman could qualify for a legal “therapeutic” abortion. Very few did. Unplanned pregnancies in turn fed the demand for back-alley abortionists who could charge exorbitant rates and operate under unhealthy, sometimes deadly conditions.
    Starting in the 1960s, some doctors began to push for the liberalization of abortion laws. The case of Sherri Finkbine, who had to go to Sweden for a legal abortion in 1962 after inadvertently taking a drug (thalidomide) known to cause severe birth defects, helped galvanize public opinion. In the late 1960s feminists joined doctors in the fight, calling not just for reform of abortion laws but for their outright repeal, as represented in the call for “abortion on demand.” By 1972 sixteen states and the District of Columbia had liberalized their laws.
  • Forty years later, the Supreme Court still affirms women’s fundamental constitutional right to abortion but has allowed a wide range of restrictions and limits to be placed on that right. An abortion is legal, but you may not be able to find a clinic to perform one. That middle ground is remarkably similar to where popular opinion rests: showing support for women’s right to end a pregnancy but also strong unease about the procedure, especially after the first trimester.
    The polarizing effects of Roe v. Wade were seen almost immediately in the political realm. Feminists hailed the right to abortion as a vital cornerstone of women’s ability to control their reproductive choices and their lives, but the decision galvanized opponents and helped to kill the Equal Rights Amendment. In 1976, the U.S. Congress passed the Hyde Amendment, which prohibited the use of federal funds for Medicaid abortions even if they were medically necessary; the Supreme Court upheld this restriction in 1980. Followers of conservative and fundamental religions, including many women, continued to speak out against abortion as antithetical to their vision of family. Meanwhile, groups such as Phyllis Schlafly’s Eagle Forum and Beverly LaHaye’s Concerned Women for America increasingly moved abortion to the forefront of their anti-feminist platform, where it has remained ever since.
  • In terms of abortion politics, the 1980s were a period of what Sandra Morgen called the Three Rs: retrenchment, Reagan, and Operation Rescue. The general shift in the political climate to the right after the election of Ronald Reagan in 1980 stalled the momentum for civil rights and feminism. As part of cutbacks in government spending (spurred by the deficit but really as a way to cut programs Republicans thought the government had no business funding in the first place), healthcare and anti-poverty programs were especially hard hit, with deleterious effects on the provision of reproductive services to the nation’s women, especially poor women. Add to that the founding by Randall Terry of Operation Rescue in 1986, which used violence and intimidation outside abortion clinics to try to keep women from entering. The escalating violence, which included clinic bombings, arson, and the murder of abortion providers, led to the passage of the Freedom of Access to Clinic Entrances Act in 1994.
  • As the anti-abortion movement chipped away at access to abortion, in effect making it increasingly difficult to find a legal abortion provider in many parts of the country, supporters of abortion rights found they were fighting battles on many fronts. Susan Faludi’s 1991 bestseller, Backlash: The Undeclared War Against American Women, detailed the shifting political climate. Organizations such as Planned Parenthood and NARAL Pro-Choice America intensified their efforts, raising money, lobbying Congress and statehouses, and on occasion, such as the 1989 March for Reproductive Rights, bringing hundreds of thousands of abortion supporters to the nation’s capital. Women of color played an important role in challenging anti-abortion legislation by highlighting its racial and class implications and broadening the movement for reproductive rights into one for reproductive justice. Rather than holding a “March for Choice” in 2004, an energized and diverse group of activists converged in record numbers for the “March for Women’s Lives.”
    Not surprisingly, these political efforts found more favor with Democratic administrations than Republican. The Clinton administration supported the passage of the clinic access bill and directed the Justice Department to aggressively counter abortion violence. Since Barack Obama took office in 2009, restrictions against embryonic stem cell research have been lifted, the international gag order restricting information about birth control techniques in foreign aid has been dropped, and the “morning-after pill” is more widely available without a prescription, even to teenagers. And yet state legislatures as well as Congress continue to add more and more restrictions on the provision of abortion. The irony is that by imposing increasingly stringent regulations on abortion clinics to bring them practically in line with hospitals, abortion provision has now come almost full circle since the early 1960s, when hospitals were the only places where women could have legal abortions and then only with the permission of a panel of doctors.
  • There is no end in sight to this polarization. Polls show women holding firm allegiance to both sides of the issue, with support strongest for access to abortion in the first trimester (12 weeks) but declining dramatically after that, even among those who claim to be “pro-choice.” There is also widespread support for abortion in the cases of rape and incest, as well as when the life of the mother is threatened.
    When the abortion battles are viewed against the backdrop of the revolutionary changes in women’s lives over the past half century, it is clear that many Americans still feel a certain unease about women’s new freedoms, sexual or otherwise. Even though there has been a sea change in attitudes about women’s sexual expression, the ongoing debate over abortion shows that the question of women’s self-determination over their own bodies is far from settled.

“Abortion and Women of Color: The Bigger Picture” (August 6, 2008)[edit]

Susan A. Cohen, “Abortion and Women of Color: The Bigger Picture”, Guttmacher Policy Review, Volume 11, Issue 3, (August 6, 2008)

  • This much is true: In the United States, the abortion rate for black women is almost five times that for white women. Antiabortion activists, including some African-American pastors, have been waging a campaign around this fact, falsely asserting that the disparity is the result of aggressive marketing by abortion providers to minority communities.
  • The truth is that behind virtually every abortion is an unintended pregnancy. This applies to all women—black, white, Hispanic, Asian and Native American alike. Not surprisingly, the variation in abortion rates across racial and ethnic groups relates directly to the variation in the unintended pregnancy rates across those same groups.
  • Abortion rates have been declining in the United States for a quarter of a century, from a high of 29.3 per 1,000 women aged 15–44 in 1981 to an historic low (post-Roe v. Wade) of 19.4 in 2005. The overall number of abortions has been falling too, dropping to 1.2 million in 2005. Currently, about one-third of all abortions are obtained by white women, and 37% are obtained by black women. Latinas comprise a smaller proportion of the women who have abortions, and the rest are obtained by Asians, Pacific Islanders, Native Americans and women of mixed race (see chart).
  • These patterns of abortion rates mirror the levels of unintended pregnancy seen across these same groups. Among the poorest women, Hispanics are the most likely to experience an unintended pregnancy. Overall, however, black women are three times as likely as white women to experience an unintended pregnancy; Hispanic women are twice as likely. Because black women experience so many more unintended pregnancies than any other group—sharply disproportionate to their numbers in the general population—they are more likely to seek out and obtain abortion services than any other group. In addition, because black women as a group want the same number of children as white women, but have so many more unintended pregnancies, they are more likely than white women to terminate an unintended pregnancy by abortion to avoid an unwanted birth.

"From Privacy to Autonomy: The Conditions for Reproductive and Sexual Freedom" (1990)[edit]

Copelon, Rhonda "From Privacy to Autonomy: The Conditions for Reproductive and Sexual Freedom". in Fried, Marlene Gerber (ed.). “From Abortion to Reproductive Freedom: Transforming a Movement” (1990). South End Press. ISBN 9780896083875.

  • Since 1973 the Court decision in “Roe v. Wade” has survived numerous assaults. For about a decade following the 1873 decision, the “fetal personhood” campaign, spearheaded by the Catholic Church and later joined by Protestant New Right fundamentalists, held center stage.
    Right-to-life advocates argue for the subservience of women to the fetus, pitting images of innocent and helpless souls against those of selfish, unnatural, and murderous feminimity. Their goal is not simply to save fetuses but to return woman to her “proper place”-to assure that motherhood remains her primary preoccupation. Their campaign has had some terrible successes in the Court, particularly in the decisions in “Harris v. McRae”, permitting legislatures to deny abortion funding to poor women and “Baird v. Bellotti”, predicating a teenage girl’s rights ton parental approval or a judicial shaming ceremony. In 1983, however, a number of fetal rights efforts initiated at the outset of the Reagan administration’s effort to have the Court water down “Roe”, although its position was substantially adopted by Justice Sandra Day O’Connor in her dissenting opinion.
    • p.28
  • The Reagan Presidency provided the mechanism for the ultimate attack on “Roe v. Wade”-the appointment of over one-half of the federal judiciary and almost one-half of the Justices of the Supreme Court who were chosen because of their allegiance to the overruling of “Roe” and the dismantling of the modern right of privacy, as well as most of the rights protected by the Bill of Rights.
    The Reagan administration cloaked its right wing agenda in the argument that the Court had no power to protect rights not articulated in the text of the Constitution or intended by the framers. While parading as the “jurisprudence of original intent,” the practical implications of resuscitating the framers’ intent as the measure of the Constitution explain its popularity on the Right. When the “founding fathers” are sacralized as the fount of wisdom, we are not reminded that they lived in a thoroughly patriarchal society, preserved slavery in the Constitution, and mocked the idea of the vote for women. Even the Radical Republicans who framed principle of quality after the Civil War did not envision school desegregation or the equality of women. In contrast to the originalist school, defenders of the modern Court’s decisions argue that the Constitution is a document for the ages and that the broad principles it expresses are to be given new meaning in light of the historical evolution of the society as well as of the new, lived meaning of human rights.
    • p.29
  • The first challenge to the criminal abortion laws through litigation and reform bills in state legislatures envisioned abortion as a doctor’s professional prerogative. Then in 1969 in New York, the first feminist challenge to the original abortion laws was filed, putting women’s right to control their bodies and lives at center stage. Whereas in the legislatures women had to break into an ongoing dialogue between male legislators and experts, in the courts it was easier to focus attention on their experience, need, and entitlement to control reproduction. This transformed a social reform movement for legal abortion led by doctors, family planners, and population controllers into a human rights struggle. As Ellen Willis wrote: “It was the feminist demand for an “unconditional right to abortion” that galvanized women and “created effective pressure for legislation.”
    The claim of privacy played a central role in early abortion rights advocacy. The first legal cases involved doctors who challenged the imposition of criminal sanctions as an interference with the privacy of the doctor-patient relationship. The appeal to privacy also reflected the more liberal orientation of some feminist abortion advocates and a more cautious approach to litigation.
    • p.32
  • The core idea of the right to abortion-that women should be in control of decision making over their reproduction-employs the notion of non-interference by the state to reinforce rather than undermine women’s autonomy. In this respect it is a progressive demand. But, as it has been elaborated by many pro-choice advocates and by the Court, it is still a limited and deeply flawed basis for reproductive freedom. There has emerged a sharp tension between two notions of privacy: the liberal idea of privacy as a the negative and qualified right to be left alone (so long as nothing too significant is at stake), and the more radical ideal of privacy as the positive liberty of self-determination and an aspect of equal personhood. Both practically and theoretically, the privacy doctrine is double-edged, having within it the tendency to constrain as well as to expand reproductive rights.
    • p.33
  • The face that abortion rights have been qualified by fetal viability since “Roe v. Wade” is attributable, of course, to political compromise but also to the combined defects of a negative theory of privacy and a truncated view of women’s personhood. To limit a woman’s right-whether it be to decide on an abortion or refuse Caesarean surgery in childbirth-in the interest of viable yet still physically dependent potential life denies her full moral and physical autonomy.
    • p.36

"Committed to Availability, Conflicted about Morality: What the Millennial Generation Tells Us about the Future of the Abortion Debate and the Culture Wars" (June 9, 2011)[edit]

Daniel Cox, Robert P. Jones; "Committed to Availability, Conflicted about Morality: What the Millennial Generation Tells Us about the Future of the Abortion Debate and the Culture Wars". Public Religion Research Institute. June 9, 2011.

  • A solid majority of Americans say abortion should be legal in all (19%) or most (37%) cases, compared to 4-in-10 who say it should be illegal in all (14%) or most (26%) cases.
    With the exception of white evangelical Protestants, majorities of all major religious groups say abortion should be legal in all or most cases. A majority of Americans across the political spectrum say it is more socially acceptable today to be “pro-choice” rather than “pro-life.”
    Nearly 6-in-10 (58%) Americans say that at least some health care professionals in their communities should provide legal abortions. With the exception of white evangelical Protestants and Latino Catholics, majorities of all major religious groups agree that at least some health care professionals in their community should provide legal abortions. Americans who live in large metropolitan areas are much more likely than those who live in rural communities to say legal abortion services should be available in their community (67% vs. 39% respectively).
  • The binary “pro-choice”/“pro-life” labels do not reflect the complexity of Americans’ views on abortion. Seven-in-ten Americans say the term “pro-choice” describes them somewhat or very well, and nearly two-thirds simultaneously say the term “pro-life” describes them somewhat or very well. This overlapping identity is present in virtually every demographic group.
  • The decoupling of attitudes on abortion and same-sex marriage suggests that these topics, which served in the past as the heart of the “values” agenda, are no longer necessarily linked in the minds of Americans. Roughly the same percentage of Americans said abortion should be legal in all or most cases in 1999 (57%) as say this today (56%). In contrast, the percentage of Americans who said marriages between same-sex couples should be recognized by the law as valid has grown 18 points over this same period, from 35% in 1999 to 53% in 2011.
  • Millennials are less supportive of legal abortion than their demographic profile would suggest.
    Millennials generally have traits associated with higher levels of support for the legality of abortion: they are more educated, more liberal, and more likely to be religiously unaffiliated.
    Millennials exemplify the decoupling of attitudes on legal abortion and same-sex marriage. They are much more likely than the general public to favor same-sex marriage, but they are not significantly more likely than the general public to support the legality of abortion (60% vs. 56% in the general public).
    Millennials have largely positive top of mind associations with same-sex marriage but have largely negative top of mind associations with abortion.
    Millennials are conflicted about the morality of abortion, but most say same gender sexual relationships are morally acceptable. Nearly 6-in-10 (57%) Millennials say sex between two adults of the same gender is morally acceptable, compared to only 46% who say having an abortion is morally acceptable.
    Unlike all other age groups, Millennials register different levels of support for the availability and legality of abortion. On the one hand, Millennials are strongly committed to the availability of abortion and are significantly more likely than the general public to say that at least some health care professionals in their community should provide legal abortions (68% vs. 58% respectively). But they are no more likely than the general public to say that abortion should be legal in all or most cases. These findings suggest general measures of legality may not fully capture support for legal abortion among Millennials.
  • On the issue of abortion, Americans hold complex and sometimes contradictory views, and grasping this complexity is critical for understanding the dynamics of the debate.
    Approximately 3-in-10 Americans hold decidedly mixed views about the circumstances in which having an abortion should be possible. When measured on a composite scale of support for abortion in five specific circumstances, 43% say abortion should be possible in most or all of these circumstances, 29% say abortion should not be possible in most or all of these circumstances, and 28% hold decidedly mixed views.
    Majorities of Americans simultaneously say abortion is morally wrong (52%) and that it should be legal in all or most cases (56%).
  • The study identified and tested a number of hypotheses about independent influences on attitudes about the legality of abortion. The following factors are independent predictors of support for the legality of abortion, even when controlling for other demographic characteristics:
    Having a situationalist rather than a principle-based approach to morality has a positive impact on support for the legality of abortion.
    Knowing someone who has had an abortion has a positive impact on support for the legality of abortion.
    Having seen MTV’s reality shows about unmarried pregnant teenagers has a positive impact on support for the legality of abortion.
    Recently seeing an ultrasound image of a fetus has a negative impact on support for the legality of abortion.
  • Among Americans who attend church at least once or twice a month, majorities report hearing their clergy talk about the issue of abortion (54%) or homosexuality (51%) in church. Catholics are significantly more likely than Protestants to hear about abortion in church.
    More than 7-in-10 (72%) religious Americans believe it is possible to disagree with the teachings of their religion on the issue of abortion and still be considered a person of good standing in their faith.
    A majority of all major religious groups, including Catholics and white evangelical Protestants agree with this statement.
  • The Millennials, Religion, and Abortion Survey is the largest national public opinion survey ever conducted on abortion and the influence of religion and moral values on the issue. Because of its large sample size (N=3,000 interviews), it allows us to paint a portrait of generational, religious, and ethnic differences that has not been previously possible.
  • Over the last decade, a majority or plurality of Americans have said abortion should be legal in all or most cases, although there has been some volatility. Specifically, throughout most of the decade, solid majorities usually hovering around the mid-50’s reported that abortion should be legal in all or most cases, compared to roughly 4-in-10 who said it should be illegal in all or most cases. In August 2001, and again in 2009, the country was nearly divided, but numbers soon returned to their previous pattern. Our most recent data reflects the dominant pattern: a solid majority of Americans say abortion should be legal in all (19%) or most (37%) cases, and 4-in-10 say it should be illegal in all (14%) or most (26%) cases.
    The most polarized positions—views that abortion should be legal or illegal in all cases—have consistently been a minority opinion. Currently, roughly 1-in-5 (19%) Americans report that abortion should be legal in all cases, and 14% report that it should be illegal in all cases. Over the last ten years, the percentage of Americans who say abortion should be legal in all cases has never risen above 21%, and the percentage who say it should be illegal in all cases has never risen above 17%.
  • Views on abortion vary significantly by age, religion, race, education, political affiliation, and geographic region. However, there are no significant gender differences in views about the legality of abortion. Attitudes among the Millennial generation (ages 18 to 29) do not significantly differ from attitudes in the general population about the legality of abortion. Six-in-ten Millennials believe that abortion should be legal in all (22%) or most (38%) cases, compared to approximately 4-in-10 who say abortion should be illegal in all (13%) or most (25%) cases. Americans ages 65 and older are the only age group that differs significantly from the general public. Among this older age cohort, only about 4-in-10 say abortion should be legal in all (14%) or most (29%) cases, compared to half who say it should be illegal in all (17%) or most (33%) cases.
  • With the exception of white evangelical Protestants, majorities of all other major religious groups favor legalized abortion. At least two-thirds of religiously unaffiliated Americans (69%), white mainline Protestants (67%), and black Protestants (66%) say abortion should be legal in all or most cases. A majority (54%) of all Catholics say abortion should be legal in all or most cases, including 51% of Latino Catholics. Among white evangelical Protestants, however, less than 3-in-10 (29%) say abortion should be legal in all or most cases, compared to two-thirds (67%) who say it should be illegal in all or most cases.
  • There are significant differences by race and ethnicity. Nearly two-thirds (64%) of African Americans believe abortion should be legal in all or most cases. A solid majority (56%) of non-Hispanic whites say abortion should be legal in all or most cases, mirroring the general population. Latinos, in contrast, are evenly divided on the issue, with 47% saying abortion should be legal in all or most cases and 49% saying it should illegal in all or most cases.
  • Higher educational attainment levels are associated with more supportive views of legal abortion. Among Americans with a post-graduate education, nearly 7-in-10 (68%) say abortion should be legal in all or most cases. In contrast, Americans with a high school education or less are nearly evenly divided on the issue, with 50% saying abortion should be legal in all or most cases and 46% saying it should be illegal in all or most cases.
  • Democrats are approximately 30 points more likely to say abortion should be legal than Republicans. Seven-in-ten Democrats say abortion should be legal in all or most cases. Among Republicans and Americans who identify with the Tea Party movement, roughly 4-in-10 say abortion should be legal in all or most cases (38% and 41% respectively). Solid majorities of Republicans and Americans who identify with the Tea Party movement say abortion should be illegal in all or most cases (60% and 55% respectively). Political independents closely mirror the general population.
  • Americans who live in more urban areas or who live in the Northeast or West are more likely to support legalized abortion than those who live in rural areas or in the South and Midwest. Solid majorities of Americans in the Northeast and West say abortion should be legal in all or most cases (66% and 60% respectively). Americans who live in the South or Midwest are divided, with 51% of each region supporting legal abortion in all or most cases. Sixty-three percent of Americans who live in urban areas believe abortion should be legal in all or most cases, while Americans who live in rural communities are divided, with 45% saying abortion should be legal in all or most cases and half (50%) saying it should be illegal in all or most cases.
  • Nearly 3-in-10 (29%) Americans say abortion is a critical issue facing the country today; an equal number (29%) say that it is one among many important issues; and 4-in-10 say it is not that important compared to other issues. In comparison, close to 8-in-10 (78%) Americans report that the economy is a critical issue, and more than 4-in-10 Americans say that immigration (43%) and the environment (42%) are critical issues. Fewer than 1-in-4 (23%) report that same-sex marriage is a critical issue; same-sex marriage is the only issue about which a majority (53%) say it is not that important compared to other issues.
    Generally speaking, there are only minor variations in priorities among demographic groups, and most subgroups rank abortion fourth out of five issues, with same-sex marriage generally ranking fifth. Three major exceptions to this pattern are white evangelical Protestants, Republicans, and those who identify with the Tea Party. Members of these three subgroups rank abortion third behind the economy and immigration and rank the environment last.
    There are significant differences in the salience of abortion between those who believe abortion should be legal and those who believe it should be illegal. Those who oppose legal abortion are more than three times as likely as those who support legal abortion to say it is a critical issue. Among those who say abortion should be illegal in all cases, nearly two-thirds (65%) say that abortion is a critical issue. In contrast, among those who say abortion should be legal in all cases, only 19% say it is a critical issue.
  • Over the last decade, the pattern of support for legalized abortion and same-sex marriage have been dramatically different. As we noted above, despite some modest volatility, support for legalized abortion has been generally stable during this period. Roughly the same percentage of Americans said abortion should be legal in all or most cases in 1999 (57%) as say this today (56%). On the issue of same-sex marriage, in contrast, there has been a dramatic shift in opinion, especially over the last decade. In 1999, only 35% of the public said marriages between same-sex couples should be recognized by the law as valid. In 2011, a majority (53%) say same-sex marriage should be recognized by the law as valid, an 18-point increase.
  • The pattern of support on each of these issues by age also shows remarkable differences between the two issues. There is no significant difference between the views of Millennials and the general public on the issue of abortion. Among age cohorts, only seniors have a significantly different profile. Nearly equal numbers of Millennials (60%), Americans age 30-49 (58%) and Americans age 50-64 (59%) say abortion should be legal in all or most cases, compared to just 43% of Americans age 65 and over.
  • Views on abortion differ markedly depending on the particular circumstances. In order to get a more nuanced picture of how specific circumstances matter for Americans’ views on abortion, we adapted a battery of questions about circumstances from the General Social Survey, one of the longest-running sources of polling on social issues. Strong majorities agree that it should be possible for a woman to obtain a legal abortion in four of seven circumstances: if the woman’s physical health is seriously endangered by the pregnancy (86%); if she became pregnant as a result of rape (79%); if the woman’s mental health is seriously endangered by the pregnancy (74%); and if there is a strong chance of serious defect in the baby (66%).
    Americans are more ambivalent or opposed to a woman obtaining a legal abortion in three other specific circumstances. Americans are divided over whether a woman should be able to obtain a legal abortion because the woman is still in high school (47% possible, 49% not possible). Majorities of Americans say it should not be possible for a woman to obtain a legal abortion in two circumstances: the family is low income and cannot afford any more children (52%); and the woman is not married and does not want to marry the man (58%).
  • There are significant divisions by religious affiliation. Two-thirds (67%) of the religiously unaffiliated and half (50%) of white mainline Protestants say abortion should be possible in most or all circumstances. White Catholics and black Protestants are more divided, but pluralities of each group (44% and 41% respectively) say abortion should be possible in most or all circumstances. Black Protestants are also notable as the group most likely to have mixed views about abortion (36%). In contrast, fewer than 1-in-4 white evangelical Protestants (23%) and Latino Catholics (22%) say abortion should be possible in most or all circumstances. Latino Catholics are half as likely as white Catholics to believe that abortion should be possible in most or all circumstances (22% vs. 44% respectively). It is also noteworthy that at least one-quarter of every major religious group hold mixed views about the circumstances in which abortion should be possible.
  • Perhaps the most remarkable trait about Americans who have mixed views on abortion is that, with the exception of their educational profile, they are nearly indistinguishable from the general public. They are evenly divided between men and women. They reflect proportional numbers of racial and ethnic minorities, and they are also proportionally spread across age categories. A plurality of Americans with mixed views on abortion are politically independent (36%) or moderate (40%), also mirroring the political profile of the public at large. They draw proportionally from major religious groups and attend religious services at roughly the same rates as the general population. Their one distinguishing characteristic is that a majority (52%) of Americans who have mixed views on abortion have a high school education or less, compared to 42% of the general public.
    As is expected, Americans with mixed views on abortion are nearly evenly divided on the question of the legality of abortion, with 48% saying abortion should be legal in all or most cases, and 45% saying abortion should be illegal in all or most cases.
  • A slim majority (51%) of Americans say that obtaining an abortion in their community is not too difficult or not at all difficult. One-third (33%) report that it is somewhat or very difficult, and a significant number (17%) report being unsure or did not answer the question. Among Millennials, 55% believe it is not at all or not too difficult to obtain an abortion, and 37% say that it is somewhat or very difficult. Millennials are more likely than other age cohorts to have an opinion about how difficult it is to get an abortion; only 7% report that they are unsure or do not know, compared to 28% of Americans age 65 or older. There are no significant differences in opinion on this question by political or religious affiliation or by gender.
    Americans who live in rural areas are about twice as likely as those who live in urban areas to believe that it is either somewhat or very difficult to get an abortion (48% and 25% respectively). A majority (55%) of urban residents say it is not too or not at all difficult. There are no differences in the views of Americans by region; across each region, Americans are much more likely to say it is not that difficult to get an abortion than say it is difficult.
    Despite divisions among Americans about the permissibility of abortion across different circumstances, nearly 6-in-10 (58%) Americans agree that at least some health care professionals in their communities should provide legal abortions. However, views differ dramatically by age, religion, education, geography, and community type.
  • Nearly 7-in-10 (68%) Millennials, but only 42% of seniors age 65 and older, say there should be some legal abortion services available in their community. The views of Americans age 30-49 and 50-64 mirror the views of the general population on this issue.
    Majorities of religiously unaffiliated Americans (71%), white mainline Protestants (72%), and black Protestants (56%) say at least some health care professionals in their community should provide legal abortions. Catholics are more divided on this issue overall, but there are double-digit ethnic divisions among Catholics. Nearly 6-in-10 (58%) white Catholics say that at least some health care professionals in their community should provide abortions, compared to only 38% of Latino Catholics. White evangelical Protestant views are very similar to Latino Catholics; only 37% say their communities should have at least some health care professionals who provide abortion services.
    Divisions are also large by educational attainment. Approximately three-quarters (76%) of Americans with a post-graduate degree say some health care providers should provide legal abortion services, compared to only 47% of those with a high school education or less.
    Americans who live in the Northeast (66%) and West (63%) are significantly more likely than those who live in the Midwest (53%) or South (52%) to say at least some health care professionals should provide legal abortion services. Three-quarters (67%) of Americans who live in large cities believe that at least some health care professionals should provide abortions, compared to only 39% of Americans who live in rural areas.
  • Nearly 3-in-4 (73%) Americans favor requiring women under the age of 18 to get the consent of at least one parent before they are allowed to have an abortion. Roughly 1-in-4 (24%) Americans oppose this policy. Support for this policy is strong across demographic, religious, and political groups. Approximately 7-in-10 (71%) Millennials support this requirement, as do nearly two-thirds (64%) of Americans age 65 and older. Support for parental consent laws are also high across the political spectrum, including 64% of Democrats, 74% of Independents, 84% of Republicans, and 85% of those identifying with the Tea Party. Americans who self-identify as politically liberal are the least likely to favor a requirement that women under the age of 18 get parental consent, but even among this group, 54% favor this policy.
  • Reflecting their complex pro-choice/pro-life identities, many Americans simultaneously affirm seemingly contradictory statements about the purpose of abortion laws. Strong majorities, for example, simultaneously say that it is appropriate for abortion laws to protect the life of the fetus throughout the entire pregnancy, and that it is appropriate for laws to preserve a woman’s freedom to make her own decisions (63% to 70%). Roughly 8-in-10 also say it is appropriate for abortion laws to protect the health and well-being of women, and that it is appropriate for laws to encourage women to make more responsible decisions (82% and 78% respectively).
  • A slim majority (52%) of Americans believe having an abortion is morally wrong, compared to 40% who say it is morally acceptable. Millennials are more divided on the morality of abortion, with half (50%) saying having an abortion is morally wrong and 46% saying it is morally acceptable. Among Americans age 65 and older, 57% say abortion is morally wrong, and 31% say it is morally acceptable. There are no significant gender differences in attitudes about the moral acceptability of abortion.
    Majorities of most major religious groups—including white evangelical Protestants (75%), African American Protestants (60%), and Catholics (58%)—believe that having an abortion is morally wrong. White Mainline Protestants stand out here, with roughly equal numbers saying having an abortion is morally acceptable (45%) or morally wrong (43%). A strong majority (61%) of religiously unaffiliated Americans believe having an abortion is morally acceptable. More than two-thirds of Republicans and 7-in-10 members of the Tea Party movement say abortion is morally wrong, compared to only 42% of Democrats.
  • Americans are more likely to say that having an abortion is morally wrong than they are to say that it is a sin. On the theological question, Americans are divided: 46% believe having an abortion is a sin, and 44% disagree. There are few generational differences on this question. Millennials’ views roughly resemble those of the general population: 45% believe having an abortion is a sin, but a plurality (49%) disagree.
    There are significant religious and political divisions on this question. Nearly 7-in-10 (69%) white evangelicals, and nearly two-thirds of black Protestants (64%) and Latino Catholics (65%), agree that having an abortion is a sin. White Catholics are evenly divided, with 46% agreeing that having an abortion is a sin, and 46% disagreeing. White mainline Protestants are the only major religious group in which a majority (55%) does not believe that having an abortion is a sin.
    There are also significant gender and political differences. Women are somewhat more likely than men to say that having an abortion is a sin (50% vs. 43%), which may reflect the fact that women generally have higher levels of religious engagement than men. More than 6-in-10 Republicans and Americans who identify with the Tea Party movement (61% and 62% respectively) believe that having an abortion is a sin, compared to only 39% of Democrats and 43% of political independents.
  • Despite holding significant moral and theological concerns, nearly 6-in-10 (59%) Americans believe that in certain circumstances having an abortion is the most responsible decision a woman can make. Approximately one-third (35%) reject this statement and say that having an abortion is a selfish decision that allows a woman to avoid taking responsibility. Millennials are no more likely than older Americans to say that abortion can be the most responsible decision a woman can make.
  • With the exception of white evangelical Protestants and Latino Catholics, strong majorities of all major religious groups—including 68% of white mainline Protestants, 60% of black Protestants, and 63% of white Catholics—say that in certain circumstances having an abortion is the most responsible decision a woman can make. In contrast, only 38% of white evangelical Protestants and 44% of Latino Catholics agree. A majority (56%) of white evangelicals and a plurality (47%) of Latino Catholics say that having an abortion is a selfish decision that allows a woman to avoid taking responsibility.
    Notably, more than one-third those who believe having an abortion is morally wrong (36%) or having an abortion is a sin (35%) also nonetheless believe having an abortion is in some circumstances the most responsible decision a woman can make. Among Americans who take a more situationalist approach to morality, two-thirds (67%) say having an abortion is in some circumstances the most responsible decision a woman can make. Even among Americans who take a more principle-based approach to morality, half (50%) say it is in some cases the most responsible decision a woman can make.
  • In the general population and all other age groups except for Millennials, nearly equal numbers support the legality of abortion and the local availability of abortion services. Millennials, however, support the availability of local abortion services at a significantly higher rate (68%) than they support the legality of abortion (60%).
  • On the question of legality, when controlling for other characteristics, Millennials are surprisingly 1.3 times more likely than older Americans to say abortion should be illegal in all or most cases. In contrast, on the question of availability, when controlling for the same other characteristics, Millennials are about 1.5 times more likely than older Americans to say at least some health care providers should provide legal abortions in their community.
  • One distinctive pattern worth noting is the difference between attitudes among white religious groups and minority religious groups across these four measures. Among all white religious groups, support for local availability is higher than support for legality. Among minority religious groups and minorities overall, support for legality exceeds support for local availability. For example, nearly two-thirds of black Protestants (66%) and a slim majority (51%) of Latino Catholics say abortion should be legal in all or most cases. However, a smaller majority (56%) of black Protestants and only 38% of Latino Catholics say at least some health care professionals should provide legal abortions in their local communities.
  • Americans who attend religious services at least weekly are more likely to oppose the legality of abortion than those who attend less frequently or who never attend religious services. Among the approximately 4-in-10 Americans who attend religious services at least once a week, 60% say abortion should be illegal in all or most cases, compared to 36% who say it should be legal in all or most cases. In contrast, nearly two-thirds (64%) of Americans who attend services less frequently (monthly or a few times a year), and nearly three-fourths (74%) of Americans who attend services seldom or never, say abortion should be legal in all or most cases. This general pattern holds among Millennials and all other age groups.
    Church attendance patterns do not influence opinions on abortion equally in all religious groups. Most importantly, frequency of attendance matters more for Catholics than it does for other major religious groups. Among Catholics, 41% attend church at least weekly, 38% attend church monthly or a few times a year, and 19% say they seldom or never attend. Among the approximately 4-in-10 Catholics who attend church at least weekly, only about one-third (34%) say abortion should be legal in all or most cases. But strong majorities of Catholics who attend monthly or a few times a year (62%) or who attend seldom or never (78%) say abortion should be legal in all or most cases.
  • Religious affiliation appears to matter more among some religious groups than others. Majorities of white evangelical Protestants in all measurable religious attendance categories say abortion should be illegal in all or most cases. Conversely, majorities of white mainline Protestants and black Protestants in all religious attendance categories say abortion should be legal in all or most cases. <br Frequency of church attendance also influences Americans’ views about the availability of abortion services in their neighborhoods. Among those who attend religious services at least once a week, a slim majority (52%) disagree that there should be at least some health care professionals in their communities who provide legal abortions, but 42% of this group say these services should be available. Strong majorities of Americans who attend religious services monthly or a few times a year (63%) and those who attend seldom or never (74%) say at least some health care professional in their communities should provide legal abortions. These attendance patterns generally hold up within religious groups with two exceptions: majorities of even the most frequently attending white Mainline Protestants (62%) and black Protestants (52%) say at least some health care professionals should provide legal abortions in their communities.
  • Certain theological views are also linked to views about abortion. Americans who say the Bible is the word of God and should be taken literally, word for word, are more likely to believe abortion should be illegal. Among this group, roughly 6-in-10 (59%) say abortion should be illegal in all or most cases and less than 4-in-10 (37%) say it should be legal in all or most cases. A majority (53%) of Americans who say the Bible is the literal word of God, but that not everything in it should be taken literally believe abortion should be legal. Among Americans who believe that the Bible is a book written by men and not the word of God, more than 8-in-10 believe abortion should be legal in all (34%) or most (49%) cases. These patterns generally hold across religious groups.
  • Among Americans who attend church at least once or twice a month, majorities report hearing their clergy talk about the issue of abortion (54%) and homosexuality (51%) in church. There are dramatic differences, however, in this pattern among religious subgroups.
    Regularly attending Catholics are significantly more likely than regular churchgoers overall to hear about the issue of abortion. More than 7-in-10 (72%) white Catholics who attend worship at least once or twice a month say their clergy talk about the issue of abortion, while only about one-third (35%) say they hear about the issue of homosexuality. The gap among regularly attending Latino Catholics is somewhat smaller, but they are still more likely to hear about the issue of abortion (63%) than homosexuality (49%).
    There is a less pronounced emphasis gap among Protestants. Among white evangelicals, 57% report hearing about the issue of homosexuality, while 54% say they hear about abortion from their clergy. More than 6-in-10 (61%) black Protestants say their clergy speak out on the issue of homosexuality, while a smaller majority (52%) hear about abortion. White mainline Protestants are significantly less likely than any other religious group to hear their clergy talk about either issue; only about 4-in-10 report hearing about homosexuality (43%) or abortion (39%) in their churches.
  • Americans who regularly attend religious services and hear their clergy speak about the issue of abortion or homosexuality report hearing that these issues are morally wrong. Among Americans who hear their clergy speak about abortion in church, 81% hear it is morally wrong, compared to just 3% who hear it is morally acceptable. Similarly, among Americans who hear their clergy speak about the issue of homosexuality in church, nearly 8-in-10 (77%) hear that it is morally wrong, compared to only 5% who hear that it is morally acceptable.
    White mainline Protestants and white Catholics hear significantly different emphases from their clergy on these two issues. Three-quarters (75%) of white mainline Protestants hear from their clergy that abortion is morally wrong, compared to just 54% who report hearing their clergy say homosexuality is morally wrong. Among white Catholics, 86% report hearing their clergy say that abortion is morally wrong, compared to 64% who hear this same negative message about the issue of homosexuality. There are no significant differences in clergy messages on these two issues among white evangelicals, Latino Catholics, or black Protestants.
    The messages Americans are hearing in church are strongly correlated with their views on the issues of abortion. Among Americans whose clergy say abortion is morally wrong, approximately two-thirds (66%) believe abortion should be illegal in all or most cases. In contrast, less than half of those who do not hear about the issue from their clergy, or whose clergy do not take a clear position on the issue, believe abortion should be illegal in all or most cases (42% and 45% respectively).
  • Strong majorities of Americans believe it is possible to disagree with the teachings of their religion on the issue of abortion (72%) or homosexuality (63%) and still be considered a person of good standing in their faith. Protestants generally say there is more room for disagreement on the issue of abortion, while Catholics say there is more room for disagreement on the issue of homosexuality.
    White mainline Protestants are more likely than any other major religious group to believe that they can still be a good Christian even if they disagree with the teachings of their religion on the issue of abortion (86%) or homosexuality (77%). More than two-thirds (67%) of white evangelicals say that it is possible to disagree with their religion’s teachings on abortion and still be considered a good Christian, but they are the only religious group in which less than a majority (47%) agree that it is possible to be a good Christian if one disagrees with their religion’s teachings on homosexuality. Catholics are about as likely as other religious groups to say you can still be a good Catholic even if you disagree with official church teachings on abortion (68%), and they are significantly more likely than the general population to say the same about the issue of homosexuality (74%).
  • Among Americans who identify with a religious faith, a majority overall give their places of worship high marks (either an ‘A’ or ‘B’) on how they handle the issues of abortion (58%) and homosexuality (55%). White evangelicals are most likely to give their churches high marks for how they are handling the issue of abortion (68%) and homosexuality (67%). Majorities of black Protestants also give their churches high marks for handling abortion (52%) and homosexuality (54%).
    On the other hand, less than half of white mainline Protestants and Catholics give their places of worship high marks on either issue. Forty-nine percent of white mainline Protestants give their churches high marks on their handling of abortion, and nearly identical numbers give their churches high marks on their handling of homosexuality (48%). Among Catholics, 49% give high marks to their churches for how they handle the issue of abortion, but only 42% give their churches high marks for handling the issue of homosexuality. Catholics are more likely than other religious groups to give their churches low marks for handling both issues. About 1-in-4 Catholics give their places of worship low marks (either a ‘D’ or ‘F’) for their handling of both the issue of abortion (24%) and the issue of homosexuality (26%).
    Among Catholics, 44% say the position of the Catholic Church on the issue of abortion is too conservative, 45% say the position of Catholic Church on the issue of abortion is about right, and just 7% say it is too liberal. Among Catholics who attend worship services at least once a week, less than one-third (31%) say the Church’s position is too conservative, while nearly 6-in-10 (59%) say it is about right. Catholics who say the position of Catholic Church on the issue of abortion is too conservative are more likely to give the Church poor marks for how it is handling the issue of abortion than Catholics overall (37% to 24% respectively).
  • More than 6-in-10 (61%) Americans say that it is wrong for religious leaders to attempt to publicly pressure politicians on the issue of abortion, compared to 35% who say that it is right for religious leaders to do this. Two-thirds of white mainline Protestants (67%) and nearly 6-in-10 Catholics (58%) and black Protestants (58%) say it is wrong for religious leaders to publicly pressure politicians on the issue of abortion. Even among more politically conservative constituencies, such as Republicans (48%), Americans who identify with the Tea Party movement (49%), and white evangelical Protestants (49%), less than half say that it is right for religious leaders to attempt to publicly pressure politicians on the issue of abortion. There are no significant differences on this question by age, education, or gender.
  • There are a number of factors that influence attitudes about abortion. Demographic factors like education, income, age, and race; religious factors like evangelical religious affiliation, frequency of attendance, and views of the Bible; and political characteristics like party affiliation and political ideology each are significant independent predictors of views about abortion. In addition to these well-known factors, we tested six new factors as predictors of views on the legality of abortion: holding a situationalist approach to morality; having empathetic traits; knowing someone who has had an abortion; knowing someone who has a special needs child; seeing recently an ultrasound of a fetus; or watching television programs featuring young unmarried women who are pregnant or who have young children.
  • Americans who embrace a more situationalist ethic are much more likely to support legalized abortion than those who favor a more principle-based approach to moral issues. Among Americans who embrace a situationalist ethic, nearly two-thirds (64%) say abortion should be legal in all or most cases. In contrast, among Americans who embrace a principle-based approach to morality, a plurality (49%) say abortion should be illegal in all or most cases, and only 46% say abortion should be legal in all or most cases.
  • Knowing someone who has had an abortion, however, has a strong influence on views about abortion. More than 6-in-10 (61%) Americans say that they know someone who has had an abortion, compared to 38% who say they do not. With the exception of seniors, there are no large differences between age groups; only 42% of seniors report knowing someone who has had an abortion.
    Among those who know someone who has had an abortion, roughly two-thirds (64%) say this is someone in their own generation. About 1-in-5 (22%) say it is someone in another generation, and 13% say they know someone in both their own and another generation who has had an abortion.
    There are significant differences in support for the legality of abortion between those who do and do not know someone who has had an abortion. Among Americans who say they know someone who has had an abortion, about 6-in-10 (61%) say it should be legal in all or most cases. Among those who do not know someone, less than half (49%) say abortion should be legal in all or most cases.
    The experience of knowing someone who has had an abortion also has a strong influence on views about the availability of legal abortion in local communities. Nearly two thirds (65%) of those who know someone who has had an abortion say at least some health care professionals in their local communities should provide legal abortions, compared to only 48% of those who do not know someone who has had an abortion.
  • Nearly 6-in-10 (58%) Americans say they have recently seen an ultrasound image, either over email, in a printout or on Facebook. Younger Americans are significantly more likely than older Americans to report seeing an ultrasound. Nearly two-thirds (64%) of Millennials and 69% of Americans age 30-49 say they have recently seen an ultrasound, compared to only 35% of Americans age 65+.
    When no other variables are controlled for, Americans who have recently seen an ultrasound image do not differ from the general public in their views about the legality of abortion. Like the general population, 56% of those who have seen an ultrasound image say abortion should be legal in all or most cases. However, when we applied other demographic controls in order to understand the isolated effect of seeing an ultrasound image, we find a modest but significant negative impact on support for legal abortion. In other words, Americans who have recently seen an ultrasound are less likely to say abortion should be legal in all or most cases than those who have not.
  • Movies and television shows about young pregnant women or young unwed mothers have a modest but significant impact on views about the legality and morality of abortion. Overall, younger Americans are far more likely than older Americans to report having seen a television show or a movie about this topic. Among Millennials, more than 7-in-10 (71%) report having seen a movie or TV show about teenage pregnancy. Among seniors age 65 and up, fewer than one-third (31%) report having seen movies or shows that feature these themes. Roughly 1-in-5 (17%) Americans, including nearly 3-in-10 (29%) Millennials, report having seen one of MTV’s two popular reality shows on this topic: “16 and Pregnant” or “Teen Mom.”
    Americans who have seen MTV’s shows “Teen Mom” or “16 and Pregnant” are significantly more likely than the general public to say that abortion should be legal in all or most cases (65% vs. 56% of the public) and to say that having an abortion is morally acceptable (48% vs. 40% of the public). They are also nearly twice as likely as those who have not seen these shows to say that at least some health care professionals in their communities should provide legal abortions (65% vs. 34% respectively).
  • The analysis above allows us to sort out factors that are independent predictors of attitudes on abortion. Of the six factors tested, four have a significant effect and two are not significant. Among the significant factors, three have a positive significant effect on support for abortion being legal in all or most cases: holding a situationalist view of morality; knowing someone who has had an abortion; and having seen either of MTV’s two reality shows featuring young unmarried women who are pregnant or who have young children. One item has a negative significant effect on support for abortion being legal in all or most cases: recently seeing an ultrasound image of a fetus. Finally, two items had no significant effect: self-identifying as being empathetic and knowing someone with a special needs child.

“Racism, Birth Control, and Reproductive Rights" (1990)[edit]

Angela Davis, “Racism, Birth Control, and Reproductive Rights" in Fried, Marlene Gerber (ed.). “From Abortion to Reproductive Freedom: Transforming a Movement” (1990). South End Press. ISBN 9780896083875.

  • The ranks of the abortion rights campaign did not include substantial numbers of women of color. Given the racial composition of the larger women’s liberation movement, this was not at all surprising. When questions were raised about the absence of racially oppressed women in both the larger movement and in the abortion rights campaign, two explanations were commonly proposed in the discussions and literature of the period: women of color were overburdened by their people’s fight against racism, and/or they had not yet become conscious of the centrality of sexism. But the real meaning of the almost lily0white complexion of the abortion rights campaign was not to be found in ostensibly myopic or underdeveloped consciousness among women of color. The truth lay buried in the ideological underpinnings of the birth control movement itself.
    The failure of the abortion rights campaign to conduct a historical self-evaluation led to a dangerously superficial appraisal of Black people’s suspicious attitudes toward birth control in general. Granted, when some Black people unhesitatingly equated birth control with genocide, it did appear to be an exaggerated-even paranoid-reaction. Yet white abortion rights activists missed a profound message, for underlying these cries of genocide were important clues about the history of the birth control movement. This movement, for example, had been known to advocate involuntary sterilization-a racist form of mass “birth control.” If ever women would enjoy the right to plan their pregnancies, legal and easily accessible birth control measures and abortions would have to be complemented by an end to sterilization abuse.
    • p.16
  • When Black and Latina women resort to abortions in such large numbers, the stories they tell are not so much about the desire to be free of their pregnancy, but rather about the miserable social conditions which dissuade them from bringing new lives into the world.
    Black women have been aborting themselves since the earliest days of slavery. Many slave women refusing to bring children into a world of interminable forced labor, where chains and floggings and sexual abuse for women were the everyday conditions of life. A doctor practicing in Georgia around the middle of the last century noticed that abortions and miscarriages were far more common among his slave patients than among the white women he treated.
    Why were self-imposed abortions and reluctant acts of infanticide such common occurrence during slavery? Not because Black women had discovered solutions to their predicament, but rather because they were desperate. Abortions and infanticides were acts of desperation, motivated not by the biological birth process but by the oppressive conditions of slavery. Most of these women, no doubt, would have expressed their deepest resentment had someone hailed their abortions as a stepping stone toward freedom.
    • p.17
  • During the early abortion rights campaign, it was too frequently assumed that legal abortions provided a viable alternative to the myriad problems posed by poverty. As if having fewer children would create more jobs, higher wages, better schools, etc. This assumption reflected the tendency to blur the distinction between “abortion rights” and the general advocacy of “abortions”. The campaign often failed to provide a voice for women who wanted the “right” to legal abortions while deploring the social conditions that prohibited them from bearing more children.
    • p.17
  • The abortion rights activists of the early 1970s should have examined the history of their movement. Had they done so, they might have understood why so many of their Black sisters adopted a posture of suspicion toward their cause. They might have understood how important it was to undo the racist deeds of their predecessors, who had advocated birth control as well as compulsory sterilization as a means of eliminating the “unfit” sectors of the population. Consequently, the young white feminists might have been more receptive to the suggestion that their campaign for abortion rights include a vigorous condemnation of sterilization abuse, which had become more widespread than ever.
    It was not until the media decided that the casual sterilization of two Black girls in Montgomery, Alabama, was a scandal worth reporting that he Pandora’s box of sterilization abuse was finally flung open. But by the time the case of the Relf sisters broke, it was practically too late to influence the politics of the abortion rights movement. It was the summer of 1973 and the Supreme Court decision legalizing abortions had already been announced in January.
    • pp.21-22

"Disparities in Abortion Rates: A Public Health Approach"[edit]

Dehlendorf, Christine; Lisa Harris (October 1, 2013). "Disparities in Abortion Rates: A Public Health Approach". American Journal of Public Health. 103 (10): 1772–1779.

  • Women of lower socioeconomic status and women of color in the United States have higher rates of abortion than women of higher socioeconomic status and White women. Opponents of abortion use these statistics to argue that abortion providers are exploiting women of color and low socioeconomic status, and thus, regulations are needed to protect women. This argument ignores the underlying causes of the disparities. As efforts to restrict abortion will have no effect on these underlying factors, and instead will only result in more women experiencing later abortions or having an unintended childbirth, they are likely to result in worsening health disparities. We provide a review of the causes of abortion disparities and argue for a multifaceted public health approach to address them.
  • The abortion rate in the United States is higher than that in most other developed countries.Although this fact alone requires attention, looking deeper within these statistics reveals an additional area of concern: similar to many health outcomes in the United States, there are substantial disparities in abortion rates in the United States, with low-income women and women of color having higher rates than affluent and White women. In 2008, the abortion rate for non-Hispanic White women was 12 abortions per 1000 reproductive-age women, compared with 29 per 1000 for Hispanic women, and 40 per 1000 for non-Hispanic Black women. Disparities in abortion rates also exist by socioeconomic status (SES), with women with incomes less than 100% of the federal poverty level (FPL) having an abortion rate of 52 abortions per 1000 reproductive-age women, compared with a rate of 9 per 1000 among those with incomes greater than 200% FPL. In analyses assessing both income and race/ethnicity, both are independently associated with abortion rates.
  • In the past several years, the differences in rates of abortion have received increasing political attention, with those opposed to abortion rights citing differences in abortion rates as evidence of the diabolical nature of the “abortion industry.” Abortion rights opponents point to racial/ethnic differences in abortion rates as evidence of racism and coercion among those who support the right to obtain abortions. Not only do these messages explicitly blame those providing abortion for targeting communities of color, they also assign guilt to women of color who decide to have abortions by implying that they are falling victim to a racist conspiracy. Differences in abortion rates by income are also seen as evidence of exploitation by abortion providers, who are claimed to be aggressively profiting from public funding of abortion for low-income women. Although there is no evidence of racial targeting or routine profiteering by abortion providers, from the perspective of those who espouse these views, the problem of disparities in abortion rates can only be solved by limiting access to and utilization of abortion services.
    Motivated by a concern that this politicized perspective on disparities in abortion rates fails to consider their actual underlying causes, and thus will not ultimately lead to meaningful policy or programmatic outcomes, we review what is known about the origins of disparities in abortion rates by both race/ethnicity and SES.
  • Although popular discourse often focuses on making abortion “rare,” this does not allow for the reality that, for a woman with an unintended pregnancy who desires an abortion, being able to obtain this procedure in a timely and safe manner is in fact a desirable outcome. In addition, the framing of abortion as something that needs to be rare may actually contribute to the ongoing stigmatization of abortion and of women who seek it, which in turn can lead to delayed or unsafe abortion. However, as it is desirable to avoid an unintended pregnancy that leads to abortion in the first place, we suggest that it is constructive to address disparities in abortion rates that result from structural social inequalities—especially racism and poverty—without seeing abortion as a bad outcome once an unintended pregnancy has occurred. When such an approach is taken, the focus shifts from the overall number of abortions to helping women achieve their personal fertility desires.
  • The documented disparities in abortion rates in the United States mirror other fundamental inequalities: people of color and those with lower income and less education fare worse across a wide range of health outcomes, including infant mortality, cancer incidence, and life expectancy. These disparities are related to systemic hardships experienced by disadvantaged communities, including decreased access to health care, higher levels of stress, exposure to racial discrimination, and poorer living and working conditions. Understanding the systemic nature of these disparities and their relationship to health outcomes provides an essential context to the consideration of disparities in abortion rates. This broader understanding is of particular importance given the cultural tendency for discussion of abortion and sexual health to engender judgment of individual women’s behavior, as well as a historical propensity for negative stereotyping about the sexual and reproductive behavior of non-White and lower-income individuals.
    We share the perspectives of important theorists of race and health who have noted that the continued use of classifications of race, ethnicity, and SES are important, not because they identify meaningful differences at the level of individual behavior or biology, but rather because they reflect larger systems of structural inequality, including racism and systematic inequalities in both opportunities and power. In this approach race is understood as a social and political rather than a biological category. As a consequence, data presented throughout this article on higher rates of both poor health outcomes and higher risk behaviors in women of color and low-SES women should be seen as reflective of adverse social circumstances rather than individual failings. In a similar way, data on lower rates of adverse health outcomes and risk behaviors in White and more affluent women should be seen as reflective of the privileges and advantages that accompany membership in a dominant social group.
  • Race/ethnicity and SES (and gender) intersect to form a person’s identity, and these dimensions of identity affect all aspects of day-to-day life. Among other things, they influence where people live, the nutritional value of food to which they have ready access, and the degree of discrimination or respect people experience. In addition, race/ethnicity and SES circumscribe educational and vocational opportunities, and access to quality health care and to health insurance.21 These factors have also played significant roles in the ways in which reproduction has historically been allowed, required, or denied for populations of women.14,22–24 Therefore, although we do present data about individual-level factors influencing disparities in reproductive health indicators, our ultimate goal is to create greater understanding of the pervasive economic and social forces that underlie them.
  • Although the proportion of pregnancies that are unintended is high for all women at 51%, there are significant differences among population subgroups. Rates of unintended pregnancy are highest among Blacks, Hispanics, and women with lower SES. The most recent data in which the independent effects of race/ethnicity and SES have been examined come from the 2008 National Survey of Family Growth (NSFG). By race/ethnicity, 70% of all pregnancies among Black women and 57% among Hispanic women were unintended, compared with 42% among White women. With respect to income, 64% of pregnancies among women with an income of less than 100% FPL were unintended, whereas only 37% of pregnancies were unintended among women with an income of more than 200% FPL. There were similar findings by educational level. Furthermore, this analysis demonstrated that both Black and Hispanic race/ethnicity and being lower-income were independent predictors of unintended pregnancy.
    With regard to unintended pregnancy, an additional important consideration is the rate of adolescent pregnancy, of which more than 80% are unintended. Significant racial/ethnic disparities exist in this outcome as well, with a rate of 44 pregnancies per 1000 females between ages 15 and 19 years among non-Hispanic Whites, 124 per 1000 among non-Hispanic Blacks, and 129 per 1000 among Hispanics. Although the overall rate of adolescent pregnancy has declined over the past decade, disparities between groups have persisted, and similar disparities exist by socioeconomic variables.
  • Risk of unintended pregnancy is associated with sexual activity, either without use of contraceptive protection or with the use of a contraceptive method that is ineffective in that instance. In addition, age of initiation of sexual activity is itself a risk factor for adolescent pregnancy. Though recent data show that adolescents are delaying sexual initiation to older ages, the proportion of adolescents who engage in sexual intercourse varies by race/ethnicity and by SES. National studies have consistently shown that Black adolescents initiate intercourse at younger ages than White adolescents. By contrast, Hispanics have the oldest mean age of sexual initiation, at age 18 years. Researchers have also shown an inverse relationship between sexual experience and SES.
  • For women and girls who are sexually active and who do not currently desire children, use of contraceptive methods is clearly associated with the ability to prevent pregnancy. Studies performed at the national and regional levels have found that there are differences in effective use of contraception by women’s race/ethnicity and SES that likely influence disparities in unintended pregnancy. The most striking disparities in contraception use are those in the percentage of women at risk for unintended pregnancy who report using no contraceptive method. In the most recent NSFG, which includes data from 2006 to 2010, 17.2% of Black women and 10.4% of Hispanic women at risk for unintended pregnancy were using no contraceptive method, compared with 9.5% of non-Hispanic White women. Although there were no differences by education and income in these most recent data, previous versions of the NSFG have found differences by these socioeconomic variables. Analyses of the NSFG have not isolated the independent effects of race/ethnicity and socioeconomic factors, but other studies have found that generally differences by education and race/ethnicity persist after adjustment, and income is not as strongly associated.
    Among women using contraception, race/ethnicity has also been found to be associated with decreased likelihood of using highly effective methods, whereas socioeconomic variables have not been associated with this finding. In the most recent NSFG, 14.1% of non-Hispanic White women who used contraception relied on condoms, compared with 18.1% of Hispanics and 19.5% of Blacks. Although this analysis did not control for confounding factors, studies using multivariate techniques have also found that race/ethnicity is associated with use of less effective methods such as condoms. Although higher rates of condom use may be appropriate for the prevention of sexually transmitted infections, including HIV, they are less efficacious at preventing pregnancy.
    Other studies have looked at contraceptive failure rates by sociodemographic factors, and have found that both income and race/ethnicity are associated with a higher likelihood of failure among those using contraception. Data from the 2002 NSFG found that Blacks and Hispanics had a 21% and 15% rate, respectively, of contraceptive failure in 1 year, compared with 10% among non-Hispanic Whites, and those with an income less than 100% FPL had a 20% failure rate, compared with 8% for those with an income greater than 200% FPL. Although some of these differences are likely attributable to differences in the contraceptive methods used, this study found differences in condom failure rates by both race/ethnicity and income, suggesting that differences in failure rates may exist even among those using the same method. Continuation of a chosen contraceptive method also has an impact on the risk of unintended pregnancy, as discontinuation can be associated with gaps in contraceptive use. While studies of predictors of method discontinuation have been limited, analyses with NSFG data have found that Black and low-SES women have higher rates of discontinuation of the oral contraceptive pill. These analyses indicate that both race/ethnicity and SES are associated with selection of contraceptive methods, as well as women’s use of their chosen method.
  • As noted previously, chronic disadvantage and stress experienced by low-SES individuals and people of color in the United States influence disparities in multifaceted ways. For example, living in disadvantaged neighborhoods is associated with adverse health behaviors such as smoking, and experiences of discrimination are associated with decreased likelihood of seeking preventive health services. These same hardships may underlie disparities in timing of initiation of sexual activity and contraceptive use, and the resulting disparities in unintended pregnancy and abortion rates. Although the pathways by which this occurs have not been comprehensively investigated, topics that have been studied include differences in neighborhood-level resources and opportunities, access to and quality of family planning care, mistrust of health care providers and contraceptive technologies, perceived infertility, and pregnancy attitudes. In combination, these areas of research begin to indicate the pervasiveness of the disadvantage that women of color and low-SES women face in the context of their reproductive lives.
    An important influence on sexual initiation is the neighborhood in which adolescents live. Studies have found higher sexual risk for young people living in neighborhoods where there are higher levels of poverty, idle youths, and social disorganization, and lower proportions of working women and lack of economic and educational opportunities. Analyses controlling for both neighborhood and individual-level characteristics that have found little or no differences by race or individual socioeconomic variables suggest the importance of these structural influences on sexual activity.
  • With respect to contraceptive use, factors underlying the findings (i.e., lower-SES women and women of color being less likely to use contraception, less likely to use highly effective methods, and more likely to discontinue methods than higher-SES and White women) include differences in access to, quality of, and acceptability of family planning, as well as differences in perceived need for family planning. With respect to access, lack of insurance coverage for contraception and family planning care is a significant barrier, as it is estimated that more than half of US women of reproductive age are in need of publicly funded family planning care, and only 40% of these women actually receive these services. Low-SES women and Black and Hispanic women are more likely to be uninsured and, therefore, lack of insurance coverage is a likely contributor to disparities in contraceptive use.
    Even when receiving family planning care, poor and non-White women may continue to face barriers to contraceptive use. Quality of care is one factor, as non-White patients have been found to be less likely to rate their family planning visits positively. In addition, studies have suggested that women of color may experience pressure to utilize contraceptives and limit their family size, and also may receive different recommendations from their providers about family planning methods. One survey study found that approximately two thirds of Black women reported having experienced race-based discrimination when receiving family planning care. As pressure to utilize a method and lower quality of care have been associated with lower contraceptive use, these factors may contribute to disparities in reproductive outcomes.
  • Another potential related contributor to differences by race/ethnicity in contraceptive use is the finding that women of color may have less knowledge and more concerns about contraceptive methods than do White women. One potential explanation for lower knowledge is that Black and Hispanic adolescents are less likely to receive sexuality education that includes information about birth control methods. Skepticism of contraception may relate to distrust of the health care system in general, as well as concern about the motivation of family planning programs grounded in the historical context of coercive family planning policies targeted at these same groups of women. A recent analysis of a nationally representative survey indicated that skepticism about the motivation of family planning providers is widespread; 42% of Blacks and 51% Hispanics surveyed believed that the government promotes birth control to limit minorities, compared with only 25% of Whites.
  • Finally, women of color have been found to be more likely to perceive themselves to be infertile, which may decrease their motivation to use contraception. In fact, these fears of infertility are not unfounded as women of color and low-SES women have substantially higher rates of infertility than White women and women of higher SES.
  • Pregnancy ambivalence—defined as having a lack of definitive intention regarding pregnancy planning—has increasingly been studied as a central concept in women’s reproductive health, and may have relevance to reproductive health disparities. Studies have found that women who are ambivalent about pregnancy are more likely not to use contraception at all, to use it infrequently, to have gaps in use, and to use less effective methods of contraception. Studies investigating differences in pregnancy attitudes by race/ethnicity include one that found that 39% of Latinas and 37% of Black women provided ambivalent responses about pregnancy, compared with 16% of White women. In addition, there are differences by race/ethnicity in pregnancy intention among adolescents, with the 2002 NSFG reporting that 66% of White female adolescents would be “very upset” if they were to become pregnant, compared with only 51% of Blacks and 46% of Hispanics. No similar studies have investigated differences in pregnancy ambivalence by SES. Although the reasons behind these racial/ethnic differences in pregnancy ambivalence have not been well-studied, they may relate to the presence or absence of alternative life opportunities, the perception of control over one’s life course, the availability of social supports for early childbearing, and lack of perceived adverse effects of unplanned childbearing.
  • Disparities in abortion rates are related to disparities in unintended pregnancy, and associated disparities in contraceptive use. Structural factors, including economic disadvantage, neighborhood characteristics, lack of access to family planning, and mistrust in the medical system underlie these findings.
    Understanding this context allows us to critically consider the efforts of abortion rights opponents to politicize disparities in abortion rates as part of a larger effort to limit access to abortion care through such means as expanding regulations on abortion care, including increased waiting periods and counseling and facilities requirements. This focus on limiting access to abortion does nothing to mitigate the underlying inequities in wealth, education, health care, discrimination, or other life experiences that may influence reproductive health disparities, nor do they address specific disparities in contraceptive use or unintended pregnancy that lead to disparities in abortion rates. Instead, the resulting policies result in more women experiencing later abortions or having an unintended childbirth. As later abortions are associated with higher medical risk and greater cost to women, and unintended childbirth is associated with decreased opportunities for education and paid employment, as well as with adverse maternal and infant health effects, this orientation has the potential to cause worsened health and social outcomes and to increase medical and social disparities.
  • Additional barriers to contraceptive use that can be addressed include gaps in knowledge about contraceptive methods and concerns about safety, especially among women of color. Improving contraceptive counseling is one strategy to accomplish this goal; further research is needed on ways to assist women in making informed decisions about their contraceptive use. One focus of this counseling can be ensuring that women have accurate knowledge about the most highly effective reversible methods—intrauterine devices and the contraceptive implant—as expanded use of these methods would have a substantial impact on unintended pregnancy. However, because of the history of coercive family planning care in the United States, particular attention should be paid to ensuring that patient autonomy is prioritized in this counseling and that issues of possible patient mistrust are addressed. Indeed, we are in need of data about how women in general—and low-income women and women of color in particular—experience the recent push among family planning specialists to increase use of these methods. For clinicians, these methods may be understood simply as a means to decrease unintended pregnancy, but to women—and perhaps low-income and women of color in particular, in light of historical atrocities—they may carry different meanings, such as coercion, lack of trust in patients, or that doctors do not want poor or minority women to reproduce.
  • Because there is extensive variation in the sexual education that is provided in schools, more standardized curriculums and laws to ensure compliance could have an impact on disparities.
  • Whereas abortion is overall lower risk than continuing a pregnancy to term, abortions at later gestational ages are associated with greater risk than those performed earlier. As Black women and women with lower levels of education are more likely to have later abortions, this exposes them to greater health risks. Improving access to abortion would therefore have a positive impact on disparities in abortion-related morbidity. In addition, disparities in maternal morbidity and mortality and infant mortality illustrate the importance of ensuring quality care for women who continue their pregnancies and in providing economic supports to reduce the contribution of poverty to these outcomes.
  • Providing public and private insurance coverage for abortions is an important component of improving access to abortion, and would enable low-income women who desire abortions to obtain them in a safe and timely manner. This would have a beneficial impact on health outcomes through helping to ensure that women receive abortion care at the earliest and, therefore, safest gestational age possible. Currently, federal money, including Medicaid funds, cannot be used to pay for abortions unless the pregnancy is a result of rape or incest or the pregnant woman’s life is in danger. In addition, 33 states ban the use of state funds except in cases where federal funds are available. Even in cases where women should be eligible for federal funds, few are able to access this financial support.
  • As the mean charge for a nonhospital abortion at 10 weeks gestation is $543, and the mean charge for a nonhospital abortion at 20 weeks is $1562, there are substantial financial barriers to access, particularly among low-SES populations. These barriers affect women’s ability to obtain timely abortion services, as indicated by a study that found that low-SES women reported that the cost of paying for an abortion delayed their access to abortion, and other studies that have found that the cost of abortion is in general a barrier to care. A study in California, in which Medicaid funding is available, further supports the importance of the availability of public funding on access to abortion. Women who reported difficulties obtaining Medicaid coverage experienced 4-times-greater odds of having an abortion in the second trimester compared with those who did not experience barriers to this coverage.
  • Additional steps that can be taken to improve access to abortion services include decreasing state regulations, such as mandatory waiting periods, which pose barriers to care, and increasing the number of providers. Currently, 87% of all counties in the United States do not have an abortion provider, and 35% of women of reproductive age live in these counties. This lack of available services results in many women accessing abortion services having to travel long distances.
    This attention to expanding and facilitating access to abortion care is in direct contradiction to the approach taken by those whose focus is on decreasing abortions, and reflects a focus on optimizing and decreasing disparities in health outcomes, rather than emphasizing a goal of reducing the absolute number of abortion procedures. In addition to these benefits on the timing of abortion, improving access to abortion care would ensure that all women are able to make the decision that is best for them regarding childbearing when faced with an unintended pregnancy. It is not surprising that studies have found that restricted access to abortion services can limit women’s ability to abort a pregnancy when they wish to do so, and that these effects may be particularly pronounced for Black women and women with lower educational attainment. As unintended childbearing is associated with adverse effects, this can further exacerbate health and social disparities. Although there is a general social discomfort with conceptualizing an increase in the number of abortions as a positive outcome, consideration of the interrelated aspects of women’s reproductive health makes clear that limiting abortion does not address the largest underlying cause of abortion—unintended pregnancy—but rather only results in increasing disparities, in addition to limiting women’s ability to control their reproductive lives.
  • Women who continue their pregnancies should have access to quality prenatal care to help reduce disparities in birth outcomes among women of color and low-SES women compared with White women and women with more financial resources. Although public financing for prenatal care was expanded substantially in the 1980s, there continue to be documented disparities in receipt of prenatal care and in the quality of care provided, as well as disparities in maternal and infant outcomes by race and SES. Efforts to improve the accessibility and quality of these services can further ensure that all women who continue their unplanned pregnancies have the best possible pregnancy outcomes.
    An additional consideration in supporting women who wish to continue their pregnancies is the fact that women may decide to terminate pregnancies out of a realistic assessment of the level of economic social supports available to them after a child is born. This is especially true with the presence of maximum family size policies, which deny increases in welfare benefits after the birth of additional children, in many states. Indeed, research suggests that inability to afford a(nother) child is a commonly expressed reason for seeking an abortion. Policies that provide additional economic supports for low-income parents are an important component of ensuring that women are making the reproductive decisions that are best for them.
  • The recent expansion of efforts to use disparities in abortion rates as a political strategy to justify limiting access to abortion has the potential to increase disparities in women’s health by increasing abortions at later gestational ages and raising rates of unintended childbirth. In addition, decreased access to abortion limits women’s ability to make the best decisions about childbearing for themselves and their families. Research and policy that recognizes the importance of all aspects of women’s reproductive health—including pregnancy prevention, abortion care, pregnancy services, and economic supports—are essential to meeting the reproductive health care needs of low-SES women and women of color. This work must recognize that, although disparities are associated with differences in individual-level factors, these factors are constrained and produced by larger structural inequities, including racism and poverty, and by a legacy of coercive reproductive health policies.

“Opposition and Intimidation: The abortion wars and strategies of political harassment” (2007)[edit]

Alesha E. Doan (2007). “Opposition and Intimidation: The abortion wars and strategies of political harassment”. University of Michigan Press. Ch. 1, “Political Protest or Political Harassment? Social Movements, Morality Politics, and Abortion”

  • By the 1990s, 86 percent of abortion providers continued to be the targets of various forms of harassment (Forrest and Henshaw 1987; Johnson 1999, 248; Cozzarelli and Major 1998; Henshaw 1995a).
    • p.24
  • For the longest time they thought I was wearing a disguise-you know, the long bear… they went on the radio and said a lot of outrageous things. And then it began to get more personalized. And they called my house, wrote letters, things like that. There were occasions when they tried to follow us after leaving the clinic but they always gave up. [Now] they are actually using my physical image and broadcasting it around. (Interview with a doctor who works for several abortion clinics, 1999)
    • p.27
  • It’s uglier now; the tone [of the protest] is uglier. I had to tint my [car] windows because I pick up the doctor, and install a security system in my house because I know they are coming within two blocks of my house. I have a young son at home. So these were the steps we had to take. (Interview with the director of a women’s health clinic, 1999)
    • p.27
  • Right way they were drawn to me because I’m an older woman and they thought they were going to scare me off. So they lit right into me and started with the postcards after they got my license plate number. And they sent postcards to my neighbors where I live and it said “this is Barbara Anderson and she is happy. She wants you to know that she is very pleased to be killing babies at the Planned Parenthood Clinic.” One time I returned home to find a plastic bag of tose heads hanging on my gate… with a letter saying we hope you like roses and it went on to say that they wished I wouldn’t do this terrible thing. (Interview with Barbara Anderson, Planned Parenthood volunteer escort, (November 2003)
    • p.27

“U.S. Supreme Court strikes down Louisiana abortion law, similar to Ohio’s, requiring doctors to have agreements with nearby hospitals” (June 29, 2020)[edit]

Sabrina Eaton, cleveland.com and Laura Hancock, cleveland.com , “U.S. Supreme Court strikes down Louisiana abortion law, similar to Ohio’s, requiring doctors to have agreements with nearby hospitals”. Cleveland. June 29, 2020.

  • “Even if they obtain an appointment at a clinic, women who might previously have gone to a clinic in Baton Rouge or Shreveport would face increased driving distances,” Breyer wrote. “New Orleans is nearly a five hour drive from Shreveport; it is over an hour from Baton Rouge; and Baton Rouge is more than four hours from Shreveport. The impact of those increases would be magnified by Louisiana’s requirement that every woman undergo an ultrasound and receive mandatory counseling at least 24 hours before an abortion.”
  • Roberts wrote a separate opinion that concurred with the majority. He referred to a 2016 court decision about a similar Texas law -- from which he had dissented. But he wrote that his hands were tied.
    “The result in this case is controlled by our decision four years ago invalidating a nearly identical Texas law,” Roberts wrote. “The Louisiana law burdens women seeking previability abortions to the same extent as the Texas law, according to factual findings that are not clearly erroneous. For that reason, I concur in the judgment of the Court that the Louisiana law is unconstitutional.”
  • Ohio abortion rights proponents, such as Tam Nickerson of Cleveland’s Preterm abortion and sexual health clinic, celebrated the ruling.
    “Today’s Supreme Court ruling ensures that clinics can keep providing care for the patients that trust us,” she said in a statement. “But it’s not enough to keep things as they are. Systemic attacks on abortion have impacted the number of clinics open across Ohio and the country, and these attacks will not stop with today’s ruling. Ohio politicians are considering many anti-abortion measures in session right now. Fortunately, today’s ruling will allow us to continue serving our patients and fighting for a world where abortion and reproductive healthcare access are even more available without shame or stigma.”
  • Aaron Baer, president of Citizens for Community Values, a Christian policy organization, said the decision was disappointing.
    “The Supreme Court has put politics over the health and safety of women,” he said. “Louisiana was simply trying to hold surgical abortion facilities to the same standard as other surgical facilities. This is the definition of an undemocratic decision when five unelected judges can overrule an entire state legislature.”
  • Justice Clarance Thomas, in a dissent, wrote that the Louisiana clinic didn’t have standing. He argued that women don’t have a right to abortion under the privacy guarantees in the 14th Amendment.
    “Moreover, the fact that no five Justices can agree on the proper interpretation of our precedents today evinces that our abortion jurisprudence remains in a state of utter entropy. Since the Court decided Roe, Members of this Court have decried the unworkability of our abortion case law and repeatedly called for course corrections of varying degrees,” Thomas wrote.
  • Justice Samuel Alito wrote a dissent for himself and Gorsuch, to disagree with part of Thomas’ dissent. Furthermore, Gorsuch wrote part of his own dissent, as did Kavanaugh.
    “In any event, contrary to the view taken by the plurality and (seemingly) by the Chief Justice, there is ample evidence in the record showing that admitting privileges help to protect the health of women by ensuring that physicians who perform abortions meet a higher standard of competence than is shown by the mere possession of a license to practice,” Alito wrote.
  • Abortion rights advocates say the Louisiana law was adopted to shutter abortion clinics, like an Ohio law that requires abortion clinics to have transfer agreements with nearby hospitals. They argue the admissions credentials aren’t needed and hospitals frequently deny admitting privileges to doctors who provide abortions, for reasons ranging from ideological opposition, fear of backlash, or the fact that their patients rarely need emergency care.
    Attorneys told the Supreme Court that implementing the Louisiana law would force closure of every abortion clinic in the state except one, and allow just one doctor in the state to perform abortions.
  • NARAL Pro-Choice Ohio Deputy Director Jaime Miracle said Ohio’s law has forced closure of abortion clinics in Toledo and Cincinnati that couldn’t get transfer agreements with nearby hospitals. Abortion providers say the agreements are unnecessary because federal laws require hospitals to take in any patient who comes to them in an emergency. Abortion clinics are also challenging Ohio’s law in federal court.
    The Louisiana law at issue in the case, June Medical Services v. Russo, is identical to a Texas law the court ruled unconstitutional in its 2016 Whole Women’s Health v. Hellerstedt decision. The law’s opponents contended it should be rejected on those grounds. The attorney for June Medical Services Julie Rikelman, told the court that nothing has changed “that would justify such a legal about-face.”
    “The lack of benefits of these laws is not state-dependent,” Rikelman said when the case was argued in March. “The medical consensus is clear that in no state do they serve health and safety benefits. And, in fact, even the federal government a few months ago removed an admitting privileges requirement from its regulations of surgery centers nationwide, finding that the requirement is medically unnecessary and imposes burdens.”
  • Louisiana Solicitor General Elizabeth Murrill told the court her state’s law and regulatory structure are different from the Texas law that was overturned.
    “Louisiana’s decision to require abortion providers to have admitting privileges was iustified by abundant evidence of life-threatening health and safety violations, malpractice, noncompliance with professional licensing rules, legislative testimony from post-abortive women, testimony from doctors who took care of abortion providers’ abandoned patients,” Murrill argued. “Doctors and healthcare providers and healthcare facilities are heavily regulated for ethics reasons and for consumer protection.”
    She said the record showed that abortion doctors who applied for privileges at hospitals “can get privileges, they did get privileges.”
    “These doctors should not be able to challenge a regulation that protects people -- that -- that is intended to protect a class of people from a certain type of activity,” said Murrill. “It’s health and safety regulations.”

"Alabama Lawmakers Move To Outlaw Abortion In Challenge To Roe V. Wade" (May 1, 2019)[edit]

Elliott, Debbie (May 1, 2019). "Alabama Lawmakers Move To Outlaw Abortion In Challenge To Roe V. Wade". NPR.org. Retrieved May 6, 2019.

  • In what would likely become the most restrictive abortion ban in the country, the Alabama House Tuesday passed a bill that would make it a crime for doctors to perform abortions at any stage of a pregnancy, unless a woman's life is threatened. The legislation is part of a broader anti-abortion strategy to prompt the U.S. Supreme Court to reconsider the right to abortion.
    Republican state Rep. Terri Collins of Decatur, Ala., defended her "Human Life Protection Act" during at times contentious debate on the House floor.
    "This bill is focused on that baby that's in the womb that is a person," Collins said. "That baby, I believe, would choose life."
  • Democratic lawmakers walked out in protest before the final 74-3 vote. During debate, they questioned the motive for an abortion ban in a state that has refused to expand Medicaid. "I do support life, but there are some people that just support birth, they don't support life," said Democratic Rep. Merika Coleman of Birmingham, Ala. "Because after a child is born there are some things that need to happen. We need to make sure that child has adequate health care," Coleman said.
  • "When a woman is pregnant, an abortion is no longer legal," says Collins, explaining the bill.
    The bill criminalizes abortion, meaning doctors would face felony jail time up to 99 years if convicted. The only exceptions are for a serious health risk to the pregnant woman or a lethal anomaly of the fetus. There are no exceptions for cases of rape or incest. A woman would not be held criminally liable for having an abortion.
    Collins says the bill follows a constitutional amendment approved by Alabama voters last year that recognizes the "rights of unborn children." It defies the U.S. Supreme Court's landmark decision that protects a woman's right to abortion.
    "This bill is simply about Roe v. Wade," says Collins. "The decision that was made back in 1973 would not be the same decision that was decided upon today if you relooked at the issue."
  • Alabama Pro-Life Coalition President Eric Johnston says there's a reason there's so much activity now. "The dynamic has changed," Johnston says. "The judges have changed, a lot of changes over that time, and so I think we're at the point where we need to take a bigger and a bolder step." The bold move to outlaw nearly all abortions is drawing protests from abortion-rights advocates.
    A coalition called Unite for Reproductive and Gender Equity demonstrated outside the Alabama State House last month.
    "This bill is an awful piece of grandstanding," said Amanda Reyes of Tuscaloosa, Ala. She is president of the Yellowhammer Fund, a group that helps women pay for abortions. "If you make abortion illegal somewhere that doesn't mean that abortion goes away," says Reyes. "It just becomes more difficult and more dangerous to access."
  • The bill is expected to win final passage in the Republican-majority Alabama Senate. The ACLU of Alabama says it will sue if the abortion ban becomes law.
    Executive Director Randall Marshall says the bill is unconstitutional. "There is simply nothing that Alabama can do to interfere with the right of access to abortion," Marshall says. "That is a federal right and the federal Constitution clearly trumps all state law."

“Abortion Debate” (2008)[edit]

Farrell, Courtney (2008). “Abortion Debate”. ABDO Publishing Company.

  • When a woman gets an abortion, she is intentionally ending her pregnancy. Since abortion ends a developing human life, it is a sensitive subject. Some people are so opposed to abortion that they believe it should be illegal. Others believe a woman should have the right to make the choice of whether to have an abortion.
    The question of abortion is a question about rights. Activists choose sides in the conflict depending on whose rights they most passionately defend. The fetus, the pregnant woman, her male partner, and the couple’s parents all have advocates who defend their rights. In this debate, we see democracy in action.
    Almost half of the pregnancies that occur in the United States are not planned. Approximately 40 percent of these pregnancies end in abortion. In other cases, mothers who may have been troubled by their pregnancies grow to love their babies. Still, 10 percent of newborn babies are reported as unwanted. Some situations are resolved by adoptive parents raising the baby. Other babies, often those of drug addicts or rape victims, are abandoned at hospitals. These babies receive care as wards of the state and eventually are put up for adoption. Children with physical and emotional disabilities are not likely to be adopted and are raised in orphanages.
    Should abortion be a choice? Opinions differ, but one-third of U.S. women will have had an abortion by age 45.
    • Chapter 1 “A Sensitive Subject”, pp. 6–7.
  • A 1327 English law made abortion legal at any time during pregnancy. In England, abortion was still legal by 1670, but the American colonies had different rules. In the colonies, abortion was illegal, though it did not carry as severe a penalty as murder.
    • p.18
  • Records from early America reveal a society quite different from the morally strict one often portrayed in stories. Although the colonies were founded by stern religious groups sex before marriage was not uncommon. Records detailed marriages and births in the colonies. They also revealed that, before 1680, 3 percent of newly married women gave birth within six months of their marriage, and 8 percent had babies in fewer than nine months from their wedding day. This trend continued over time, and from 1760-1800, one-third of all brides gave birth to their first child in less than nine months of marriage. There was little dishonor in this, and even when unmarried women had babies, they could become “respectable” by marrying the baby’s father.
    Colonial law stated that a single woman could say the name of her baby’s father while she was in labor, and the court would automatically believe her. This practice stemmed from the danger of dying in childbirth in a time before Cesarean surgical births were possible. In the deeply religious colonies, it was believed a woman would never lie before possibly meeting God.
    If the father of the baby was already married, or unwilling to marry the mother, the couple faced disgrace. Although the father would be ordered to pay child support, many women were desperate to avoid dishonor.
    • ”Abortion From Past to Present”, pp.19-20
  • In colonial times, surgical abortions were so dangerous, women almost never survived them. But many substances to bring about abortions were known. Depending on the amount used, these could accidentally kill both the mother and the fetus, kill only the fetus, or fail to work at all.
    • ”Abortion From Past to Present”, p.20
  • During the 1800s, American cities were growing. Many young people left their rural villages and traveled to cities in search of work. This trend had the side effect of removing many young people form the influence of their families. When single women became pregnant, there was no less pressure from the community for the issue to be resolved by marriage.
    Although many churches opposed it, abortion was legal in most places in America during the nineteenth century. Midwives often prescribed herbs that would cause abortions, and advertisements for tonics that promised to cure “menstrual blockages” were common in publications of the time. American courts first took up the issue in 1812, in the “Commonwealth v. Bangs” case. In “Bangs”, the Massachusetts Supreme Court pronounced abortion legal, but only before quickening-the time when the mother could feel the fetus moving. At this point society had not addressed the question of the rights of the unborn. Laws were passed primarily to protect women’s lives. Many women were injured or killed each year either by abortion-inducing drugs or by surgical abortions performed by inept folk healers.
    • ”Abortion From Past to Present”, pp.21-22
  • In response to an 1859 AMA resolution against abortion, state laws began banning abortion. At this point in time, there was no pro-life movement. Abortion was banned mainly because it was unsafe. By 1890, abortion was illegal throughout most of the United States. However, despite a ban in Michigan, in 1882 doctors in that state reported that 17 to 32 percent of all pregnancies were still aborted.
    • ”Abortion From Past to Present”, pp.22-23
  • By 1900, abortion was illegal in all states except Kentucky, though it was only allowed in cases when it was necessary to maintain the life or health of the mother. These special cases were called “therapeutic abortions.” However, it was up to the physician to determine when an abortion was necessary. Some doctors interpreted the law loosely, especially in cases involving wealthy women or those with connections to the medical profession.
    Although abortion was illegal, enforcement of the law was weak, and women were rarely brought to trial. In 1904, a Chicago doctor reported that 10 to 13 percent of all pregnancies in the city were ending in abortion.
    • ”Abortion From Past to Present”, p.23
  • Since all legal abortions were supposed to be therapeutic, hospitals limited the number of abortions they would perform. If an abortion was necessary to preserve the woman’s health, she was often required to be made sterile to prevent her from ever getting pregnant again. Therapeutic abortions for poor women were denied more often than those for wealthy ones.
    • p.32
  • Despite the pill, many unintended pregnancies still ended in illegal abortions. Women often died as a result of illegal abortions, often performed by abortionists who were not doctors. The problem was worse for women of color. In the early 1960s in New York City, one out of four child-birth related deaths among white women was caused by abortion but abortion caused half of such deaths among nonwhite women.
    • pp.33-34

"Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives" (2005)[edit]

Finer, Lawrence B.; Frohwirth, Lori F.; Dauphinee, Lindsay A.; Singh, Susheela; Moore, Ann M. (2005). "Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives" (PDF). Perspectives on Sexual and Reproductive Health. 37 (3): 110–18.

  • RESULTS: The reasons most frequently cited were that having a child would interfere with a woman’s education, work or ability to care for dependents (74%); that she could not afford a baby now (73%); and that she did not want to be a single mother or was having relationship problems (48%). Nearly four in 10 women said they had completed their childbearing, and almost one-third were not ready to have a child. Fewer than 1% said their parents’ or partners’ desire for them to have an abortion was the most important reason. Younger women often reported that they were unprepared for the transition to motherhood, while older women regularly cited their responsibility to dependents.
    CONCLUSIONS: The decision to have an abortion is typically motivated by multiple, diverse and interrelated reasons. The themes of responsibility to others and resource limitations, such as financial constraints and lack of partner sup-port, recurred throughout the study.
    • p.110
  • Public discussion about abortion in the United States has generally focused on policy: who should be allowed to have abortions, and under what circumstances. Receiving less attention are the women behind the statistics—the 1.3 million women who obtain abortions each year1—and their reasons for having abortions. While a small proportion of women who have abortions do so because of health concerns or fetal anomalies, the large majority choose termination in response to an unintended pregnancy. However, “unintended pregnancy” does not fully capture the reasons and life circumstances that lie behind a woman’s decision to obtain an abortion. What personal, familial, social and economic factors lead to the decision to end a pregnancy?
    The research into U.S. women’s reasons for having abortions has been limited. In a 1985 study of 500 women in Kansas, unreadiness to parent was the reason most often given for having an abortion, followed by lack of financial resources and absence of a partner. In 1987, a survey of1,900 women at large abortion providers across the country found that women’s most common reasons for having an abortion were that having a baby would interfere with school, work or other responsibilities, and that they could not afford a child. Since 1987, little research in this area has been conducted in the United States, but studies done in Scandinavia and worldwide have found several recur-ring motivations: economic hardship, partner difficulties and unreadiness for parenting. An extensive literature (both quantitative and qualitative) examines how women make the decision to have an abortion or a birth. Here, we focus on women who have already made the decision to have an abortion.
    Why revisit this topic? One compelling reason is that the abortion rate declined by 22% between 1987 and 2002, and another is that the demographic characteristics of reproductive-age women in general and of abortion patients in particular have changed since 1987. For example, the proportion of abortion patients who have already had one or more children has increased, as have the proportions who are aged 30 or older, who are nonwhite and who are cohabiting. In addition, between 1994 and 2000, the proportion of women having abortions who were poor in-creased. Because social and demographic characteristics may be associated with motivations for having an abortion, it is important to reassess the reasons why women choose to terminate a pregnancy.
    A better understanding of these motivations can inform public opinion and prevent or correct misperceptions. Like-wise, a fuller appraisal of the life circumstances within which women decide to have an abortion bears directly on the issue of public funding for abortions and provides evidence of how increasing legal and financial constraints on access to abortion may affect women’s lives.
    • p.110
  • Most women in every age, parity, relationship, racial, income and education category cited concern for or responsibility to other individuals as a factor in their decision to have an abortion. In contrast to the perception (voiced by politicians and laypeople across the ideological spectrum) that women who choose abortion for reasons other than rape, incest and life endangerment do so for “convenience,”our data suggest that after care-fully assessing their individual situations, women base their decisions largely on their ability to maintain economic stability and to care for the children they already have.
    In addition, the topic of women’s limited resources, such as financial constraints and lack of partner support, regularly appeared in the survey and interview responses. A large majority of women cited financial hardship, often along with other reasons. Financial problems, exacerbated by other forms of instability, limit women’s ability to provide sufficient support to additional children. The concept of responsibility is inseparable from the theme of limited resources; given their present circumstances, respondents considered their decision to have an abortion the most responsible action. The fact that many women cited financial limitations as a reason for ending a pregnancy suggests that further restrictions on public assistance to families could contribute to a continued increase in abortions among the most disadvantaged women.
    Although these concerns appeared among all groups, different groups of women gave diverse reasons for having abortions. Younger women who had not begun their child-bearing often reported that they were unprepared for the transition to motherhood, while older women, the large majority of whom were already mothers, regularly cited their responsibility to children or other dependents as a key factor behind the decision to have an abortion.
    Only a small proportion of women cited concerns about their own health. However, the qualitative results showed that these concerns encompassed not just risks to future health, but also the health burden of pregnancy itself. They further revealed how health concerns are linked to the concept of responsibility: Some women saw the physical bur-den of pregnancy and its associated health conditions as threatening their ability to fulfill responsibilities to dependents. Others underscored the importance of appropriate birth spacing for their own health and for the health and economic security of their children.
    • pp.117-118
  • In light of the public debate over the morality of abortion, it is notable that the women in our survey emphasized their conscious examination of the moral aspects of their decisions. Although some described abortion as sinful and wrong, many of those same women, and others, described the indiscriminate bearing of children as a sin, and their abortion as “the right thing” and “a responsible choice.” Respondents often acknowledged the complexity of the decision, and described an intense and difficult process of deciding to have an abortion, which took into account the moral weight of their responsibilities to their families, them-selves and children they might have in the future.
    • p.118
  • Some advocates have used highly selective samples to claim that the majority of women having abortions are coerced into the decision. Such claims suggest that women lack control over their own lives, but our findings attest that women independently make the decision to have an abortion. The proportion of women citing influence from partners or parents is small (and has declined since 1987), and fewer than 1% of respondents indicated that this influence was their most important reason.
    • p.118
  • The fact that an increasing proportion of women having abortions are poor underscores the importance of public assistance for family planning programs as an effective means of reducing the incidence of both unintended pregnancy and abortion.
    • p.118

"Study: Abortions Are Safe When Performed By Nurse Practitioners, Physician Assistants, Certified Nurse Midwives" (1/2013)[edit]

Elizabeth Fernandez, "Study: Abortions Are Safe When Performed By Nurse Practitioners, Physician Assistants, Certified Nurse Midwives". UCSF, (1/2013)

  • Nationally, 92 percent of abortions take place in the first trimester but studies find that black, uninsured and low-income women continue to have less access to this care, according to the researchers.
    In California, 13 percent of women using state Medicaid insurance obtain abortions after the first trimester. Because the average cost of a second trimester abortion is substantially higher than a first trimester procedure and abortion complications increase as the pregnancy advances, shifting the population distribution of abortions to earlier gestations may result in safer, less costly care, according to the research team.
  • “Increasing the types of health care professionals who can provide early aspiration abortion care is one way to reduce this health care disparity,’’ said lead author Tracy Weitz, PhD, MPA, a UCSF associate professor and director of Advancing New Standards in Reproductive Health at the UCSF Bixby Center for Global Reproductive Health. “Policy makers can now feel confident that expanding access to care in this way is evidence-based and will promote women’s health.’’
    Currently, non-physicians are allowed to perform aspiration abortions in four states: Montana, Oregon, New Hampshire and Vermont. In other states, non-physician clinicians are permitted to perform medication but not aspiration abortions. In recent years, in an effort to limit abortion availability, several states have put laws on the books to prohibit non-physician clinicians from performing abortions.
  • In the study, 40 nurse practitioners, certified nurse midwives and physician assistants from four Planned Parenthood affiliates and from Kaiser Permanente of Northern California were trained to perform aspiration abortions. They were compared to a group of nearly 100 physicians, who had a mean of 14 years of experience providing abortions.
    Altogether, 5,675 abortions were performed in the study by nurse practitioners, certified nurse midwives and physician assistants, compared to 5,812 abortions by physicians. The abortions were performed between August 2007 and August 2011 at 22 clinical facilities in California.
    The researchers found that both groups of abortion providers had few complications – less than 2 percent, including incomplete abortions, minor infection and pain. Statistically, according to the researchers, the complication rates were not different between the two groups of providers.
  • “The value of this study extends beyond the question of who can safely perform aspiration abortion services in California because it provides an example of how research can be used to answer relevant health care policy issues,’’ said study co-author Diana Taylor, PhD, RNP, professor emeritus in the UCSF School of Nursing. “As the U.S. demand for cost-effective health care increases, workforce development has become a key component of health care reform. All qualified health professionals should perform clinical care to the fullest extent of their education and competency.’’

"Abortion Incidence and Services in the United States in 2000" (2003)[edit]

Finer, L.B.; Henshaw, S.K. (2003). "Abortion Incidence and Services in the United States in 2000". Perspectives on Sexual and Reproductive Health. 35 (1): 6–15. doi:10.1363/3500603. PMID 12602752. Archived from the original on 22 January 2016.

  • RESULTS: From 1996 to 2000, the number of abortions fell by 3% to 1.31 million, and the abortion rate declined 5% to 21.3 per 1,000 women 15-44. (In comparison, the rate declined 12% between 1992 and 1996.) The abortion ratio in 2000 was 24.5 per 100 pregnancies ending in abortion or live birth, 5% lower than in 1996. The number of abortion providers decreased by 11% to 1,819 (46% were clinics, 33% hospitals and 21% physicians' offices); clinics provided 93% of all abortions in 2000. In that year, 34% of women aged 15-44 lived in the 87% of counties with no provider, and 86 of the nation's 276 metropolitan areas had no provider. About 600 providers performed an estimated 37,000 early medical abortions during the first six months of 2001; these procedures represented approximately 6% of all abortions during that period. Abortions performed by dilation and extraction were estimated to account for 0.17% of all abortions in 2000.
  • Induced abortion, one of the most frequently performed surgical procedures in the United States, is experienced by a substantial proportion of American women. More than one-fifth of all pregnancies end in abortion, a reflection of the fact that almost half of U.S. pregnancies are unintended. Trends in abortion may reflect a number of factors, such as variations in the underlying incidence of unintended pregnancy and changes in how women resolve unplanned pregnancies and in the availability or accessibility of abortion services. Therefore, regular and accurate estimates of abortion incidence and service provision are essential for monitoring trends in reproductive behavior.
    After remaining fairly steady for most of the 1980s, the number of abortions in the United States declined from a high of 1.61 million in 1990 to 1.36 million in 1996, the last year for which comprehensive abortion incidence data were collected. The abortion rate declined from 29.3 per 1,000 women aged 15-44 in 1980 and 27.4 in 1990 to 22.4 in 1996. The abortion ratio (the proportion of pregnancies ending in abortion) also fell during the early and mid-1990s. These declines meant that in the mid-1990s, measures of abortion reached the lowest levels since the 1970s.
  • Meanwhile, a continuing decline in the number of providers could result in more limited access to abortion services. The number of U.S. abortion providers fell from a high of 2,900 in 1982 to about 2,000 in 1996, and the proportion of counties without a provider increased from 77% in 1978 to 86% in 1996. A 1997 survey of obstetricians and gynecologists who perform abortions indicated that 57% were aged 50 or older, fueling the perception that the number of providers will decline drastically as current providers reach retirement age. However, some evidence indicates that training opportunities for providers have begun to increase.
  • The number of abortions in the United States declined 3% between 1996 and 2000, from 1.36 million to 1.31 million. This was the lowest number of abortions since 1976. The abortion rate also declined through 2000, reaching 21.3 abortions per 1,000 women 15-44 in that year. This figure represents a 5% drop over the four-year interval and is the lowest rate since 1974. The abortion ratio declined to 24.5 abortions per 100 pregnancies ending in abortion or live birth in 2000; this also represents a 5% drop since 1996 and the lowest figure since 1974. Including estimated miscarriages, 21% of all pregnancies in 2000 ended in abortion (not shown).
    The number of abortions and abortion rates vary widely by region and state of occurrence. Six states that account for 40% of women aged 15-44—California, Florida, Illinois, New Jersey, New York and Texas—accounted for 55% of all abortions in 2000. Rates were highest in New Jersey and New York, and were relatively high (above 30 per 1,000 women 15-44) in California, Delaware, Florida and Nevada. The states with the fewest abortions—South Dakota, North Dakota and Wyoming—are largely rural states and have relatively small populations. The lowest rates were in Kentucky, South Dakota and Wyoming; Idaho, Mississippi, Missouri, Utah and West Virginia also had low rates (seven or fewer per 1,000 women 15-44). Among the 25 states with the largest populations of women 15-44, the lowest abortion rate was in Kentucky.
    Between 1996 and 2000, the abortion rate declined in every region of the country, but changes varied by region and, even more so, by state. The abortion rate declined in 35 states and the District of Columbia; the greatest percentage decreases occurred in Kentucky and Wyoming. Percentage changes are most meaningful in states with the greatest number of abortions, since small absolute changes in states with few abortions can result in large percentage shifts. Among the states reporting at least 10,000 abortions in 1996, the largest declines occurred in Massachusetts and Missouri. The abortion rate increased in 15 states. The largest percentage increase occurred in Delaware, and the largest increase among states with at least 10,000 abortions in 1996 occurred in Kansas (15%).
  • A total of 1,819 providers performed at least one abortion in 2000—11% fewer than in 1996. In comparison, the number of providers declined by 14% from 1992 to 1996. The number of providers in 2000 was 37% lower than the all-time high of 2,908 in 1982 (not shown).
  • Abortion providers were located in 404 of the 3,141 U.S. counties in 2000. Overall, 87% of counties had no provider of abortions. More than 90% of counties in the Midwest and South had no abortion provider; outside of these regions, the only states with no provider in at least 90% of counties were Idaho, Montana, Utah and Wyoming.
    Although the vast majority of counties had no provider, only 34% of women aged 15-44 in 2000 lived in counties with no abortion providers, because many of these have relatively small populations. However, nearly half of women in the Midwest (49%) and South (45%) lived in counties that lacked abortion services. In 19 states in these regions, at least half of women lived in counties without an abortion provider. However, in six states in the same regions—Delaware, Florida, Illinois, Maryland, Michigan and Texas (and the District of Columbia)—fewer than one-third lived in counties with no provider. Fewer than one in five women in the Northeast and West lived in counties without an abortion provider; the proportion was less than one-third in 13 states in these regions and more than one-half in only three.
  • The proportion of counties with no abortion provider in 2000 (87%) changed little compared with that in 1996 (86%), but remained higher than the proportion in 1978 (77%). In addition, the proportion of counties with no provider of 400 or more abortions per year has changed little over time, indicating that the drop in counties with providers has been concentrated in those where providers perform fewer than 400 abortions per year.
    Most abortion providers are located in metropolitan areas: 94% of all providers and 99% of those who performed 400 or more abortions in 2000 (not shown). Even so, 61% of counties in metropolitan areas had no abortion provider, and 70% had no large provider. Of nonmetropolitan counties, 97% had no provider, and virtually all lacked a provider of at least 400 abortions per year.
    Overall, the proportion of women living in a county without a provider increased from 27% in 1978 to 30% in 1985 and 34% in 2000. However, figures based on comparable metropolitan classifications indicate that the proportion of women with no provider in their county increased from 1978 to 1996 in both metropolitan and nonmetropolitan counties, but changed only slightly between 1996 and 2000. There was no change during the 1990s in the proportion of women in metropolitan areas living in counties with no large provider, although the levels were slightly greater than those in 1978 and 1985. Almost all women in nonmetropolitan counties have lived without a large abortion provider.
  • Between 1996 and 2000, the U.S. abortion rate fell 5%, a decline less than half as steep as that seen between 1992 and 1996 (12%). The number of abortion providers continued to decline between 1996 and 2000, at a rate slightly lower than that during 1992-1996. The 1996-2000 period saw the continuing consolidation of abortion provision at clinics, particularly specialized clinics; only 7% of abortions in 2000 were performed in nonclinic facilities. This trend may be partially due to increasing legal constraints on the circumstances under which abortions may be performed, such as zoning rules and state licensing and inspection requirements. Specialized clinics may be better able to deal with new restrictions than physicians' offices and nonspecialized clinics, which may not be willing or able to undertake the expenses and time required to comply with them. This factor may be most relevant in South Carolina and Mississippi, where new licensing laws have created burdensome requirements for small providers; at least one South Carolina provider has reportedly closed in response to the new regulations.
  • For most American women, access to abortion is directly tied to where they live. Only 3% of nonmetropolitan counties have a provider, and almost none of those providers performed more than 400 abortions in 2000. Of metropolitan counties, only 30% have a large abortion provider. Surprisingly, although the proportion of nonmetropolitan counties with a provider has declined, the proportion of women in nonmetropolitan counties with a provider appears to have increased slightly, probably because of population shifts toward counties with providers. In metropolitan areas, the proportion of women living in counties with providers has changed little.
    The Northeast and West are characterized by higher abortion rates and greater access to providers than are the Midwest and South, and also by more supportive laws regarding abortion. In some states, abortion decreases may be due to regulatory requirements placed on women seeking abortion. For example, in Wisconsin, the imposition of a two-day delay law may have contributed to the 21% decline in the abortion rate (although women there may increasingly have gone to Illinois, particularly Chicago, to obtain abortions). In other states, rates may decline because many women travel out of state to have abortions. This may occur when the barriers to obtaining an abortion—such as gestational limits or other restrictions, or expense—are lower in neighboring states.
  • In the past, the U.S. abortion rate has been distinctly higher than the rate in other industrialized countries. Although the U.S. rate (21.3 per 1,000 women 15-44) is still higher than those in many western European countries, it is now within the range of rates in a few other developed countries, such as Sweden (18.7) and Australia (22.2). Furthermore, U.S. rates vary by women's ethnicity and socioeconomic standing; the rate among white non-Hispanic women is in the middle range of other developed countries, but other ethnic groups have higher rates. Moreover, poor and near-poor women have rates roughly twice as high as their wealthier counterparts.
    This article has documented current levels of abortion and abortion service provision. More research needs to be done both to understand why abortion service provision is changing and the impact on women of the small number and geographic concentration of providers. In addition, further work is needed to determine the causes of declines in the abortion rate. Increasing use of emergency contraception appears to have been a major contributor in recent years: An estimated 51,000 pregnancies were averted by emergency contraception in 2000, accounting for 43% of the decrease in abortions since 1994. Contraceptive use trends through 1995—improvements in use (e.g., a shift to greater use of long-acting, highly effective methods) and reductions in the proportion of women using no method—may have continued. The abortion rate decline between 1994 and 2000 was greatest among teenagers. Both a decline in sexual activity among adolescents and increased use of contraceptives at first intercourse contribute to decreasing pregnancy and abortion rates among adolescents.
  • With more than one in five U.S. pregnancies ending in abortion, it is clear that American women are becoming pregnant far more often than they desire. More than half of these pregnancies occur among women who had difficulty using contraceptive methods effectively or who experienced method failure, and nearly half occur among the minority of sexually active women who use no contraceptives, reflecting the high rate of pregnancy among this group.37 The challenge of reducing U.S. abortion rates without increasing unintended births requires action on several fronts, but foremost among these are increasing (and increasing the effectiveness of) contraceptive use by sexually active women and their partners, improving access to contraceptive services for those who are disadvantaged and ensuring the availability of a broader range of more-effective and user-friendly contraceptive methods.

"Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives" (2005)[edit]

Finer, L.B.; Frohwirth, L.F.; Dauphinee, L.A.; Singh, S.; Moore, A. M. (2005). "Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives". Perspectives on Sexual and Reproductive Health. 37 (3): 110–18. doi:10.1111/j.1931-2393.2005.tb00045.x. PMID 16150658. Archived from the original on 7 January 2012.

  • RESULTS: The reasons most frequently cited were that having a child would interfere with a woman's education, work or ability to care for dependents (74%); that she could not afford a baby now (73%); and that she did not want to be a single mother or was having relationship problems (48%). Nearly four in 10 women said they had completed their childbearing, and almost one-third were not ready to have a child. Fewer than 1% said their parents' or partners' desire for them to have an abortion was the most important reason. Younger women often reported that they were unprepared for the transition to motherhood, while older women regularly cited their responsibility to dependents.
    CONCLUSIONS: The decision to have an abortion is typically motivated by multiple, diverse and interrelated reasons. The themes of responsibility to others and resource limitations, such as financial constraints and lack of partner support, recurred throughout the study.
  • Public discussion about abortion in the United States has generally focused on policy: who should be allowed to have abortions, and under what circumstances. Receiving less attention are the women behind the statistics—the 1.3 million women who obtain abortions each year1—and their reasons for having abortions. While a small proportion of women who have abortions do so because of health concerns or fetal anomalies, the large majority choose termination in response to an unintended pregnancy.2 However, "unintended pregnancy" does not fully capture the reasons and life circumstances that lie behind a woman's decision to obtain an abortion. What personal, familial, social and economic factors lead to the decision to end a pregnancy?
    The research into U.S. women's reasons for having abortions has been limited. In a 1985 study of 500 women in Kansas, unreadiness to parent was the reason most often given for having an abortion, followed by lack of financial resources and absence of a partner.3 In 1987, a survey of 1,900 women at large abortion providers across the country found that women's most common reasons for having an abortion were that having a baby would interfere with school, work or other responsibilities, and that they could not afford a child.4 Since 1987, little research in this area has been conducted in the United States, but studies done in Scandinavia and worldwide have found several recurring motivations: economic hardship, partner difficulties and unreadiness for parenting. An extensive literature (both quantitative and qualitative) examines how women make the decision to have an abortion or a birth. Here, we focus on women who have already made the decision to have an abortion.
    Why revisit this topic? One compelling reason is that the abortion rate declined by 22% between 1987 and 2002, and another is that the demographic characteristics of reproductive-age women in general and of abortion patients in particular have changed since 1987. For example, the proportion of abortion patients who have already had one or more children has increased, as have the proportions who are aged 30 or older, who are nonwhite and who are cohabiting. In addition, between 1994 and 2000, the proportion of women having abortions who were poor increased. Because social and demographic characteristics may be associated with motivations for having an abortion, it is important to reassess the reasons why women choose to terminate a pregnancy.
  • Respondents to the structured survey of reasons for abortion were not substantially different from a nationally representative sample of abortion patients surveyed in 2000 in terms of age, marital status, parity, income, education, race or gestation. Twenty percent were 19 or younger, and 57% were in their 20s. Seventy-two percent had never been married, and 59% had had at least one child. Some 60% were below 200% of the federal poverty line, including 30% who were living in poverty (not shown). More than half had attended college or received a college degree. Thirty-one percent of respondents were black, and 19% were Hispanic. (Four percent completed the questionnaire in Spanish.) Sixty-one percent were at fewer than nine weeks of gestation, and 85% were at fewer than 13 weeks.
    However, the characteristics of abortion patients had changed between 1987 and 2000, and these changes were reflected in the 1987 and 2004 surveys of reasons for abortion. For example, the proportion who were mothers increased from 48% to 61% in the nationally representative surveys carried out in 1987 and 2000; a similar increase (from 42% to 59%) was seen between the 1987 and 2004 surveys of reasons. The median age of respondents was 23.0 in the 1987 survey of reasons and 24.1 in 2004 (not shown). Fifty percent of women were below 200% of the federal poverty level in the 1987 survey of reasons, while in 2004, 60% were below this level. Also, the proportion who were Hispanic rose from 7% in 1987 to 19% in 2004.
  • Reasons in 2004. Among the structured survey respondents, the two most common reasons were "having a baby would dramatically change my life" and "I can't afford a baby now" (cited by 74% and 73%, respectively). A large proportion of women cited relationship problems or a desire to avoid single motherhood (48%). Nearly four in 10 indicated that they had completed their childbearing, and almost one-third said they were not ready to have a child. Women also cited possible problems affecting the health of the fetus or concerns about their own health (13% and 12%, respectively). Respondents wrote in a number of specific health reasons, from chronic or debilitating conditions such as cancer and cystic fibrosis to pregnancy-specific concerns such as gestational diabetes and morning sickness.
    The most common subreason given was that the woman could not afford a baby now because she was unmarried (42%). Thirty-eight percent indicated that having a baby would interfere with their education, and the same proportion said it would interfere with their employment. In a related vein, 34% said they could not afford a child because they were students or were planning to study.
  • [T]he proportion of women indicating that they had completed their desired childbearing increased substantially (and significantly) between 1987 and 2004, from 28% to 38%. To assess whether this shift was due to a change in mothers' propensity to give this reason (in addition to the change in population composition described earlier), we stratified this analysis by both survey year and whether the woman had any children. The findings showed that mothers in 2004 were more likely to report this reason than were mothers in 1987 (not shown). Thus, the overall increase likely reflected both a rise in the proportion of abortion patients who were already mothers and an increased tendency of mothers to give this reason.
  • Financial difficulties. Higher proportions of women who were unmarried or cohabiting, nonwhite, poorer and unemployed said they could not afford to have a child now, compared with their respective counterparts. This reason was also more commonly given by young teenagers and women aged 20–24. Some of these social and demographic characteristics likely have overlapping influence. For example, young women are likely to be unmarried, and poor women are likely to be unemployed. In the multivariate analysis, marital status and both economic variables remained significant: Women who were married, who were in the highest income category and who were employed had reduced odds of saying they could not afford a baby (odds ratios, 0.4–0.6).
  • A cross-cutting theme was women's responsibility to children and other dependents, as well as considerations about children they may have in the future. Most women in every age, parity, relationship, racial, income and education category cited concern for or responsibility to other individuals as a factor in their decision to have an abortion. In contrast to the perception (voiced by politicians and laypeople across the ideological spectrum) that women who choose abortion for reasons other than rape, incest and life endangerment do so for "convenience,"13 our data suggest that after carefully assessing their individual situations, women base their decisions largely on their ability to maintain economic stability and to care for the children they already have.
    In addition, the topic of women's limited resources, such as financial constraints and lack of partner support, regularly appeared in the survey and interview responses. A large majority of women cited financial hardship, often along with other reasons. Financial problems, exacerbated by other forms of instability, limit women's ability to provide sufficient support to additional children. The concept of responsibility is inseparable from the theme of limited resources; given their present circumstances, respondents considered their decision to have an abortion the most responsible action. The fact that many women cited financial limitations as a reason for ending a pregnancy suggests that further restrictions on public assistance to families could contribute to a continued increase in abortions among the most disadvantaged women.
  • In light of the public debate over the morality of abortion, it is notable that the women in our survey emphasized their conscious examination of the moral aspects of their decisions. Although some described abortion as sinful and wrong, many of those same women, and others, described the indiscriminate bearing of children as a sin, and their abortion as "the right thing" and "a responsible choice." Respondents often acknowledged the complexity of the decision, and described an intense and difficult process of deciding to have an abortion, which took into account the moral weight of their responsibilities to their families, themselves and children they might have in the future.

"Rates of serious infection after changes in regimens for medical abortion" (July 9, 2009)[edit]

Fjerstad, Mary; Trussell, James; Sivin, Irving; Lichtenberg, E. Steve; Cullins, Vanessa (July 9, 2009).[ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3568698/ "Rates of serious infection after changes in regimens for medical abortion"]. New England Journal of Medicine. 361 (2): 145–151.

  • From 2001 through March 2006, Planned Parenthood health centers throughout the United States provided medical abortion (abortion by means of medication) principally by a regimen of oral mifepristone followed 24 to 48 hours later by vaginal misoprostol. In response to concern about serious infections, in early 2006 Planned Parenthood changed the route of misoprostol administration from vaginal to buccal and required either routine provision of antibiotics or universal screening and treatment for chlamydia; in July 2007, Planned Parenthood began requiring routine treatment with antibiotics for all medical abortions.
  • Rates of serious infection dropped significantly after the joint change to buccal misoprostol from vaginal misoprostol and to either testing for sexually transmitted infection or routine provision of antibiotics as part of the medical abortion regimen. The rate declined 73%, from 0.93 per 1000 abortions to 0.25 per 1000 (absolute reduction, 0.67 per 1000; 95% confidence interval [CI], 0.44 to 0.94; P<0.001). The subsequent change to routine provision of antibiotics led to a further significant reduction in the rate of serious infection — a 76% decline, from 0.25 per 1000 abortions to 0.06 per 1000 (absolute reduction, 0.19 per 1000; 95% CI, 0.02 to 0.34; P = 0.03).
    CONCLUSIONS
    The rate of serious infection after medical abortion declined by 93% after a change from vaginal to buccal administration of misoprostol combined with routine administration of antibiotics.
  • The Planned Parenthood Federation of America (PPFA) is a federation of 97 independent local affiliates operating 880 health centers throughout the United States; roughly 300 of those health centers provide medical abortion. In 2008, a total of 96,738 women received medical abortions (abortion by means of medication), representing 32% of first-trimester abortions in Planned Parenthood health centers. Extensive data gathering during the use of mifepristone and vaginal misoprostol indicated that efficacy (successful medical abortion without the need for surgical intervention) was 98.5%; a subsequent audit of abortions performed with the use of buccal rather than vaginal misoprostol showed virtually identical efficacy.
    Antibiotics have been routinely administered at the time of surgical abortions since the publication of a meta-analysis showing that their use resulted in a 42% reduction in postabortion infection rates. When medical abortion was first introduced, there was little concern about the risk of infection, because there is no use of instruments in the cervix or uterus unless the procedure fails. However, it is clear that serious infections do occur.
    Data are lacking to compare the rates of serious infection with antibiotic treatment and the rates without such treatment among women undergoing medical abortion. The Food and Drug Administration (FDA) states that it “does not have sufficient information to recommend the use of prophylactic antibiotics for women having a medical abortion.”The current American College of Obstetricians and Gynecologists Practice Bulletin on medical abortion states that no data exist to support the routine use of preventive antibiotics for medical abortion.
  • By late 2005, four women in the United States and one in Canada had died from a rare bacterial infection, with Clostridium sordellii, after medical abortion with mifepristone and misoprostol.9 In contrast, no such deaths had been reported in Europe, where medical abortion had been available longer and far more women had used it. One hypothesis for the difference was that vaginal administration of misoprostol was very common in the United States but not so common in Europe. Another hypothesis was that periprocedural antibiotics were routinely provided in the United Kingdom but not in the United States.
  • The provisions of FDA approval stipulate that any physician who orders, provides, or supervises the provision of mifepristone must sign an agreement with the sole U.S. distributor of mifepristone (Danco Laboratories) to report all serious adverse events associated with its use. Serious adverse events include all ongoing pregnancies (pregnancies that continue after the use of mifepristone or misoprostol), hemorrhage requiring emergency treatment, serious infections, hospitalizations, potentially life-threatening events, and death. Danco submits all such reports to the FDA. Staff members at Planned Parenthood health centers were trained in accurate and complete reporting of serious adverse events. Adverse-event reports are centrally tracked and monitored. Planned Parenthood health centers are audited on site for internal accreditation by the PPFA. Since 2005, concurrent with the starting date of our analysis, the accreditation process has included auditing to verify that adverse events related to the use of mifepristone for medical abortions are submitted as required.
  • During the course of the study, 243,692 women underwent medical abortion at Planned Parenthood centers. After the exclusion of 15,869 women who did not meet eligibility criteria (<7%), the analysis population included 227,823 women, among whom 92 serious infections were reported.
  • We observed significant and clinically important reductions in the risk of serious infections among patients who had undergone medical abortion after a change from vaginal to buccal administration of misoprostol and after the adoption of routine preventive treatment with antibiotics. Although the observational design of our study precludes a determination of cause and effect, it is plausible that the changes in practice patterns could explain the reductions in the rate of serious infection. Because PPFA instituted more than one measure at a time, it is difficult to estimate from our analyses the relative values of different interventions. However, the fact that Planned Parenthood health centers adopted two infection-reduction measures in Period 2 allows further exploration of this issue.
  • Although a randomized clinical trial would be the preferred approach to determine whether the use of buccal rather than vaginal administration of misoprostol might reduce the rate of serious infection and whether a strategy of routine antibiotic coverage is superior to a strategy of screening before treating, this study design would not have been feasible. Given the low rates of serious infection, such a design would have required a prohibitively large sample. The large population that receives care at Planned Parenthood centers allowed the discerning of changes over time in the rates of serious infection after medical abortion. In summary, the current report shows that changes in PPFA policies for medical abortion that involve replacing vaginal administration of misoprostol with buccal administration and, later, providing routine antibiotics coupled with a highly monitored, systemwide surveillance network were associated with significant reductions in the rates of serious infections.

"Choice, Life Groups Slam Obama Order on Abortion Funding" (March 21, 2010)[edit]

"Choice, Life Groups Slam Obama Order on Abortion Funding". Fox News. (March 21, 2010).

  • Pro-choice and pro-life groups on Sunday strongly denounced a deal by pro-life Democrats and President Obama to ensure limits on taxpayer money for abortion services, outlined in a Senate health insurance overhaul now on the verge House approval.
    Abortion rights supporters chastised the president, saying he caved on his principles by agreeing to issue an executive order that strengthens limits on abortion. Abortion opponents, on the other hand, said Obama's pending order does nothing to prohibit spending on abortion services as provided in the Senate bill.
  • "I'm pleased to announce that we have an agreement, and it's with the help of the president and the speaker we were able to come to an agreement to protect the sanctity of life in the health care reform. There will be no public funding for abortion in this legislation," Stupak said.
    The White House issued its own statement about the executive order.
    The president "will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion," reads the statement from White House Communications Director Dan Pfeiffer.
    "While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented," the statement reads.
  • "Because of Roe v. Wade, courts have interpreted the decision as a statutory mandate that the government must provide federal funding for elective abortion in through federal programs. In other words, no executive order or regulation can override a statutory mandate unless Congress passes a law that prohibits federal funding from being used in this manner," Boehner, R-Ohio, said in a statement.
    Rep. Joe Pitts, R-Pa., added that pro-life Democrats should be alarmed by a promise coming from a politician with a 100 percent rating from NARAL Pro-Choice America.
    "This puts the fate of the unborn in the hands of the most pro-abortion president in history," he said.

"Transforming the Reproductive Rights Movement: The Post-Webster Agenda" (1990)[edit]

Mariene Gerber Fried, “Transforming the Reproductive Rights Movement: The Post-Webster Agenda”, in Fried, Marlene Gerber (ed.). “From Abortion to Reproductive Freedom: Transforming a Movement” (1990). South End Press. ISBN 9780896083875.

  • No matter how we try to control the clinic battles, we remain in a structurally defensive position. In the year and a half since Operation Rescue came to town, we have tried nearly everything-from holding a demonstration away from the clinics; to counter-demonstrating on the other side of the street; to interposing our bodies between the anti-abortionists and the clinic. Our level of organization at the clinics is impressive-a 3,000-person phone tree; hundreds of trained escorts and clinic coordinators who communicate with beepers and special codes. Despite all of this, it is not our show. Our efforts have been directed at figuring out what they are doing and how to foil them. It is not surprising, then, that even when we “win,” it doesn’t feel like victory. Most disturbing, however, is the siege mentality at the clinics. It is painful to witness what women must face in order to exercise their right to make reproductive choices. Some women will not push their way through demonstrators to get into a clinic. Some will not even come at all if they anticipate harassment by anti-abortionists. It is painful even when the women are undaunted by the harassment, even when they and we fight back: a young man accompanying his girlfriend for an abortion escorts her to the clinic wielding a baseball bat. He says to the anti-abortionists, “You mess with her, you’re in trouble.” The girlfriend of a woman coming to the clinic punches one of the blockaders who tries to top her. It is painful even when the effects are radicalizing-often women having abortions become politically active after having had to confront anti-abortion demonstrator. It is still disturbing and angering.
    Is this “safe and legal” abortion?
    • pp.1-2
  • Abortion campaigns offer unprecedented opportunities for alliances between activists and groups fighting for the rights of poor women, yet many of these opportunities have been missed. The women’s movement has a history of trading away the rights of women of color and working-class women in favor of gains for more privileged women. Because of this history, we must consciously and aggressively make clear that we are not about to repeat this pattern in the present or future. Steps must be taken to develop a multi-racial and class-conscious movement for abortion rights. One way to do this is to acknowledge the fact that poor women have consistently borne the brunt of the attack on abortion rights. For poor women, the legal right to abortion is empty, and choice an abstraction. Without access to abortion services, it is as if “Roe v. Wade” never happened.
    • p.6
  • While I understand the urgency individuals and groups feel about the need to protect some ground, this is a dangerous approach. It is a strategy that trades away the most basic aspect of abortion rights-the fact that abortion is fundamentally a woman’s right to decide, at any point in pregnancy, for any reason. Going for what we think we can get right now helps to legitimize the view that there are morally acceptable and morally unacceptable abortions and that those decisions are best made by someone other than the pregnant women. Feminists need instead to be arguing for the right of every woman to make her own decision.
    • pp.7-8
  • In many cities, activists find themselves caught among a variety of political tendencies. Abortion clinics are not political organizations although they have become they key political battlefield. Clinic workers have taken on heroic qualities, since going to work sometimes involves fighting one’s way through an angry mob. Nonetheless, their stake in this is to continue providing services, some for profit, others not. There are many clinic directors who view pro-choice demonstrators in almost the same way they view anti-abortion militants-as disruptions to their business as usual. While clients and clinic escorts have been generally supportive of pro-choice demonstrators, we have been told repeatedly by some clinic directors that the safety and privacy of their patients and their ongoing ability to operate are compromised by direct confrontations with anti-abortionists.
    • p.10

"Americans Walk the Middle Road on Abortion" (April 10, 2000)[edit]

The Gallup Poll Monthly, "Americans Walk the Middle Road on Abortion", (April 10, 2000)

  • A recent Gallup poll, conducted March 30-April 2, updates where the public stands on abortion. In the broadest sense, the majority of Americans reject extreme positions on abortion and favor legalizing it under limited conditions. Just 28% think abortion should be legal under any circumstances and even fewer, 19%, think it should be illegal in all circumstances, while 51% say it should be legal "only under certain circumstances." These results are generally consistent with the public's position on the abortion issue in recent years. And, while there have been slight shifts in public abortion attitudes over the past 25 years, the basic pattern remains the same as when Gallup first asked about it in 1975.
  • Even though public opinion about terminating a pregnancy has remained stable over time in the broad sense, the nature of that opinion appears decidedly ambiguous. The level of support for abortion appears to vary significantly, depending upon the specific circumstances under which the procedure takes place. It takes little probing, for example, to find that support for abortion rises to as high as 84% in circumstances in which the woman's life is in danger, and drops to as low as 8% for abortions conducted in the third trimester.
    In fact, Americans appear to be sympathetic to many of the circumstances that compel some women to choose abortion. In addition to the "life of the mother" circumstance, most Americans think abortion should be legal when the woman's physical health is endangered (81%), or when the pregnancy is the result of rape or incest (78%). A majority also supports termination when the woman's mental health is endangered (64%), and when there is evidence the baby may be physically impaired (53%) or mentally impaired (53%). On the other hand, one circumstance Americans reject as valid is financial inability, with only 34% saying abortion should be legal when the woman or family cannot afford to raise the child; 62% reject this rationale.
    When the public is asked about the legality of abortion according to the stage of the development of the fetus rather than the specific circumstances involved, nearly two-thirds of Americans believe abortion should be legal in the first three months of pregnancy, while two-thirds or more say it should be illegal in the second and third trimesters.
  • Interestingly, despite Americans' general acceptance of abortion in the early stages of pregnancy, the public tilts against legalizing a drug that induces abortions in the first trimester. Today, only 39% of Americans favor making the abortion pill RU-486 available in the United States as a prescription drug; 47% oppose it while 14% are unsure.
    However, much of this opposition could be due to Americans' lack of familiarity with the drug. Only 54% say they have heard or read anything about RU-486. Among this group, approval of its introduction in the United States as prescription drug is relatively high, with 54% in favor and only 38% opposed. By contrast, disapproval of RU-486 is high among the 45% of Americans who have not heard of the drug. Among this group only 23% favor its use, while 58% are opposed.
  • The Partial-Birth Abortion Ban Act was originally introduced in Congress in 1995. Gallup polls since then indicate the public widely favors legislation that would place a national ban on a particular procedure used to perform late-term abortions, except in cases in which it is necessary to save the life of the mother. In the latest survey, 66% support the legislation to ban partial-birth abortions, while just 29% oppose it. In fact, the ban is supported by a majority of Democrats and those who call themselves "pro-choice" as well as by most Republicans and those who say they are "pro-life."

"Alabama just criminalized abortions – and every single yes vote was cast by a white man" (May 15, 2019)[edit]

Garrand, Danielle (May 15, 2019). "Alabama just criminalized abortions – and every single yes vote was cast by a white man". CBS News. Retrieved May 15, 2019.

  • Twenty-five members of the Alabama State Senate voted to pass the nation's most restrictive abortion bill on Tuesday — and every single one of them were white men. On Wednesday, the state's Republican female governor, Kay Ivey, signed the bill into law.
    After hours of discussion, the Senate on Tuesday passed the near-total abortion ban in a 25 to 6 vote. Of the 35 senators in the state, four are women, and they are all Democrats.
    All 25 of the male senators to vote "yes" on the bill were Republicans.
  • Ivey, the state's second female governor, tweeted a photo of herself signing the bill with the caption "To the bill's many supporters, this legislation stands as a powerful testament to Alabamians' deeply held belief that every life is precious & that every life is a sacred gift from God."
  • House Bill 314, known as the "Human Life Protection Act" prohibits abortion or attempted abortion in Alabama, except "in cases where abortion is necessary in order to prevent a serious health risk to the unborn child's mother," according to the bill.
    It criminalizes the procedure, reclassifying abortion as a Class A felony, punishable by up to 99 years in prison for doctors. Attempted abortions will be reclassified as a Class C penalty. The legislation doesn't make an exceptions for victims or rape or incest.
    Rep. Terri Collins, a Republican, sponsored the bill in the House, which voted 74-3 to approve it in April. All six Republican women voted for the measure.
  • Alabama's ban is just the most recent in a barrage of anti-abortion measures at state level. Last week, Georgia Gov. Brian Kemp signed into law the state's so-called "fetal heartbeat" bill, legislation that will prohibit abortions after a heartbeat is detected in an embryo, which is usually about five to six weeks into a pregnancy -- before most women know they're pregnant. The state was the sixth to pass such a law, and the fourth this year alone.

"The tiny American towns passing anti-abortion rules" (April 27, 2021)[edit]

Jessica Glenza, "The tiny American towns passing anti-abortion rules". The Guardian. April 27, 2021.

  • Over the last year of the pandemic, 23 tiny towns in Texas have approved local laws declaring themselves “sanctuary cities for the unborn”, passing ordinances to make the procedure punishable by a $2,000 fine.
    In April, the tiny village of Hayes Center, Nebraska, became the 24th, and the first outside Texas.
    “Would we ever see an abortion clinic in Hayes Center? Maybe not,” said Kim Primavera, a Hayes Center trustee. Four of the village’s five trustees are women, and most are young. They represent about 280 people here. “But it’s always better to be proactive than reactive in life in general,” she said.
    The Hayes Center Times-Republican, the local newspaper which Primavera partially owns, reported that not a single person in town spoke against the measure.
  • The towns and their leaders differ, but there is one constant: traveling preacher Mark Lee Dickson, a director of the tiny non-profit Right to Life of East Texas.
    “I don’t have an abortion story, I’m a 35-year-old virgin. But I’ve seen the impacts of suicide and the throwing away of life in general,” Dickson said. “That’s why I’m so passionate about the subject of abortion.”
  • When CNN, the New York Times and the Associated Press called about the ordinance, Dickson wrote potential quotes for Mayor Jesse Moore, emailed them to the city secretary and asked if Moore found any appealing. It’s unclear if Moore ultimately used the quotes.
    “Innocent human life must always be protected and preserved,” wrote Dickson in one email to the city secretary. “This would be a great quote as well. Let me know if he [the mayor] is good with these,” he wrote.
  • Widespread attention propelled the ordinances forward as conservative media began to cover Dickson’s successes. It also gained him the monied backing of the religious Thomas More Society law firm.
    The firm represented Waskom and six other cities when they were sued by the American Civil Liberties Union (ACLU) for libel after calling abortion providers “criminal organizations” in their ordinances. Texas’s former solicitor general, Jonathan F Mitchell, known for his work against unions, also offered his services to towns sued by the ACLU.
    “We do have a village attorney,” said Primaveria, “but in this case” Mitchell agreed to represent the towns, she said.
  • But even with the clout of lawyers behind the ordinances, some towns still found the legislation too divisive. The leaders of Carthage, Texas, where a 14ft statue of Jesus Christ stands on eastern outskirts of town, voted the ordinance down. It was simply bad policy, leaders argued.
    “I am not going to be having an abortion. That is left up to the individual themselves if they want to have it,” Ida Beck, Carthage commissioner, said in a meeting where the ordinance was voted down, according to local newspaper the Panola Watchman. “They’re the ones who have to stand before God and face that.”
    That Dickson is still busy passing such ordinances, traveling Texas, Nebraska and Missouri, is evidence of how the Trump administration empowered grassroots and often extreme campaigners, experts said.
  • The biggest challenge for Dickson is just around the corner. The voters of Lubbock, Texas, will decide whether their town of 253,000 should be described as a “sanctuary city” for the unborn on 1 May.
    The vote would not undo the right to obtain an abortion in Lubbock. Federal law supersedes local. But a success would sow confusion, heap pressure on a Planned Parenthood clinic, and further galvanize a movement bent on delegitimizing the courts.

"Every State That's Tried to Ban Abortion Over the Coronavirus" (April 7, 2020)[edit]

Gold, Hannah (April 7, 2020). "Every State That's Tried to Ban Abortion Over the Coronavirus". The Cut. Retrieved April 7, 2020.

  • Just days into the national surge of coronavirus cases, as an increasing number of states called for nonessential businesses to shut down, some Republican legislators began using the public health crisis as an opportunity to deny health care to patients seeking abortions. The tactic has been replicated in the past couple of weeks, with governors in several states peddling the cynical argument that temporarily banning abortion will help shore up their supply of medical gear for hospitals overwhelmed by the pandemic.
    So far, lawmakers in six states — Ohio, Texas, Alabama, Iowa, Oklahoma, and Arkansas — have attempted to halt abortion services indefinitely. In March, providers in Alabama, Iowa, Ohio, and Oklahoma filed lawsuits to prevent the orders from taking effect in their states. A similar lawsuit has been filed in Texas as well. On April 1, injunctions were granted in Ohio, Texas, and Alabama, so that clinics would be able to remain in operation. However, a federal appeals court quickly overturned the Texas injunction, kicking off a legal back-and-forth that has now escalated to the Supreme Court. On April 6, a federal judge in Oklahoma also granted an injunction, and the case against Iowa was dropped on April 1, after it was determined that the state would not ban all abortions.
  • Anti-abortion legislators are taking advantage of a crisis to further their agenda. Many states are moving to limit nonessential medical procedures, like dental checkups and colonoscopies, in an attempt to conserve protective gear for health-care workers; by labeling abortion, too, as “nonessential,” they hope to institute a de facto temporary ban. This ignores the widespread medical consensus that abortion is an “essential component of comprehensive health care” and that it’s a time-sensitive procedure. Were these directives allowed to stand, they would force women to have to travel hundreds of miles to obtain safe and legal terminations at a time when three-quarters of Americans have been urged or ordered to stay at home.
  • In late March, Ohio’s deputy attorney general, Jonathan Fulkerson, issued letters to three abortion providers ordering them to comply with the state’s freeze on nonessential medical procedures. Two of the clinics that received letters announced they would continue to provide abortions because they are essential medical procedures.
    On April 1, district court judge Michael Barrett ruled in favor of Planned Parenthood and other reproductive rights groups challenging the state’s new abortion restrictions, ordering that the ban be suspended for two weeks. On Friday, Barrett extended that temporary restraining order for an additional two weeks.
  • On March 23, Texas’s attorney general, Ken Paxton, issued a warning that, to be in compliance with Governor Greg Abbott’s recent executive order temporarily banning elective medical procedures, “any type of abortion that is not medically necessary to preserve the life or health of the mother” would be prohibited. Providers who didn’t comply with the order could result in fines of up to $1,000 or 180 days in jail — an extraordinarily unsafe prospect at this time, even beyond the carceral system’s routine injustices.
    On March 30, a federal judge halted the state’s temporary abortion ban. The following day, however, the Fifth Circuit Court of Appeals overturned the temporary restraining order, reinstating the ban. Paxton celebrated the ruling on Twitter:
    The Fifth Circuit affirmed its decision on April 7, allowing the de facto ban to stand. But the same judge who halted the ban in late March then issued a temporary restraining order blocking parts of the measure. As of April 9, medication abortion was once again available in Texas. Patients who risked running up against the state’s gestational limitations before the nonessential-surgery suspension was lifted were also allowed to terminate their pregnancies. The Fifth Circuit came back and blocked the medication-abortion caveat the next day, however, and it looked like the case was headed to the Supreme Court. On Monday night, however, the Fifth Circuit ruled that the medication abortion — which involves a provider handing a patient two pills — did not qualify as a “procedure” and did not eat up crucial medical equipment, and the complainants withdrew their case from SCOTUS on Tuesday.
  • The American Civil Liberties Union filed a lawsuit on behalf of abortion providers in late March, after Iowa Governor Kim Reynolds listed abortion among nonessential medical procedures temporarily banned across the state in response to the pandemic. However, the suit was dropped right before a scheduled hearing, after the state clarified it would not ban all surgical abortions.
  • Alabama’s three remaining abortion clinics sought a temporary restraining order after the state’s attorney general, Steve Marshall, implied that the Alabama Department of Public Health’s March 27 order, which suspended elective medical procedures, could apply to patients seeking abortions. According to the lawsuit, Marshall “refused to provide any further guidance as to how [his office] is interpreting the scope of the order other than to make plain that in its view, some — and perhaps most — abortions are not permitted.”
    On March 30, Alabama district court judge Myron Thompson issued a temporary restraining order suspending the ban, at least until April 6, when he would hear arguments over video conference. Thompson said in his ruling that “the state’s interest in immediate enforcement of the March 27 order — a broad mandate aimed primarily at preventing large social gatherings — against abortion providers does not, based on the current record, outweigh plaintiffs’ concerns.” On April 12, Thompson issued a preliminary injunction, restoring access.
  • Several advocacy groups, including the Center for Reproductive Rights, filed a suit at the end of March, seeking a temporary restraining order on Governor Kevin Sitt’s executive order suspending elective medical procedures through April 7. The order would have banned nearly all abortions, except when one could be proved necessary to prevent health risks to the patient.
    On April 6, federal judge Charles Goodwin blocked the order, writing in his decision that the state of Oklahoma “has acted in an ‘unreasonable,’ ‘arbitrary,’ and ‘oppressive’ way — and imposed an ‘undue burden’ on abortion access — in imposing requirements that effectively deny a right of access to abortion.”
  • On April 3, Arkansas Governor Asa Hutchinson ordered all non-essential medical procedures and surgeries be postponed. On Friday, the state’s last remaining abortion clinic — Little Rock Family Planning Services — received a cease-and-desist letter from the health department saying the clinic was in violation of the order, because the state considered abortions that were “not immediately necessary to protect the life or health of the patient” to be elective procedures. Further violations, the letter said, would trigger the suspension of the clinic’s license.
    On Monday, April 13, the ACLU filed an emergency lawsuit with the U.S. Court for the Eastern District of Arkansas, arguing that “nothing in the current crisis justifies” suspending abortion access, and further, that “prohibiting abortion during the pandemic will not achieve any of the State’s public-health objectives and is in fact likely to exacerbate the crisis.”
  • There have been rumblings of anti-abortion action in Kentucky, too, although no steps to curtail abortion have been taken so far. On March 27, the Courier-Journal reported that the state’s attorney general, Daniel Cameron, asked that the Democratic Governor Andy Beshear categorize abortions as an elective medical procedure to ban them. In a statement, Cameron called on the state’s anti-abortion Republican legislators to join his cause “to protect the health of … patients and slow the spread of coronavirus.”
    Beshear’s executive order to ban elective procedures, issued March 23, is vague, leaving the definition of “essential” open to the interpretation of medical professionals. When asked, days later, whether abortion qualifies as essential medical care, Beshear responded, “I leave it to our health professionals to determine what falls into elective and the essential.” Abortion providers in Kentucky are continuing to officer services in compliance with the state’s order and in spite of the AG’s rhetoric.
  • Only a single clinic providing abortion access remains in Mississippi, and on March 24, the state’s Republican governor, Tate Reeves, reiterated his desire to paralyze it. Reeves repeated the anti-choice line about abortion being an elective procedure and therefore temporarily banned. “It is without question that the lone clinic in Jackson does, in fact, operate doing procedures that are elective and not required,” he said.
    Nonetheless, the Center for Reproductive Rights confirmed in an email to the Cut that Mississippi’s abortion clinic, remains open, active, and in compliance with the state’s emergency directives.

“The Racist History of Abortion and Midwifery Bans” (July 1, 2020)[edit]

Michele Goodwin, “The Racist History of Abortion and Midwifery Bans”, ACLU, (July 1, 2020)

  • Following the Supreme Court’s decision in June Medical Services v. Russo this week, it is worth reflecting on the racist origins of the anti-abortion movement in the United States, which date back to the ideologies of slavery. Just like slavery, anti-abortion efforts are rooted in white supremacy, the exploitation of Black women, and placing women’s bodies in service to men. Just like slavery, maximizing wealth and consolidating power motivated the anti-abortion enterprise. Then, just as now, anti-abortion efforts have nothing to do with saving women’s lives or protecting the interests of children. Today, a person is 14 times more likely to die by carrying a pregnancy to term than by having an abortion, and medical evidence has shown for decades that an abortion is as safe as a penicillin shot—and yet abortion remains heavily restricted in states across the country.
  • Prior to the Civil War, abortion and contraceptives were legal in the U.S., used by Indigenous women as well as those who sailed to these lands from Europe. For the most part, the persons who performed all manner of reproductive health care were women — female midwives. Midwifery was interracial; half of the women who provided reproductive health care were Black women. Other midwives were Indigenous and white.
  • Abortion was an expedient way to frame their campaign to create monopolies on women’s bodies for male doctors. The American Medical Association explicitly contributed to this cause through its exclusion of women and Black people.
    Today, as people debate whether anti-abortion platforms benefit Black women, the clear answer is no. The U.S. leads the developed world in maternal and infant mortality. The U.S. ranks around 50th in the world for maternal safety. Nationally, for Black women, the maternal death rate is nearly four times that of white women, and 10 to 17 times worse in some states.

"Law and Everyday Death: Infanticide and the Backlash against Woman's Rights after the Civil War." (2006)[edit]

Gordon, Sarah Barringer. "Law and Everyday Death: Infanticide and the Backlash against Woman's Rights after the Civil War." Lives of the Law. Austin Sarat, Lawrence Douglas, and Martha Umphrey, Editors. (University of Michigan Press 2006)

  • The sense that infanticide was both prevalent and largely unpunished was not confined to the working women whose interests the suffragists claimed to represent. Especially in large cities, married women of wealth and stature also “redden[ed] their souls” with the blood of their own children. The problem was especially common in urban areas, where the lure of pleasure led women to sacrifice infants to their own selfish desires. Abortion, charged the conservative press, was as much a threat as the murder of newborns. Both were forms of infanticide. A “New York Times” editorial, written on the day of the Hester Vaughn rally in New York, claimed that “the horrible crime of infanticide prevails to such an extent in America, that in some localities the growth of the population is seriously affected by it. In great cities especially, its results are as shocking as they are alarming; and the attention of social philosophers and Christian moralists has lately been directed to the necessity of adopting some means of limiting its prevalence.” The “Times” also charged that upperclass women were guilty of infanticide: “It is not only practiced by women who, having gone astray, are so anxious to conceal the result of their errors as not to stop at murder, but women who are legally married, and move in respectable society, redden their souls and their hands with the blood of legitimate children, to escape the trouble of maternity and the labor of nurture and training. The growth of flourishing businesses that openly advertised abortifacient medicines fueled a sense that the incidence of abortion among middle-and upper-class women was rising in proportion to falling birth rates among native-born, white Protestant women.
    • pp.65-66
  • Concern over the vulnerability of children increased as the rate of abortions and the apparent power of women grew in the nineteenth century. Woman’s rights activists were frequently blamed for threats to the welfare of children, and the decision whether to have children at all. Letters to the editor in Philadelphia papers about the Vaughn case revealed that the connection between Vaughn’s situation and the practices of upper-class women was widely perceived. Fighting back against New York suffragists, for example, one outraged correspondent claimed that “we have the authority of Henry Ward Beecher and other divines, for believing that amongst the virtuous matrons of the virtuous city of New York, [infanticide] is of frequent occurrence and regarded as a very trifling offence; therefore . . . we need not be surprised if these ladies pass resolutions condemning the Philadelphia jury which regards so trifling an offence as the killing of an innocent babe, ‘murder in the first degree.’” Opponents translated “Hester Vaughnism” into an excuse to attack the middle-class women who defended Vaughn, charging them with the crime Vaughn had been convicted of.
    • p.66
  • These attempts to deflect support for Vaughn by arguing that her case represented simply a more overt form of the abortion (and associated selfish individualism) practiced by wealthier women, were met head-on by suffragists. In a column in the “Revolution”, Parker Pillsbury claimed that agitation for the pardon and release of Hester Vaughn was expressly designed to “unfold that very evil [infanticide] in all its horrible enormity and extent.’ Suffragists shared with Judge Ludlow the sense that infanticide was a growing and urgent problem in American cities. They embraced the claim that abortion and infanticide were identical morally, if not criminally. To hammer home the connection, they shot back at Philadelphia, insisting that “infanticide is as fashionable among the virtuous matrons of Philadelphia as those of [New York.” Pillsbury’s speech on behalf of Vaughn at the Cooper Institute was directed at precisely this issue, arguing that to hold Vaughn guilty was to apply a double standard. It would be unfair, Pillsbury argued, to hold a working woman accountable for a practice indulged in with impunity by “fashionable matrons” and their husbands. Pillsbury also claimed that the press itself was as guilty at any patron of the famous abortionist known as “Madame Restell”: “Did it never occur to you that in large numbers of these newspapers-religious papers not excluded-professional infanticide is advertised in a disgusting form? (Applause_. Have your not in your own city professional murderers? How many newspapers have you too pure to advertise these murders from week to week? (A voice, ‘None.’).”
    • pp.66-67
  • ”The loathsome operators of the abomination,” claimed suffragists, were the real murderers. But the legal system punished only innocent young women who had no control over their actions and were too poor to provide shelter and care for their babes. The “Revolution” reported a case in January 1869 in which a newborn frozen to death after its mother gave birth in a shed near Bethlehem, Pennsylvania. “Why not try her for murder?” the editor queried rhetorically, implying that Hester Vaughn, like the woman in the story, was a victim of circumstances beyond her control.
    • p.67
  • As the historian Linda Gordon has pointed out, nineteenth-century woman’s rights activists did not support abortion, focusing instead on abstinence and husbands’ responsibility for respecting their wives’ desires for “Voluntary Motherhood.” In the nineteenth century, liberal suffragists accepted broadly what most twentieth- and twenty-first-century feminists deny categorically: that is, they equated abortion with infanticide. As Gordon put it, motherhood in nineteenth-century activism was both central to respect for women, and the site of male sexual tyranny. To embrace abortion would be to countenance sexual licentiousness, woman’s rights activists concluded, instead of attacking the problem where it began, in the unlimited access of husbands to their wives’ bodies. Exemption from motherhood was not a viable alternative in nineteenth-century suffragism, for it would mean the abandonment of the source of women’s unique ability to rise above individual identify, and all the selfishness that such individualism implied. According to one report of the Hester Vaughn rally, Elizabeth Cady Stanton’s announcement that the “Revolution” accepted no advertisements for abortifacients or other forms of birth control was greeted with applause.
    • p.67

“The Moral Property of Women” (2002)[edit]

Gordon, Linda (2002). “The Moral Property of Women”. University of Illinois Press. ISBN 0-252-02764-7. “Ch.2 The Criminals”

  • Abortion was much more common than infanticide, however, practiced most often by the married and frequent in all classes. In 1862, when the wife of a Confederate general, William Dorset Pender, wrote him that she was, unfortunately, pregnant, he wrote her pious phrases about “God’s will” but also sent her pills that his camp surgeon had thought might “relieve” her.
    • p.24
  • In 1871 Dr. Martin Luther Holbrook wrote that American women were “addicted” to the wicked practice and that it was especially widespread in New England, where the decline in the birth rate was most pronounced. One antiabortion propagandist, in a style clearly intended to repel and frighten, wrote: “Nowadays, if a baby accidentally find a lodgement in the uterus, it may perchance have a knitting-needle stuck in its eyes before it has any.”
    • pp.24-25
  • In 1872 the New York Times called abortion “The Evil of the Age.” The Times” estimated that there were two hundred full-time abortionists in New York City, not including doctors who performed abortions occasionally. It may be that tens of thousands of abortions were done in New York City alone in the 1870s, one judge estimating, probably exaggeratedly, one hundred thousand a year in the 1890s. In 1904 a physician estimated six to ten thousand a year in Chicago. In the 1890s doctors were estimating two million abortions a year in the United States-they too were probably exaggerating, but the numbers represented their anxiety. In 1921, when statistics on these matters were more reliable, a Stanford University study calculated that one out of every 1. To 2.3 pregnancies ended in abortion, of which at least 50 percent were illegal. Among a thousand women who went to a birth control clinic in the Bronx, New York, in 1931032, 3 percent had had at least one illegal abortion, a proportion that applied to Catholics as well as Protestants and Jews.
    • p.25
  • In 1881 the Michigan Board of Health estimated one hundred thousand abortions a year in the United States, with just six thousand deaths, or a 6 percent mortality rate. There is some misunderstanding about abortion safety today because the campaign for legalized abortion has understandably emphasized the dangers of illegal abortion. In fact, illegal abortions in this country have an impressive safety record. The Kinsey investigators, for example, were impressed with the safety and skill of the abortion they surveyed. Studies of maternal mortality in the late 1920s and early 1930s found that 13-14 percent resulted from illegal abortion (meaning, of course, that 86-87 percent resulted from child-birth). Legal abortion had made that ratio even more uneven today in the United States, when eleven times more women die in childbirth than from abortions.
    This does not mean that abortions were pleasant. They were painful and frightening, and anxiety was worse because they were “gotten in sin” and, often, in isolation. The physical risk was heightened by the illegality, just as it is today.
    • p.25
  • The criminalization of abortion also increased women’s anxiety. Before the nineteenth century, few people considered abortion wrong is performed in the first few months of pregnancy. The first modern legislation banning abortion altogether did not originate in catholic canon law, as is widely believed, but in the secular law of England in 1803. Until then the Protestant churches had gone along with the Catholic tradition that before “quickening”-the moment at which the fetus was believed to gain life-abortion was permissible. U.S. courts upheld this interpretation until at least 1845. The Catholic Church was a follower, not a leader, in restricting abortion, only legislating to prohibit it in 1869, well after most stated in the United States of America had outlawed all abortion during the Civil War period. Throughout the nineteenth century, most American women seemed to share the belief that before quickening, taking action to “bring on menstruation” was in no way reprehensible.
    • p.25
  • Stories of men dosing their pregnant girlfriends with abortifacients come from all periods of American history. In Maryland in 1652, Susanna Warren, a single woman made pregnant by “prominent citizen” Captain Mitchell, said that he prepared for her a “potion of Phisick,” put it in an egg, and forced her to take it.” It didn’t work and she brought charges against him. Slaves commonly practiced abortion. An antebellum doctor found abortion four times as frequent among blacks as among whites, noting that “all country practitioners are aware of the frequent complaints of planters from this subject.” Though the doctor may have been underestimating the prevalence of abortion among whites, abortion among slaves was undoubtedly not only a tool of self-preservation but also a form of resistance.
    • pp.26-27
  • We have more information about the commercialization of abortion in the later nineteenth century because the New York Times embarked on a series of investigative reports about it. The professional abortionists who advertised in the papers were often medical imposters-that is, they lacked medical degrees, though many “doctors” did too, having purchased their degrees from diploma mills. Frequently abortionists used several aliases, sometimes to avoid old prosecutions, sometimes to operate several establishments simultaneously under different names. Sometimes the advertisements would feature a woman’s name, as a woman seeking help would be more likely to approach another woman, although the abortionist might be male.
    • pp.28-29
  • When the medical establishment undertook a campaign against abortion in the second half of the nineteenth century, its very vehemence served as a further indication of the prevalence of illegal abortions. In 1857 the American medical Association (AMA) initiated a formal investigation of the frequency of abortion. Seven years later the AMA offered a prize for the best popular antiabortion tract. Medical attacks on abortion grew in number and virulence until, by the 1870s, both professional and popular journals were virtually saturated with the issue. Physicians bemoaned the widespread lay acceptance of abortion before quickening; in order to break that sympathy, they adopted a new vocabulary that described abortion in terms designed to shock and repel, such as “antenatal infanticide.” Physicians attempted to frighten women away from abortion by emphasizing its dangers. Their common assertion that there was “no” safe abortion may have betrayed ignorance, but more likely it was an exaggeration justified by what they believed was a higher moral purpose. Yet occasionally even antiabortion doctors allowed the truth to slip out, revealing despite themselves why their campaign remained ineffective. It is such a simple and comparatively safe matter for a skillful and aseptic operator to interrupt an undesirable pregnancy at an early date,” wrote Dr. A. L. Benedict of Buffalo, New York, an opponent of abortion, “That the natural temptation is to comply with the request.
    • p.30

"Justices Back Ban on Method of Abortion" (April 19, 2007)[edit]

Greenhouse, Linda (April 19, 2007). "Justices Back Ban on Method of Abortion", The New York Times.

  • The banned procedure, known medically as “intact dilation and extraction,” involves removing the fetus in an intact condition rather than dismembering it in the uterus. Both methods are used to terminate pregnancies beginning at about 12 weeks, after the fetus has grown too big to be removed by the suction method commonly used in the first trimester, when 85 percent to 90 percent of all abortions take place.
    While the ruling will thus have a direct impact on only a relatively small subset of abortion practice, the decision has broader implications for abortion regulations generally, indicating a change in the court’s balancing of the various interests involved in the abortion debate.
    Most notable was the emphasis in the majority opinion, by Justice Anthony M. Kennedy, on the implication of abortion’s “ethical and moral concerns.”
    “The act expresses respect for the dignity of human life,” Justice Kennedy said.
  • Mr. Bush welcomed the ruling, saying: “The Supreme Court’s decision is an affirmation of the progress we have made over the past six years in protecting human dignity and upholding the sanctity of life. We will continue to work for the day when every child is welcomed in life and protected in law.”
    It was also a vindication for the strategic choice the anti-abortion movement made 15 years ago, when the prospect of persuading the Supreme Court to reconsider the right to abortion seemed a distant dream.
    By identifying the intact procedure and giving it the provocative label “partial-birth abortion,” the movement turned the public focus of the abortion debate from the rights of women to the fate of fetuses. In short order, 30 states banned the procedure.
  • The court did not explicitly overturn any of its precedents, although Justice Ruth Bader Ginsburg, writing for the four dissenters, said the decision was “so at odds with our jurisprudence” that it “should not have staying power.” Justice Ginsburg called the decision “alarming” and said the majority’s “hostility” to the right to abortion was “not concealed.”
  • Justice Kennedy took pains to describe the decision as faithful to the court’s earlier rulings, including the one in the Nebraska case. He said that by defining the prohibited procedure more precisely, the federal law avoided the vagueness the court had found in the Nebraska statute and thus did not place doctors at risk of violating it inadvertently.
    Congress passed the law in response to the court’s ruling in the Nebraska case, responding specifically to the majority’s insistence in that case that the law must include an exception for circumstances when the banned procedure was necessary for the sake of a pregnant woman’s health. Congress provided an exception only to save a pregnant woman’s life, as Nebraska had, declaring that the procedure was never necessary for a woman’s health.
  • Justice Kennedy, in addressing the need for the health exception, said on Wednesday that it was acceptable for Congress not to include one because there was “medical uncertainty” over whether the banned procedure was ever necessary for the sake of a woman’s health. He said that pregnant women or their doctors could assert an individual need for a health exception by going to court to challenge the law as it applied to them.
    Justice Ginsburg said that this approach was unrealistic and “gravely mistaken.” She said that requiring “piecemeal” litigation “jeopardizes women’s health and places doctors in an untenable position.”
    Clarke D. Forsythe, president of Americans United for Life, a leading anti-abortion group, said approvingly that while the court did not technically overturn the Nebraska decision, the new ruling “effectively gutted it.”
    Dr. LeRoy H. Carhart, the Nebraska doctor who challenged both the state law in 2000 and the federal law in this case, Gonzales v. Carhart, No. 05-380, said that “those who support this law are trying to outlaw all abortions, one step at a time.”
  • In his discussion of the court’s precedents, Justice Kennedy went so far as to suggest that the new ruling was in fact compelled by the court’s decision in Planned Parenthood v. Casey, the 1992 case that reaffirmed the basic holding of Roe v. Wade that women have a constitutional right to abortion. Justice Kennedy supported that result and helped write the decision’s unusual joint opinion.
    On Wednesday, he said that “whatever one’s views concerning the Casey joint opinion, it is evident a premise central to its conclusion — that the government has a legitimate and substantial interest in preserving and promoting fetal life — would be repudiated were the court now to affirm the judgments of the courts of appeals” that struck down the federal law.
    In describing the federal law’s justifications, Justice Kennedy said that banning the procedure was in fact good for women, protecting them against terminating their pregnancies by a method they might not fully understand in advance and would come to regret later.
    “Respect for human life finds an ultimate expression in the bond of love the mother has for her child,” he said, adding: “It is self-evident that a mother who comes to regret her choice to abort must struggle with grief more anguished and sorrow more profound when she learns, only after the event, what she once did not know: that she allowed a doctor to pierce the skull and vacuum the fast-developing brain of her unborn child, a child assuming the human form.”
  • Justice Ginsburg objected vehemently that “this way of thinking reflects ancient notions of women’s place in the family and under the Constitution — ideas that have long since been discredited.”
    She cited century-old Supreme Court cases that upheld a paternalistic view of women’s place in society and contrasted those with more recent cases, including one she successfully argued to the court in 1977 and one in which she wrote the majority opinion in 1996, that rejected “archaic and overbroad generalizations” and assumptions about women’s inherent dependency.
  • One law professor, Martin S. Lederman of Georgetown University, commented after reading Justice Ginsburg’s response on this point that Justice Kennedy’s opinion “was an attack on her entire life’s work.”
    In her opinion, Justice Ginsburg said the majority had provided only “flimsy and transparent justifications” for upholding the law, which she noted “saves not a single fetus from destruction” by banning a single method of abortion. “One wonders how long a line that saves no fetus from destruction will hold in face of the court’s ‘moral concerns,’ ” she said.

"The Roberts Court Takes on Abortion" (November 5, 2006)[edit]

Linda Greenhouse, "The Roberts Court Takes on Abortion". New York Times. (November 5, 2006).

  • THE arguments the Supreme Court will hear on Wednesday on the constitutionality of the federal Partial-Birth Abortion Ban Act promise much more than a resumption of a familiar debate over a method of terminating a pregnancy.
    In defining the permissible limits on access to abortion, only six years after declaring a similar restriction unconstitutional in a case from Nebraska, the court must go a long way toward defining its stance toward precedent, its relationship to Congress, and its view of its own role in the constitutional system. As it decides the new cases, the still-emerging Roberts court will inevitably be defining itself.
    That much is clear from briefs submitted to the court by the abortion rights side, where many believe that their only hope of prevailing lies in persuading Justice Anthony M. Kennedy to reconsider the position he took in an emotionally laden dissenting opinion in the Nebraska case. Justice Kennedy said then that states should be able to outlaw “a procedure many decent and civilized people find so abhorrent as to be among the most serious of crimes against human life.”
    Justice Sandra Day O’Connor, who retired in January, voted with the 5-to-4 majority. No one knows whether either of the two newest justices, her successor, Samuel A. Alito Jr., or Chief Justice John G. Roberts Jr., might step into her shoes. But the fate of the federal law may rest with Justice Kennedy, the only one of the four dissenters who accepts the court’s precedents on the basic right to abortion.
  • Three federal appeals courts have considered the federal law, and all three have declared it unconstitutional on the basis of the Nebraska decision.
    The court is hearing the Bush administration’s appeal of two of those rulings. The administration argues that the federal law and the Nebraska ruling can coexist if the court recognizes an obligation to defer to Congress’s judgment that a health exception is unnecessary. But if the court finds otherwise, Solicitor General Paul D. Clement will argue, then the Nebraska precedent, not the federal law, should fall.
  • Leaders of abortion rights groups, caught by surprise when the National Right to Life Committee first publicized the procedure, known medically as “intact dilation and evacuation,” initially said it was very rare.
    But now, medical organizations and medical school professors who have filed briefs attacking the law say that in fact, doctors performing abortions in the second trimester, when about 10 percent of all abortions take place, often try to remove the fetus in as intact a condition as possible. The goal is to avoid complications caused by the repeated insertion of surgical tools and by sharp bone fragments that can injure the patient internally.
    The doctors say it is not always possible to tell in advance whether intact removal can be achieved, or whether the process of extraction will dismember the fetus. In any event, they say, intact and “disarticulated” abortions are “part and parcel of the same procedure,” meaning that doctors could not know when they might be placing themselves in legal jeopardy.
    Abortion opponents are now the ones who describe the procedure as rare, seeking to offer reassurance that banning it would not deprive women of access to safe second-trimester abortions.
  • “Infanticide” is a potent label, frequently used by abortion opponents. One brief describes the procedure as “killing a child in the birth process.” While this description is true in the sense that uninterrupted gestation leads to birth — “He not busy being born is busy dying,” in the words of the Bob Dylan song — it is well off the mark as a description of what actually occurs.
    The standard procedure used by Dr. Warren M. Hern, the author of a widely consulted textbook on abortion and one of the leading providers of abortions after 18 weeks of pregnancy, is to “induce fetal demise” by injecting a drug one or two days before the abortion.
    “The cognitive construct of the law has nothing to do with current medical practice,” Dr. Hern, who is not involved in the cases, said last week.

"Induced abortion: an overview for internists" (2004)[edit]

Grimes, DA; Creinin, MD (2004). "Induced abortion: an overview for internists". Annals of Internal Medicine. 140 (8): 620–26. doi:10.7326/0003-4819-140-8-200404200-00009. PMID 15096333.

  • Most internists' practices include large numbers of patients who have had or will seek induced abortion. Although abortion rates are declining, were they to remain stable, an estimated 43% of all U.S. women would have had one or more induced abortions during their reproductive years. More than 30 million U.S. women now share this experience.
  • Several important demographic and medical trends are evident over the past 3 decades. The proportion of teenage patients having abortions has declined, as has the proportion of married women. Women have been obtaining abortions at progressively earlier gestational ages and by suction, rather than sharp, curettage. As of 1999, over half of all women having abortions were mothers of one or more children. A nationwide survey by the Alan Guttmacher Institute indicated that in 2000 and 2001, most women older than 17 years of age reported a religious affiliation: 43% Protestant, 27% Catholic, 8% other, and 22% no religious affiliation. Forty-six percent of women had not used a contraceptive method in the month in which they conceived; inconsistent use of contraceptive method was the main cause of pregnancy among those using contraception.
  • Access to abortion clinics remains a problem: Clinics cluster in metropolitan areas. About one third of women of reproductive age live in the 87% of U.S. counties without an abortion provider. Among the nation's 276 metropolitan areas, 86 have no provider. About a quarter of women have to travel 50 miles or more to reach a clinic; this geographic barrier hinders both service provision and follow-up in case of complications.
  • Unlike most other operations, the cost of abortion has dropped dramatically over the past 3 decades. The current charges are below market value for several reasons. First, the Hyde Amendment cut off federal payment of nearly all abortions for poor women in 1977, and clinics have intentionally tried to keep the price within reach of women of limited means. Seventeen states, including California and New York, currently use state funds to pay for medically necessary abortions; 33 states and the District of Columbia prohibit funding of medically necessary abortions, except in extraordinary cases. Nationwide, only a quarter of women receive services billed directly to public or private insurance. Second, competition between clinics in cities has kept costs low. In 2001 and 2002, the average self-paying woman was charged $372 for a surgical abortion at 10 weeks. Adjusted for the increase in the consumer price index over the past 3 decades, the charge should be several times higher. In general, clinics set medical and surgical abortion prices to be similar so as to eliminate financial reasons for women to choose between the methods.

"The limitations of U.S. statistics on abortion" (1997)[edit]

The Guttmacher Institute. "The limitations of U.S. statistics on abortion". Issues in Brief. New York: 1997. Archived from the original on 4 April 2012.

  • There are few authoritative data to support claims regarding how many late-term abortions are performed, and little understanding of the complexities involved in securing such data. This Issues in Brief describes how abortion data are obtained, what they consist of and why they have inherent limitations.
  • Termination of pregnancy is one of the most frequently performed surgical procedures in the United States. There were 1.5 million abortions in 1992, and the incidence is estimated to have declined to 1.4 million in 1994. Although abortion incidence is the subject of some academic research and much anecdotal reporting, nationally valid data are available from only two sources: the federal Centers for Disease Control and Prevention (CDC) and The Alan Guttmacher Institute (AGI).
    The CDC initiated its enumeration of abortions in 1969, two years after Colorado became the first state to liberalize its abortion law. AGI began its collection of information in 1974, the year after the Supreme Court handed down its ruling in Roe v. Wade that the Constitution protects a woman's decision to terminate her pregnancy prior to the viability of the fetus. After viability, ruled the Court, abortion could be prohibited except when it was necessary to preserve the woman's life or he alth. The CDC collects abortion statistics yearly. AGI, dependent on private funding, has had to limit its data collection in recent times to every four years.
  • The data collected by the CDC and AGI are complementary, but have different emphases. The CDC, consistent with its federal function, focuses particular attention on the safety of the procedure, while AGI concerns itself with the availability of abortion services throughout the country.
    The methods of data collection differ as well. The CDC collects most of its information indirectly, mainly through reports from state health departments. Reports for the 45 states that collect information on abortion and the District of Columbia vary in completeness, with some lacking information on as many as 40-50% of the abortions that occur in the state.
  • [T]he only national data on the incidence of abortion by weeks of gestation come from the CDC reports, which are dependent on state-generated information that is often incomplete. States also vary in their methods of recording gestational age: Some use the number of weeks that have elapsed since the woman's last menstrual period (which overstates the length of gestation), and others record the physician's estimate of gestational age. In addition, individual states, over time, have changed their reporting format, making it difficult to observe trends and make comparisons.
    The CDC reports group all abortions after 20 weeks of gestation into one category. After the CDC figures are adjusted for underreporting, approximately 16,450 procedures, or roughly 1% of all abortions in 1992, were estimated to have been performed beyond 20 weeks since the woman's last menstrual period.
  • In 1987 and 1995, AGI collected information nationally on the socioeconomic characteristics of approximately 10,000 women obtaining abortions. The results of the 1995 survey show that the women who are most likely to obtain an abortion have an annual income of less than $15,000, are enrolled in Medicaid, are aged 18-24, are nonwhite or Hispanic, are separated or never-married, live with a partner outside marriage and have no religious affiliation. Catholics are as likely as the general population of women to terminate a pregnancy, Protestants are less likely to do so, and Evangelical Christians are the least likely to do so.
  • Data have also become more difficult to collect over time as harassment has escalated at abortion clinics or at the offices of physicians for whom abortion is a large part of their medical practice. The violence and fear engendered by some protests probably increases the reluctance of providers to report abortions to the state health authorities or even to respond to private inquiries from AGI.
    In addition, the most difficult data to obtain are from private practitioners who perform a small number of abortions. Should the nonsurgical methods that are currently being introduced on a trial basis gain widespread acceptance in physicians' offices, the completeness of abortion data would be likely to decrease further.
    Because information from providers is not likely to improve and, indeed, may erode further, perhaps inquiries regarding abortion should be addressed to the women themselves. However, women are often reluctant to report having had an abortion. In fact, under reporting of abortion is a common problem in surveys around the world, a factor that then hinders the gathering of information on the number of pregnancies that women experience, especially unintended pregnancies.

"Alan Guttmacher Institute, Induced Abortion, Facts in Brief, 2002" (2002)[edit]

"Induced Abortion Facts in Brief" (2002) Retrieved via InfoPlease January 7, 2007. (Updated February 11, 2017) Adapted from "Alan Guttmacher Institute, Induced Abortion, Facts in Brief, 2002". Facts in Brief Archived October 13, 2007, at the Wayback Machine from Guttmacher Institute

  • Nearly half of pregnancies among American women are unintended, and about 4 in 10 of these are terminated by abortion. 22% of all pregnancies (excluding miscarriages) end in abortion.
    40% of pregnancies among white women, 67% among blacks and 53% among Hispanics are unintended.
    In 2008, 1.21 million abortions were performed, down from 1.31 million in 2000. However, between 2005 and 2008, the long-term decline in abortions stalled. From 1973 through 2008, nearly 50 million legal abortions occurred.
    Each year, two percent of women aged 15?44 have an abortion. Half have had at least one previous abortion.
    At least half of American women will experience an unintended pregnancy by age 45, and, at current rates, one in 10 women will have an abortion by age 20, one in four by age 30 and three in 10 by age 45.
  • 18% of U.S. women obtaining abortions are teenagers; those aged 15-17 obtain 6% of all abortions, teens aged 18-19 obtain 11%, and teens younger than age 15 obtain 0.4%.
    Women in their 20s account for more than half of all abortions; women aged 20-24 obtain 33% of all abortions, and women aged 25-29 obtain 24%.
    Non-Hispanic white women account for 36% of abortions, non-Hispanic black women for 30%, Hispanic women for 25% and women of other races for 9%.
    37% of women obtaining abortions identify as Protestant and 28% as Catholic.
    Women who have never married and are not cohabiting account for 45% of all abortions.
    About 61% of abortions are obtained by women who have one or more children.
    42% percent of women obtaining abortions have incomes below 100% of the federal poverty level ($10,830 for a single woman with no children).
    27% of women obtaining abortions have incomes between 100-199% of the federal poverty level.
    The reasons women give for having an abortion underscore their understanding of the responsibilities of parenthood and family life. Three-fourths of women cite concern for or responsibility to other individuals; three-fourths say they cannot afford a child; three-fourths say that having a baby would interfere with work, school or the ability to care for dependents; and half say they do not want to be a single parent or are having problems with their husband or partner.
  • 54% of women having abortions used a contraceptive method during the month they became pregnant.
    8% of women having abortions have never used a method of birth control; nonuse is greatest among those who are young, unmarried, poor, black, Hispanic, or poorly educated.
    46% of women who have abortions had not used a contraceptive method during the month they became pregnant. Of these women, 33% had perceived themselves to be at low risk for pregnancy, 32% had had concerns about contraceptive methods, 26% had had unexpected sex and 1% had been forced to have sex.
    About half of unintended pregnancies occur among the 11% of women who are at risk for unintended pregnancy but are not using contraceptives. Most of these women have practiced contraception in the past.
  • The number of U.S. abortion providers remained stable between 2005 (1,787) and 2008 (1,793). 87% of all U.S. counties lacked an abortion provider in 2008; 35% of women live in those counties.
    The number of abortion providers declined by 11% between 1996 and 2000 (from 2,042 to 1,819). 87% of all U.S. counties lacked an abortion provider in 2000. These counties were home to 34% of all 15?44-year-old women.
    42% of providers offer very early abortions (before the first missed period) and 95% offer abortion at eight weeks from the last menstrual period. Sixty-four percent offer at least some second-trimester abortion services (13 weeks or later), and 23% offer abortion after 20 weeks. Only 11% of all abortion providers offer abortions at 24 weeks.
    In 2009, the average amount paid for a nonhospital abortion with local anesthesia at 10 weeks' gestation was $451.
  • In September 2000, the U.S. Food and Drug Administration approved mifepristone to be marketed in the United States as an alternative to surgical abortion.
    In 2008, 59% of abortion providers, or 1,066 facilities, provided one or more early medication abortions. At least 9% of providers offer only early medication abortion services.
    Medication abortion accounted for 17% of all nonhospital abortions, and about one-quarter of abortions before nine weeks' gestation, in 2008.
  • Abortion is one of the safest medical procedures, with minimal?less than 0.05%?risk of major complications that might not need hospital care.
    Abortions performed in the first trimester pose virtually no long-term risk of such problems as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.
    Exhaustive reviews by panels convened by the U.S. and British governments have concluded that there is no association between abortion and breast cancer. There is also no indication that abortion is a risk factor for other cancers.
    In repeated studies since the early 1980s, leading experts have concluded that abortion does not pose a hazard to women's mental health.
    The risk of death associated with abortion increases with the length of pregnancy, from one death for every one million abortions at or before eight weeks to one per 29,000 at 16-20 weeks-and one per 11,000 at 21 or more weeks.
    58% of abortion patients say they would have liked to have had their abortion earlier. Nearly 60% of women who experienced a delay in obtaining an abortion cite the time it took to make arrangements and raise money.
    Teens are more likely than older women to delay having an abortion until after 15 weeks of pregnancy, when the medical risks associated with abortion are significantly higher.
  • In the 1973 Roe v. Wade decision, the Supreme Court ruled that women, in consultation with their physician, have a constitutionally protected right to have an abortion in the early stages of pregnancy that is, before viability, free from government interference.
    In 1992, the Court upheld the right to abortion in Planned Parenthood v. Casey. However, the ruling significantly weakened the legal protections previously afforded women and physicians by giving states the right to enact restrictions that do not create an ?undue burden? for women seeking abortion.
    Thirty-five states currently enforce parental consent or notification laws for minors seeking an abortion. The Supreme Court ruled that minors must have an alternative to parental involvement, such as the ability to seek a court order authorizing the procedure.
    Even without specific parental involvement laws, six in 10 minors who have an abortion report that at least one parent knew about it.
    Congress has barred the use of federal Medicaid funds to pay for abortions, except when the woman's life would be endangered by a full-term pregnancy or in cases of rape or incest.
    17 states use public funds to pay for abortions for some poor women, but only four do so voluntarily; the rest do so under a court order.[18] About 20% of abortion patients report using Medicaid to pay for abortions[6] (virtually all in states where abortion services are paid for with state dollars).
    In 2006, publicly funded family planning services helped women avoid 1.94 million unintended pregnancies, which would likely have resulted in about 860,000 unintended births and 810,000 abortions.

“Lessons from Before Roe: Will Past be Prologue?” (March 1, 2003)[edit]

“Lessons from Before Roe: Will Past be Prologue?” The Guttmacher Policy Review, Vol. 6 Iss. 1, March 1, 2003. ===

  • The Supreme Court did not "invent" legal abortion, much less abortion itself, when it handed down its historic Roe v. Wade decision in 1973. Abortion, both legal and illegal, had long been part of life in America. Indeed, the legal status of abortion has passed through several distinct phases in American history. Generally permitted at the nation's founding and for several decades thereafter, the procedure was made illegal under most circumstances in most states beginning in the mid-1800s. In the 1960s, states began reforming their strict antiabortion laws, so that when the Supreme Court made abortion legal nationwide, legal abortions were already available in 17 states under a range of circumstances beyond those necessary to save a woman's life.
  • Estimates of the number of illegal abortions in the 1950s and 1960s ranged from 200,000 to 1.2 million per year. One analysis, extrapolating from data from North Carolina, concluded that an estimated 829,000 illegal or self-induced abortions occurred in 1967.
    One stark indication of the prevalence of illegal abortion was the death toll. In 1930, abortion was listed as the official cause of death for almost 2,700 women—nearly one-fifth (18%) of maternal deaths recorded in that year. The death toll had declined to just under 1,700 by 1940, and to just over 300 by 1950 (most likely because of the introduction of antibiotics in the 1940s, which permitted more effective treatment of the infections that frequently developed after illegal abortion). By 1965, the number of deaths due to illegal abortion had fallen to just under 200, but illegal abortion still accounted for 17% of all deaths attributed to pregnancy and childbirth that year. And these are just the number that were officially reported; the actual number was likely much higher.
    Poor women and their families were disproportionately impacted. A study of low-income women in New York City in the 1960s found that almost one in 10 (8%) had ever attempted to terminate a pregnancy by illegal abortion; almost four in 10 (38%) said that a friend, relative or acquaintance had attempted to obtain an abortion. Of the low-income women in that study who said they had had an abortion, eight in 10 (77%) said that they had attempted a self-induced procedure, with only 2% saying that a physician had been involved in any way.
    These women paid a steep price for illegal procedures. In 1962 alone, nearly 1,600 women were admitted to Harlem Hospital Center in New York City for incomplete abortions, which was one abortion-related hospital admission for every 42 deliveries at that hospital that year. In 1968, the University of Southern California Los Angeles County Medical Center, another large public facility serving primarily indigent patients, admitted 701 women with septic abortions, one admission for every 14 deliveries.
  • A clear racial disparity is evident in the data of mortality because of illegal abortion: In New York City in the early 1960s, one in four childbirth-related deaths among white women was due to abortion; in comparison, abortion accounted for one in two childbirth-related deaths among nonwhite and Puerto Rican women.
    Even in the early 1970s, when abortion was legal in some states, a legal abortion was simply out of reach for many. Minority women suffered the most: The Centers for Disease Control and Prevention estimates that in 1972 alone, 130,000 women obtained illegal or self-induced procedures, 39 of whom died. Furthermore, from 1972 to 1974, the mortality rate due to illegal abortion for nonwhite women was 12 times that for white women.
  • Although legal abortions were largely unavailable until the years just before Roe, some women were always able to obtain the necessary approval for an abortion under the requirements of their state law. In most states, until just before 1973, this meant demonstrating that a woman's life would be endangered if she carried her pregnancy to term. In some states, especially between 1967 and 1973, a woman also could receive approval for an abortion if it were deemed necessary to protect her physical or mental health, or if the pregnancy had resulted from rape or incest.
    Even so, the process to obtain approval for a legal abortion could be arduous. In many states, it involved securing the approval of a standing hospital committee established specifically to review abortion requests. Either as a matter of state law or hospital policy, these committees frequently required that additional physicians examine the woman to corroborate her own physician's finding that an abortion was necessary to protect her life or physical health. Likewise, a licensed psychiatrist might be required to second the judgment of a woman's doctor that an abortion was necessary on mental health grounds, or a law enforcement officer might be required to certify that the woman had reported being sexually assaulted.
    Contemporaneous accounts noted that a woman's ability to navigate this process successfully generally required having a long-standing relationship with a physician. In practice, this meant that the option was only available to those who were able to pay for the review process, in addition to the procedure itself. One study of the 2,775 so-called therapeutic abortions at private, not-for-profit hospitals in New York City between 1951 and 1962 found that 88% were to patients of private physicians, rather than ward patients served by the hospital staff. The abortion to live-birth ratio for white women was five times that of nonwhite women, and 26 times that of Puerto Rican women.
  • The year before the Supreme Court's decision in Roe v. Wade, just over 100,000 women left their own state to obtain a legal abortion in New York City. According to an analysis by The Alan Guttmacher Institute, an estimated 50,000 women traveled more than 500 miles to obtain a legal abortion in New York City; nearly 7,000 women traveled more than 1,000 miles, and some 250 traveled more than 2,000 miles, from places as far as Arizona, Idaho and Nevada.
    Data from the New York City Department of Health confirm that this option, as difficult as it was, was really only available to the small proportion of women who were able to pay for the procedure plus the expense of travel and lodging. (Nonresidents were not eligible for either Medicaid-covered care in New York or care from the state's public hospitals.) While eight in 10 nonresidents obtaining abortions in the city between July 1971 and July 1972 were white, seven in 10 city residents who underwent the procedure during that time were nonwhite.
    A serious consequence of having to travel long distances to obtain an abortion was the resulting delay in having the procedure performed, which could raise the risk of complications for the woman. No more than 10% of New York City residents who had an abortion in the city in 1972 did so after the 12th week of pregnancy; in contrast, 23% of women from nonneighboring states who had an abortion in New York City did so after the 12th week.
    Moreover, a woman who traveled long distances to obtain an abortion not only had to undergo the rigors of travel shortly after a surgical procedure but also was precluded from continuity in her medical care if she needed follow-up services. By the time a complication occurred, an out-of-state woman might already be home, where she would be unable to receive care from the physician who performed the abortion and, perhaps, from any physician with significant abortion experience.
  • Legal abortion has been part of American life for much of the nation's history. Under English common law, the cornerstone of American jurisprudence, abortions performed prior to "quickening" (the first perceptible fetal movement, which usually occurs after the fourth month of pregnancy) were not criminal offenses. With no state enacting specific legislation during nearly the first third of the nation's history, this traditional principle prevailed. The medical literature of the day, both popular and professional, included frequent references to methods of abortion.
    In the mid-1800s, Massachusetts enacted the first state law making abortion or attempted abortion at any point in pregnancy a criminal offense. By the turn of the century, almost all states had followed suit. In the early 1960s, only Pennsylvania prohibited all abortions, but 44 other states only allowed abortion when the woman's life would be endangered if she carried the pregnancy to term. Alabama, Colorado, New Mexico, Massachusetts and the District of Columbia permitted abortion if the life or physical health of the woman was in jeopardy; Mississippi allowed abortions in case of life endangerment or rape.
    Violating these laws could have serious legal consequences, not only for the provider but potentially for others as well. In nine states, the laws considered it a criminal offense to aid, assist, abet or counsel a woman in obtaining an illegal abortion. Fourteen states explicitly made obtaining an abortion, as well as performing one, a crime. Women were rarely convicted for having an abortion; instead, the threat of prosecution often was used to encourage them to testify against the provider.

"Misinformed Consent: The Medical Accuracy of State-Developed Abortion Counseling Materials" (October 23, 2006)[edit]

"Misinformed Consent: The Medical Accuracy of State-Developed Abortion Counseling Materials". (October 23, 2006).

  • Informed consent—the concept that individuals have a right to receive relevant, accurate and unbiased information prior to receiving medical care so they can make sound decisions regarding treatment—is a bedrock principle of medical ethics. Moreover, the obligation to provide such information is mandated by statute or case law in all 50 states. Under the banner of informed consent, a majority of states have enacted abortion counseling laws requiring physicians to provide specified information to women seeking abortions. Many of these laws require the state health department to develop detailed written materials that must be distributed to women prior to the procedure.
    An analysis of these state-developed materials demonstrates that they do not always measure up to the gold standard of informed consent. Particularly with regard to certain hot-button issues, the information presented is either out-of-date, biased or both. In some cases, the state goes so far as to include information that is patently inaccurate or incomplete, lending credence to the charge that states' abortion counseling mandates are sometimes intended less to inform women about the abortion procedure than to discourage them from seeking abortions altogether.
  • States have been enacting "informed consent" mandates specific to abortion for decades, and 32 states currently have mandates in effect. In general, they require providers to inform a woman of the nature of the procedure and the risks associated with it—as well as the risks of pregnancy and childbirth—and the "probable gestational age" of the fetus. In some cases, however, the statutes are biased on their face. In seven states, they mandate the provision of negative and unscientific information about abortion and its implications. In five other states, they require that the woman be told that the state favors childbirth over abortion.
    Whether biased or not, abortion rights activists have tended to oppose counseling mandates specific to abortion, which they consider egregious examples of political interference in the doctor-patient relationship. For its part, the American Medical Association has long opposed any legislative measure that would require "procedure-specific" informed consent. Nonetheless, the U.S. Supreme Court in 1992 ruled in favor of abortion-specific informed consent mandates in Planned Parenthood of Southeastern Pennsylvania v. Casey. In upholding Pennsyl-vania's law requiring preabortion counseling, the Court said such mandates are permissible as long as the information the law requires to be given to the woman is "truthful and nonmisleading."
    Given the propensity for states to take advantage of that authority, the Guttmacher Institute undertook a content analysis of state-written counseling materials to better understand the information physicians are required to distribute to women seeking an abortion. In July 2006, we conducted a 50-state investigation to discover in which states the health department had developed materials; we found that 22 states had done so, all under the direction of their legislatures. (One additional state, Oklahoma, has a law requiring the health department to develop materials, but the department has yet to do so.) In most cases, the topics included in the materials were specifically required by law; in other cases, the topics had been selected at the discretion of the health department.
    Our analysis reveals that although most of the information in the materials about abortion comports with recent scientific findings and the principles of informed consent, some content—specifically, that which is related to breast cancer, psychological impact, fetal pain and referrals for additional care—is either misleading or altogether incorrect. Also, the investigation demonstrates that in a few cases, health departments acted to mitigate the potential harm of biased laws by publishing materials that are somewhat more balanced than the laws themselves. For example, laws in nine states require that the materials include information on the "possible detrimental psychological effects" of abortion; however, in all but two of these states, the materials describe a range of emotions—both positive and negative—a woman could experience.
  • In Casey, the Supreme Court ruled that it is within the boundaries of informed consent for abortion counseling laws to require additional information that could be useful to a woman should she decide to continue her pregnancy. Accordingly, materials in 20 states provide directories with contact information for resources that offer a range of support services, including adoption services, financial assistance, child care, health services and prenatal care. The referral information can be as brief as referring the woman to a toll-free hotline or as detailed as a list of organizations arranged by county or type of service provided.
    In all 20 states, these directories include contact information for organizations commonly known as "crisis pregnancy centers" (CPCs). CPCs often bill themselves as organizations that provide comprehensive services and support to women with unplanned pregnancies, including abortion counseling, information on adoption, parenting classes, and baby clothes and equipment. According to a recent report released by Rep. Henry Waxman (D-CA), however, CPCs often provide false and misleading information to pregnant women about the health effects of abortion in hopes of dissuading them from seeking an abortion (see box). Furthermore, according to a June 2006 report by the National Abortion Federation (NAF), the extent to which CPCs "provide real services to women is not as great as they often lead women to believe." Markedly, our analysis found that only two states, Georgia and Wisconsin, include a description of CPCs that clearly indicates that they may not provide comprehensive services and that they are antiabortion organizations.
    Moreover, even though women considering abortion are, by definition, sexually experienced and at risk of experiencing a subsequent unplanned pregnancy, only 13 of the 20 states provide women with referral information for family planning services. Typically, these lists include contact information for local clinics where contraceptive devices and counseling can be obtained.
  • Our analysis of state abortion counseling laws and materials reveals that policymakers and public health officials frequently disregard the basic principles of informed consent in favor of furthering a highly politicized antiabortion goal. And, all signs point to their continued interest in doing so. Abortion-specific "informed consent" legislation was introduced in 27 states this year. In some cases, the bills would establish new counseling mandates in states without such a requirement; in others, the bills would amend current counseling requirements. For example, legislation in 12 states would amend current law to require that women be given information on fetal pain. A bill in one state seeks to add information, although discredited, on the link between abortion and breast cancer.
    This phenomenon, moreover, is not limited to state-level politics; it also plays a role on Capitol Hill. In 2004, the federal "Unborn Child Pain Awareness Act" was introduced in both the House and Senate by Rep. Chris Smith (R-NJ) and Sen. Sam Brownback (R-KS). Similar to measures passed on the state level, the legislation would require abortion providers to recite a congressionally scripted statement that Congress has determined "an unborn child has the physical structures necessary to experience pain." The bill would also require providers to offer to administer anesthesia to the fetus. According to NAF, however, there is currently no established regimen for administering anesthesia to a fetus during an abortion procedure; NAF's position is that anesthesia should not be administered to a fetus outside of a clinical trial, because doing so poses a risk to the woman.
    Maintaining the scientific integrity of abortion counseling information goes beyond politics—it is a matter of sound public health policy. Despite the fact that the Supreme Court upheld the legality of abortion-specific mandates and said that a state could express its preference for childbirth over abortion, the Court did not clear the way for the provision of medically inaccurate information that effectively could negate a woman's ability to make an informed decision regarding her own life and health. State and federal policymakers have an obligation to uphold the integrity of information related to the health effects of abortion when enacting these counseling laws, and state departments of health (as well as Congress, if it gets into the act) have an equal obligation when developing the materials. In the current political context, holding policymakers accountable to these informed-consent obligations may be an uphill battle, but it is no less urgent for being so.
  • In July 2006, Rep. Henry Waxman (D-CA) released the results of an investigation examining the scientific accuracy of information provided by federally funded crisis pregnancy centers (CPCs), which have received over $30 million in federal funds under the Bush administration since 2001. (According to the report, most of these funds are not used for abortion counseling, but instead for abstinence-only education. However, CPCs receive additional federal funding for general “capacity building” activities.) The investigation was conducted by minority staff for the House Committee on Government Reform. Committee investigators called 25 centers that receive federal capacity-building grants, posing as pregnant 17-year-olds who were considering abortion and were seeking additional information on the procedure. The investigators reached a CPC staffer at 23 of the 25 centers.
    According to the report, an overwhelming majority of the centers—20 of the 23—provided “false or misleading information” on the physical and mental health risks of abortion to pregnant women. For example, eight centers told women that their chance of developing breast cancer will rise substantially if they have an abortion. One clinic in particular said there was a 50% greater chance that a woman will develop cancer after an abortion, whereas another said the likelihood could be as high as 80% greater.
    In addition, seven centers informed the caller that there is an increased risk of fertility problems after abortion. One center told the caller that having an abortion “could destroy your chances of ever having children again.”
    Also, 13 of the 23 centers told callers that having an abortion would cause a host of detrimental mental health outcomes. One center, for instance, said that after an abortion, the risk of suicide “goes up by seven times.” Others asserted that women could suffer from a range of negative outcomes such as guilt, numbness, anxiety, drug use, eating disorders and sexual dysfunction.
  • Alarmingly, this investigation also highlighted the fact that CPCs often mask their antiabortion agenda to attract pregnant women who are seeking medical advice and dissuade them from obtaining an abortion. Many centers act under the guise of organizations that provide pregnant women with a comprehensive set of options, including abortion services, even though CPCs neither provide abortions nor referrals for abortions. After pulling together the results of the investigation, the authors concluded, “A pregnant teenager who relied on the information from these federally funded centers would make her decision about whether to give birth or terminate her pregnancy based on erroneous facts and misinformation.” The report demonstrates the extent to which CPCs grossly distort the facts when it comes to discussing the risks associated with abortion—all in an effort to promote an antiabortion message.

"Get "In the Know": Questions About Pregnancy, Contraception and Abortion"[edit]

Guttmacher.org "Get "In the Know": Questions About Pregnancy, Contraception and Abortion". Archived from the original on March 11, 2008.

  • What is the typical age of a woman having an abortion?
    The majority of U.S. women having abortions (56%) are in their 20s.
  • Do women who have an abortion want children?
    Six in 10 U.S. women having abortions are already mothers. More than half intend to have (more) children in the future.
  • Do women with religious affiliations have abortions?
    Nearly eight in 10 U.S. women obtaining an abortion report a religious affiliation (43% are Protestant, 27% Catholic and 8% another religion). Among all women aged 15–44, 51% are Protestant, 28% are Catholic and 5% belong to other religions.
  • Are there rural-urban differences in abortion?
    Most reproductive-age women in the United States (79%) live in metropolitan areas; women in these areas account for 88% of all U.S. abortions. Most abortion providers (95%) are also located in metropolitan areas, increasing access to abortion there.
  • What is the racial or ethnic background of women who have abortions?
    No racial or ethnic group makes up a majority of women having abortions: 41% are white, 32% are black and 20% are Hispanic.
  • What racial or ethnic group has the highest abortion rate?
    The overall abortion rate is 21 per 1,000 U.S. women (i.e., each year 2.1% of all women of reproductive age have an abortion). Black and Hispanic women have higher abortion rates than non-Hispanic white women do. (The rates are 49 per 1,000 and 33 per 1,000 among black and Hispanic women, respectively, vs. 13 per 1,000 among non-Hispanic white women.) Black and Hispanic women have higher abortion rates primarily because they have higher rates of unintended pregnancy.
  • What are the trends in the characteristics of women having abortions?
    Over time, women having abortions have become increasingly likely to be poor, nonwhite and unmarried, and to already have one or more children.
  • Why do women have abortions?
    Most U.S. women cite more than one factor contributing to their decision to have an abortion: Almost three-quarters say that having a baby would interfere with work, school or other responsibilities; about three-quarters say they cannot afford to have a child; and almost half say they do not want to be a single parent or are having problems with their husband or partner.

"Parental Involvement in Minors' Abortions"[edit]

"Parental Involvement in Minors' Abortions". Guttmacher.org, March 14, 2016.

  • The majority of states require parental involvement in a minor’s decision to have an abortion. Most of these states require the consent or notification of only one parent, usually 24 or 48 hours before the procedure, but a handful of states require the involvement of both parents. Some states require the minor and a parent to provide government-issued identification to the abortion provider and/or as part of notarizing the parental consent form. In a small number of states, the parent must also provide proof of parenthood. Several states allow grandparents or other adult relatives to be involved in place of the minor’s parents, and many waive parental involvement requirements if there is a medical emergency or the young person is the victim of abuse or neglect.
    Because the U.S. Supreme Court has ruled that states may not give parents an absolute veto over their child's decision to have an abortion, most state parental involvement requirements include a judicial bypass procedure that allows a minor to receive court approval for an abortion without their parents’ knowledge or consent. Some states require judges to use specific criteria when determining whether to grant a waiver of parental involvement. These criteria can include the young person's intelligence, emotional stability and understanding of the possible consequences of obtaining an abortion. Many states require a judge to use the unusually strict legal standard of “clear and convincing evidence” to determine whether a minor is sufficiently mature and the abortion is in their best interest prior to waiving the parental involvement requirement.
  • 37 states require parental involvement in a minor’s decision to have an abortion.
    21 states require only parental consent; 3 of these require both parents’ consent.
    6 states require both parental notification and consent.
    10 states require only parental notification; 1 of these requires that both parents be notified.
    6 states permit a minor to obtain an abortion if a grandparent or other adult relative is involved in the decision.
    11 states require identification for parental consent.
    4 states require proof of parenthood for parental consent.
    2 states require a minor’s identification to have an abortion.
  • 36 states that require parental involvement have an alternative process for minors seeking an abortion.
    36 states include a judicial bypass procedure, which allows a minor to obtain approval from a court.
    7 states require judges to use specific criteria, such as a minor’s intelligence or emotional stability, for deciding whether to waive parental involvement.
    15 states require judges to use the “clear and convincing evidence” standard to determine whether the minor is mature and the abortion is in their best interest when deciding whether to waive parental involvement.
  • Most states that require parental involvement make exceptions under certain circumstances.
    34 states permit a minor to obtain an abortion in a medical emergency.
    15 states permit a minor to obtain an abortion in cases of abuse, assault, incest or neglect.

“Is Abortion Legal in Every State?” (October 27, 2019)[edit]

Tom Head, “Is Abortion Legal in Every State?”, Thoughtco, (October 27, 2019)

  • Abortion is legal in every state and has been since 1973. In the subsequent decades, however, states have imposed restrictions on abortions. In 2018 and 2019, a number of them, including Georgia, Ohio, and Kentucky, introduced "heartbeat" bills to prevent women from terminating their pregnancies beyond the six-week mark. At this point, a fetal heartbeat can be detected, but heartbeat bills have faced criticism from reproductive rights activists who argue that many women don't know they're pregnant at this early stage, known as the embryonic period. As of October 2019, courts had blocked each of the heartbeat bills from passing on the grounds that these laws are unconstitutional.
  • The Supreme Court's 1973 ruling in Roe v. Wade established that the U.S. Constitution protects one's right to have an abortion. Due to this court decision, states are prohibited from banning abortions performed before the point of viability.
    The Roe decision originally established viability at 24 weeks; Casey v. Planned Parenthood (1992) shortened it to 22 weeks. This prohibits states from banning abortions before about five-and-a-quarter months of gestation. The heartbeat bills passed by various states sought to ban abortion well before the point of viability, which is why the courts declared them unconstitutional.
  • In the 2007 case Gonzales v. Carhart, the Supreme Court upheld the Partial-Birth Abortion Act of 2003. This law criminalizes the procedure of intact dilation and extraction, a technique commonly used during second-trimester abortions.
  • Although abortion is legal in every state, it is not easily accessible everywhere. Anti-abortion activists and legislators have managed to drive some abortion clinics out of business, a strategy that effectively functions as a state-level ban in places with few abortion providers. Mississippi is a case in point; in 2012, the state nearly lost its only abortion clinic due to a law requiring abortion providers to be "certified obstetrician/gynecologists with privileges at local hospitals." At the time, just one doctor at Jackson Women's Health Organization had these privileges.
    Seven years after Mississippi's sole abortion clinic fought to stay open, the fate of Missouri's only such clinic hung in the balance because of a licensing dispute. In early 2019, Missouri's health department failed to renew the clinic’s license, arguing that the facility was out of compliance. Planned Parenthood opposed this decision, but the clinic's future remained uncertain and tied up in the courts, as of fall 2019. In addition to Missouri and Mississippi, four other states—Kentucky, West Virginia, North Dakota, and South Dakota—have just one abortion clinic.
    The reasons several states have just one abortion clinic stems from Targeted Regulation of Abortion Providers (TRAP) laws. This legislation limits abortion clinics through complex and medically unnecessary building requirements or by requiring providers to have admitting privileges at local hospitals—the case in Mississippi in 2012. Other laws, specifically those that require ultrasounds, waiting periods, or pre-abortion counseling, pressure women to reconsider ending their pregnancies.

"Women's Health Policy Facts"[edit]

"Women's Health Policy Facts" (PDF). The Henry J. Kaiser Family Foundation. 2008. Archived from the original (PDF) on February 25, 2009.

  • Approximately one-fifth (19%) of the 6.4 million pregnancies occurring annually in the U.S. end in induced abortion. While abortion is one of the most common medical procedures for women, access and availability of services has been subject to ethical and political debates. Federal and state policies have a substantial impact on women’s access to abortion services.
    • p.1
  • In 2005, 1.21 million abortions were performed in the U.S., down from 1.61 million (the all-time high) in 1990.
    • p.1
  • 49% of pregnancies were unintended in the U.S., and of these, 42% resulted in abortions in 2001 (the most recent data available).
    • p.1
  • The abortion rate (the number of abortions per 1,000 women aged 15–44) was 19.4 in 2005, a 9% drop since 2000.
    • p.1
  • 89% of abortions were performed in the first twelve weeks of pregnancy in 2004, with about 63% in the first eight weeks and 1% of abortions at 21 weeks or later.
    • p.1
  • About 19% of women having abortions in the U.S. are teens; 33% are between the ages of 20 and 24; and 48% are ages 25 and older.7 Two-thirds (67%) of women have never been married and about 61% of women have given birth before.
    • p.1
  • Abortion rates for black women (49 per 1,000 women), Hispanic women (33 per 1,000) and Asian women (31 per 1,000) are higher than those of white women (13 per 1,000).9
    • p.1
  • Abortion rates are higher among low-income women. The abortion rate for poor women has been increasing since 1994, so that the procedure is becoming increasingly concentrated among poor women, including those on Medicaid
    • p.1
  • Surgical abortions account for the majority (87%) of abortions performed in the U.S. The most common surgical methods include vacuum aspiration, dilation and curettage (D&C), and dilation and evacuation (D&E). Surgical abortion is generally not performed until the sixth week of gestation.
    • p.1
  • In 2005, medical abortions accounted for approximately 13% of all abortions (compared to 6% in 2001) and 22% of abortions before nine weeks’ gestation.
    • p.1
  • Since the 1990s, 31 states have enacted bans on procedures called “partial-birth” abortions, with 14 state laws (GA, IN, KS, LA, MS, MT, NM, ND, OH, OK, SC, SD, TN, UT) in effect. All include an exception to the ban: four states (GA, KS, NM, OH) include a health exception and the rest of the states include an exception only when a woman’s life is in danger.
    • p.1
  • In 2003, the President signed the Partial-Birth Abortion Ban Act of 2003, which banned “partial-birth” abortions with no health exception. This legislation was upheld by the Supreme Court in the April 2007 Gonzales v. Carhart decision. The procedure banned by this Act is sometimes medically defined as intact dilation and extraction. Following the high court ruling, state legislatures have been reviving their bans on late-term abortion procedures previously blocked by lower courts.
    • p.1
  • Complications from abortions are rare, with less than 0.3% of abortion patients in the U.S. experiencing a major complication requiring hospitalization.16 The annual risk of death associated with abortion has been approximately one death per 100,000 legal abortions.
    • p.1
  • The cost of an abortion varies depending on factors such as location, facility, timing, and type of procedure. In 2005, a nonhospital abortion at 10 weeks’ gestation ranged from $90 to $1,800 (average: $430), whereas an abortion at 20 weeks’ gestation ranged from $350 to $4,520 (average: $1,260).24 Costs are higher for a medical abortion than a first-trimester surgical abortion.
    • p.1

• Based on these restrictions, 32 states and DC fund abortions through Medicaid only in the cases of rape, incest, or life endangerment. SD covers abortions only in the cases of life endangerment, which does not comply with federal requirements under the Hyde Amendment. IN, UT and WI have expanded coverage to women whose physical health is jeopardized, and IA, MS, UT and VA also include fetal abnormality cases.

    • p.1
  • Seventeen states (AK, AZ, CA, CT, HI, IL, MD, MA, MN, MT, NJ, NM, NY, OR, VT, WA, WV) use their own funds to cover all or most “medically necessary” abortions sought by low-income women under Medicaid.
    • p.1
  • Five states (ID, KY, MO, ND, OK) restrict insurance coverage of abortion services in private plans: OK limits coverage to life endangerment, rape or incest circumstances; and the other four states limit coverage to cases of life endangerment.
    • p.2
  • Twelve states (CO, IL, KY, MA, MS, NE, ND, OH, PA, RI, SC, VA) restrict abortion coverage in insurance plans for public employees, with CO and KY restricting insurance coverage of abortion under any circumstances.
    • p.2
  • U.S. laws also ban federal funding of abortions for Federal employees and their dependents, Native Americans covered by the Indian Health Service, military personnel and their dependents, and women with disabilities covered by Medicare.
    • p.2
  • 1,787 facilities provided abortions in 2005 in the U.S., a 2% decline from the year 2000.
    • p.2
* 87% of U.S. counties have no abortion provider, and 35% of women of reproductive age (15–44) live in these counties. Women in the Midwest and South are more likely to live in a county without a provider (50% and 47%, respectively) than women in the Northeast and West (17% and 15%, respectively).
    • p.2
  • Over half of abortion providers (57%) performed early medical abortions in 2005, up from 33% in 2001. More than half of early medical abortions were provided at abortion clinics.
    • p.2

• Most abortion providers performed abortions within the first eight weeks. 40% performed early abortion within first four weeks’ gestation, whereas 8% of abortion providers performed abortions at 24 weeks.

    • p.2

• In recent years, 28 states have adopted laws and regulations specific to abortion clinics and providers. These laws involve special requirements for abortion providers to have health facility licenses and ambulatory surgical center licenses, or requirements that abortions after a specified gestation age be performed in a hospital, or that providers have admitting privileges in local hospitals. These policies can make it more difficult for providers to offer abortion services to women.

    • p.2
  • The Federal Freedom of Access to Clinic Entrances (FACE) Act was passed in 1994 to prohibit acts of physical or psychological intimidation to persons seeking or providing reproductive health services. Fifteen states (CA, CO, KS, ME, MD, MA, MI, MN, MT, NV, NY, NC, OR, WA, WI) and DC go beyond the FACE protections and prohibit certain specified actions aimed at abortion providers, such as threatening or intimidating staff, property damage and telephone harassment.
    • p.2
  • Twenty-four states have passed requirements for women to wait a specified time (usually 24 hours) between receiving counseling and undergoing an abortion.36 As a result, women must make two visits to the clinic, which can be difficult for those who live far from the clinic. 8% of women travel more than 100 miles to access abortion services and 19% travel between 50 and 100 miles.
    • p.2

• Thirty-five states have adopted “parental involvement” laws that require notification and/or consent of one or both parents before a minor has an abortion.38 Most states with these laws apply them to girls under age 18, although several set the level to 16 or 17.

    • p.2

“Management of unintended and abnormal pregnancy: comprehensive abortion care” (April 27, 2009)[edit]

Stanley K. Henshaw, ”Unintended pregnancy and abortion in the USA: Epidemiology and public health impact” in Paul M, Lichtenberg ES Borgatta L Grimes DA Stubblefield P Creinin (eds) “Management of unintended and abnormal pregnancy: comprehensive abortion care”. (April 27, 2009) Oxford: Wiley-Blackwell. ISBN 978-1-4051-7696-5.

  • About half of US women with unintended pregnancies choose to resolve them by abortion. In general these women believe that, given their life circumstances, taking responsibility for a new baby would be a mistake. The demographic characteristic most associated with the decision to terminate an unintended pregnancy is marital status: in 2001, 58% of unmarried women with unintended pregnancies decided on abortion, whereas only 27% of married women did so. Evidently the security of having a committed partner and the financial resources of a marriage allow most married women to continue their unplanned pregnancies.
  • Women of all education levels have occasion to seek abortion services, but college graduates have a lower abortion rate than less-educated women. Some 41% of abortions are obtained by women with some post-high school education but who are not college graduates.
    Never-married women obtain the bulk of abortions (67%); married women account for only 17%. The abortion rate is higher among never-married women (35 per 1,000) than among previously married or currently married women. The high rate among never –married women results partly form their young age compared with the other marital groups.
    Women living with a partner to whom they are not married account for 25% of abortions but only about 10% of women in the population. Their abortion rate is almost two times that of other unmarried women. Thus, cohabitating is one of the strongest risk factors for abortion.
    A majority (61%) of women having abortions in 2004 had had at least one birth, and one third had had two or more. When age is taken into account, women who have children are substantially more likely than women without children to have an abortion, and the highest abortion rate is found women with four or more children. Such women may have difficulty using contraception and thus may have unplanned children as well as abortions.
  • The high relative abortion rate of low-income women is reflected in the abortion rate according to Medicaid coverage. Twenty-four per cent of abortion patients say they are covered by Medicaid (although not necessarily for the abortion per se, except in the states that allow Medicaid to pay for abortion services), while only 9% of all US women of reproductive age have Medicaid coverage (as of 2000). Thus, the abortion rate of women with Medicaid coverage is three times as high as that of other women.
    Women covered by Medicaid have a number of attributes that may contribute to their relatively high risk of abortion: they are disproportionately non-White, unmarried, and poor, all characteristics associated with high abortion rates. In addition, many women on Medicaid are covered by that program because of a prior accidental pregnancy that they carried to term and are prone to unplanned pregnancy.
  • More than half (62%) of all induced abortions in the USA occur at eight weeks’ gestation or earlier, counting from the first day of the last menstrual period (LMP) or two weeks before the estimated date of conception. Approximately 12% o abortions are performed past 12 weeks LMP, including 1.4% past 20 weeks LMP. In most developed countries other than England and Wales, somewhat fewer abortions take place after 12 weeks LMP, probably because women respond more promptly to unwanted pregnancies and because restrictions in some countries make later abortions more difficult to obtain. Moreover, most other countries provide universal health insurance that covers abortion services. In contrast, women in the USA may be delayed by difficulty gaining access to abortion services and acquiring money to pay for the procedure.
    In all countries with relevant statistics, teenagers obtain abortions later in gestation on average than do older women. In the USA in 2004, 27% of abortions obtained by women younger than age 15 years were past 12 weeks LMP as were 17% among women aged 15 to 19 years, compared with 11% among women aged 20 and older. Abortions generally occur earlier with age until age 40, after which a few women are delayed because they mistake pregnancy for the menstrual changes of menopause.
    The delay among younger women probably reflects their inexperience in recognizing the symptoms of pregnancy, their reluctance to accept the reality of their situation, lack of knowledge of where to seek advice and services, and their hesitation to confide in adults. In addition, teenagers may have more difficulty paying for abortions, and minors may be affected by parental consent or notification requirements. In the USA laws requiring minors to either consult their parents or obtain a court order permitting the abortion cause some teenagers to experience delay in obtaining abortions.
  • Both first and second trimester abortions can be provided safely in clinics and physicians’ offices. The proportion of US abortions performed in hospitals has declined from more than 50% in 1973 to 5% in 2005. The number of hospitals where abortions are performed has dropped sharply, as has the average number of abortions per hospital provider. A tabulation of data on approximately 300,000 abortions in 14 states in 1992 indicates that, even after 20 weeks LMP, 83% were performed outside of hospitals. Near universal agreement as to the safety of second trimester abortion outside of hospitals is further demonstrated by the finding that in 2001 about 55% of abortion clinics offered the service at 18 weeks LMP or later.
  • Despite the large number of women who need abortion care, services are less available than for other common medical conditions. A significant but unknown number of women continue unwanted pregnancies because of lack of access to an abortion provider.
  • Harassment by antiabortion activists adds to the difficulty women experience in accessing abortion services and the challenges of providing services. In 2000, 80% of large nonhospital facilities (400 or more abortions a year) in the USA experienced picketing. Picketing was much less common among low-volume providers, only 10% of providers that performed fewer than 30 abortions reported being picketed. Other forms of harassment were also fairly common. Of large providers, 28% reported one or more incidents of picketing with physical contact or blocking of patients, and 18% reported vandalism. These activities impede access for women who might be intimidated by aggressive protestors.
    The stigmatization of abortion also undoubtedly affects many women, although this factor is difficult to measure. Fear of the disapproval of relatives or others in the community may inhibit many women who would choose to end their pregnancies. Some women in the USA remain unaware that abortion services are legal and available.
  • [T]he legalization of abortion in the USA, which began in several states in 1967 and culminated in the “Roe v. Wade” Supreme Court decision in 1973, brought significant health and social benefits. Before the laws changed, illegal abortions had been common. From a survey in North Carolina in 1967, researchers estimated that 829,000 abortions were occurring in the country as a whole, which is about 80% of the number of legal abortions that took place in 1975, when legal abortion services were available in all states. Other studies based on the change in the birthrate after legalization suggest that the number of illegal abortions was around 600,000 to 700,000 per year. Legalization converted those abortions to safe procedures and allowed additional women, some at high risk of complications of pregnancy and childbirth, to avoid unwanted childbearing.
    Over the decade spanning 1958 through 1967, more than 3,4000 women died from induced abortions, almost all illegal. The number rose during the 1950s and reached at least 430 in 1961, then fell during the 1960s when more physicians started providing abortions. The number of deaths fell rapidly after abortion was legalized, form 251 in 1966 to 14 in 1976. In recent years, the number of deaths has ranged between 4 and 12 per year according to the Centers for Disease Control and Prevention (CDC). During the five years from 2000 to 2004, only 43 deaths were related to legal abortion an two to illegal abortion, for a mortality rate of 0.7 per 100,000 legal abortions.
    In the 10 years between 1970 and 1980, legal abortion in the USA is estimated to have prevented 1,500 pregnancy related deaths and thousands of other complications.
  • Although contraceptive use increases after abortion, women remain at elevated risk of having another abortion because they are sexually active, willing to terminate an unintended pregnancy by abortion, have difficulty using contraceptive methods effectively, and probably become pregnancy more easily than other women. In 2004, 47% of US women obtaining abortions had had a prior induced abortion: 27% had had one, 12% two, and 8% three of more prior abortions. From 1973 until reaching a high of 49% in 1997, this percentage increased each year along with the proportion of women in the population who had had abortions and were therefore at risk of an additional abortion. In 1994, about 30% of all US women aged 15 to 44 years had had one or more induced abortions, and the abortion rate among the women who had had a previous abortion was about twice that of women who had ever had an abortion Canadian statistics show that approximately 25% of teenage abortion patients will have another abortion within the next four years. An analysis of the NFSG found that 42% of US women who had a repeat abortion did so within two years of the prior abortion.
  • The high rate of repeat abortion does not mean that large numbers of women are relying on abortion as their primary means of birth control. A woman who used only abortion to limit her number of children to two would have more than 30 abortions during her lifetime. No evidence indicates that American women have such large numbers of abortions.
    On the contrary, women tend to improve their contraceptive use after having an abortion. According to the 2001 Guttmacher Institute survey of 10,683 abortion patients, 46% of women having a first abortion had used no contraceptive method during the month they became pregnant. If they had continued to use o method, on the order of 85 to 90% of second abortion would have occurred among women who had used no method because of the high pregnancy rate of non-users. In fact, the distribution of method use was similar to that of women having a first abortion, indicating that women who have an abortion improve their contraceptive use to about the same level as the women generally. The Guttmacher Institute analysis found little difference between first and subsequent abortions in the reasons for non-use or inconsistent use of contraception.
    A number of studies have sought risk factors for repeat abortion but gew have been identified. The best predictors of repeat abortion are factors that reflect exposure to risk, most notably age; the older a woman is the more opportunity she has had to experience two unintended pregnancies that end in abortion. A logistic regression analysis of the Guttmacher patient survey found that women having second or higher order abortions are also more likely to have existing children, controlling for age and other demographic variables. An analysis of the NSFG in the same report found that almost half (47%) of women who have multiple abortions also have unintended births, another consequence of unintended pregnancy and therefore a risk factor for abortion. Other studies have found that women who have a second or higher order abortion engage in more frequent sexual intercourse than women having a first abortion.

“Abortion patients in 1994–1995: characteristics and contraceptive use” (1996)[edit]

Henshaw SK and Kost K, “Abortion patients in 1994–1995: characteristics and contraceptive use”, Family Planning Perspectives, 1996, 28(4)

  • Annual national data describing women having abortions in the United States cover only basic demographic characteristics—age, race, ethnicity, marital status, and prior births and abortions—as well as the procedure used for the abortion and the length of the pregnancy. This information is collected by most states, and it is compiled and published at the national and state levels by the Centers for Disease Control and Prevention (CDC). However, some states have no abortion reporting system, and the CDC reports understate the number of abortions performed. The Alan Guttmacher Institute (AGI) conducts periodic surveys of all abortion providers throughout the country and uses the results together with the CDC data to estimate the number of abortions nationwide and the abortion rate according to a variety of characteristics.
    • p.140
  • Although white women obtain 61% of abortions, their abortion rate, reflected by an index of 0.8, is well below that of women of other races. The index for black women is 2.2, or nearly triple that of white women, and the differential has increased since 1987. The index for women of races other than black or white is 1.6, but this may be inflated by the inclusion of some Hispanic women in this group (as explained in the methodology section). In the 1987 survey, which classified all Hispanic women as white or black, the age-standardized abortion rate for women of “other” races was only slightly above that of all women; the 1994—1995 index would be about the same as the 1987 rate if Hispanics were excluded from this group.
    Hispanic women have a much higher abortion rate than non-Hispanics, but their rate is not as high as that of black women. The index for Hispanics is reduced some-what when standardized for age (from 1.9 to 1.8), but is still roughly twice that of non-Hispanic women (0.9). The age-standardized index for Hispanics has increased substantially from its 1987 level of 1.4.
    • p.143
  • As expected, a large majority (89%) of women having abortions live in counties classified by the federal government as metropolitan, and metropolitan women are twice as likely as nonmetropolitan women to have abortions (indices of 1.1 and 0.6, respectively). The comparatively low abortion index of nonmetropolitan women may reflect their difficulty in gaining access to abortion services, which are unavailable in the counties where 85% of nonmetropolitan women reside. The limited availability of abortion facilities is indicated by the finding that 43% of the patients surveyed traveled outside their home county for abortion services (not shown). In 1987, by contrast, 39% of abortions took place outside the woman’s county of residence.
    • p.144
  • The patterns of contraceptive use among abortion patients may or may not mirror the use patterns of all women at risk of unintended pregnancy. Each contraceptive method entails a different probability of becoming pregnant, and women’s method choice often differs by their socioeconomic and demographic characteristics. Consequently, users of each method may differ in their likelihood of carrying an unexpected pregnancy to term or of having an abortion. For example, women who use only periodic abstinence may, for religious or other reasons, be more likely than users of other methods to carry an unexpected pregnancy to term.
    • p.144
  • Poverty status is strongly associated with contraceptive use; 64% of the women whose family income is at least twice the federal poverty level were using a method, compared with 49% of those with an income under the poverty level. Of the racial and ethnic groups, white non-Hispanic women are the most likely to have been using a method (67%), while Hispanic women are the least likely (45%).
    • p.145
  • Among the women who experienced contraceptive failure, the methods used differ little among the racial or ethnic groups. The largest differences are that black women are more likely than nonblack and Hispanic women to have used the condom and less likely to have used withdrawal. Age differences are marked: Whereas 76% of women younger than 18 had used condoms, only 49% of women 30 or older had used this method. Pill use peaked (at 25%) among women aged 20—29, while use of “other” methods (mainly the diaphragm, sponge, spermicides and periodic abstinence) increased sharply with age, from 1% of women younger than 18 to 24% of those 30 and older. Possibly because age is correlated with income, the proportion who used other methods also increased as family income as a proportion of the poverty level rose. Otherwise, there is little association of method used with poverty status.
    • p.146
  • Between 1987 and 1994—1995, condom use among abortion patients who were using a method when they became pregnant increased dramatically among all women, regardless of race, ethnicity, age or poverty status; the increase was greatest among black and Hispanic women. In the same time period, pill use declined among abortion patients who had a contraceptive failure. This decline occurred primarily among blacks and Hispanics, but substantial decreases also took place among women of all ages except those 30 and older, and among those of all income levels except the highest.
    • p.146
  • The risk of unintended pregnancy leading to abortion varies widely among demographic subgroups. The factors associated with high risk are relatively young age (18—24), being separated or divorced, cohabiting while unmarried, being Hispanic or of a minority race, having a low income, being covered by Medicaid and having had four or more births. Factors that are associated with low abortion rates include being a born-again or Evangelical Christian, being aged 35 or older, having high income, living in a nonmetropolitan county, being married and identifying with a religion other than Catholicism.
    • p.147
  • To further lower the abortion rate, the focus should continue to be on reducing the number of couples who use no contraceptive method at all. Most of those who were not using a method had used one in the past and conceived within a very short period after discontinuing use. Thus, it is very important for couples to avoid lapses in method use and to immediately adopt another method when they discontinue one.
    Next in importance would be to improve the effectiveness with which condoms are used, since one-third of abortion patients experienced the failure of this method. Because most of these failures probably resulted from inconsistent use, the need for protection at every act of intercourse should be stressed.
    • p.147

"The Accessibility of Abortion Services in the United States" (1991)[edit]

Henshaw, S.K. (1991). "The Accessibility of Abortion Services in the United States" (PDF). Family Planning Perspectives. 23 (6): 246–63. Archived (PDF) from the original on 24 March 2016. Retrieved 25 October 2017.

  • METHODS: In 2001–2002, The Alan Guttmacher Institute surveyed all known abortion providers in the United States, collecting information on their delivery of abortion services and on the number of abortions performed.
    RESULTS: A minority of abortion providers offer services before five weeks from the last menstrual period (37%) or after 20 weeks (24% or fewer), but the proportions have increased since 1993. Providers estimate that one-quarter of women having abortions in nonhospital facilities travel 50 miles or more for services, and that 7% are initially unsure of their abortion decision. The majority of providers (59%) say that these clients usually receive abortions during a single visit. An average self-paying client was charged $372 for a surgical abortion at 10 weeks in 2001, up from $319 in 1997; only 26% of clients receive services billed directly to public or private insurance. Early medical abortions are becoming increasingly available but are more expensive than surgical abortions. More than half (56%) of providers experienced antiabortion harassment in 2000, but types of harassment other than picketing have declined since 1996.
    • p.16
  • Unintended pregnancies and induced abortions are common and occur among women of all social and economic groups. Yet the availability and accessibility of abortion services have long been a concern for reproductive health professionals, as women seeking an abortion have a fairly narrow time period during which they can obtain the procedure. Measures of availability have generally declined since 1982: The number of abortion providers in the United States has fallen by 37%, and the proportion of women who live in counties with no abortion provider has increased from 28% to 34%.2 In 2000, 86 of the country’s 276 metropolitan areas and almost all nonmetropolitan areas had no abortion provider.
    Accessibility is harder to measure than availability, because of the variety of possible barriers, both tangible and intangible. Besides distance from a provider, cost is the most obvious tangible barrier. The provision of specific services, such as second-trimester pregnancy termination, can determine accessibility for individual women. Among the barriers that are less tangible, and therefore more difficult to quantify, are women’s lack of accurate information about the legality of abortion and about where and how to obtain abortion care, misinformation about abortion, intimidation by protesters, state-required waiting periods and mandated counseling topics that may not be relevant to a woman’s personal situation, and antiabortion attitudes among family or friends.
    • p.16
  • Providers typically set a minimum and maximum gestation at which they are willing and able to perform an abortion. These limits are expressed as the number of weeks since the woman’s last menstrual period (LMP). Thirty-seven percent of facilities that offer abortion services provide either surgical or medical abortions at four weeks or less LMP (Figure 1), often for any pregnancy that can be confirmed by ultrasound or even a pregnancy test. This represents a sharp increase from the level of 7% reported in 1993 (not shown). Eighty-two percent of abortion facilities perform abortions at six weeks LMP. Abortion clinics are more likely than other types of facilities to offer abortions at five and six weeks LMP.
    More than 90% of all abortion providers offer services at 8–10 weeks LMP. However, the proportion drops with each additional week of gestation after eight weeks LMP (typically four weeks after the woman’s first missed period) and declines steeply after 12 weeks. At 20 weeks, for example, only 33% of all providers offer abortion services, and at 21 weeks, 24% still do so.
    Hospitals and abortion clinics are much more likely than other providers to offer services past 12 weeks. At 13–15 weeks LMP, a higher proportion of abortion clinics than of hospitals perform abortions, while at 17–23 weeks LMP, the reverse is true. (Many hospitals, however, provide very few abortions and do so only in extraordinary circumstances, such as when the fetus has an abnormality or the pregnancy poses severe health risks to the woman.) After 24 weeks LMP, the number of providers offering abortion services again drops off sharply. Only 2% of all abortion providers (approximately 11 hospitals and 19 abortion clinics) provide abortions at 26 weeks.
    • p.18
  • Respondents estimated that 8% of women having abortions in nonhospital facilities travel more than 100 miles to obtain this service, and that an additional 16% travel 50–100 miles.* Travel patterns appear to have changed little over time. In both 1993 and 1997, providers also reported that 24% of clients traveled at least 50 miles, including 8% and 7%, respectively, who traveled more than 100 miles.
    The proportion traveling long distances varies by geographic region. In the East South Central and the West North Central states, 43% and 37%, respectively, of women travel at least 50 miles to obtain an abortion, including 14–15% who travel more than 100 miles. In contrast, only 11% of women in the Middle Atlantic states travel 50 miles or more.
    • p.18
  • Fifty-nine percent of nonhospital providers nationally and 60% of providers in states that do not require in-person advance counseling said that their clients usually obtain abortions in a single visit, while 15% and 14%, respectively, said that this never happens. Single-visit service is highly associated with caseload: All facilities that provided 5,000 or more abortions in 2000 usually perform abortions in a single visit, compared with only 20% of facilities providing fewer than 30 abortions (not shown).
    • p.19
  • We asked each nonhospital provider to indicate the usual charges that a woman would incur at that location for an abortion (with local anesthesia) at various gestations, including fees for any services always required for an abortion client, even if these are not billed through the provider (e.g., laboratory tests). On average, surveyed facilities charge $468 for a surgical abortion at 10 weeks LMP (Table 1). The lowest average charge ($364) is reported by specialized abortion clinics, and the highest average charge ($632) is reported by physicians’ offices.
    • p.19
  • As a pregnancy advances into the second trimester, the abortion procedure becomes more complex, because it requires more time and more skill on the part of the clinician, and charges increase. At 16 weeks, the mean and median charges ($774 and $650, respectively) are more than half again the amounts at 10 weeks (Table 1). At 20 weeks, the mean and median charges increase to $1,179 and $1,042, respectively. In the second trimester, charges vary relatively little by type of provider, but the range remains wide, with some providers charging 2–5 times the average.
    • p.19
  • One-third of abortion facilities provided early medical abortions in the first half of 2001, and this proportion was increasing rapidly. An estimated 37,000 early medical abortions occurred in this time period; 35,000 of them were provided by nonhospital facilities. One-quarter of early medical abortions in nonhospital facilities were performed using methotrexate, which was available before the Food and Drug Administration (FDA) approved mifepristone in September 2000. However, 82% of medical abortion providers were using mifepristone—although some of these used methotrexate as well. Both drugs are used in conjunction with misoprostol, a prostaglandin that is administered with- in several days of the mifepristone or methotrexate to cause contractions and expel the products of conception.
    The FDA-approved labeling specifies a fairly restrictive protocol for abortion using mifepristone: use within the first seven weeks of gestation; a mifepristone dose of 600 mg; misoprostol administered orally in the physician’s office; and a follow-up visit to the provider for an examination to confirm that the pregnancy has been completely terminated. However, experts who have reviewed published studies have concluded that more convenient and less-expensive procedures are equally safe and effective.
    • p.20
  • The great majority of providers of early medical abortion used a dose of 200 mg of mifepristone (83%), and most permitted the client to take the misoprostol at home rather than requiring her to return to the abortion facility to receive it (84%). Both practices were more common among providers that did 50 or more medical abortions than among less-experienced providers.
    Most providers (74%) reported that counseling for medical abortion takes more time than does counseling for surgical abortion. A large minority (43%) said that fewer than 10% of early medical abortion clients called with questions or problems, but one-third reported that 20% or more did so. Calls from one-fifth or more of clients were less common among the more experienced providers.
    • p.21
  • Many women seeking abortion face harassment by anti-abortion protesters; this also affects a facility’s ability to offer services. Each year, 56% of all nonhospital providers experience at least one of five types of harassment—picketing; picketing coupled with physical contact with or blocking of clients; vandalism (such as jamming of locks or other physical damage); picketing of the homes of staff; and bomb threats. Harassment is much more common in facilities with large abortion caseloads than in smaller facilities: The proportion experiencing one or more incidents ranges from 10% among facilities performing fewer than 30 abortions to 70% among those providing 400–990 abortions and to 100% of clinics providing 5,000 or more.
    • p.22
  • Picketing is by far the most common type of antiabortion activity, reported by 80% of large providers. Some 14–28% of large providers experience more extreme forms of harassment. A majority (61%) of facilities experience picketing at least 20 times a year. Other types of harassment usually occur fewer than five times per year at any one facility.
    Since 1996, all of these forms of harassment except picketing have become less common. The proportions of large providers reporting picketing with physical contact, vandalism and picketing of staff members’ homes have fallen by about half since 1992, when these activities were at their height. The proportion of large providers reporting bomb threats has fallen steadily, from 48% in 1985 to 15% in 2000.
    • p.22
  • For many women, barriers to abortion services are significantly more common than are obstacles to other common types of reproductive health care. For example, only 13% of U.S. counties have an abortion provider, while obstetric-gynecologic care is available in half of all counties. In 1997, 85% of counties had at least one publicly funded family planning clinic. Depending on the circumstances of any given woman needing abortion services, she may have to cope with gestational limits, a long distance from a provider (the effects of which may be exacerbated if she needs to make two trips or is undecided about whether to have an abortion), travel and other expenses that may not be covered by insurance, a lack of choice of method of early medical abortion and antiabortion protesters. These are the potential barriers for which we have information; other factors, including restrictive legislation and attitudes, may also pose important problems for some women.
    Gestational limits reduce the number of abortion providers available to specific women. Women frequently encounter such barriers when they seek an abortion during the second trimester. Many providers offer services only up to 12 or 14 weeks, because later abortions require more cervical dilation and greater skill on the clinician’s part, the risk of complications is greater than with earlier abortions and the demand is less. When a fetal anomaly is discovered late in the second trimester, the woman may find that facilities where the pregnancy can be terminated are difficult to locate and are far from her home. Nonetheless, the number of facilities where second-trimester abortions are performed has increased in recent years.
    A woman who discovers an unintended pregnancy at less than six weeks LMP may find that an abortion provider she contacts will not provide services then, but will ask her to wait until six weeks or later. Studies in the 1970s found a higher rate of continuing pregnancies after very early procedures. Recent research has shown, however, that with high-resolution ultrasound and careful examination of the products of conception, early surgical abortions can be performed without an elevated risk of ectopic pregnancy or incomplete abortion, and that an increasing number of providers perform such early abortions. In addition, providers of surgical abortion increasingly are offering early medical abortion.
    • p.22
  • Providers estimate that 8% of women who have abortions travel more than 100 miles to do so, a proportion that has not changed in recent years. Women who are able to over-come the barrier of distance may nevertheless suffer con- sequences. In a survey conducted in 1987–1988, half of a national sample of women who were having an abortion at 16 weeks LMP or later cited difficulty in making arrangements as a cause of delay.
    • p.23
  • Another factor affecting access is the fee that clients pay, which averages $372 at 10 weeks. This is a minimum figure, because many clients have additional expenses, such as for other services (intravenous sedation or general anesthesia), transportation, time lost from work and increased costs if the pregnancy is at a later gestation. Nonhospital providers directly bill Medicaid or other insurance for only 26% of their abortion clients, and for only 8% in states where Medicaid does not cover abortion. Whether because of Medicaid funding restrictions, a lack of insurance coverage, women’s hesitancy to use insurance coverage for abortion or providers’ inability to bill directly, most women pay directly for their abortion care.
    While the cost of an abortion may seem moderate to some, many low-income women are likely to find it substantial. Between 18% and 35% of Medicaid-eligible women who would have abortions instead continue their pregnancies if public funding is unavailable.26 The lack of Medicaid coverage may be the public policy that has the greatest impact on the number of women who want an abortion but are not able to obtain one. In addition, a woman’s need to secure funds often causes abortions to be delayed; one study found that 22% of Medicaid-eligible women who had a second-trimester abortion would have terminated their pregnancy in the first trimester if Medicaid had covered abortion services.
    • p.23
  • A majority of providers charge more for medical abortion than for surgical abortion at six weeks. This may reflect the cost of the drug, the greater amount of counseling time required for medical abortion than for surgical abortion, the number of calls from clients with problems or questions, and the greater perceived need for active follow-up of medical abortion clients, to ensure that the abortion was completed without complications. As providers gain experience with early medical abortion, however, these services may become more routine, and the additional expenses for medical abortion could fall.
    • p.23
  • Picketing remains prevalent at abortion facilities, especially at those with large caseloads. Other types of harassment have declined over time but have not disappeared. This decrease may reflect the impact that federal legislation to protect access to medical facilities has had in deterring illegal antiabortion activity, as well as the fact that by September 2000, 15 states had laws protecting access to clinics that provide reproductive health services. Nevertheless, a majority of clinics reported being picketed at least 20 times a year, and many women seeking abortion are exposed to the stress of noisy and sometimes threatening protesters.
    • p.23

"When Abortion Became Illegal" (2019)[edit]

Jacobson, Donna (2019). "When Abortion Became Illegal". Connecticut History Review. 58 (2): 49–81.

  • Abortion was rarely prosecuted in the early nineteenth century. As historian Cornelia Dayton discussed in her study, “Taking the Trade: Abortion and Gender Relations in an Eighteenth-Century New England Village,” abortions did not go to trial unless extreme circumstances required judicial intervention. Ammi Rogers’s trial became an exception in the early nineteenth century due to his conviction of inducing an abortion following “quickening.” Connecticut state Statutes did not contain a penal code that referenced abortion after quickening; rather it had Acts related to bastardry and infanticide. Therefore Rogers was convicted in part for an undefined crime. Retroactively, the Connecticut General Assembly remedied this lack of legislation during their May 1821 session.
    Since its enactment, the interpretation of the 1821 law has been extensively examined. Yet the rogers trial and indictment has only been implicated in the law through various editions of his autobiography instead of the court and legislative arhical records. Historian James Mohr in his study, “Abortion in America: The Origins and Evolution of National Policy 1800-1900”, contended the Connecticut law paralleled an 1803 English statute, Lord Elenborough’s Act. Mohr’s analysis of the Connecticut anti-abortion law is only partially persuasive. In fact Lord Ellenborough’s Act criminalized abortion during all periods of the pregnancy while the Connecticut law only criminalized abortions after the quickening. Most importantly, Mohr did not account for the impact of the Rogers trial on the Connnecticut General Assembly in drafting the 1821 abortion legislation.
    • pp.51-52
  • Marvin Olasky’s work “Abortion Rites: A Social History of Abortion Rites in America” specifically referenced the Rogers trial in his analysis of the 1821 Connecticut anti-abortion law. Olasky disagreed with Mohr’s interpretation of a connection between Connecticut’s law and Lord Ellenborough’s Act. He argued Mohr “missed a crucial contributing cause of the Connecticut law, one that hit much closer to home for the state Legislature than any a parliament three thousand miles away had done eighteen years prior.” Even though Olasky’s thesis regarding the connection of the trial and legislation is correct, he overlooked key elements in the voluminous primary documents related to the Rogers conviction necessary for a thorough analysis of the relationship between trial and legislation. The Connecticut law was merely a small topic in Olasky’s overall study.
    • p.52
  • Swift has written one of the earliest and most prominent discourses on American law. Published in 1795, A System of the Laws of the State of Connecticut, is considered the first legal text that differentiated English and American Common law. Swift emphasized the importance of law not based on inference. Rather, he believed all laws “are always to be construed strictly, for the benefit of the subject.. Nothing more is to be deduced from the words, than what they expressly warrant, and they are not to be extended by implication.” Swift carefully constructed, “Administering Poison with Intent to Murder, or Cause Miscarriage” in the Crimes and Punishment Act to be strictly interpreted as written; to criminalize inducing an abortion following the quickening and not as a separate poison control measure for apothecaries.
    Swift’s judicial record on induced miscarriages is unclear prior to the 1821 legislation. Therefore, one must consider Swift’s treatise, “A System of the Laws of the State of Connecticut” as a direct extension of his ideology. In the treatise, Swift discussed the murder of a fetus cannot be treated as a murder, for the person ‘’must be actually in existence’’ [emphasis added]. This statement was consistent with the then accepted doctrine that a fetus was not viable until birth. We wrote, “to kill a child in its mother’s womb, is not murder, but a great misdemeanor’’ [emphasis added], but if the child be born alive, and then die by reason of injury it suffered in the womb, it will be murder in hum who caused it.” Therefore, induced abortion wasn’t classified as murder. An individual became culpable o murder if the fetus didn’t abort, was alive after birth, but consequentially died from injuries suffered during the attempted abortion.
    • p.72-73
  • Swift’s interpretation of abortion in “A System of Laws” reflected William Blackstone’s earlier treatise, “Commentaries on the Laws of England.” Blackstone explicitly cited that life began “as soon as tan infant is able to stir in the mother’s womb” and added if a woman “quick with child,” is poisoned, this “’’did not constitute murder but a heinous misdemeanor” [emphasis added]. The difference between Swift and Blackstone is the reference to poison by Blackstone. He wrote his judicial interpretation approximately thirty-fuve “years” prior to the 1803 Lord Ellenborough’s Act. Therefore, Swift, a renowned legal expect, had ample opportunities prior to 1821 to suggest the incorporation of either Lord Ellenborough’s Act of Blackstone’s “Commentaries’ to the Connecticut Legislature.”
    • p.73

“Mississippi Voters Reject Personhood Amendment By Wide Margin” (November 8, 2011)[edit]

Frank James, “Mississippi Voters Reject Personhood Amendment By Wide Margin”, NPR, November 8, 2011.

  • In the end it wasn't even close. The Mississippi "personhood" amendment on Tuesday's ballot which would have legally defined human life as beginning at the moment of fertilization failed and by a very wide margin.
    Mississippi voters soundly rejected the constitutional amendment, with 58 percent voting "no" and only 41 percent voting "yes."
  • Considered one of the nation's most conservative states Mississippi, many observers thought, would give the personhood amendment perhaps its best chance for passage anywhere in the U.S.
    Initially, it looked like the gamble might pay off, with support for the initiative running so strong that passage at one point was virtually taken as a given.
    But opponents of the proposed personhood amendment waged an aggressive counter campaign that raised all kinds of troubling prospects should the amendment become law.
    For instance, they warned that the amendment raised the possibility that miscarriages would need to be investigated. Besides abortion, some birth control methods would become illegal, they said.
    What's more, the personhood amendment threatened to criminalize doctors who provide in vitro fertilization services because many embryos are never successfully implanted but instead eventually destroyed.
  • As NPR's Julie Rovner reported for a Wednesday Morning Edition piece, supporters of so-called personhood amendments have now lost in Colorado as well as Mississippi.
    JULIE: Voters in Colorado had twice rejected similar amendments to declare that life begins legally at fertilization, in 2008 and 2010...
    ... Felicia Brown Williams is outreach director for Mississippians for Healthy Families, the group that successfully fought the amendment. She said from her group's victory party last night that there was no single reason voters turned against the measure.
    BROWN WILLIAMS: It was just a matter of making sure that the voters were informed; and when they were they came to our side.

"Lubbock votes to become largest city in U.S. to ban abortion" (May 1, 2021)[edit]

Samantha Jarpe, "Lubbock votes to become largest city in U.S. to ban abortion". “Everything Lubbock”, (Posted May 1, 2021/ Updated May 2, 2021).

  • Including Lubbock, 24 cities in Texas and two cities in Nebraska passed similar ordinances, according to pro-life activist and Right to Life East Texas Director Mark Lee Dickson. Before Lubbock, the largest city to pass a similar ordinance was Big Spring with an estimated population of 28,187 people.
    However, Lubbock is the only town with an active abortion clinic to pass the ordinance. Planned Parenthood opened a clinic in the city in October 2020 and began offering abortions April 15.
  • The ordinance declares abortion in city limits “at all times and at all stages of pregnancy” an act of murder.
    However, under the ordinance, an act doesn’t qualify as an abortion if it is done to save the life of the mother, remove a fetus whose death was the result of a miscarriage or remove an ectopic pregnancy.
  • After early voting results came in, the American Civil Liberties Union of Texas issued a statement and said it would continue to “fight to protect” the rights of Lubbock residents.
    “The ACLU has a long history of challenging unconstitutional abortion bans and will continue to fight to protect the fundamental rights of the people of Lubbock,” Drucilla Tigner, Policy & Advocacy Strategist at the ACLU of Texas, said.
    In the statement, a spokesperson for Planned Parenthood of Greater Texas said the Lubbock clinic would remain open and would follow legal restrictions as required.
  • The push to make Lubbock a “Sanctuary City for the Unborn” began after Planned Parenthood announced in August it would open a clinic in the city sometime in late 2020. The nonprofit previously had a Lubbock clinic until it closed in 2013.
    A month later, State Senator Charles Perry held a news conference at a Lubbock church and said he was working to get an ordinance passed that would make conducting abortions in the city punishable by a fine of $2,000.
    Perry said the ordinance, which was drafted by Dickson, would also create standing for family members of an aborted fetus to sue abortion providers for civil damages.
  • On October 14, the city released a statement and said the proposed ordinance was contrary to Texas law. On the same day, the city also announced that a petition to consider the ordinance had been submitted to the council.
    The petition had enough verified signatures to force a vote by city council on whether to adopt or reject the ordinance. A meeting was held November 17 and the council voted 7-0 to reject the proposed ordinance.
    After the vote, the committee behind the petition filed a request to put the ordinance to a vote and in December 2020, the city council approved a May 1, 2021 election date. According to estimates, the special election cost the city between $160,000 and $200,000 to hold.
  • In early 2020, the ACLU filed a lawsuit against seven Texas towns that passed similar ordinances outlawing abortion. The focus of the lawsuit, which was filed on behalf of two pro-choice groups in the state – was solely on the ordinances’ designation of organizations assisting women in getting abortions as “criminal organizations.”
    The ACLU later dropped the lawsuit after several cities amended their original ordinances to remove language declaring specific organizations as “criminal,” while still preserving a ban on abortion.

"Abortion Surveillance — United States, 2016" (November 29, 2019)[edit]

Jatlaoui, TC; Eckhaus, L; Mandel, MG; Nguyen, A; Oduyebo, T; Petersen, Emily; Whiteman, MK (November 29, 2019). "Abortion Surveillance — United States, 2016". MMWR. Surveillance Summaries. 68 (11): 1–41. doi:10.15585/mmwr.ss6811a1. ISSN 1546-0738. PMID 31774741.

  • Results: A total of 623,471 abortions for 2016 were reported to CDC from 48 reporting areas. Among these 48 reporting areas, the abortion rate for 2016 was 11.6 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 186 abortions per 1,000 live births. From 2015 to 2016, the total number of reported abortions decreased 2% (from 636,902), the abortion rate decreased 2% (from 11.8 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 1% (from 188 abortions per 1,000 live births). From 2007 to 2016, the total number of reported abortions decreased 24% (from 825,240), the abortion rate decreased 26% (from 15.6 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 18% (from 226 abortions per 1,000 live births). In 2016, all three measures reached their lowest level for the entire period of analysis (2007–2016).
  • In 2016 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates. In 2016, women aged 20–24 and 25–29 years accounted for 30.0% and 28.5% of all reported abortions, respectively, and had abortion rates of 19.1 and 17.8 abortions per 1,000 women aged 20–24 and 25–29 years, respectively. By contrast, women aged 30–34, 35–39, and ≥40 years accounted for 18.0%, 10.3%, and 3.5% of all reported abortions, respectively, and had abortion rates of 11.6, 6.9, and 2.5 abortions per 1,000 women aged 30–34, 35–39, and ≥40 years, respectively. From 2007 to 2016, the abortion rate decreased among women in all age groups.
    In 2016, adolescents aged <15 and 15–19 years accounted for 0.3% and 9.4% of all reported abortions, respectively, and had abortion rates of 0.4 and 6.2 abortions per 1,000 adolescents aged <15 and 15–19 years, respectively. From 2007 to 2016, the percentage of abortions accounted for by adolescents aged 15–19 years decreased 43%, and the abortion rate decreased 56%. This decrease in abortion rate was greater than the decreases for women in any older age group.
    (In contrast to the percentage distribution of abortions and abortion rates by age, abortion ratios in 2016 and throughout the entire period of analysis were highest among adolescents and lowest among women aged 25–39 years. Abortion ratios decreased from 2007 to 2016 for women in all age groups.
    In 2016, almost two-thirds (65.5%) of abortions were performed at ≤8 weeks’ gestation, and nearly all (91.0%) were performed at ≤13 weeks’ gestation. Fewer abortions were performed between 14 and 20 weeks’ gestation (7.7%) or at ≥21 weeks’ gestation (1.2%). During 2007–2016, the percentage of abortions performed at >13 weeks’ gestation remained consistently low (8.2%–9.0%). Among abortions performed at ≤13 weeks’ gestation, the percentage distributions of abortions by gestational age were highest among those performed at ≤6 weeks’ gestation (35.0%–38.4%).
  • In 2016, 27.9% of all abortions were performed by early medical abortion (a nonsurgical abortion at ≤8 weeks’ gestation), 59.9% were performed by surgical abortion at ≤13 weeks’ gestation, 8.8% were performed by surgical abortion at >13 weeks’ gestation, and 3.4% were performed by medical abortion at >8 weeks’ gestation; all other methods were uncommon (0.1%). Among those that were eligible for early medical abortion on the basis of gestational age (i.e., performed at ≤8 weeks’ gestation), 41.9% were completed by this method.
  • In 2016, women with one or more previous live births accounted for 59.0% of abortions, and women with no previous live births accounted for 41.0%. Women with one or more previous induced abortions accounted for 40.7% of abortions, and women with no previous abortions accounted for 59.4%.
  • In 2015, the most recent year for which data were reviewed for abortion-related deaths, two women were identified to have died as a result of complications from legal induced abortion and for one additional death, it was unknown whether the abortion was induced or spontaneous.
  • Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. After nationwide legalization of abortion in 1973, the total number, rate (number of abortions per 1,000 women aged 15–44 years), and ratio (number of abortions per 1,000 live births) of reported abortions increased rapidly, reaching the highest levels in the 1980s before decreasing at a slow yet steady pace. During 2006–2008, a break occurred in the previously sustained pattern of decrease, although this break has been followed in subsequent years by even greater decreases. Nonetheless, throughout the years, the incidence of abortion has varied considerably across subpopulations and remains higher in certain demographic groups than others. Continued surveillance is needed to monitor changes in the incidence of abortion in the United States.
  • Among the 48 reporting areas that provided data for 2016, a total of 623,471 abortions were reported. All 48 of these areas provided data every year during 2007–2016.§§ In 2016, these areas had an abortion rate of 11.6 abortions per 1,000 women aged 15–44 years and an abortion ratio of 186 abortions per 1,000 live births. From 2015 to 2016, the total number of reported abortions decreased 2% (from 636,902 to 623,471), the abortion rate decreased 2% (from 11.8 to 11.6 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 1% (from 188 to 186 abortions per 1,000 live births). From 2007 to 2016, the total number of reported abortions decreased 24% (from 825,240), the abortion rate decreased 26% (from 15.6 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 18% (from 226 abortions per 1,000 live births). Among these same 48 areas, the annual rate of decrease fitted from the regression analysis was greater during 2007–2011 than during 2012–2016 for abortion number and rate, whereas the annual rate of decrease was greater during 2012–2016 than during 2007–2011 for abortion ratio. During 2007–2011, the number of reported abortions decreased by 25,563 abortions per year, the abortion rate decreased by 0.50 abortions per 1,000 women per year, and the abortion ratio decreased by 2.2 abortions per 1,000 live births per year. During 2012–2016, the number of reported abortions decreased by 17,120 abortions per year, the abortion rate decreased by 0.36 abortions per 1,000 women per year, and the abortion ratio decreased by 5.4 abortions per 1,000 live births per year.
  • Abortion numbers, rates, and ratios for 2016 have been calculated by reporting area of occurrence and the residence of the women who obtained the abortions. By reporting area of occurrence, a considerable range existed in the abortion rate (from 3.0 abortions per 1,000 women aged 15–44 years in South Dakota to 21.8 abortions per 1,000 women in New York [city and state combined]) and the abortion ratio (from 38 abortions per 1,000 live births in South Dakota to 373 abortions per 1,000 live births in New York [city and state combined]). Similarly, a considerable range existed in the abortion rate by residence (from 4.2 abortions per 1,000 women aged 15–44 years in South Dakota to 20.7 abortions per 1,000 women aged 15–44 years in New York [city and state combined]) and the abortion ratio (from 54 abortions per 1,000 live births in South Dakota to 354 abortions per 1,000 live births in New York [city and state combined]). Because of variation that occurred among reporting areas in the percentage of abortions obtained by out-of-state residents (from 0.6% in Alaska and Arizona to 49.8% in Kansas), abortion rates and ratios calculated by maternal residence might provide a more accurate reflection of the state-specific distribution of women obtaining abortions. However, because states vary in the level of detail they collect on maternal residence, 12.4% of abortions were reported to CDC with unknown information on maternal residence.
  • Among the 46 areas that reported by maternal age for 2016, women in their 20s accounted for the majority (58.5%) of abortions and had the highest abortion rates (19.1 and 17.8 abortions per 1,000 women aged 20–24 and 25–29 years, respectively). Women in the youngest (<15 years) and oldest (≥40 years) age groups accounted for the smallest percentages of abortions (0.3% and 3.5%, respectively) and had the lowest abortion rates (0.4 and 2.5 abortions per 1,000 women aged <15 and ≥40 years, respectively). Among the 44 reporting areas that provided data by maternal age every year during 2007–2016, this pattern across age groups was stable, with the majority of abortions and the highest abortion rates occurring among women aged 20–29 years and the lowest percentages of abortions and abortion rates occurring among women in the youngest and oldest age groups. From 2007 to 2016, abortion rates decreased among all age groups, although the decreases for adolescents (67% and 56% for adolescents aged <15 and 15–19 years, respectively) were greater than the decreases for women in all older age groups. Decreases for women aged ≥20 years ranged from 4% among women aged ≥40 years to 35% among women aged 20–24 years. Decreases in the abortion rate for all age groups, except women aged 25–29 years and 30–34 years, were greater from 2012 to 2016 than from 2007 to 2011, and the rates for all age groups either did not change or decreased from 2015 to 2016.
    In contrast to the percentage of abortions and abortion rates, abortion ratios in 2016 were lowest among women aged 25–39 years. Among the 44 reporting areas that provided data by maternal age for every year during 2007–2016, abortion ratios decreased among women in all age groups. The abortion ratio decreased for all age groups from 2012 to 2016; however, from 2015 to 2016, abortion ratios only decreased for women aged ≥30 years.
  • Among the 43 areas that reported maternal age by individual year among adolescents for 2016, adolescents aged 18–19 years accounted for the majority (67.8%) of adolescent abortions and had the highest adolescent abortion rates (9.1 and 12.4 abortions per 1,000 adolescents aged 18 and 19 years, respectively). Adolescents aged <15 years accounted for the smallest percentage of adolescent abortions (2.6%) and had the lowest adolescent abortion rate (0.4 abortions per 1,000 adolescents aged 13–14 years). Among the 39 reporting areas that provided maternal age by individual year data for adolescents annually during 2007–2016, the percentage of abortions accounted for by adolescents aged 18 and 19 years increased, whereas the percentage of abortions accounted for by adolescents aged <18 years decreased. For adolescents of all ages, decreases in abortion rates ≥50% occurred from 2007 to 2016, and were generally greater from 2012 to 2016 than from 2007 to 2011. Decreases occurred among all adolescents from 2015 to 2016.
    In 2016, the abortion ratio for adolescents was highest among adolescents aged <15 years (694 abortions per 1,000 live births) and was lowest among adolescents aged ≥17 years (292, 295, and 249 abortions per 1,000 live births among adolescents aged 17, 18, and 19 years, respectively). During 2007–2016, abortion ratios decreased among adolescents of all ages.
  • Among the 41 areas that reported gestational age at the time of abortion for 2016, approximately two thirds (65.5%) of abortions were performed at ≤8 weeks’ gestation, and nearly all (91.0%) were performed at ≤13 weeks’ gestation. Fewer abortions were performed at 14–20 weeks’ gestation (7.7%) or at ≥21 weeks’ gestation (1.2%). Among the 33 reporting areas that provided data on gestational age every year during 2007–2016, the percentage of abortions performed at ≤13 weeks’ gestation decreased minimally from 91.5% to 90.9%. However, within this gestational age range, a shift occurred toward earlier gestational ages, with the percentage of abortions performed at ≤8 weeks’ gestation increasing 3% and the percentage of abortions performed at 9–13 weeks’ gestation decreasing 8%. For the entire period of analysis, abortions performed at >13 weeks’ gestation accounted for ≤9.0% of abortions.
    Among abortions performed at ≤13 weeks’ gestation and reported by individual week of gestation for 2016, 37.8% were performed at ≤6 weeks’ gestation. The percentage contribution to abortions performed at ≤13 weeks’ gestation was progressively smaller for each additional week of gestation: 19.4% were performed at 7 weeks’ gestation, and 3.0% were performed at 13 weeks’ gestation. Among the 33 areas that reported by exact week of gestation for abortions performed at ≤13 weeks’ gestation every year during 2007–2016, the highest percentage contributions were reported for abortions performed at ≤6 weeks’ gestation (35.0%–38.4%), and smaller percentages for each additional week of gestation were reported, with approximately 3.0% of abortions performed at 13 weeks’ gestation across the 10-year period.
  • Among the 43 areas that reported by method type for 2016 and included medical abortion on their reporting form, 59.9% of abortions were surgical abortions at ≤13 weeks’ gestation, 27.9% were early medical abortions (a nonsurgical abortion at ≤8 weeks’ gestation), 8.8% were surgical abortions at >13 weeks’ gestation, and 3.4% were medical abortions at >8 weeks’ gestation; other methods (intrauterine instillation and hysterectomy/hysterotomy) were uncommon (<0.1%). Among the 33 reporting areas that included medical abortion on their reporting form and provided these data for the relevant years of comparison (2007 versus 2016, 2007 versus 2011, 2012 versus 2016, and 2015 versus 2016), use of early medical abortion increased 14% from 2015 to 2016 (from 24.5% of abortions to 27.9%); from 2007 to 2016, use of early medical abortion increased 113% (from 13.1% of abortions to 27.9%). Increases in early medical abortion occurred both from 2007 to 2011 (from 13.1% of abortions to 19.7% [50% increase]) and from 2012 to 2016 (from 21.3% of abortions to 27.9% [31% increase]).
  • Among the 30 reporting areas that provided data by procedure and individual week of gestational age each year from 2011 to 2016, during which time several clinical guidelines and an FDA labeling change extended mifepristone use to 70 days’ gestation, the percentage of abortions at 9 completed weeks’ gestation that were reported as medical abortions increased. Although the percentage of abortions at 9 weeks’ gestation reported as medical abortions did not change substantially between 2011, 2012, 2013, and 2014 (5.0%, 5.7%, 6.7%, and 7.7%, respectively), this percentage increased to 13.0% in 2015 and 24.0% in 2016. Among the 43 areas that reported by method type for 2016 and included medical abortion on their reporting form, 30.2% were medical abortions performed at ≤9 weeks’ gestation. Among these same reporting areas that reported medical abortions by individual week of gestational age, 92.5% of the medical abortions performed at ≤9 weeks’ gestation were performed at ≤8 weeks, and the remaining 7.5% were performed at 9 weeks.
  • As a corollary to the increase that occurred in use of early medical abortion at ≤8 weeks’ gestation, use of surgical abortion at ≤13 weeks’ gestation decreased 23% from 2007 to 2016 (from 78.1% of abortions to 59.8%). Surgical abortion at >13 weeks’ gestation consistently accounted for approximately 8.0%–8.8% of all abortions, and all other methods combined consistently accounted for a limited percentage of abortions (1.1%–3.4%) during 2007–2016.
  • Among the 32 areas that reported cross-classified race/ethnicity data for 2016, non-Hispanic white women and non-Hispanic black women accounted for the largest percentages of all abortions (35.0% and 38.0%, respectively), and Hispanic women and non-Hispanic women in the other race category accounted for smaller percentages (18.8% and 8.2%, respectively). Non-Hispanic white women had the lowest abortion rate (6.6 abortions per 1,000 women aged 15–44 years) and ratio (109 abortions per 1,000 live births), and non-Hispanic black women had the highest abortion rate (25.1 abortions per 1,000 women aged 15–44 years) and ratio (401 abortions per 1,000 live births). Data for 2016 also are reported separately by race and by ethnicity.
  • Among the 19 areas that reported these data for the relevant years of comparison (2007 versus 2016, 2007 versus 2011, 2012 versus 2016, and 2015 versus 2016), abortion rates decreased substantially for the three largest race/ethnicity groups: for non-Hispanic white women, the abortion rate decreased 33% (from 9.4 abortions per 1,000 women in 2007 to 6.3 in 2016); for non-Hispanic black women, the rate decreased 29% (from 36.7 abortions per 1,000 women in 2007 to 26.2 in 2016); and for Hispanic women, the rate decreased 44% (from 21.2 abortions per 1,000 women in 2007 to 11.8 in 2016). For women in the three largest race/ethnicity groups, abortion rates decreased both from 2007 to 2011 and from 2012 to 2016, although the decreases were greater during the later period. From 2007 to 2011, the abortion rates decreased 15% for non-Hispanic white women (from 9.4 to 8.0 abortions per 1,000), 11% for non-Hispanic black women (from 36.7 to 32.5 abortions per 1,000), and 18% for Hispanic women (from 21.2 to 17.3 abortions per 1,000); by contrast, from 2012 to 2016, the abortion rates decreased 18% for non-Hispanic white women (from 7.7 to 6.3 abortions per 1,000), 13% for non-Hispanic black women (from 30.2 to 26.2 abortions per 1,000), and 24% for Hispanic women (from 15.6 to 11.8 abortions per 1,000).
  • Abortion ratios also decreased from 2007 to 2016 for the three largest race/ethnicity groups: for non-Hispanic white women, the abortion ratio decreased 29% (from 146 abortions per 1,000 live births in 2007 to 103 in 2016); for non-Hispanic black women, the ratio decreased 20% (from 517 abortions per 1,000 live births in 2007 to 416 in 2016); and for Hispanic women, the ratio decreased 26% (from 210 abortions per 1,000 live births in 2007 to 155 in 2016). From 2007 to 2011, abortion ratios decreased among non-Hispanic white women (10% from 146 abortion per 1,000 live births in 2007 to 131 in 2011) and non-Hispanic black women (3% from 517 abortions per 1,000 live births in 2007 to 504 in 2011), whereas abortion ratios increased among Hispanic women (2% from 210 abortion per 1,000 live births in 2007 to 214 in 2011). By contrast, from 2012 to 2016, abortion ratios decreased among all women in the three largest race/ethnicity groups. The abortion ratio decreased 18% for non-Hispanic white women (from 125 to 103 abortions per 1,000 live births), 11% for non-Hispanic black women (from 470 to 416 abortions per 1,000 live births), and 22% for Hispanic women (from 198 to 155 abortions per 1,000 live births).
  • Among the 42 areas that reported by marital status for 2016, 14.1% of all women who obtained an abortion were married, and 85.9% were unmarried. The abortion ratio was 41 abortions per 1,000 live births for married women and 380 abortions per 1,000 live births for unmarried women. Among the 29 reporting areas that provided these data for the relevant years of comparison (2007 versus 2016, 2007 versus 2011, 2012 versus 2016, and 2015 versus 2016), the percentage of abortions among unmarried women increased 3% from 2007 to 2016 (from 83.5% to 86.0%), with a larger increase from 2007 to 2011 (3%) than from 2012 to 2016 (<1%). Among unmarried women, the abortion ratio decreased 16% from 2007 to 2016 (from 390 to 326 abortions per 1,000 live births), with a larger decrease also occurring from 2012 to 2016 (10%) than from 2007 to 2011 (3%). Among married women, the abortion ratio decreased 31% from 2007 to 2016 (from 49 to 34 abortions per 1,000 live births), with similar decreases occurring from 2012 to 2016 (13%) and from 2007 to 2011 (14%).
  • Data from the 42 areas that reported the number of previous live births for women who obtained abortions in 2016 indicate that 41.0%, 45.1%, and 13.9% of these women had zero, one or two, or three or more previous live births, respectively (Table 16. Among the 35 reporting areas that provided these data for the relevant years of comparison (2007 versus 2016, 2007 versus 2011, 2012 versus 2016, and 2015 versus 2016), the percentage of women obtaining abortions with no previous live births or with one to two previous live births each decreased 2% from 2007 to 2016; by contrast, the percentage increased 16% for women with three or more previous live births over the same time period.
    Data from the 41 areas that reported the number of previous abortions for women who obtained abortions in 2016 indicate that the majority (59.4%) had no previous abortions, 34.4% had one or two previous abortions, and 6.3% had three or more previous abortions. Among the 34 reporting areas that provided data for the relevant years of comparison (2007 versus 2016, 2007 versus 2011, 2012 versus 2016, and 2015 versus 2016), the percentage of women who had no previous abortions increased 3% (from 57.4% to 59.1%), whereas a 4% decrease occurred among women who had one or two previous abortions, and a 4% decrease occurred among women who had three or more previous abortions from 2007 to 2016. However, the percentage of women who had no previous abortions decreased 1% from 2007 to 2011 (from 57.4% to 56.8%) and then increased 3% from 2012 to 2016 (from 57.6% to 59.1%). By contrast, the percentage of women who had three or more previous abortions increased 4% from 2007 to 2011 (from 6.8% to 7.1%) then decreased 6% from 2012 to 2016 (from 6.9% to 6.5%). The percentage of women who had one or two previous abortions increased 1% from 2007 to 2011 (35.8% to 36.1%) and then decreased 3% from 2012 to 2016 (from 35.5% to 34.5%).
  • In select reporting areas, abortions that were categorized by maternal race and race/ethnicity were further categorized by maternal age and by marital status. A consistent pattern existed for abortions by maternal age across all race/ethnicity groups, with the smallest percentage of abortions occurring among adolescents aged <15 years (0.2%–0.3%) and the largest percentage occurring among women aged 20–24 years (25.6%–31.1%) and 25–29 years (26.6%–30.2%). A consistent pattern also existed for abortions by marital status across all race/ethnicity groups, with a higher percentage of abortions occurring among women who were unmarried (68.1%–92.1%) than among those who were married (7.9%–31.9%) (Table 19). For abortions among married women, the percentage was higher for non-Hispanic women in the other race group (31.9%) than for non-Hispanic white women (16.8%), Hispanic women (15.3%), and non-Hispanic black women (7.9%). For abortions among unmarried women, the percentage was higher for non-Hispanic black women (92.1%) than for non-Hispanic white women (83.2%), Hispanic women (84.7%), and women in the non-Hispanic other race group (68.1%).
  • In select reporting areas, abortions that were categorized by weeks of gestation were further categorized by maternal age, and race/ethnicity. In every subgroup for these three characteristics, the largest percentage of abortions occurred at ≤8 weeks’ gestation. However, by maternal age, 42.8% of adolescents aged <15 years and 56.8% of adolescents aged 15–19 years obtained an abortion by ≤8 weeks’ gestation, compared with 63.7%–71.0% of women in older age groups. Conversely, 23.7% of adolescents aged <15 years and 12.4% of adolescents aged 15–19 years obtained an abortion after 13 weeks’ gestation, compared with 8.1%–9.1% for women in older age groups. By race/ethnicity, 59.8% of non-Hispanic black women obtained an abortion at ≤8 weeks’ gestation, compared with 67.5%–69.4% of women from other race/ethnicity groups. Differences in abortions after 13 weeks’ gestation across race/ethnicity groups were minimal (10.3% for non-Hispanic black women, compared with 8.2%–9.1% for women in the remaining race/ethnicity groups).
  • Among abortions categorized by weeks of gestation and method type, surgical abortion accounted for the largest percentage of abortions within every gestational age category. At ≤8 weeks’ gestation, surgical abortion accounted for a smaller percentage of abortions (58.1%) than at any other stage of gestation; at 9–20 weeks’ gestation, surgical abortion accounted for 89.6%–98.8% of all abortions, and at ≥21 weeks’ gestation, it accounted for 92.7% of abortions. By contrast, at ≤8 weeks’ gestation, medical abortion accounted for 41.9% of abortions then decreased to 10.4% at 9–13 weeks and 1.0%–2.6% at 14–20 weeks before increasing to 6.5% at ≥21 weeks. For each gestational age category, abortions performed by intrauterine instillation or hysterectomy/hysterotomy were rare (<0.1%–0.5% of abortions).
  • Using national PMSS data, CDC identified three abortion-related deaths for 2015, the most recent year for which data were reviewed for abortion-related deaths. Investigation of these cases indicated that two deaths were related to legal abortion, no deaths were related to illegal abortion, and for one death, whether the abortion was induced or spontaneous was unknown.
    The annual number of deaths related to legal induced abortion has fluctuated from year to year over the past 40 years. Because of this variability and the relatively limited number of legal induced abortion-related deaths every year, national legal abortion case-fatality rates were calculated for consecutive 5-year periods during 1973–2007 and for a consecutive 8-year period. The national legal induced abortion case-fatality rate for 2008–2015 was 0.58 legal induced abortion-related deaths per 100,000 reported legal abortions. This case-fatality rate was similar to the rate for most of the preceding 5-year periods but lower than the case-fatality rate of 2.09 legal induced abortion-related deaths per 100,000 reported legal abortions for the 5-year period (1973–1977) immediately following nationwide legalization of abortion in 1973.
  • For 2016, a total of 623,471 abortions were reported to CDC by 48 areas. Among these areas, the abortion rate was 11.6 abortions per 1,000 women aged 15–44 years and the abortion ratio was 186 abortions per 1,000 live births. All 48 of these reporting areas submitted data every year during the period of analysis from 2007 to 2016, thus providing the information necessary for evaluating trends. Among these areas, the number and rate of reported abortions decreased 2%, and the abortion ratio decreased 1% from 2015 to 2016, which, in combination with decreases that occurred during previous years (11–15), resulted in the lowest values for all three measures for the entire period of analysis. Among areas that reported by age every year of the analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas decreases in the abortion rate were greater for adolescents aged <20 years than for any other age group. In addition, throughout the period of analysis, ≤9% of abortions each year were performed after 13 weeks’ gestation; approximately two thirds of abortions were performed at ≤8 weeks’ gestation, and this percentage increased from 63.7% in 2007 to 65.3% in 2016. Among areas that included medical abortion on their reporting form every year, the percentage of all abortions performed by early medical abortion (a nonsurgical abortion at ≤8 weeks’ gestation) increased from 13.1% in 2007 to 27.9% in 2016.
  • These findings underscore important maternal age differences in abortion trends. Because of the high rate and proportion of abortions that occurred among women in their 20s, women in this age group have contributed substantially to overall changes. Conversely, during 2007–2016, women aged ≥40 years had consistently low abortion rates and accounted for a limited percentage of abortions (≤3.7%); therefore, they have had a much smaller contribution to overall abortion trends. Nonetheless, among women aged ≥40 years, the abortion ratio continues to be higher than among women aged 25–39 years, indicating that unintended pregnancy is a problem that women encounter throughout their reproductive years.
    The adolescent abortion trends described in this report are important for monitoring progress that has been made toward reducing adolescent pregnancies in the United States. National birth data indicate the birth rate for adolescents aged 15–19 years in 2016 decreased 51% since 2007, compared with a 43% decrease in the abortion rate for adolescents aged 15–19 years during the same period. These findings indicate that decreases in adolescent pregnancies in the United States have been accompanied by large decreases both in adolescent births and abortions and that the pattern of decline is continuing.
  • The findings in this report indicate that although the number, rate, and ratio of reported abortions have decreased across all race/ethnicity groups, well-documented disparities exist. In this report, abortion rates and ratios remained 1.8 and 1.4 times higher, respectively, for Hispanic women than for non-Hispanic white women, and 3.8 and 3.7 times higher, respectively, for non-Hispanic black women than for non-Hispanic white women. The comparatively high abortion rates and ratios among non-Hispanic black women have been attributed to higher unintended pregnancy rates and a greater percentage of unintended pregnancies ending in abortion.
  • The findings in this report indicate the majority of women obtaining abortions do so early in gestation (≤8 weeks), when the risks for complications are lowest. Among the areas that reported gestational age data every year during 2007–2016, the percentage of abortions performed at ≤8 weeks’ gestation increased 3%. Moreover, among the areas that reported abortions at ≤13 weeks’ gestation by individual week, the distribution continued to shift toward earlier weeks of gestation, with the percentage of early abortions performed at ≤6 weeks’ gestation increasing 8% from 2007 to 2016. Nonetheless, the overall percentage of abortions performed at ≤13 weeks’ gestation did not change appreciably from 2007–2016. Reports indicate that abortions at later gestational ages are more common among certain groups of women; among women in this report, the percentage of adolescents aged ≤19 years who obtained abortions at ≤8 weeks’ gestation was smaller than the percentage of women in other age groups who obtained abortions at the same gestational age. Because procedures performed at earlier gestational ages have a lower risk for complications, a better understanding of factors that influence the gestational age at which abortions are performed is needed.
  • The trend of obtaining abortions earlier in pregnancy has been facilitated by changes in abortion practices. Research conducted in the United States during the 1970s indicated that surgical abortion procedures performed at ≤6 weeks’ gestation, compared with 7–12 weeks’ gestation, were less likely to result in successful termination of the pregnancy. However, subsequent advances in technology (e.g., improved transvaginal ultrasonography and sensitive pregnancy tests) have allowed very early surgical abortions to be performed with completion rates exceeding 97%. Likewise, the development of early medical abortion regimens has allowed for abortions to be performed very early in gestation, with completion rates for regimens that combine mifepristone and misoprostol reaching 96%–98% . In 2016, 65.5% of all reported abortions were performed at ≤8 completed weeks’ gestation; thus, the women receiving these abortions were eligible for early medical abortion (a nonsurgical abortion at ≤8 weeks’ gestation) on the basis of gestational age. Among those abortions performed at ≤8 weeks’ gestation in 2016, 41.9% were reported as medical abortions. From 2007 to 2016, the proportion of all abortions reported as early medical abortion increased from 13.1% to 27.9%, respectively. Moreover, in addition to abortions meeting the definition of early medical abortion, the percentage of abortions at 9 completed weeks’ gestation that were reported as medical abortions has increased in recent years (from 5.0%–13.0% during 2011–2015 to 24.0% in 2016). On the basis of evidence that early medical abortion is safe and effective beyond 63 days’ gestation, professional clinical practice guidelines were updated midyear in 2013 and 2014 to extend the gestational age eligibility for early medical abortion from 63 to 70 days (≤9 completed weeks). In early 2016, FDA updated its approval for use of mifepristone for early medical abortions, extending the gestational age limit to 70 days.
  • Because the annual number of deaths related to legal induced abortion is small and statistically unstable, case-fatality rates were calculated for consecutive 5-year periods during 1973–2007 and for a consecutive 8-year period during 2008–2015. The national legal induced abortion case-fatality rate for 2008–2015 was fewer than 1 per 100,000 abortions, as it was for all of the preceding 5-year periods since the late 1970s.
  • Approximately 18% of all pregnancies in the United States end in induced abortion. Multiple factors influence the incidence of abortion, including access to health care services and contraception; the availability of abortion providers; state regulations, such as mandatory waiting periods, parental involvement laws, and legal restrictions on abortion providers; increasing acceptance of nonmarital childbearing; shifts in the race/ethnicity composition of the U.S. population; and changes in the economy and the resulting impact on fertility preferences and use of contraception. However, despite the multiple influences on abortion, because unintended pregnancy precedes nearly all cases of abortions, efforts to help women avoid pregnancies that they do not desire may reduce the number of abortions.

"Abortion rate at lowest level since 1973" (February 2, 2014)[edit]

Jayson, Sharon (February 2, 2014). "Abortion rate at lowest level since 1973". USA Today. Retrieved February 3, 2014.

  • "A 13% percent drop over a three-year time period is a pretty steep decline. It's unusual," says Rachel Jones, the lead author of the study by Guttmacher, a research organization that supports the right to legal abortion and seeks to expand access to information on sexual and reproductive health.
    Jones attributes the decline to more women using "highly effective contraceptive methods such as the IUD" and the fact that the study period was during the recession and sluggish recovery.
    "Births have been falling for awhile, and the recession certainly accelerated the decrease in births," says economist Ted Joyce of Baruch College in New York, who has studied reproductive health since 1985.
    "When you consider the changes in contraception and the largest recession since the Great Depression, those two factors seem like compelling explanations for the decline," he says.
  • Guttmacher's analysis this year is the first to study state restrictions, many of which increased beginning in 2011. The report says states enacted 205 abortion restrictions between 2011 and 2013, more than in the entire previous decade combined. However, the 2008-11 study period doesn't include that surge because many restrictions didn't take effect until late 2011 or later. During the study period, 106 new abortion restrictions were implemented.
    "We didn't find any clear associations between abortion restrictions and declines in abortion rates," Jones says. "We saw drops in abortions in the states that had restrictions, but they were not substantially bigger than what we saw in other states."
    "No evidence was found that the overall drop in abortion incidence was related to the decrease in providers or to restrictions implemented between 2008 and 2011," the report says.
  • Randall O'Bannon, of the National Right to Life Committee in Washington, D.C., which opposes abortion, views the new report as "significant progress."
    "We're seeing some tangible results," he says. "Obviously, we have had some impact."
  • Whether the next report in three years will reflect continued declines depends on how the courts rule on state laws that would effectively restrict access to abortion providers, economist Joyce says.
    "The courts haven't ruled whether these are constitutional," he says. "It really depends on whether those more serious restrictions go into effect. If they do, you're likely to see an increased decline in abortion rates."
  • An estimated 239,400 early medication abortions were performed in 2011, representing 23% of all non-hospital abortions, an increase from 17% in 2008, the report says.

"Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008" (10 May 2016)[edit]

Jerman, Jenna; Jones, Rachel K.; Onda, Tsuyoshi (10 May 2016). "Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008" – via www.guttmacher.org.

  • Abortion is common in the United States and is a critical component of comprehensive reproductive health care. However, information about individuals who have abortions is limited. For example, population-based surveys, which are used to obtain information about many aspects of reproductive and sexual health, do not adequately measure the prevalence of abortion, and only about half of abortions provided in the United States are captured by these types of surveys. While the Centers for Disease Control and Prevention (CDC) publishes annual abortion statistics, including selected demographic characteristics of abortion patients, this information is limited and incomplete, as it is collected from individual state health departments with variable abortion-reporting requirements. For example, the CDC does not report abortion data from California, New Hampshire or Rhode Island, and the accuracy of abortion information can vary substantially by state over time. To address these limitations, the Guttmacher Institute periodically collects information from U.S. abortion patients, and the results of the most recent survey are summarized in this report.
  • The abortion rate declined 13% between 2008 and 2011, and while there is little evidence to suggest that the state abortion regulations passed during that time period were responsible for the drop in abortions, restrictions passed in some states in more recent years have been particularly onerous. These include waiting periods that may require patients to visit the clinic twice, requirements that abortion clinics meet the standards of ambulatory surgical centers or acquire hospital admitting privileges for their clinicians, and bans on the use of private insurance and plans purchased through state exchanges to pay for abortion services.
  • The proportion of abortions accounted for by adolescents declined significantly between 2008 and 2014—by 32%. In particular, the proportion accounted for by 15–17-year-olds declined 44% over this period, and that among 18–19-year-olds dropped by 25%. The 2014 abortion index of 0.4 for the former group indicates that they were substantially underrepresented among abortion patients relative to their representation in the larger population of women.
  • Relationship status can be a proxy for exposure to sexual activity, and can also influence individuals’ and couples’ childbearing goals. The distribution of abortion patients and abortion indices varied by relationship status. About 14% of abortion patients were married, and an additional 31% were cohabiting. A slight majority were not living with a partner in the month they became pregnant (46% had never married and 9% had been previously married).
    The 2014 abortion index of 0.4 for married patients indicates that they were substantially underrepresented among abortion patients relative to all women of reproductive age. Cohabiting women were overrepresented by a factor of 2.1, meaning they had an abortion rate twice the national average. The abortion index for never-married, noncohabiting patients was slightly higher than average. The abortion indices for most relationship statuses remained unchanged from 2008, with the exception of that for cohabiting women, which declined from 2.6 to 2.1.
  • Disparities in reproductive health outcomes by race and ethnicity are well documented,18–20 and may be an important indicator of systemic barriers to preventive services. No racial or ethnic group made up the majority of abortion patients in 2014. Overall, 39% were white, 28% black, 25% Hispanic, 6% Asian or Pacific Islander, and 3% of other background. The racial and ethnic composition of patients was quite similar in 2008.
  • Educational goals are often cited as a reason to delay childbearing, as many individuals wish to complete their schooling and better position themselves economically before having children.21 In 2014, some 9% of abortion patients aged 20 or older had less than a high school degree, and the overwhelming majority—91%—had graduated from high school; more than one in five had a college degree. The proportion of patients aged 20 or older who had not graduated from high school declined significantly over the six-year period (from 12% to 9%).
  • How individuals achieve their desired family size—including the timing and spacing of any births—is often part of a complicated calculus, and decisions regarding pregnancy outcomes are made in the context of existing and planned children. In 2014, it continued to be the case that the majority of abortion patients (59%) had had at least one previous birth, including one-third who had had two or more; 41% of abortion patients had had no prior births. These proportions were largely unchanged from 2008.
  • Over the last few decades, abortion and unintended pregnancy have become increasingly concentrated among poor patients. This trend continued through 2014, when there was a significant increase in the proportion of abortion patients accounted for by this group: Forty-nine percent of patients had family incomes of less than 100% of the federal poverty level, while 42% were in this group in 2008. An additional 26% of patients in 2014 had incomes that were 100–199% of the poverty threshold. (We refer to patients in the lowest and middle categories as poor and low income, respectively.) The increase in poor abortion patients was countered by a decrease in the proportion of patients in the highest income group (200% or more of the federal poverty level), from 31% to 25% over the six-year period.
  • The majority of abortion patients indicated a religious affiliation: Seventeen percent identified as mainline Protestant, 13% as evangelical Protestant and 24% as Roman Catholic, while 8% identified with some other religion. Thirty-eight percent of patients did not identify with any religion. The proportion of women who identified as mainline Protestant declined by 24% since 2008, whereas the proportion with no affiliation increased by 38%. The proportion identifying as Catholic decreased by 15% from the earlier survey, though this change was only marginally significant.
    The abortion index for Catholic women showed that their relative abortion rate was nearly the same as that for all women (1.1). Mainline Protestants were slightly underrepresented among abortion patients (0.8), while evangelical Protestants had an abortion rate that was half of the national average. Patients with no affiliation were overrepresented among abortion patients, having a relative abortion rate of 1.8. The abortion index had declined slightly for mainline Protestants, and had increased slightly for those with no affiliation.
  • Unintended pregnancy is not limited to heterosexual women. Sexual minority women may have an elevated risk for unintended pregnancy because of differences in sexual health knowledge or behaviors, or because of a higher prevalence of risk factors such as previous exposure to abuse. The vast majority of abortion patients identified as heterosexual or straight (94%). Four percent of patients said they were bisexual, while only 1% identified as “something else” and 0.3% as homosexual, gay or lesbian. Respondents who indicated “something else” could write in a more specific response; 12 of the 81 who answered affirmatively indicated “pansexual,” which was the only response provided by more than one respondent.
  • While fewer abortion patients were uninsured in 2014 than in 2008, there were no significant changes in how patients paid for their abortions. Regardless of insurance coverage, 53% of patients reported that they paid for the abortion themselves. Medicaid was the second-most-common method of payment, reported by 24% of patients; the overwhelming majority of these patients (96%) lived in the 15 states that allow state funds to be used to pay for abortions (not shown). Fifteen percent of patients reported that they used their private insurance to pay for the procedure, and 14% relied on some type of financial assistance. Notably, most patients with private health insurance (61%) paid out of pocket for their abortion (not shown). Eight percent relied on more than one payment method, most commonly paying themselves and getting financial assistance. While there were shifts in type of payment between 2008 and 2014—in particular, a decrease in the proportion who were self-paying and an increase in reliance on Medicaid—the changes were not statistically significant.
  • In many ways, abortion patients in 2014 were quite similar to those in 2008. As in the earlier survey, the majority of patients were in their 20s, unmarried and nonwhite, and had graduated high school, had at least one previous birth and had a religious affiliation. However, smaller proportions of patients in 2014 were adolescents and were uninsured, and a larger proportion were poor.
    The percentage of abortion patients accounted for by adolescents has been declining for decades, but the 32% drop between 2008 and 2014 was particularly notable. A comparable drop was seen in the teenage birthrate, which declined 40% during this period, meaning that fewer teenagers were getting pregnant in 2014 than in 2008. There were no significant changes in sexual activity or contraceptive use patterns among adolescents during this time period, and economists speculate that increased educational opportunities, the media and the economy may have influenced these trends. Understanding the reasons behind these declines could have important policy implications, and more research is needed to better understand the range of factors influencing these patterns.
  • Poor women continue to account for a disproportionate share of abortion patients, and this representation increased from 42% to 49% over the six-year period, mostly driven by an increase in the population of women of reproductive age who are poor. The abortion index for poor women changed little, and disparities in abortion rates by income did not increase between 2008 and 2014. Still, it is now the case that 75% of abortion patients are low income, having family incomes of less than 200% of the federal poverty level.

"U.S. Abortion Attitudes Remain Closely Divided" (June 11, 2018)[edit]

Jeffrey Jones (June 11, 2018). "U.S. Abortion Attitudes Remain Closely Divided". Gallup.

  • Although there has been some variation in past years, Americans have typically been closely split on whether they consider themselves pro-choice or pro-life, particularly since 2000, when the averages have been 47% pro-choice and 46% pro-life. During the 1990s -- when Gallup first asked the question -- more Americans personally identified as pro-choice than as pro-life by 51% to 40%, on average.
  • When asked more specifically about their views on the legality of abortion, half of Americans adopt a middle-of-the-road position, saying abortion should be legal "only under certain circumstances." Americans with more absolute positions tend to come down on the side of abortion being legal under any circumstances (29%) than being illegal in all circumstances (18%).
    Historically, Americans have been most likely to favor the middle position -- abortion being legal under certain circumstances. Rarely has the percentage saying abortion should sometimes be legal fallen below 50%, averaging 53% since it was first asked in 1975.
    There has been a slight uptick in the percentage saying abortion should always be legal, from 21% in 1975 -- two years after the Roe v. Wade decision legalized abortion nationwide -- to 29% today. This percentage has varied in the interim, peaking at 33% in 1991, 1994 and 1995, but reverting to 21% as recently as 2009, and averaging 27%.
    In the 1975 poll, 22% of Americans said abortion should be illegal in all circumstances. The 18% who currently hold this view matches the average over the past 43 years.
  • Although close to eight in 10 Americans believe abortion should be legal in all or some circumstances, further probing of their attitudes finds the public favoring more restrictive rather than less restrictive laws. In a follow-up question asked of those in the middle "legal under certain circumstances" group, most of these respondents say it should be legal "only in a few" rather than in "most" circumstances.
    The result is that 43% of Americans say abortion should be legal in all (29%) or most (14%) circumstances, while a majority of 53% say it should be legal in only a few (35%) or no circumstances (18%). No fewer than 51% of Americans have favored more restrictive abortion laws since 1994, when Gallup first asked the follow-up probe of those saying abortion should be legal under certain circumstances.
  • Since Gallup first measured attitudes about the morality of abortion in 2001, an average of 41% have regarded it as acceptable and 49% as wrong. Though attitudes have fluctuated, at no point have more Americans said abortion is morally acceptable than have said it is morally wrong.
  • Abortion has long been a divisive issue in U.S. politics, and Americans are no closer to reaching a consensus on it than they were in the initial years after the practice became legal in the U.S. more than 40 years ago.
  • While relatively few Americans appear to favor making abortion illegal, a slim majority appear sympathetic to taking steps to limit the circumstances under which abortions are permitted.

"Patterns in socioeconomic characteristics of women obtaining abortions in 2000–2001" (2002)[edit]

Jones RK, Darroch JE and Henshaw SK, "Patterns in socioeconomic characteristics of women obtaining abortions in 2000–2001", “Perspectives on Sexual and Reproductive Health”], 2002, 34(5):226–235

  • Abortion is a common experience among U.S. women. Nevertheless, because abortion is a sensitive topic for many people, it is commonly underreported in national surveys, and representative information about women who have abortions is limited. Most states and the District of Columbia collect data on the characteristics of women who have abortions as part of their vital statistics systems; the Centers for Disease Control and Prevention (CDC) tabulates and publishes these data in summary form. However, this information is limited to a few basic demographic characteristics.
    Accurate national information describing women who have abortions may dispel, or confirm, stereotypes that arise when people are reluctant to talk openly about their abortion experiences. In addition, given that abortion rates decreased throughout the 1990s, identifying the groups of women in which the decrease was below average or in which no decrease occurred can help policymakers and family planning providers determine which groups of women at which point in their lives need greater assistance preventing unintended pregnancies.
  • Between 1994 and 2000, the abortion rate fell by 11%, from 24 to 21 per 1,000 women aged 15-44; in 2000, 25% of all pregnancies (excluding miscarriages) ended in abortion. Subgroups of women varied, often dramatically, in their rates of abortion, reflecting differences in rates of pregnancy and in the proportions of pregnancies ending in abortions.
    Age. Almost one in every five women (19%) who had an abortion in 2000-2001 were adolescents, more than half (56%) were in their 20s and a quarter (25%) were 30 or older. The proportion aged 15-19 had decreased slightly, from 21% in 1994. Most teenagers having abortions in both years were aged 18-19 (12% of all women having abortions), while only 1% were younger than 15.
    Women aged 20-24 have a higher abortion rate than any other age-group (47 abortions per 1,000), and women aged 40 or older have an exceptionally low rate (four per 1,000). Adolescents also have a higher-than-average abortion rate—25 per 1,000 women aged 15-19. The relatively high adolescent abortion rate is largely attributable to a high level of abortion among women aged 18-19 (39 per 1,000); the rate among 15-17-year-olds is 15 per 1,000.
  • Two-thirds of women having abortions in 2000 had never been married, one in six were currently married and another one in six were separated, divorced or widowed when they became pregnant. The proportion of women having an abortion who had never been married increased from 64% in 1994 to 67% in 2000.
  • Despite their high pregnancy rate (99 per 1,000), married women have a low abortion rate because they carry the overwhelming majority of their pregnancies (92%) to term. Previously married and never-married women are much less likely than married women to become pregnant, but more than four out of 10 of their pregnancies end in abortion.
  • Although 19% of unmarried U.S. women aged 15-44 are living with their partners, these women accounted for 31% of abortions among unmarried women in 2000, up from 21% in 1994. Abortion rates changed little for unmarried, cohabiting women between 1994 and 2000, following a steep rate of decline in their abortion rates between 1987 and 1994. Rates declined substantially (20%) among unmarried women who were not cohabiting between 1994 and 2000. The 1994-2000 pattern represents a dramatic slowdown in the rate of decrease among cohabiting women and an increasing rate of decline for noncohabiting, unmarried women. In all three years, cohabiting women had high abortion rates.
  • A large proportion (73%) of all women having abortions had been pregnant before: Some 48% had had a previous abortion, including 36% who had experienced both a previous birth and an abortion and 12% who had experienced only a previous abortion. It is also worth noting that 52% of women having abortions in 2000 intended to have (more) children in the future, and 22% were unsure of their birth intentions (not shown).
  • Abortion services are concentrated in cities, so it is often easier for women residing in metropolitan counties to obtain these services. Nine in 10 women obtaining abortions reside in metropolitan areas, compared with eight in 10 women aged 15-44. Women in metropolitan counties and those in nonmetropolitan counties had similar rates of decline in abortion between 1994 and 2000, but the abortion rate among women living in metropolitan counties in 2000 was still twice that among women residing in nonmetropolitan counties (24 vs. 12 per 1,000).
  • Poverty. Women with incomes below 200% of poverty made up 30% of all women of reproductive age, but accounted for 57% of all women having abortions in 2000: Twenty-seven percent of abortions were obtained by women living below the poverty line, and another 31% by women with incomes of 100-199% of poverty. The concentration of economically disadvantaged women among those having abortions was greater in 2000 than in 1994, when 50% of women obtaining abortions had incomes of less than 200% of poverty.
  • Medicaid. About one-quarter of women obtaining abortions were covered by Medicaid for general health care. The abortion rate among all women with Medicaid coverage (57 per 1,000) was three times the rate among women not covered by Medicaid. Between 1994 and 2000, the abortion rate among Medicaid recipients increased, whereas the rate among women who were not receiving Medicaid declined.
    The increase in abortion rates among women with Medicaid coverage between 1994 and 2000 was an abrupt change from the 1987-1994 period, when abortion rates for this group declined substantially. Women with Medicaid coverage in 1987 had 71 abortions per 1,000, and by 1994 this rate had decreased by 29%, a decline that was larger than that for women with no Medicaid coverage.
  • Race/ethnicity. Of women obtaining abortions, 41% were non-Hispanic white, 32% were non-Hispanic black and 20% were Hispanic. The remaining women were Asian or Pacific Islander (6%) or Native American (1%). Between 1994 and 2000, the proportion of women obtaining abortions who were Asian or Pacific Islander increased.
    The lowest abortion rate of all the racial and ethnic groups examined was among white women (13 per 1,000), while the highest rate was among black women (49 per 1,000). Hispanic and Asian women had abortion rates slightly higher than average (33 and 31 per 1,000, respectively). Between 1994 and 2000, abortion rates fell for all groups but Asians; the drop was largest (20%) among white women.
    White women also had a lower pregnancy rate than any of the other racial or ethnic groups and, with only 18% of pregnancies ending in abortion, were the most likely to carry their pregnancies to term.
    Black women's high abortion rate reflects both their high pregnancy rate and the high proportion of conceptions (43%) that ended in abortion. Hispanic women had the highest pregnancy rate of all the racial and ethnic groups (132 per 1,000); one-quarter of pregnancies ended in abortion.
  • Education. Among women aged 20 or older, those who had not graduated from high school accounted for 13% of abortions. High school graduates made up 30% of women having an abortion, and those with at least some college, 57%.
    The abortion rate among college graduates (13 per 1,000) was lower than average; moreover, women with college degrees were the only educational group to show a higher-than-average decline in abortion rates (30%) between 1994 and 2000. The relatively small proportion of pregnancies among college graduates that ended in abortion (21%) and the below-average pregnancy rate account for their low abortion rate. Women with some college had a pregnancy rate that was lower than average, but 38% of their pregnancies ended in abortion in 2000, resulting in the highest abortion rate of any educational group (26 per 1,000).
  • Religious affiliation. The majority of women older than 17 who obtained an abortion reported a religious affiliation. The highest proportion (43%) identified themselves as Protestant. Twenty-seven percent of women having an abortion identified themselves as Catholic, and 8% as a member of another religion; 22% reported no religious affiliation. Thirteen percent identified themselves as "born-again" or evangelical, three-fourths of whom were Protestant (not shown).
    Women affiliated with "other" religions and those who did not identify with any religion had the highest abortion rates (31 and 30 per 1,000, respectively). Women with no religious affiliation experienced the largest decline in abortion of all the groups examined (35%).
  • Information gathered from this nationally representative sample reveals that the typical woman having an abortion is between the ages of 20 and 30, has never married, has had a previous birth, lives in a metropolitan area, and is economically disadvantaged and Christian. However, women who have abortions are diverse, and unintended pregnancy leading to abortion is common in all population subgroups.
    Although the national abortion rate decreased by 11% between 1994 and 2000, not all population groups participated equally in the decline, and some groups experienced increases. As a result, women having abortions are increasingly those who are never-married, low-income, nonwhite and Hispanic, and have already had at least one child.
    Birthrates changed little between 1994 and 2000, and limited data suggest that no change occurred in the proportion of births that were unintended. Information from women who gave birth in 17 states in 1999 reveals that between one-third and one-half of these births were unintended. Comparable information gathered in nine of the states in 1993 suggests that the proportion of births that were unintended changed little between 1993 and 1999. If these dynamics apply to all women, then the decrease in abortion between 1994 and 2000 reflects decreases in both the overall rate of unintended pregnancy and the proportion of women with unintended pregnancies who have abortions.
  • Abortion rates among adolescents have been declining since the late 1980s. Parental involvement laws for minors took effect in eight states between 1994 and 2000. It is unlikely that these restrictions account for much of the decline in adolescent abortion rates during this time period because these states account for only 17% of female adolescents, and abortion rates also declined during this time period for other groups not affected by such restrictions. The pregnancy rate for adolescents aged 15-19 fell from 91 per 1,000 in 1994 to about 72 per 1,000 in 2000. The proportion of adolescent pregnancies ending in abortion was similar in both years—35% in 1994 and 34% in 2000, indicating that adolescent abortion rates did not decline between 1994 and 2000 because more teenagers were carrying their pregnancies to term. The decline in adolescent pregnancy may be a continuation of a trend toward more consistent use of contraceptives and use of more effective methods as well as decreases in sexual activity among at least some subgroups.
  • Economically disadvantaged women, who had high abortion rates in both 1994 and 2000, were the only group we examined whose abortion rate increased substantially during this period. Given that poverty is susceptible to measurement error, actual changes in abortion rates by poverty status may have been less drastic than our analysis suggests. Nonetheless, our findings demonstrate that abortion rates increased for economically disadvantaged women and women on Medicaid, while they decreased for middle- and higher-income women.
  • The decline in the number of women covered by Medicaid, and the parallel increase in the number with no insurance, was not accompanied by increased funding for free or low-cost family planning services. In fact, funding for Title X, the largest source of public funding for contraceptive services for women not covered by Medicaid, remained stable between 1994 and 1999 once inflation is taken into account. As a result, economically disadvantaged women may have had more difficulties accessing family planning services during this time period.
  • Black and Hispanic women are more likely than white women to be economically disadvantaged, and this partially explains their higher abortion rates. Within all three racial and ethnic groups, there is a clear association between poverty status and abortion, the abortion rate being higher among poor and low-income women than among those with incomes greater than 200% of poverty. However, economic status, as measured by poverty status, does not explain all the differences between racial and ethnic groups. Except in the lowest poverty-status group, black women have the highest abortion rates, followed by Hispanic women, and the lowest rates occur among white women. In 1994, the higher abortion rate among black women reflected primarily a rate of unintended pregnancy much higher than those among white and Hispanic women, as well as a somewhat higher proportion of unintended pregnancies ending in abortion. Black, Hispanic and white women at risk of unintended pregnancy have roughly similar levels of contraceptive use, but nonpoor black women using reversible methods have higher levels of contraceptive failure than do similar white and Hispanic women. Thus, the high levels of abortion among black women across economic statuses also point to a need for greater assistance in preventing unintended pregnancies.

“Contraceptive Use Among U.S. Women Having Abortions in 2000-2001” (November/December 2002)[edit]

Rachel K. Jones, Jacqueline E. Darroch, Stanley K. Henshaw; “Contraceptive Use Among U.S. Women Having Abortions in 2000-2001” Volume 34, Issue 6, (November/December 2002)

  • Some 45 of every 1,000 women aged 15–44 in the United States had an unintended pregnancy in 1994 (the latest year for which data are available). The high level of unintended pregnancy can be attributed to three factors: the failure of couples at risk of unintended pregnancy to practice contraception, incorrect or inconsistent use of contraceptive methods, and method failure among those practicing contraception correctly and consistently.
    Approximately one-half of unintended pregnancies end in abortion. A substantial minority of women having abortions—42% in 1994–1995 and 49% in 1987—became pregnant because they and their partners were not using a contraceptive method. It is unknown, however, what proportion of pregnancies among method users were due to inconsistent or incorrect contraceptive use and what proportion were accounted for by method failure.
    • p.294
  • More than half of women obtaining abortions in 2000 (54%) had been using a contraceptive method during the month they became pregnant. This figure is slightly lower than the proportion of women having abortions in 1994 who had been contraceptive users (58%), but slightly higher than the proportion reported in 1987 (51%). In 2000, approximately 15% of women had been using the most effective methods—1% used long-acting methods (sterilization, the IUD, implants or injectables) and 14% the pill. Twenty-eight percent of all women having abortions had used the male condom, down from 32% in 1994 (the only method to decline by more than three percentage points). Withdrawal and periodic abstinence had been used by roughly one in 10 women having abortions.
    • p.296
  • Women using no contraceptive method made up a larger proportion of women having abortions than of all women at risk of unintended pregnancy (46% vs. 7%), mainly because the likelihood of pregnancy is extremely high among fertile, sexually active women when they do not use a contraceptive method. In contrast, a substantially lower proportion of women having abortions than of all women at risk of unintended pregnancy had used sterilization and other long-acting methods (1% vs. 41%), which reflects the very high rates of use-effectiveness of these methods. Pill users were underrepresented among women having abortions, whereas women using condoms and withdrawal were overrepresented. These patterns reflect the fact that women using oral contraceptives are more successful in avoiding accidental pregnancy than are those who rely on barrier or nonprescription methods.
    • p.296
  • The proportion of women having abortions who had not been using a contraceptive when they became pregnant varied across social and demographic subgroups from 37% to 54% (Table 2). Bivariate analyses reveal that adolescents and women aged 20–24 were significantly more likely than women aged 30 or older to be nonusers (47–50% vs. 44%). Decreases in income and education are associated with in-creased contraceptive nonuse: Women with family incomes below 300% of the federal poverty level were more likely than women with higher incomes not to be using a method of birth control in the month they became pregnant (45–52% vs. 40%), and women with less than a college degree were significantly more likely than college graduates to be nonusers (41–54% vs. 37%). Blacks, Hispanics and women of other races and ethnicities were more likely than whites to be nonusers (50–52% vs. 39%). Union status was barely associated with nonuse of contraception. Women who were the most likely to be nonusers were also the most likely never to have used a contraceptive method. For example, adolescents were more likely than women aged 30 or older to have never practiced contraception (12–19% vs. 7%).
    • pp.296-297
  • On the basis of our survey findings, we estimate that of the 1.3 million women who underwent induced abortions in 2000, 608,000 had not been using a contraceptive method around the time they became pregnant, 610,000 had been using a method but not consistently or correctly, and 95,000 had thought they were using the method perfectly but became pregnant because of method failure.* Although these estimates are based solely on women’s retrospective reports and perceptions of why they became pregnant, they raise issues that are common among all contraceptive users and thus need to be addressed.
    • p.301
  • Method failure rates during perfect use are quite low for oral contraceptives and male condoms (0.1–0.5% and 3%, respectively, in the first year of use). Previous research has found that some women overreport compliance with contraceptive regimens, and women having abortions may have overreported perfect method use. Nonetheless, the potential number of unintended pregnancies due to method failure is quite large. In 1995, 10 million women were using

the pill, and eight million the condom. If all 10 million women using the pill did so perfectly over the full year, 0.1–0.5%, or 10,000–50,000 users, would have become pregnant. Similarly, if all eight million condom users used the method perfectly for the year, 3%, or 240,000, would have become pregnant. These estimates confirm the validity of the number of abortions that women attributed to method failure during perfect use (95,000). This finding underscores the importance of providing women and their partners with information and services they need to select methods with which they are most likely to be successful, as well as the continuing need for development of additional method choices.

    • p.301
  • Nearly one-fifth of all women having abortions—one in three nonusers and one in five condom users—were not using a contraceptive method or were using it inconsistently because of a perceived low risk of pregnancy. Some of these women may have assumed they were having intercourse in a “safe time” in their menstrual cycle; others may have thought their risk of pregnancy was low because they were postpartum or breastfeeding. Furthermore, some may have simply perceived the risk of becoming pregnant to be low, and some may have thought they or their partner was sterile. The frequency of perceived low risk for pregnancy among women who had abortions shows that women and their partners need accurate information about the probability of conception when contraception is not used, the variability of fertility cycles and the importance of consistent contraceptive use.
    • p.302
  • Twenty-seven percent of contraceptive nonusers and 13% of condom users—or 16% of all women having abortions— became pregnant because they were not expecting to have sex. Ambivalence about contraception had been experienced by 22% of nonusers, and small proportions of pill and condom users indicated that they did not care or they “didn’t feel like” using their method. Very few women indicated that ambivalence about childbearing intentions had directly influenced their contraceptive use, but among women who had used condoms in the month they became pregnant, those who intended to have a child or more children were more likely than those who did not to report inconsistent condom use or condom breakage or slippage.
    • p.302

"Abortion Incidence and Access to Services in the United States, 2008" (March 2011)[edit]

Jones, Rachel K.; Kooistra, Kathryn (March 2011). "Abortion Incidence and Access to Services in the United States, 2008" (PDF). Perspectives on Sexual and Reproductive Health. 43 (1): 41–50. doi:10.1363/4304111. PMID 21388504. Retrieved December 8, 2017.

  • RESULTS: In 2008, an estimated 1.21 million abortions were performed in the United States. The abortion rate increased 1% between 2005 and 2008, from 19.4 to 19.6 abortions per 1,000 women aged 15–44; the total number of abortion providers was virtually unchanged. Small changes in national abortion incidence and number of providers masked substantial changes in some states. Accessibility of services changed little: In both years, 35% of women of reproductive age lived in the 87% of counties that lacked a provider. Fifty-seven percent of nonhospital providers experienced antiabortion harassment in 2008; levels of harassment were particularly high in the Midwest (85%) and the South (75%).
    • p.41
  • The incidence of abortion in the United States declined for more than a decade, but this trend may be ending, or at least leveling off. Nationwide, the number of abortions peaked in 1990, at 1.61 million, and dropped 25%, to 1.21 million, by 2005.1 Similarly, the abortion rate declined 29% over the same period, from 27.4 per 1,000 women aged 15–44 to 19.4 per 1,000. However, data from the Centers for Disease Control and Prevention (CDC), based on records from health

departments in 48 reporting areas, show that the number and rate of abortions increased 3% between 2005 and 2006.
The number and rate of abortions are in part dependent on the accessibility of abortion services, which may be affected by the number of providers, gestational limits, cost and antiabortion harassment. The number of abortion providers in the United States has been declining steadily:* It peaked in 1982, at 2,900 facilities, and had fallen to 1,800 by 2005. In that year, 87% of counties lacked an abortion provider, and 35% of women aged 15–44 lived in those counties; some of these women may lack the time or resources to travel to a provider.

    • p.41
  • In 2009, the murder of Dr. George Tiller—an abortion provider in Kansas—brought renewed attention to the issue of antiabortion harassment. Extreme acts of violence against abortion providers may lead to declines in the number of providers in the area. In 2000, some 82% of

facilities providing 400 or more abortions per year experienced some type of harassment. Most commonly, harassment took the form of picketing and physical contact with or blocking of patients, but 15% of large providers received a bomb threat.

    • p.41
  • We asked fewer questions of hospitals because the individuals answering the questionnaires in these settings typically have access to less information about clients. Information restricted

to nonhospital facilities represents the experience of most women having abortions, since these providers perform the vast majority of all abortions (95% in 2005).

    • p.42
  • In the prior census, California’s health department provided information about hospitals, but only for inpatient abortions (typically procedures performed late in the second trimester). For the current survey, we obtained hospital data on both inpatient and outpatient procedures; this

allowed us to identify 65 additional hospital providers in the state in 2008. These facilities performed 470 abortions in 2008, and we expect many of them had provided small numbers of abortions in previous years as well.
Of the abortions that occurred in 2008, some 82% were reported by providers, 9% came from health department data, 6% were estimated by knowledgeable sources and 3% were projections or internal estimates. By comparison, in 2005, some 76% of abortions were reported by providers, 12% came from health departments, 9% were external estimates and 3% were estimated internally.

    • p.42
  • The incidence of abortion in the United States changed little between 2005 and 2008: The number of abortions increased by 0.5%, from 1,206,200 to 1,212,350, and the abortion rate increased 1%, from 19.4 to 19.6 per 1,000 women aged 15–44 (Table 1). The abortion ratio did not change over this period, remaining at 22 abortions per 100 pregnancies.
    The lack of change in abortion incidence nationally masks variations by state. Delaware had the highest abortion rate in 2008 (40 per 1,000 women), partly because of a 37% increase in the number of abortions (Table 2, page 44). Most of this increase can be attributed to one provider that acknowledged underreporting abortions in the 2005 survey. New York and New Jersey had the second and third highest abortion rates (38 and 31 abortions per 1,000 women, respectively). The abortion rate in the District of Columbia dropped 45% between 2005 and 2008, from 54 to 30 per 1,000, which made it the fourth highest in the country. High rates were also seen in Maryland, California, Florida, Nevada and Connecticut (25–29 per 1,000).
    Wyoming had the lowest abortion rate, less than 1 per 1,000 women; the fi ve states with the next lowest rates were Mississippi, Kentucky, South Dakota, Idaho and Missouri (5–6 abortions per 1,000). Notably, rates based on abortions performed in a given state may differ from rates based on abortions obtained by a state’s residents. For example, while only 70 abortions were reported in Wyoming in 2005, an estimated 1,100 were obtained by Wyoming residents in that year, and almost all of them occurred out of state.
    • p.43
  • Change in abortion rates varied both within and across regions between 2005 and 2008. As in prior years, the rate was highest in the Northeast (27 abortions per 1,000 women), followed by rates in the West, the South and the Midwest (22, 18 and 14 per 1,000, respectively). Both the South and the West showed slight increases in rates between 2005 and 2008 (1–2%). The largest rate increases in the South were in Delaware and Louisiana (39% and 38%, respectively); Georgia and Kentucky also had substantial increases (18% and 16%, respectively). California accounted for 18% of the nation’s abortions in 2008, and its 2% increase was responsible for most of the increase in the West. The abortion rate in the Northeast did not change between 2005 and 2008; over this period, the rate rose by 23% in Pennsylvania, while it declined by 8% in Massachusetts and 9% in New Jersey. In the Midwest, the abortion rate was unchanged; the sizable increases in North and South Dakota mainly refl ect small absolute increases in the relatively small number of abortions performed in those states. More notable were changes in two states that account for almost half of abortions in the Midwest: The abortion rate in Illinois rose by 9%, while Michigan showed a 5% decrease.
    • p.43
  • The national trend in the number of abortion providers paralleled that of abortion rates, showing very little change: 1,793 in 2008, compared with 1,787 in 2005 (Table 3). Twenty-seven states and the District of Columbia experienced a decrease in providers, while nine had overall.
    • p.44
  • 94% of non-hospital medical abortions used mifepristone and misoprostol—6% used methotrexate and misoprostol—in the United States in 2008. increases and 14 experienced no change. The number of providers declined in the South (10%), the Northeast (8%) and the Midwest (5%). In contrast, it grew 15% in the West, largely because of a 23% increase in California. Without the newly identified facilities in California, the number of providers there would have increased by only 8%.
    • p.44
  • The potential impact of the loss of providers in a given state varies depending on the total number of providers in that state. For example, the largest decreases in the absolute number of providers occurred in New York and Florida, each of which had 12 fewer providers in 2008 than in 2005. However, this numerical loss of providers represented a 12% decline in providers in Florida but only a 5% decline in New York, because the latter had about 250 providers in both years. The loss of 10 providers in New Jersey represented a decline of 12% of that state’s providers.
    • pp.45-46
  • In 2008, the overwhelming majority of U.S. counties (87%) lacked an abortion provider, and 35% of women of reproductive age lived in these counties. The proportions were lower in the Northeast (53% and 18%) and the West (74% and 13%). The former is the most densely populated region, which partially accounts for the relatively good coverage. In addition, the fact that states in both regions have larger (and fewer) counties than states in the Midwest and the South helps explain the below-average proportions of counties without a provider. Abortion services are concentrated in cities. However, 69% of counties in metropolitan areas lacked a provider (not shown), and 25% of metropolitan women aged 15–44 lived in those counties. Almost all nonmetropolitan counties—97%—lacked an abortion provider, and 92% of women of reproductive age in these areas resided in those counties. These figures were virtually unchanged from those for 2005.
    • p.46
  • The 378 specialized abortion clinics accounted for 21% of all abortion providers, but performed 70% of all abortions in 2008 (Table 4). Most of these facilities reported 1,000 or more abortions during the year. A total of 473 nonspecialized clinics accounted for 24% of all abortions; some were similar to abortion clinics in having caseloads of 1,000 or more abortions per year. Overall, the

number of very large providers (those performing 5,000 or more procedures) increased by more than 50% between surveys: Twenty facilities of this size accounted for 12% of all abortions in 2005, whereas 31 such facilities provided 17% of abortions in 2008.

    • p.46
  • Thirty-four percent of abortion providers were hospitals in 2008, but these facilities accounted for only 4% of all abortions. Many hospitals provide abortions only in cases of fetal anomaly or serious risk to the woman’s health, and a majority (65%) performed fewer than 30 abortions in 2008. Twenty-two hospitals reported 400–999 abortions during the year, and only nine reported 1,000 or more.
    • p.46
  • Some 19% of providers were physicians’ offices, but these facilities accounted for only 1% of

all abortions. A majority of these offices (57%) reported fewer than 30 abortions; our survey may have missed a number of small providers in this category.

    • p.46
  • Fifty-nine percent of facilities provided one or more early medication abortions in 2008, a slightly higher proportion than in 2005; a 4% increase in the number of such providers occurred over this period (Table 5). The number of nonspecialized clinics that provided early medication abortion services increased by 23%, but the numbers of hospitals and physicians’ offices doing so decreased (by 13% and 9%, respectively). Eighty-three percent of abortion clinics and 88% of other clinics performed at least one early medication abortion in 2008, whereas 25% of hospitals and 55% of physicians’ offices did so. The likelihood of providing early medication abortion services increased with caseload—from 30% among the smallest providers to 94% among the largest.
    A substantial number of clinics and physicians’ offices—164 facilities, or 9% of all providers—offered early medication abortions, but not surgical abortions (not shown). Eleven percent of physicians’ offices were in this group, as were 27% of nonspecialized clinics. (Information on number of early medication abortions was not available for 34% of nonhospital facilities and 49% of physicians’ offices, and some of these facilities may have provided only this service; hence, our estimate is a

conservative one.)
Some 199,000 early medication abortions were performed in nonhospital facilities in 2008, representing a 24% increase from 2005. Mifepristone was used for 94% of these procedures (187,000), and methotrexate for the remainder (not shown). Slightly more than half of early medication abortions were administered by abortion clinics, and most of the rest by nonspecialized clinics. Physicians’ offices averaged about two medication abortions per month and accounted for only 2% of all such procedures. In 2008, some 17% of all abortions performed in nonhospital facilities were early medication abortions; nonspecialized clinics had the highest proportion of such abortions (30%). Early medication abortions accounted for a larger share of procedures at facilities with smaller caseloads: 37–49% at facilities in the two smallest caseload categories, but only 9% at those with the largest caseloads. We did not collect data on the gestational age at which abortions were performed, but using gestation data from the CDC,2 we estimate that in 2008, slightly more than one-quarter of eligible abortions, or those before nine weeks’ gestation, were performed using medication.

    • p.46
  • Most providers have limits on the earliest and latest gestations at which they will perform abortions, and women who are very early in their pregnancy or in the second trimester may have a difficult time locating appropriate services. Some 42% of providers offered abortions at four or fewer weeks since a woman’s last menstrual period (not shown). The greatest proportion of providers offered abortions at eight weeks’ gestation (95%), and 64% offered at least some second-trimester abortion services (13 weeks or later). Twenty-three percent offered abortions after 20 weeks’ gestation, and 11% did so.
    Gestational limits varied by provider type. The pro-portion of nonspecialized clinics performing abortions dropped markedly after nine weeks—98% offered abortions at nine weeks’ gestation, while 63% did so at 10 weeks—probably because some provided only early medication abortion services. By comparison, 98% of abortion clinics offered abortions through the first trimester. Hospitals were more likely than other types of providers to offer abortions at later gestations: Fifty-eight percent reported that they performed abortions at 20 weeks’ gestation, whereas 36% of abortion clinics did so. at 24 weeks. Access to very early and later abortions changed little since 2005, when 40% of providers offered abortions at four weeks and 8% did so at 24 weeks.
    • p.47
  • A majority of women who access abortion services are poor or have a low income, and most women pay for the procedure out of pocket. The cost of obtaining an abortion, which varies by provider type and gestational age, may prevent some women from accessing this service.

In 2009, the median charge* for a surgical abortion at 10 weeks’ gestation was $470 (Table 6, page 48). Abortion clinics charged the least ($425), and physicians’ offices the most ($535). Surgical abortions at 10 weeks’ gestation were most expensive at facilities that performed fewer than 30 abortions per year ($629) and least expensive at facilities with the highest caseloads ($400).
We weighted the cost data by number of abortions to account for the fact that more women obtain abortions at facilities with lower charges; the resulting measure represents abortion patients’ mean out-of-pocket expenditures. Women obtaining a surgical abortion at 10 weeks’ gestation paid $451 in 2009, on average. The comparable figure in 2006 was $413, which is equivalent to $440 in inflation-adjusted 2009 dollars.11 Thus, the average amount that women paid for a first-trimester surgical abortion increased by only $11 between 2006 and 2009.

    • p.47
  • Abortions after the first trimester cost more because of the extra time, skill and resources required. The median charge for an abortion at 20 weeks’ gestation was $1,500, and charges across provider types and facility caseloads ranged from $1,100 to $1,650.
    The median charge for early medication abortions was $490. Patterns in these charges by type of facility and caseload were similar to those for surgical abortions at 10 weeks, though the price difference between the lowest and highest cost facilities was smaller ($50). Notably, the median charge for this procedure was higher than that for surgical procedures at 10 weeks, perhaps because early medication abortion is a newer technology, and providers consider the cost of the drug an add-on to the cost

of their services. This general difference in the median cost held across provider types and caseloads, with two exceptions: At physicians’ offices and at facilities with the smallest caseloads, a medication abortion cost less than a surgical procedure. These providers may specialize in medication abortion and, in turn, charge more for surgical abortion because it requires more training and specialized equipment.

    • pp.47-48
  • Exposure to antiabortion harassment was common among nonhospital abortion providers in 2008: Fifty-seven percent experienced at least one of six types of harassment (Table 7). Picketing was the most common form of harassment (reported by 55%), followed by picketing combined with blocking patient access to facilities (21%). Internet harassment was assessed for the first time in this survey, and 3% of providers reported that protesters had posted pictures of patients on the Internet.
    The overwhelming majority of abortion clinics—88%—experienced at least one form of harassment in 2008. Eighty-seven percent reported picketing; 42% reported picketing with patient blocking, and 21% cited incidents of vandalism. Nearly two-thirds of other clinics reported

any type of harassment, but only 10% of physicians’ offices did so.
Harassment was also commonly reported by facilities that performed 400 or more abortions per year (89%). In 2000, when harassment was last assessed, 82% of providers with this size caseload reported at least one of five forms of harassment,4 which suggests a slight increase over this period. (Internet harassment was not measured in 2000, but even when this item was excluded from the 2008 data, 89% of these providers experienced at least one type of harassment.) Additionally, between 2000 and 2008, the proportion of such providers reporting picketing increased from 80% to 88%, and the proportion reporting picketing with contact or blocking access increased from 28% to 37%; the proportion that received bomb threats declined from 15% to 5%. Almost all providers that performed 1,000 or more abortions had been picketed in 2008, and 63% of facilities that performed 5,000 or more abortions reported picketing that involved blocking or physical contact. Nearly one in five of the largest facilities reported a bomb threat.
The incidence of harassment varied by region; 85% of providers in the Midwest and 75% in the South experienced any form of harassment, compared with 48% and 44% in the Northeast and the West, respectively. All types of harassment were more common among facilities in the Midwest and the South than elsewhere. Levels of harassment did not vary by gestational age at which abortions were offered among providers that performed 400 or more per year (not shown).

    • p.48
  • The long-term national decline in abortion incidence has stalled and may have ended. Both the number of abortions and the abortion rate increased slightly between 2005 and 2008. Notably, the small change in abortion incidence at the national level masks substantial changes in some states.
    Delaware’s abortion rate is twice the national average and reflects, in part, that residents of other states obtain abortions in Delaware. Out-of-state residents accounted for an estimated 25% of abortions performed in the state in 2004. However, the apparent dramatic increase in the

state’s abortion incidence is probably spurious, because abortions in 2005 were underreported at one facility. In other states, shifts in abortion incidence may be partially explained by interstate dynamics. For example, the decrease in the number of abortions in New Jersey was paralleled by an increase in the number in neighboring Pennsylvania. In 2004, some 12% of abortions among Pennsylvania residents were obtained out of state, but this proportion may have dropped in 2008. Meanwhile, although the District of Columbia still has one of the highest abortion rates in the country, it had the greatest decrease in abortion rate between 2005 and 2008, while neighboring Virginia had an increase. Over this three-year period, the District of Columbia experienced a substantial decline in providers because several clinics closed. In 2004, almost one in five abortions in the District were obtained by nonresidents,9 and in more recent years women likely chose to obtain an abortion in their state of residence, or had no choice but to do so. Indeed, the increase in abortion incidence in Virginia may reflect that fewer of this state’s women traveled to the District to terminate their pregnancies, as well as that more women traveled from the District to Virginia for this purpose.
Changes in abortion incidence may also be due to developments within a state. For example, the abortion rate in Georgia increased 18% between 2005 and 2008. The state gained three large clinic providers (including an abortion clinic), but it lost five small providers (hospitals and physicians’ offices). As a result, the proportion of women of reproductive age who lived in counties without a provider declined by five percentage points from the 62% level found in 2005, and the shift in provider types may have increased access to services and, in turn, the abortion rate.

    • pp.48-49
  • Early medication abortion has become an integral part of abortion care. Although the proportion of providers offering this service increased only slightly between 2005 and 2008, both the number of early medication abortions and the proportion of all abortions accounted for by this method grew substantially. Mifepristone use has grown steadily since its introduction in the United States in 2000, and substantially in recent years. We found a large increase in the number of mifepristone-induced abortions, from 158,000 in 200712 to 187,000 in 2008. This increase over one year corresponds with recent usage estimates from the manufacturer and may suggest an increased reliance on this procedure.13 Early medication abortion appears to be particularly important for nonspecialized clinics; it accounted for 30% of all abortions at these facilities, and a minimum of 27% of nonspecialized clinics offered only early medication abortion services.
    • p.49
  • Most of our measures of accessibility of abortion services showed little change between 2005 and 2008. As in the earlier year, 35% of women of reproductive age lived in the 87% of counties that lacked a provider. The proportions of providers offering abortions at four weeks after a woman’s last menstrual period and at 24 weeks also remained stable. Furthermore, after adjustment for inflation, the average amount that women paid for a first-trimester surgical abortion increased by only $11 between 2006 and 2009. This small change was particularly notable given that medical price inflation has increased at a faster pace than inflation in other sectors. The moderate rise in abortion cost may be the result of overt efforts by providers to keep the procedure affordable, or given the increase in poverty among abortion patients, it may reflect that more women obtain abortions at facilities that charge the least.
    • p.49
  • Most nonhospital abortion providers experienced at least one form of harassment, and the proportion of large providers reporting any form of harassment increased slightly between 2000 and 2008. For the first time, we examined variations in harassment by provider type, caseload and region; virtually all abortion clinics and large facilities had experienced at least one form of harassment, as had at least three-quarters of providers in the Midwest and the South. Extreme forms of harassment lead to fewer abortion providers,3 and the relatively high levels of harassment in the South and Midwest may have contributed to both the decline in numbers of abortion providers and their relatively small numbers in these regions.
    Media reports suggest that the economic recession that began in late 2007 has led to increased demands for abortion services. This study was unable to assess these claims, as the small increase in abortion incidence began

before the recession.

    • p.49
  • Undercounting has likely become more pronounced over the last decade because of the integration of mifepristone for early medication abortion at facilities that do not offer surgical abortions. In particular, facilities that performed few abortions may have been reluctant to identify themselves as abortion providers and may not have responded to the survey mailed out by the distributor of mifepristone.
    While these dynamics might influence statistics related

to the total number of providers, facilities with larger caseloads—which account for the overwhelming majority of abortions—are more easily identified because they are typically known by other providers in their communities and advertise on the Internet and in the yellow pages.

    • p.49
  • While nationally it would appear that little has changed regarding abortion incidence, abortion is only part of the larger picture of unintended pregnancy, and information on unintended births is also needed. An increase in the rate of unintended births along with the abortion rate would indicate that unintended pregnancy is on the rise. Alternately, if the rate of unintended births decreased, then the slight increase in the abortion rate might indicate that abortion had become more accessible. Between 1994 and 2000, abortion rates increased among poor and low-income women, while they decreased among those with higher incomes;18 the fact that the representation of poor women among abortion patients increased between 2000 and 2008,10 while the abortion rate declined only slightly during this period, suggests that barriers to abortion services were reduced for this population. In the context of the economic recession that was occurring in 2008, their growing representation could also signify that increasing financial instability left low-income women less able to prevent unintended pregnancy or less well equipped to carry an unintended pregnancy to term.
    Patterns in abortion incidence and number of providers have several public policy implications. Abortions are usually the result of unintended pregnancies; affordable family planning services need to be widely available to women and their partners to reduce the number of unintended pregnancies and, in turn, abortions. In addition, it is important to remove barriers to abortion services, especially for low-income women. Only 17 states use their own funds to cover all or most medically necessary abortions for women with Medicaid coverage. If more states did so, or if federal restrictions on Medicaid coverage for abortions were lifted, poor women could more easily access services when confronted with an unintended pregnancy. Harassment of abortion providers continues to be a problem, particularly in the Midwest and the South. More states need to enact and enforce laws that prohibit the most overt and damaging forms of harassment and allow access to this legal, needed and basic health care service.
    • p.50

"Abortion Incidence and Service Availability in the United States, 2017" (2019)[edit]

Jones, Rachel K.; Witwer, Elizabeth; Jerman, Jenna (2019)."Abortion Incidence and Service Availability in the United States, 2017". Guttmacher Institute. doi:10.1363/2019.30760.

  • In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend.
    *The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15–44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country.
    *A total of 339,640 medication abortions occurred in 2017—about 39% of all abortions.
    *As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians’ offices and hospitals accounted for 5%.
  • Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates.
    * Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births.
    *Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.
  • Abortion surveillance in the United States is an important public health indicator that is needed to estimate pregnancy rates, and it can also serve as a measure of access to reproductive health care. Between 2011 and 2014, the U.S. abortion rate declined from 16.9 to 14.6 abortions per 1,000 women aged 15–44, the lowest rate ever recorded and the continuation of a decades-long trend. Still, in 2014, almost one in five pregnancies ended in abortion, and given abortion rates in that year, an estimated one in four U.S. women will have an abortion in their lifetime. These statistics demonstrate that abortion is not uncommon.
  • The Supreme Court of the United States recognized the constitutional right to abortion in 1973 in Roe v. Wade. In the decades since, the Court has continued to affirm the fundamental right to abortion, including in 1992 in Planned Parenthood v. Casey and in 2016 in Whole Women’s Health v. Hellerstedt.3,4 Despite existing precedents, states have continued to find ways to restrict or ban abortion, enacting more than 227 restrictions between January 2014 and June 2019.5 More than a dozen cases challenging some of the most extreme restrictions—such as bans on abortions after six weeks’ gestation—currently have the potential to reach the Supreme Court, and the outcomes could pose significant challenges to the legal framework protecting abortion rights. If the Court undermines or overturns Roe v. Wade, this will likely exacerbate existing disparities in abortion access and may allow individual states to explicitly or effectively ban abortion altogether. Although prior research has not found state policy to be the primary driver of the decline in the national abortion rate, abortion bans would undoubtedly prevent many individuals from obtaining abortion care in clinical settings.
    Documenting changes in the number of health care facilities that provide abortion is also an important activity, as the number of facilities can directly affect the availability and accessibility of care. In 2014, the vast majority (95%) of abortions were provided by clinic facilities, while 4% were provided by hospitals and 1% by private physicians’ offices. Between 2011 and 2014, the number of clinics providing abortions had declined by 6%. These declines were steepest in the Midwest and South (22% and 13%, respectively), regions that had also enacted the most abortion restrictions. Still, the 2014 study did not identify a clear association between changes in clinic numbers and state abortion rates between 2011 and 2014; for example, the declines in abortion rates in some states that had lost one-third or more of their clinic facilities mirrored, or were smaller than, the national decline. Updated national data suggest that the overall number of facilities providing abortion did not change much between 2014 and 2017, but state and regional patterns of clinic closures may reveal meaningful patterns in availability of and access to services over time.
  • The total number of abortions, the abortion rate and the abortion ratio in the United States all declined between 2014 and 2017. In 2017, 862,320 abortions were provided in clinical settings, a 7% decline from 2014. The 2017 abortion rate of 13.5 abortions per 1,000 women aged 15–44 represented an 8% decline from 2014. Just under one in five pregnancies (births and abortions), 18.4%, ended in abortion in 2017.
    While abortion incidence and rates declined in most states, the degree of change varied substantially. Declines in abortion rates were largest in Delaware, Arkansas, West Virginia, Alabama and Virginia; most of these states also had abortion rates substantially lower than the national rate in 2014, so even a small change in this measure can seem large. Abortion rates increased in Mississippi, New Jersey, Minnesota, Georgia, Maryland and Wisconsin. While abortion rates declined in all four regions, the drop was steepest in the West (14%). Indeed, states considered to be supportive of abortion rights in 2017—including large states such as California and New York—accounted for 43% of all U.S. abortions in that year but 55% of the decline since 2014.
    Areas with the highest abortion rates in 2017 were the District of Columbia, New Jersey, New York, Maryland and Florida. Rates were lowest in Wyoming, South Dakota, Kentucky, Idaho and Missouri. Notably, our study measures abortion by state of occurrence and does not account for individuals crossing state lines for abortion care; in the five states with the lowest rates, 28% or more of individuals go out of state to obtain abortions.
  • In 2017, 1,587 health care facilities were known to have provided abortions, a 5% decline from 2014. Changes in the overall number of facilities over time varied by facility type. The number of hospitals providing abortions declined by 19%, from 638 to 518. This decrease was largely attributable to California, where 114 hospitals that provided 633 abortions in 2014 reported zero procedures in 2017 (data not shown). California hospitals accounted for the same proportion of abortions in the state in both years (5%).
  • In 2017, 89% of U.S. counties did not have a clinic facility that provided abortion care, and 38% of women aged 15–44 lived in these counties; these figures are comparable to those found in 2014—90% and 39%, respectively. In five states, fewer than 10% of women lived in a county without a clinic facility: California, Connecticut, Hawaii, Nevada and New York. In Mississippi and Wyoming, more than 90% of women lived in a county without such a clinic.
  • In 2017, 339,640 medication abortions were provided in nonhospital facilities, a 25% increase from 2014. Medication abortion accounted for 39% of all abortions. Assuming that health care providers followed the FDA-recommended regimen that allows mifepristone to be administered up to 10 weeks’ gestation, we estimate that 60% of all eligible abortions were early medication abortions (data not shown). The majority of medication abortions were provided by specialized clinics and at high-volume facilities (those with annual caseloads of more than 1,000 abortions).
  • Between 2014 and 2017, abortions provided in clinical settings in the United States continued to decline. The 2017 rate of 13.5 abortions per 1,000 women aged 15–44 is the lowest recorded since abortion was legalized nationally in 1973 and is 54% lower than the peak rate of 29.3 per 1,000 in 1980. The decline was seen across all four regions and most states.
    One factor that can contribute to declines in abortion is a reduction in the number of facilities providing this care. While hospitals and physicians’ offices constituted a substantial share of abortion-providing facilities, the overwhelming majority of abortions, 95%, were provided by clinics
  • All 10 states that had a meaningful increase in clinic numbers also showed declines in their abortion rates. Most of the new facilities, or facilities that had not previously provided abortions in these states, were nonspecialized clinics, suggesting that the concurrent expansion of abortion care and decrease in abortion rates was taking place in the context of an increase in comprehensive health care.
    While the decline in the number of clinics providing abortion care in some states likely prevented some patients from obtaining wanted abortions, other factors also contributed to the decline in the abortion rate. Fertility rates declined in virtually all states between 2014 and 2017, suggesting that the drop in abortions was not compensated for by an increase in births. Rather, declines in reported abortions could be related to at least two other factors: self-managed abortion and a decline in pregnancy rates.
  • The majority of patients obtaining abortions are poor or low-income, many lack health insurance that will cover the procedure, and many live in states with numerous abortion restrictions.
    These factors, along with the increased accessibility of resources to help individuals safely self-manage their abortions outside of a clinical setting, likely account for some of the decline in abortions that we have documented. However, one national survey of U.S. adult women, conducted in 2017, found that only 1.4% reported ever having attempted to end a pregnancy on their own. Moreover, 24% of these instances had occurred prior to 2000, and only 28% were reported to have been successful. Abortion is underreported on surveys of this type, and the actual incidence may be higher, but it is nonetheless unlikely that even a substantial increase in self-managed abortion can account for the majority of the decline in abortion incidence nationally during the study period.
    The decline in births and abortions also means that fewer people were getting pregnant. Improved contraceptive use is one factor that could have contributed to this change. The most recent national data suggest that between 2014 and 2016, the proportion of women aged 15–44 using long-acting reversible contraceptive methods increased by 23%, from 13% to 16%; levels of sterilization were 25% and 26%, respectively. Greater reliance on highly effective methods appears to have been balanced by a drop in the use of hormonal methods such as the pill and the injectable (Depo) which, combined, declined from 29% to 25% of all contraceptive use. Still, it is possible that a decline in contraceptive failures could have reduced the incidence of unintended pregnancy. Additionally, state-level efforts to increase access to long-acting reversible contraceptive methods may have had a measurable impact, particularly in states with higher-than-average abortion rates.
  • Our study measured abortion by state of occurrence, but many patients cross state lines to obtain care. For example, CDC data for 2015 suggest that 28% of abortions reported to have occurred to residents of Idaho and 83% of those to residents of Wyoming were obtained in other states. Similarly, though the District of Columbia (DC) had the highest abortion rate in the country in 2017, the majority of abortions provided in DC in 2014 were for nonresidents, most commonly individuals from Maryland or Virginia.
  • Declines in abortion were seen in all four regions of the United States, including in states with policy landscapes that were both restrictive toward and supportive of abortion rights. However, access to abortion, when measured by the number of clinic facilities in a state, has become more polarized across regions of the country. The overall number of clinics increased in the Northeast and the West but declined in the Midwest and the South; in addition, more states (all in the Midwest or the South) have only one clinic remaining. These patterns demonstrate that the existence of more clinic facilities does not necessarily translate to an increase in abortion rates. Rather, an increase in clinic numbers likely represents greater access to health care in general, enabling patients to travel shorter distances, obtain abortion care in nonspecialized settings and perhaps obtain contraceptive care more easily.
    Medication abortion plays an integral role in abortion care, having accounted for 39% of all abortions in 2017 and more than half of abortions occurring prior to 10 weeks’ gestation. The availability of mifepristone not only allows some patients to choose between types of abortion procedure, but also lends itself to innovations in health care delivery models, such as telemedicine. For this reason, the landscape of abortion provision and access in the United States may change as these innovations spread. In addition, the increased availability of highly effective and affordable abortion pills via the internet has the potential to substantially increase access to abortion, for which future surveillance efforts will need to account. It will also be important to ensure that policies and funding promote access to all methods of abortion, so that people seeking this care are able to obtain the care that is best for them.
    As abortion service delivery and utilization continue to be restricted at the state level, documentation of abortion incidence, abortion rates and numbers of service sites is necessary to establish baselines and measure trends in a changing health care landscape.

"The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review" (April 2009)[edit]

Theodore J. Joyce; Stanley K. Henshaw; Amanda Dennis; Lawrence B. Finer; Kelly Blanchard (April 2009). "The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review" (PDF). Guttmacher Institute. Archived from the original (PDF) on 16 March 2012. Retrieved 31 December 2010.

  • Proponents of mandatory counseling and waiting period laws argue that the state has a duty to ensure that before a woman decides to terminate a pregnancy she has been given ample time, after having been given information about her pregnancy and abortion, to weigh her options. Those opposed to these laws argue that such statutes are unneeded because physicians are required to obtain informed consent before all procedures (including abortion), that the laws impose an unnecessary burden on women who are seeking abortions and that women are able to make informed decisions about terminating a pregnancy without the imposition of a state-mandated waiting period. Opponents further argue that mandatory counseling and waiting period laws serve no medical purpose and are a ruse to decrease the accessibility of abortion.
    • p.3
  • Evaluators of mandatory counseling and waiting period laws face many of the same challenges that confront researchers of other state policies that affect access to abortion services, such as parental involvement laws and Medicaid financing of abortions.‡ For instance, national data on abortion compiled by the Centers for Disease Control and Prevention are collected by state of occurrence and not by state of residence. Using abortion data by state of occurrence to evaluate a mandatory counseling and waiting period law can lead to spurious findings if women leave their state of residence for an abortion, and if nonresidents stop coming into a state for the procedure, once the law is enforced. The problem is exacerbated by the relatively few states (seven*) that enforce the strictest form of a mandatory waiting period law—requiring in-person counseling at least 18 hours prior to the procedure—since women can travel to nearby states if they want an abortion without a required delay. In addition, mandatory counseling and waiting period laws affect women of all ages and incomes, not just minors or those eligible for Medicaid. However, older, nonpoor women have more education and are more likely to have independent income, their own means of transportation and other resources that could make accessing services in other states a more feasible option. For the results of an evaluation to be valid, therefore, researchers should demonstrate that few women left their state of residence to obtain an abortion in response to laws of this kind, or if they did, the researcher must be able to include in the analysis abortions obtained by a state’s residents in other states.
    • pp.3-4
  • Distinguishing short-term from longer-term effects of a law is another challenge. A mandatory counseling and waiting period law may cause an initial drop in abortion rate or a rise in the rate of second-trimester abortions. However, as more women become aware of the law and as more clinics improve scheduling and administration of the counseling, the “costs” associated with compliance may fall, along with the law’s impact on outcomes. In any case, it is very difficult to credibly link longer-term declines in abortion or the timing of abortion to the impact of a law, given the likelihood of confounding from other factors that influence abortion rates.
    • p.5
  • Early qualitative assessments of experiences with mandatory counseling and waiting period laws found that abortion patients and providers were burdened in multiple ways by the legislation. Women who had obtained an abortion described negative physical and mental health consequences, such as physical discomfort and mental distress. Women also reported increased burdens from having to visit clinics multiple times and having to travel out of state to a provider who was not affected by such laws. Interviews with providers suggested that many struggled to adjust to the laws immediately after implementation. These early findings make intuitive sense, as any change in this type of regulation will have some effect on providers and patients, particularly as the logistics of meeting the new requirements are being worked out. But it is important to note that these studies were conducted in a limited geographic area and included a relatively small number of women and providers. Despite the limited generalizability of these qualitative studies, they are valuable because they are the only ones to evaluate mandatory counseling and waiting period laws using such methods.
    • p.15
  • The results from Mississippi were the most convincing. Overall, the state’s mandatory counseling and waiting period statute—with its requirement that all counseling be done in person 24 hours prior to an induced termination—was associated with a decline in the abortion rate, a rise in abortions obtained out of state and an increase in the proportion of second-trimester abortions. These findings were consistent across three studies, each with a distinct research design.
    • p.15
  • The broader analyses that included data from all available states found that counseling and waiting period laws had no impact on abortion rates or birthrates. Most laws are less demanding than that of Mississippi, and it is probably safe to conclude that if they affect reproductive outcomes, the effect is not large. However, the possibility of unmeasured confounding variables and other limitations of the studies preclude ruling out small effects. A corollary finding is that mandatory counseling also has little effect on women’s abortion decisions. Since states require that specific information be provided to the woman before the waiting period, if the delay has no effect, then neither does the mandated counseling.
    • p.15
  • We conclude that mandatory counseling and waiting period laws that require an additional in-person visit before the procedure likely increase both the personal and the financial costs of obtaining an abortion, thereby preventing some women from accessing abortion services. If neighboring states have similar laws, so that access to an abortion provider who does not require this strict form of waiting period requires extensive travel, then such laws are likely to lower abortion rates, delay women who are seeking abortions and result in a higher proportion of second-trimester abortions. Laws that allow mandatory counseling to be delivered over the Internet or by mail or telephone impose lower costs on both patients and providers, and neither the waiting period requirement nor the counseling appears to have a large impact on reproductive outcomes. However, by definition such statutes do cause some delay, and the one study that addressed this issue found a 41% increase in the rate of second-trimester abortions.6 While this might not be an accurate measure of the magnitude of the effect, it is likely that some abortions are delayed to the second trimester.
    • p.15

"Alabama governor signs nation's most restrictive anti-abortion bill into law" (May 15, 2019)[edit]

Kelly, Caroline (May 15, 2019). "Alabama governor signs nation's most restrictive anti-abortion bill into law". CNN. Retrieved May 15, 2019.

  • Alabama Gov. Kay Ivey on Wednesday signed into law a controversial abortion bill that could punish doctors who perform abortions with life in prison.
    “Today, I signed into law the Alabama Human Life Protection Act, a bill that was approved by overwhelming majorities in both chambers of the Legislature,” said Ivey, a Republican, in a statement. “To the bill’s many supporters, this legislation stands as a powerful testament to Alabamians’ deeply held belief that every life is precious and that every life is a sacred gift from God.”
    The Alabama Senate passed the bill 25-6 late Tuesday night. The law only allows exceptions “to avoid a serious health risk to the unborn child’s mother,” for ectopic pregnancy and if the “unborn child has a lethal anomaly.”
  • “No matter one’s personal view on abortion, we can all recognize that, at least for the short term, this bill may similarly be unenforceable,” Ivey wrote. “As citizens of this great country, we must always respect the authority of the U.S. Supreme Court even when we disagree with their decisions. Many Americans, myself included, disagreed when Roe v. Wade was handed down in 1973. The sponsors of this bill believe that it is time, once again, for the U.S. Supreme Court to revisit this important matter, and they believe this act may bring about the best opportunity for this to occur.”
  • Republican state Sen. Clyde Chambliss, who ushered the bill through the chamber, repeatedly referred on the Senate floor Tuesday to a “window” of time between conception and when a woman knows for certain that she’s pregnant. The state senator said he believed that time was between about seven and 10 days.
    Yashica Robinson, an obstetrician at the Alabama Women’s Center for Reproductive Alternatives who provides abortion services, said the law would have a “devastating impact” on patients. She said that she was unclear under what circumstances the law would allow an abortion based on “reasonable medical judgment” and health of the mother.
    “I’m not clear about exactly what that means,” Robinson said on CNN’s “Anderson Cooper 360.” “I’ve already met instances where it is difficult for us to determine those things in the health care setting now, and it has resulted in delays in care.”
  • The bill’s passage Tuesday night elicited a wave of protest from a slew of Democrats, including 2020 hopefuls, and celebrities.
    Washington Gov. Jay Inslee, Minnesota Sen. Amy Klobuchar, Vermont Sen. Bernie Sanders and former Texas Rep. Beto O’Rourke all ripped the legislation as unconstitutional. New Jersey Sen. Cory Booker, California Rep. Eric Swalwell, former Colorado Gov. John Hickenlooper, and Massachusetts Sen. Elizabeth Warren vowed to protect Roe.
    New York Sen. Kirsten Gillibrand announced that she was headed to Georgia to “fight back, hard, on the frontlines” against “the greatest threat to reproductive freedom in our lifetimes.”
    Former Democratic presidential nominee Hillary Clinton called the bill an example of “appalling attacks on women’s lives and fundamental freedoms.”
  • American Civil Liberties Union of Alabama Executive Director Randall Marshall promised Ivey a lawsuit, slamming the governor for the anticipated legal costs that the legislation would mean for the state from court challenges. Br> “By signing this bill, the governor and her colleagues in the state legislature have decided to waste millions in Alabama taxpayer dollars in order to defend a bill that is simply a political effort to overturn 46 years of precedent that has followed the Supreme Court’s Roe v. Wade decision,” he wrote in a statement Wednesday.
    “We will not allow that to happen, and we will see them in court,” Marshall added. “Despite the governor signing this bill, clinics will remain open, and abortion is still a safe, legal medical procedure at all clinics in Alabama.”
    Marshall told CNN on Tuesday before the bill’s Senate passage that his organization would join with the national ACLU, Planned Parenthood and Planned Parenthood Southeast to challenge the measure in court within “a few weeks” should it become law.
  • Staci Fox, president of Planned Parenthood Southeast, reiterated promises of a court challenge.
    “We vowed to fight this dangerous abortion ban every step of the way and we meant what we said,” Fox told CNN. “We haven’t lost a case in Alabama yet and we don’t plan to start now.”

"Illinois governor signs sweeping abortion protection bill into law" (June 12, 2019)[edit]

Caroline Kelly (June 12, 2019). "Illinois governor signs sweeping abortion protection bill into law". CNN.

  • Democratic Illinois Gov. JB Pritzker signed a sweeping abortion access protection bill into law Wednesday.
    “Today we proudly proclaim that in this state, we trust women,” Pritzker said at a bill signing event at the Chicago Cultural Center. “And in Illinois we guarantee as a fundamental right a woman’s right to choose.”
  • The Illinois bill, effective immediately, protects an individual’s “fundamental right to make autonomous decisions about one’s own reproductive health,” including to continue a “pregnancy and give birth or to have an abortion.”
    The bill repeals the Illinois Abortion Law of 1975, which punished doctors for abortions not deemed “necessary,” as well as the the state’s Partial-birth Abortion Ban Act. It also establishes “that a fertilized egg, embryo, or fetus does not have independent rights under the law, of this State.”
    Pritzker praised the bill as a safeguard against federal abortion restrictions and expressly welcomed women from states limiting reproductive care to seek care in Illinois.
    The bill “ensures that women’s rights do not hinge on Roe V. Wade or the whims of an increasingly conservative supreme court in Washington,” he said.
    He later urged states that have pushed forward abortion bans to “change their minds” and “revisit the issue.”
    “But Illinois knows where we stand and we’re going to be here for women if they have to be refugees from other states,” he added.
  • State lawmakers Wednesday touted Illinois as a beacon of support for reproductive health in light of recent restrictions by nearby states such as Missouri – and their possible future implications – on abortion access.
    Democratic state Rep. Kelly Cassidy, who sponsored the bill in the House, said Wednesday that with the bill’s signing, “we are building a firewall around Illinois to protect access to reproductive healthcare for everyone.”
    Bill co-sponsor Democratic state Sen. Melinda Bush said that “we want to make sure that Illinoisans can now rest assured – regardless of what happens at the federal level, they’ll have access to comprehensive” reproductive care.
    She also urged other states to “#belikeIllinois and trust women,” she said, adding that lawmakers would ask “every other state legislature to take this up.”
  • Pro-life advocates have criticized the bill. The Thomas More Society, a pro-life law firm based in Chicago, characterized the bill as “legalizing the death penalty, with no possibility of appeal, for viable unborn preemies.”
    Former Illinois Representative and Thomas More Society Vice President Peter Breen slammed the measure as “the most radical sweeping pro-abortion measure in America and makes Illinois an abortion destination for the country.”
  • The bill passed the state Senate by a 34-20 vote last month, with Bush describing the bill as a safeguard against the “real possibility” of an attempt to overturn Roe.
    Pritzker has consistently backed the bill, urging the Senate to pass it after the state House did so by a 64-50 vote and expressing anticipation to sign in.
    “With reproductive healthcare under attack across the country, we must do everything in our power to protect women’s rights in Illinois,” he tweeted at the time, adding, “Today was a major step forward for every woman in this state and I look forward (to) continuing my work as an ally by signing the Reproductive Healthcare Act into law.”

"CHARTS: How Roe v. Wade changed abortion rights" (January 22, 2013)[edit]

Kliff, Sarah, "CHARTS: How Roe v. Wade changed abortion rights". The Washington Post, (January 22, 2013).

  • Today marks the 40th anniversary of Roe v. Wade, the landmark Supreme Court decision that made abortion a legal right. The decision was transformational: Overnight, abortion went from being banned by all but a handful of states to being legal in all 50. Movements quickly built up in defense, and opposition, of the ruling.
    Forty years later, a lot has changed. While the Roe decision still stands, abortion opponents have made significant gains passing restrictions on abortion access. There are fewer abortion providers than there were in 1973 and fewer clinics.
  • Legal abortion rates increased significantly following the Roe decision but have declined for the past three decades.
    In 1973, Roe v. Wade legalized first-trimester, elective abortion and also gave some protections to terminations later in the pregnancy. Abortion rates climbed after the decision, a trend that had started in the late 1960s, as states began liberalizing their abortion laws.
    Abortion rates have now been declining since the 1980s and hit an all-time low in 2009, the most recent year for which data is available.
  • The number of abortion providers has declined steadily since the mid-1970s, although looks to have held relatively steady in the late 2000s.
    Ever since the early 1980s, the number of doctors performing abortions has steadily declined. A number of factors likely contribute to this trend, including state-level abortion restrictions and a wave of violence against abortion providers in the 1990s, when five were killed. The decrease in abortion providers has correlated with a decrease in the rate of abortions.
  • Abortion has become increasingly concentrated among low-income, minority women.
    Over the past four decades, the demographics of abortion have shifted significantly. In 1973, white women accounted for over three-quarters of all abortions. Now, that number hovers just below 60 percent.
  • A wave of abortion restrictions passed in 2011, followed by a steep drop in 2012.
    Roe provides widespread protections to elective abortions in the first trimester of pregnancy. But in later rulings, the Supreme Court has allowed states to restrict access to abortion. Since them, states have increasingly done so. In 2011, states passed 92 laws restricting abortion access, more than double the restrictions passed in any other year. The number dropped to 43 in 2012 - fewer than in 2011, but still higher than any other year prior.
  • Most abortion restrictions target minors or focus on delaying the procedure with a waiting period.
    States have gravitated towards a handful of abortion restrictions that appear to pass muster with the Supreme Court. Waiting periods and parental notifications became more frequent in the 1990s, after the Supreme Court ruled that such restrictions did not represent an "undue burden" on the woman.

"Abortion Surveillance — United States, 2018" (2020)[edit]

Kortsmit, K; Jatlaoui, TC; Mandel, MG (2020). "Abortion Surveillance — United States, 2018". MMWR. Surveillance Summaries. Centers for Disease Control and Prevention. 69 (7): 1–29. doi:10.15585/mmwr.ss6907a1. PMC 7713711. PMID 33237897.

  • Results: A total of 619,591 abortions for 2018 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2009–2018, in 2018, a total of 614,820 abortions were reported, the abortion rate was 11.3 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 189 abortions per 1,000 live births. From 2017 to 2018, the total number of abortions and abortion rate increased 1% (from 609,095 total abortions and from 11.2 abortions per 1,000 women aged 15–44 years, respectively), and the abortion ratio increased 2% (from 185 abortions per 1,000 live births). From 2009 to 2018, the total number of reported abortions, abortion rate, and abortion ratio decreased 22% (from 786,621), 24% (from 14.9 abortions per 1,000 women aged 15–44 years), and 16% (from 224 abortions per 1,000 live births), respectively.
    In 2018, women in their 20s accounted for more than half of abortions (57.7%). In 2018 and during 2009–2018, women aged 20–24 and 25–29 years accounted for the highest percentages of abortions; in 2018, they accounted for 28.3% and 29.4% of abortions, respectively, and had the highest abortion rates (19.1 and 18.5 per 1,000 women aged 20–24 and 25–29 years, respectively). By contrast, adolescents aged <15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.6%, respectively) and had the lowest abortion rates (0.4 and 2.6 per 1,000 women aged <15 and ≥40 years, respectively). However, abortion ratios in 2018 and throughout 2009–2018 were highest among adolescents (aged ≤19 years) and lowest among women aged 25–39 years. Abortion rates decreased from 2009 to 2018 for all women, regardless of age. The decrease in abortion rate was highest among adolescents compared with women in any other age group. From 2009 to 2013, the abortion rates decreased for all age groups and from 2014 to 2018, the abortion rates decreased for all age groups, except for women aged 30–34 years and those aged ≥40 years. In addition, from 2017 to 2018, abortion rates did not change or decreased among women aged ≤24 and ≥40 years; however, the abortion rate increased among women aged 25–39 years. Abortion ratios also decreased from 2009 to 2018 among all women, except adolescents aged <15 years. The decrease in abortion ratio was highest among women aged ≥40 years compared with women in any other age group. The abortion ratio decreased for all age groups from 2009 to 2013; however, from 2014 to 2018, abortion ratios only decreased for women aged ≥35 years. From 2017 to 2018, abortion ratios increased for all age groups, except women aged ≥40 years. In 2018, approximately three fourths (77.7%) of abortions were performed at ≤9 weeks’ gestation, and nearly all (92.2%) were performed at ≤13 weeks’ gestation. In 2018, and during 2009–2018, the percentage of abortions performed at >13 weeks’ gestation remained consistently low (≤9.0%). In 2018, the highest proportion of abortions were performed by surgical abortion at ≤13 weeks’ gestation (52.1%), followed by early medical abortion at ≤9 weeks’ gestation (38.6%), surgical abortion at >13 weeks’ gestation (7.8%), and medical abortion at >9 weeks’ gestation (1.4%); all other methods were uncommon (<0.1%). Among those that were eligible (≤9 weeks’ gestation), 50.0% of abortions were early medical abortions. In 2017, the most recent year for which PMSS data were reviewed for pregnancy-related deaths, two women were identified to have died as a result of complications from legal induced abortion.
  • Interpretation: Among the 48 areas that reported data continuously during 2009–2018, decreases were observed during 2009–2017 in the total number, rate, and ratio of reported abortions, and these decreases resulted in historic lows for this period for all three measures. These decreases were followed by 1%–2% increases across all measures from 2017 to 2018.
  • After nationwide legalization of abortion in 1973, the total number, rate (number of abortions per 1,000 women aged 15–44 years), and ratio (number of abortions per 1,000 live births) of reported abortions increased rapidly, reaching the highest levels in the 1980s, before decreasing at a slow yet steady pace. During 2006–2008, a break occurred in the previously sustained pattern of decrease, although this break has been followed in subsequent years by even greater decreases. Nonetheless, throughout the years, abortion incidence continues to vary across subpopulations. Continued surveillance is needed to monitor changes in abortion incidence in the United States.
  • Among the 49 reporting areas that provided data for 2018, a total of 619,591 abortions were reported. Of these abortions, 614,820 (99.2%) were from 48 reporting areas that provided data every year for 2009–2018. In 2018, these continuously reporting areas had an abortion rate of 11.3 abortions per 1,000 women aged 15–44 years and an abortion ratio of 189 abortions per 1,000 live births. In 2017, the total number, rate, and ratio of reported abortions decreased to historic lows for the period of analysis for all three measures. From 2017 to 2018, the total number of reported abortions and abortion rate increased 1% (from 609,095 to 614,820 total abortions and from 11.2 to 11.3 abortions per 1,000 women aged 15–44 years), and the abortion ratio increased 2% (from 185 to 189 abortions per 1,000 live births). From 2009 to 2018, the total number of reported abortions decreased 22% (from 786,621), the abortion rate decreased 24% (from 14.9 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 16% (from 224 abortions per 1,000 live births).
    In 2018, a considerable range existed in abortion rates by reporting area of occurrence (from 2.4 to 26.8 abortions per 1,000 women aged 15–44 years in South Dakota and New York City) and abortion ratios (from 32 to 518 abortions per 1,000 live births in South Dakota and the District of Columbia). The percentage of abortions obtained by out-of-state residents also varied among reporting areas (from 0.4% in Arizona to 65.4% in the District of Columbia). Overall, 0.9% of abortions were reported to CDC with unknown residence.
  • Among the 48 areas that reported abortion numbers by women’s age for 2018, women in their 20s accounted for the majority (57.7%) of abortions and had the highest abortion rates (19.1 and 18.5 abortions per 1,000 women aged 20–24 and 25–29 years, respectively). Women in the youngest (<15 years) and oldest (≥40 years) age groups accounted for the smallest percentages of abortions (0.2% and 3.6%, respectively) and had the lowest abortion rates (0.4 and 2.6 abortions per 1,000 women aged <15 and ≥40 years, respectively). In contrast, abortion ratios in 2018 were lowest among women aged 25–39 years (126–189 per 1,000 live births).
  • Among the 44 reporting areas that provided data each year by women’s age for 2009–2018, this pattern across age groups was stable, with the majority of abortions and the highest abortion rates occurring among women aged 20–29 years and the lowest percentages of abortions and abortion rates occurring among women in the youngest and oldest age groups. From 2009 to 2018, abortion rates decreased among all age groups, although the decreases for adolescents (64% and 55% for adolescents aged <15 and 15–19 years, respectively) were greater than the decreases for women in all older age groups. From 2009 to 2013, the abortion rates decreased for all age groups, and from 2014 to 2018, the abortion rates decreased for all age groups except women aged 30–34 years and ≥40 years. From 2017 to 2018, abortion rates did not change or decreased among women aged ≤24 and ≥40 years; however, the abortion rate increased among women aged 25–39 years. During 2009–2018, abortion ratios decreased among women in all age groups, except for adolescents aged <15 years. The abortion ratio decreased for all age groups from 2009 to 2013; however, from 2014 to 2018, abortion ratios only decreased for women aged ≥35 years. From 2017 to 2018, abortion ratios increased for all age groups, except women aged ≥40 years.
    Among the 46 areas that reported women’s age by individual year among adolescents for 2018, adolescents aged 18–19 years accounted for the majority (69.7%) of adolescent abortions and had the highest adolescent abortion rates (8.6 and 12.2 abortions per 1,000 adolescents aged 18 and 19 years, respectively). Adolescents aged <15 years accounted for the smallest percentage of adolescent abortions (2.5%) and had the lowest adolescent abortion rate (0.4 abortions per 1,000 adolescents aged 13–14 years). In 2018, the abortion ratio for adolescents was highest among adolescents aged <15 years (833 abortions per 1,000 live births) and was lowest among adolescents aged ≥17 years (336, 346, and 284 abortions per 1,000 live births among adolescents aged 17, 18, and 19 years, respectively).
  • Among the 31 areas that reported race/ethnicity data for 2018, non-Hispanic White women and non-Hispanic Black women accounted for the largest percentages of all abortions (38.7% and 33.6%, respectively), and Hispanic women and non-Hispanic women in the other race category accounted for smaller percentages (20.0% and 7.7%, respectively). Non-Hispanic White women had the lowest abortion rate (6.3 abortions per 1,000 women) and ratio (110 abortions per 1,000 live births), and non-Hispanic Black women had the highest abortion rate (21.2 abortions per 1,000 women) and ratio (335 abortions per 1,000 live births).
  • Among the 42 areas that reported by marital status for 2018, 14.8% of women who obtained an abortion were married, and 85.2% were unmarried. The abortion ratio was 44 abortions per 1,000 live births for married women and 378 abortions per 1,000 live births for unmarried women.
  • Data from the 43 areas that reported the number of previous live births for women who obtained abortions in 2018 indicate that 40.7%, 24.8%, 19.8%, and 14.7% of these women had zero, one, two, or three or more previous live births, respectively. Data from the 40 areas that reported the number of previous abortions for women who obtained abortions in 2018 indicate that the majority (59.9%) had previously had no abortions, 23.9% had previously had one abortion, 9.9% had previously had two abortions, and 6.4% had previously had three or more abortions.
  • Among the 42 areas that reported gestational age at the time of abortion for 2018, approximately three fourths (77.7%) of abortions were performed at ≤9 weeks’ gestation, and nearly all (92.2%) were performed at ≤13 weeks’ gestation. Fewer abortions were performed at 14–20 weeks’ gestation (6.9%) or at ≥21 weeks’ gestation (1.0%). Among the 34 reporting areas that provided data every year on gestational age for 2009–2018, the percentage of abortions performed at ≤13 weeks’ gestation changed negligibly, from 91.8% to 91.5%. However, within this gestational age range, a shift occurred toward earlier gestational ages, with the percentage of abortions performed at ≤6 weeks’ gestation increasing 8% and the percentage of abortions performed at 7–9 weeks’ and 10–13 weeks’ gestation decreasing 2% and 14%, respectively. During 2009–2018, abortions performed at >13 weeks’ gestation accounted for ≤9.0% of abortions. Among the 45 areas that reported by method type for 2018 and included medical abortion on their reporting form, 52.1% of abortions were surgical abortions at ≤13 weeks’ gestation, 38.6% were early medical abortions (a nonsurgical abortion at ≤9 weeks’ gestation), 7.8% were surgical abortions at >13 weeks’ gestation, and 1.4% were medical abortions at >9 weeks’ gestation; other methods, including intrauterine instillation and hysterectomy/hysterotomy, were both uncommon (<0.1%). Among the 37 reporting areas*** that included medical abortion on their reporting form and provided these data for the relevant years of comparison, use of early medical abortion increased 9% from 2017 to 2018 (from 34.7% of abortions to 37.7%) and 120% from 2009 to 2018 (from 17.1% of abortions to 37.7%). Increases in early medical abortion occurred both from 2009 to 2013 (from 17.1% of abortions to 22.7% [33% increase]) and from 2014 to 2018 (from 23.3% of abortions to 37.7% [62% increase]).
  • Among the 40 areas that reported abortions categorized by individual weeks of gestation and method type, surgical abortion accounted for the largest percentage of abortions within every gestational age category, except ≤6 weeks’ gestation. At ≤6 weeks’ gestation, surgical abortion accounted for 45.1% of abortions. Surgical abortion accounted for 55.3% of abortions at 7–9 weeks’ gestation, 93.8%–98.4% of abortions at 10–20 weeks’ gestation, and 91.9% of abortions at ≥21 weeks’ gestation. In contrast, medical abortion accounted for 54.9% of abortions at ≤6 weeks’ gestation, 44.7% of abortions at 7–9 weeks’ gestation, 6.2% of abortions at 10–13 weeks’ gestation, 1.5%–3.2% of abortions at 14–20 weeks’ gestation, and 7.2% of abortions at ≥21 weeks’ gestation. For each gestational age category (if applicable), abortions performed by intrauterine instillation or hysterectomy/hysterotomy were rare (<0.1%–0.8% of abortions).
  • In selected reporting areas, abortions that were categorized by weeks of gestation were further categorized by age and race/ethnicity. In every subgroup for these characteristics, the largest percentage of abortions occurred at ≤9 weeks’ gestation. In 42 reporting areas, by age, 55.1% of adolescents aged <15 years and 71.5% of adolescents aged 15–19 years obtained an abortion at ≤9 weeks’ gestation, compared with ≥76.8% among age groups aged ≥20 years. Conversely, 21.7% of adolescents aged <15 years and 10.3% of adolescents aged 15–19 years obtained an abortion after 13 weeks’ gestation, compared with 7.3%–8.0% for women in older age groups. In 30 reporting areas, by race/ethnicity, 73.3% of non-Hispanic Black women obtained an abortion at ≤9 weeks’ gestation, compared with 79.6%–81.5% of women from other racial/ethnic groups. Differences in abortions after 13 weeks’ gestation across race/ethnicity were minimal (8.8% for non-Hispanic Black women, compared with 6.5%–8.1% for women in the remaining racial/ethnic groups).
  • The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973. Because of this variability and the relatively limited number of deaths related to legal induced abortions every year, national legal abortion case-fatality rates were calculated for consecutive 5-year periods during 1973–2017. The national legal induced abortion case-fatality rate for 2013–2017 was 0.44 legal induced abortion-related deaths per 100,000 reported legal abortions. This case-fatality rate was lower than the rates for the preceding 5-year periods.
  • For 2018, a total of 619,591 abortions were reported to CDC by 49 areas. Of these reporting areas, 48 submitted data every year for 2009–2018, thus providing the information necessary for consistently reporting trends. Among these 48 areas, for 2018, the abortion rate was 11.3 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 189 abortions per 1,000 live births. Although the rate of reported abortions declined overall from 2009 to 2018, from 2017 to 2018, the number and rate of reported abortions increased 1%, and the abortion ratio increased 2%.
  • Among areas that reported data continuously by age from 2009 to 2018, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas adolescents aged ≤19 years had the lowest abortion rates. During 2009–2018, women aged ≥40 years accounted for a relatively small proportion of reported abortions (≤3.7%). However, the abortion ratio among women aged ≥40 years continues to be higher than among women aged 25–39 years. These data underscore important age differences in abortion measures.
  • The adolescent abortion trends described in this report are important for monitoring progress that has been made toward reducing adolescent pregnancies in the United States. From 2009 to 2018, national birth data indicate that the birth rate for adolescents aged 15–19 years decreased 54% (44,55), and the data in this report indicate that the abortion rate for the same age group decreased 55%. These findings highlight that decreases in adolescent births in the United States have been accompanied by large decreases in adolescent abortions.
  • As in previous years, abortion rates and ratios differ across racial/ethnic groups. For example, in 2018, compared with non-Hispanic White women, abortion rates and ratios were 3.4 and 3.0 times higher among non-Hispanic Black women and 1.7 and 1.4 times higher among Hispanic women. Similar differences have been demonstrated in other U.S.-based research. The comparatively higher abortion rates and ratios among non-Hispanic Black women have been attributed to higher unintended pregnancy rates and a greater percentage of unintended pregnancies ending in abortion in this group. The complex factors contributing to differences to ensure equitable access to quality family planning services need to be identified.
  • In 2018, the majority of abortions occurred early in gestation (≤9 weeks), when the risks for complications are lowest. In addition, over the last 10 years, approximately three fourths of abortions were performed at ≤9 weeks’ gestation, and this percentage increased from 74.2% in 2009 to 76.2% in 2018. Moreover, among the areas that reported abortions at ≤13 weeks’ gestation by individual week, the distribution of abortions by gestational age continued to shift toward earlier weeks of gestation, with the percentage of early abortions performed at ≤6 weeks’ gestation increasing from 33.6% in 2009 to 36.2% in 2018.
    From 2009 to 2018, the percentage of abortions performed at >13 weeks’ gestation did not change appreciably, remaining at ≤9.0%. Previous research indicates that the distribution of abortions by gestational age differs by various sociodemographic characteristics. In this report, the percentage of adolescents aged ≤19 years who obtained abortions at >13 weeks’ gestation was higher than the percentage of women in older age groups who obtained abortions. Multiple factors might influence the gestational age when abortions are performed.
    The trend of obtaining abortions earlier in pregnancy has been facilitated by changes in abortion practices. Research conducted in the United States during the 1970s indicated that surgical abortion procedures performed at ≤6 weeks’ gestation, compared with 7–12 weeks’ gestation, were less likely to result in successful termination of the pregnancy. However, subsequent advances in technology (e.g., improved transvaginal ultrasonography and sensitivity of pregnancy tests) have allowed very early surgical abortions to be performed with completion rates exceeding 97%. Likewise, the development of early medical abortion regimens has allowed for abortions to be performed early in gestation, with completion rates for regimens that combine mifepristone and misoprostol reaching 96%–98%. In 2018, 77.7% of all reported abortions were ≤9 weeks’ gestation thus were eligible for early medical abortion; of these, 50.0% were reported as medical abortions. Moreover, among areas that included medical abortion on their reporting form, the percentage of all abortions performed by early medical abortion increased 120% from 2009 to 2018.
  • The national legal induced abortion case-fatality rate for 2013–2017 was fewer than 1 per 100,000 abortions, as it was for all the previous 5-year periods since the late 1970s, demonstrating the low risk for death associated with legal induced abortion.
  • Ongoing surveillance of legal induced abortion is important for several reasons. First, abortion surveillance can be used to help evaluate programs aimed at preventing unintended pregnancies. Although pregnancy intentions can be difficult to assess, abortion surveillance provides an important indicator of unintended pregnancies because up to 42% of unintended pregnancies in the United States end in abortion. Efforts to help women avoid unintended pregnancies might reduce the number of abortions. Second, routine abortion surveillance is needed to assess trends in clinical practice patterns over time. Information in this report on the number of abortions performed through different methods (e.g., medical or surgical) and at different gestational ages provides the denominator data that are necessary for analyses of the relative safety of abortion practices. Finally, information on the number of pregnancies ending in abortion is needed in conjunction with data on births and fetal losses to estimate the number of pregnancies in the United States and determine rates for various outcomes of public health importance (e.g., adolescent pregnancies).
  • Approximately 18% of all pregnancies in the United States end in induced abortion. Multiple factors influence the incidence of abortion, including access to health care services and contraception; the availability of abortion providers; state regulations, such as mandatory waiting periods, parental involvement laws, and legal restrictions on abortion providers; increasing acceptance of nonmarital childbearing; and changes in the economy and the resulting impact on fertility and contraceptive use.

"Supreme Court declines to hear Kentucky ultrasound law" (December 9, 2019)[edit]

John Kruzel, "Supreme Court declines to hear Kentucky ultrasound law". “The Hill”, December 9, 2019.

  • The Supreme Court has declined to hear a challenge to a Kentucky law that obligates doctors to show and describe ultrasounds to women who seek abortions, even if patients object.
    The justices’ decision not to take up the case leaves intact a federal appeals court ruling that upheld the law against a First Amendment challenge that claimed the measure abridged doctors’ freedom of speech.
    The Kentucky Ultrasound Informed Consent Act requires physicians, prior to an abortion, to perform an ultrasound, describe and display its images to the patient, and make the fetal heartbeat audible.
  • The American Civil Liberties Union (ACLU), which brought the case on behalf of the challengers, lamented the justices’ denial of review.
    “This law is not only unconstitutional, but as leading medical experts and ethicists explained, deeply unethical,” said Alexa Kolbi-Molinas, senior staff attorney at the ACLU Reproductive Freedom Project. “We are extremely disappointed that the Supreme Court will allow this blatant violation of the First Amendment and fundamental medical ethics to stand.”
  • The anti-abortion nonprofit group Students for Life, meanwhile, celebrated the petition denial as a win for the pro-life movement.
    “This is another pro-life law that will be allowed to stand and will help protect preborn babies from abortion,” the group said via Twitter.

"Abortion Surveillance --- United States, 2000" (2003)[edit]

Laurie D. Elam-Evans, Ph.D., Lilo T. Strauss, M.A., Joy Herndon, M.S., Wilda Y. Parker, Sonya V. Bowens, M.S., Suzanne Zane, D.V.M.,Cynthia J. Berg, M.D. (2003). "Abortion Surveillance --- United States, 2000". Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002). Center for Disease Control. 52 (12): 1–32. PMID 14647014. Retrieved October 2, 2013.

  • Results: A total of 857,475 legal induced abortions were reported to CDC for 2000 from 49 reporting areas, representing a 0.5% decrease from the 861,789 legal induced abortions reported by 48 reporting areas for 1999 and a 1.3% decrease for the same 48 reporting areas that reported in 1999. The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2000 (for the same 48 reporting areas as 1999), compared with 256 reported for 1999. This represents a 3.8% decline in the abortion ratio. The abortion rate (for the same 48 reporting areas as 1999) was 16 per 1,000 women aged 15--44 years for 2000. This was also a 3.8% decrease from the rate reported for procedures performed during 1997--1999 for the same 48 reporting areas.
    The highest percentages of reported abortions were for women aged <25 years (52%), women who were white (57%), and unmarried women (81%). Fifty-eight percent of all abortions for which gestational age was reported were performed at <8 weeks of gestation, and 88% were performed before 13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2000, steady increases have occurred in the percentage of abortions performed at <6 weeks of gestation. Few abortions were performed after 15 weeks of gestation; 4.3% were obtained at 16--20 weeks and 1.4% were obtained at >21 weeks. A total of 31 reporting areas submitted data stating that they performed medical (nonsurgical) procedures, making up 1.0% of all reported procedures from the 42 areas with adequate reporting on type of procedure.
    In 1998 and 1999 (the most recent years for which data are available), 14 women died as a result of complications from known legal induced abortion. Ten of these deaths occurred in 1998 and four occurred in 1999; no deaths were associated with known illegal abortion.
  • Interpretation: From 1990 through 1997, the number of legal induced abortions gradually declined. In 1998 and 1999, the number of abortions continued to decrease when comparing the same 48 reporting areas. In 2000, even with one additional reporting state, the number of abortions declined slightly. In 1998 and 1999, as in previous years, deaths related to legal induced abortions occurred rarely (<1 death per 100,000 abortions).
  • For 2000, CDC compiled data that were voluntarily provided from 49 reporting areas in the United States: 47 states (excluding Alaska, California, and New Hampshire), the District of Columbia, and New York City. Legal induced abortion was defined as a procedure, performed by a licensed physician or someone acting under the supervision of a licensed physician, that was intended to terminate a suspected or known intrauterine pregnancy and to produce a nonviable fetus at any gestational age (1,2). The total number of legal induced abortions was available from all reporting areas; however, not all of these areas collected data regarding some or all of the characteristics of women who obtained abortions. Thus, the availability of data on characteristics of women obtaining an abortion varied by reporting area in 2000.
    Most reporting areas (46 states, the District of Columbia, and New York City) collected and reported adequate data (i.e., data categorized in accordance with surveillance variables and with <15% unknown values) by age of the woman, whereas only 29 states, the District of Columbia, and New York City collected and reported adequate data by Hispanic ethnicity.
  • This report provides overall and state-specific abortion statistics. For all characteristics for which birth or population data were available, abortion ratios (number of abortions per 1,000 live births) or abortion rates (number of abortions per 1,000 women in a given age group) are provided. Starting with 1996, abortion ratios were calculated by using the number of live births to residents of each area, from birth data reported to CDC's National Center for Health Statistics (NCHS); numbers had previously been received from state health departments. The population data used for calculating abortion rates had previously been obtained from the U.S. Census Bureau postcensual data. However, because of the impact of changes in Office of Management and Budget (OMB) standards in 1997 that allowed for multiple race selections on the 2000 Census, no population data were released by the Census Bureau. NCHS bridged race and ethnicity data were used for calculating abortion rates; this involves a model that translates multiple race responses for an individual into the one, single response that the model predicts the individual most likely would have reported under the 1977 OMB standards.
  • Case-fatality rates for 1972--1997 are provided in this report. Case-fatality rates for 1998--1999 cannot be calculated because a substantial number of abortions occurred in the four nonreporting states, and the total number of abortions (the denominator) is unknown.
  • Overall, the annual number of legal induced abortions in the United States increased gradually until it peaked in 1990, and it has declined in most years thereafter (Figure 1). In 2000, a total of 857,475 legal induced abortions were reported to CDC by 49 reporting areas. This represents a 0.5% decrease from 1999, for which 861,789 legal induced abortions were reported from 48 reporting areas (Table 1) and a 1.3% decrease in the same 48 reporting areas as 1999.
    The national legal induced abortion ratio increased from 196 per 1,000 live births in 1973 (the first year that 52 areas reported) to 358 per 1,000 live births in 1979 and remained nearly stable through 1981 (Figure 1) (Table 2). The ratio peaked at 364 per 1,000 live births in 1984 and since then has shown a nearly steady decline. In 2000, the abortion ratio was 245 per 1,000 live births in 49 reporting areas and 246 for the same 48 reporting areas available for 1999. This represents a 3.8% decrease from 1999 (256 per 1,000 live births) for the 48 reporting areas (Table 2) (6).
    The national legal induced abortion rate increased from 14 abortions per 1,000 women aged 15--44 years in 1973 to 25 per 1,000 in 1980. In the 1980s and early 1990s, the rate remained stable at 23--24 abortions per 1,000 women aged 15--44 years, and during 1994--1997 it again stabilized at 20--21. The abortion rate remained unchanged at 17 per 1,000 women aged 15--44 years from 1997 through 1999 in the same 48 reporting areas. In 2000, the abortion rate declined to 16 per 1,000 women aged 15--44 years (overall and in the same 48 reporting areas as 1999).
  • The numbers, ratios, and rates of reported legal induced abortions are presented by area of residence as well as by area of occurrence. In 2000, the highest numbers of reported legal induced abortions occurred in New York City (94,466), Florida (88,563), and Texas (76,121); the fewest† occurred in Idaho (801), South Dakota (878), and North Dakota (1,341) (Table 3). The abortion ratios by state or area of occurrence ranged from 39 per 1,000 live births in Idaho to 869 per 1,000 live births in the District of Columbia. The rates by occurrence ranged from 3 per 1,000 women aged 15--44 years in Idaho to 46 per 1,000 women aged 15--44 years in the District of Columbia. These ratios and rates should be viewed with consideration of the sizable variation by state in the percentage of abortions obtained by out-of-state residents. In 2000, approximately 9% of reported abortions were obtained by out-of-state residents. The percentages ranged from 0.4% in Hawaii to 56% in the District of Columbia (Table 3). Data by state of residence are incomplete because three states (Alaska, California, and New Hampshire) did not report and five states (Arizona, Florida, Iowa, Louisiana, and Massachusetts) did not provide any data concerning the residence status of all women obtaining abortions in their state.
  • Women aged 20--24 years were known to have obtained 33% of all abortions for which age was adequately reported. Women aged <15 years were known to have obtained <1.0% of all abortions in areas where age was reported (Table 4). Abortion ratios were highest for the youngest women (708 abortions per 1,000 live births for women aged <15 years) and lowest for women aged 30--34 years (145 per 1,000 live births) (Figure 2) (Table 4). In contrast to abortion ratios, among women for whom age was reported, abortion rates were highest for women aged 20--24 years (33 abortions per 1,000 women) and lowest for women at the extremes of reproductive age (2 abortions per 1,000 women aged 13--14 years and 2 per 1,000 women aged 40--44 years) (Table 4). Among adolescents (aged <20 years), the percentage of abortions obtained increased with increasing age. However, the abortion ratio was highest for those <15 years (701 abortions per 1,000 live births)§ and lowest for those aged 19 years (324 per 1,000 live births) (Table 5). Conversely, the rates of abortions were lowest for adolescents aged <15 years (2 per 1,000 women aged 13--14 years) and highest for women age 19 (29 per 1,000 women aged 19 years) (Table 5).
  • Abortion trends by age indicate that since 1973, abortion ratios for women aged <15 years have been higher than for any other age group (Figure 3). For women aged <19 years and those aged >40 years, the abortion ratio increased overall from 1974 through the early 1980s and declined thereafter (Figure 3). The abortion ratio for women aged 20--34 years (the groups with the highest fertility rates) (7) has remained essentially stable since the mid-1980s. The abortion ratio for women aged 35--39 years has gradually declined over time.
    In 2000, for women whose weeks of gestation at the time of abortion were adequately reported, 57% of reported legal induced abortions were known to have been obtained at <8 weeks of gestation, and 87% at <13 weeks (Table 6). Overall, 23% of abortions were known to have been performed at <6 weeks of gestation, 18% at 7 weeks, and 17% at 8 weeks (Table 7). Few reported abortions occurred after 15 weeks of gestation; 4.3% were at 16--20 weeks, and 1.4% were at >21 weeks.
  • For women whose type of procedure was adequately reported, almost all (97%) abortions were known to have been performed by curettage and 0.4% by intrauterine instillation (Table 8). Hysterectomy and hysterotomy were included in the "other" procedure category and were known to have been used in fewer than 0.01% of all abortions. Thirty-one reporting areas submitted data stating that they performed medical (nonsurgical) procedures,¶ hereafter referred to as medical abortions. Medical abortions make up approximately 1% of all procedures reported from the 42 areas with adequate reporting on type of procedure. However, three areas included medical abortions in the "other" category because data for medical abortions are not collected as a separate category on their abortion reporting form. For 2000, a total of 6,895 medical abortion procedures were submitted by the 28 reporting areas that reported medical abortions separately. This reflects an increase of 10% from the 6,278 medical abortions reported by 26 reporting areas for 1999 (6). We do not know to what extent the 6,895 medical abortions reported to CDC for 2000 represent the use of this procedure in all reporting areas.
  • In the 41 areas for which race was adequately reported, approximately 55% of women who obtained legal induced abortions were known to be white, 35% were black, and 7% were of other races; for 3% of the women, race was unknown. (Table 9). The abortion ratio for black women (503 per 1,000 live births) was 3.0 times the ratio for white women (167 per 1,000 live births). Additionally, the abortion ratio for women of other races (329 per 1,000 live births) was 2.0 times the ratio for white women. The abortion rate for black women (30 per 1,000 women) was 3.1 times the rate for white women (10 per 1,000 women), whereas the abortion rate for women of other races (22 per 1,000 women) was 2.2 times the rate for white women.
  • In the 41 areas for which race was adequately reported, approximately 55% of women who obtained legal induced abortions were known to be white, 35% were black, and 7% were of other races; for 3% of the women, race was unknown. (Table 9). The abortion ratio for black women (503 per 1,000 live births) was 3.0 times the ratio for white women (167 per 1,000 live births). Additionally, the abortion ratio for women of other races (329 per 1,000 live births) was 2.0 times the ratio for white women. The abortion rate for black women (30 per 1,000 women) was 3.1 times the rate for white women (10 per 1,000 women), whereas the abortion rate for women of other races (22 per 1,000 women) was 2.2 times the rate for white women.
    Twenty-nine states, the District of Columbia, and New York City reported adequate data** concerning the ethnicity of women who obtained legal induced abortions (Table 10). The percentage of abortions known to have been obtained by Hispanic women in these reporting areas was 17% overall and ranged from <0.1% in Kentucky to 46% in New Mexico. For Hispanic women in these reporting areas, the abortion ratio was 225 per 1,000 live births. The abortion rate for Hispanic women was 16 abortions per 1,000 women.
    For women whose marital status was adequately reported, 78% of women who obtained abortions were known to be unmarried (Table 11). The abortion ratio for unmarried women was 8.8 times the ratio for married women (570 versus 65 abortions per 1,000 live births).
    For women for whom data on previous live births was adequately reported, 39% of women who obtained legal induced abortions were known to have had no previous live births, and 86% had had two or fewer previous live births (Table 12). The abortion ratio was highest for women who had three previous live births (285 per 1,000 live births) and lowest for women who had one previous live birth (194 per 1,000 live births).
    In 2000, of women who obtained an abortion and whose number of previous abortions was adequately reported, 53% were reported to have obtained an abortion for the first time. Eighteen percent of women were reported to have had two or more previous abortions (Table 13).
  • As in the past, approximately 88% of all abortions (for which gestational age at the time of abortion was reported adequately) were obtained during the first 12 weeks of gestation (Table 1). The percentage of women who obtained an abortion at <8 weeks of gestation increased with age, with the exception of women aged 35--39 years (Figure 4) (Table 16). This association is most pronounced for abortions obtained at <6 weeks' gestation (Table 17). The percentage of women who obtained an abortion at >21 weeks of gestation decreased with age for women through 25--29 years. Among women with adequately reported race and weeks of gestation, white women and women of other races were more likely than black women to obtain abortions at <6 or 7 weeks of gestation (Table 17). Among women with adequately reported known ethnicity and weeks of gestation, 25% of Hispanic women obtained abortions at <6 weeks of gestation and 59% obtained abortions at <8 weeks' gestation. This is slightly more than the 57% of non-Hispanic women who obtained abortions at <8 weeks' gestation (Table 17).
    For women whose type of procedure and weeks of gestation were adequately reported, approximately 99% of reported abortions obtained at <15 weeks of gestation were performed by using curettage (primarily suction procedures) (Table 18). Approximately 88% of the 6,229 reported medical abortions were performed at <8 weeks' gestation, representing 1.6% of all abortions that were performed at <8 weeks' gestation. At >16 weeks of gestation, medical abortions (n = 559) also made up 1.6% of all abortions. Medical abortions constituted <0.1% of procedures performed in the 9--15-weeks gestation range. Intrauterine instillation involved the use of saline or prostaglandin and was used rarely (0.3% of all abortions), primarily at >16 weeks of gestation.
  • From the National Pregnancy Mortality Surveillance System, CDC identified 22 maternal deaths for 1998 and 17 maternal deaths for 1999 that were thought to be potentially related to abortion. These maternal deaths were identified either by some indication of abortion on the death certificate or from information such as a news report associated with the death. Investigation of these cases showed that 10 of the 22 deaths in 1998 and four of the 17 deaths in 1999 were related to legal induced abortion and none to illegal induced abortion (Table 19). For 1998, 11 deaths were due to spontaneous abortion, and one death was found not to be abortion related. For 1999, 10 deaths were due to spontaneous abortion, and three deaths were found not to be abortion related. Numbers of deaths due to legal induced abortion were highest before the 1980s, with very few deaths occurring in 1999 (Table 19). Possible abortion-related deaths that occurred during 2000--2002 are currently being investigated.
  • A total of 857,475 legal induced abortions were reported for 2000 in the United States from 47 states, the District of Columbia, and New York City. This is a decline of 0.5% from the legal induced abortions reported for 1999 from 48 reporting areas. A decline of 1.3% in the number of abortions is seen when the same 48 reporting areas from 1999 are compared with those for 2000. Before 1998, a substantial number of legal induced abortions were estimated to have been performed in California (e.g., >23% of the U.S. total in 1997). Beginning in 1998, data were no longer estimated for nonreporting states. The lack of data for California for 2000 explains most of the 28% decrease from the annual number of abortions reported in 1997 as well as a portion of the decrease in the total ratio and rate.
  • Overall, abortion ratios and abortion rates have declined over time (Figure 1). The abortion ratio for 2000 (246 per 1,000 live births for the same 48 reporting areas as 1999) was a 3.8% decline from the previous year. The abortion rate (16 per 1,000 women aged 15--44 years for the same 48 reporting areas as 1999) was also a decline of 3.8% from the rate reported in 1999. The overall declines in the abortion ratio and rate over time may reflect multiple factors, including a decrease in the number of unintended pregnancies; a shift in the age distribution of women toward the older and less fertile ages; reduced or limited access to abortion services, including the passage of abortion laws that affect adolescents (e.g., parental consent or notification laws and mandatory waiting periods); and changes in contraceptive practices, including an increased use of contraception, such as condoms, and, among young women, of long-acting hormonal contraceptive methods that were introduced in the early 1990s.
    The abortion rate reported here for the United States was higher than recent rates reported for Canada and Western European countries and lower than rates reported for China, Cuba, most Eastern European countries, and several of the Newly Independent States of the former Soviet Union.
  • As in previous years, the abortion ratio in 2000 varied substantially by age. Although the abortion ratio was highest for adolescents in 2000, the ratio has gradually declined for women aged <15 and 15--19 years since the mid 1980s. Other studies also have indicated a decrease in birth rates for women aged 15--19 years during 1991--2000 and a decrease in adolescent pregnancy rates 1991--1997.
  • The percentage distribution of abortions by known weeks of gestation has shifted slightly since the late 1970s. From 1992 (when detailed data on early abortions were first available) through 2000, data have indicated steady increases in procedures performed at <6 weeks' gestation with decreases occurring in the percentage of abortions performed at 8, 9--10, and 11--12 weeks' gestation. The increase in the percentage of abortions known to have been performed at <6 weeks may be related to an increase in availability of early abortion services since 1992 as well as to an increase in medical and surgical procedures that can be performed early in gestation. Abortions performed early in pregnancy are associated with lower risks of mortality and morbidity. The proportions of abortions performed later in pregnancy (>13 weeks) have varied very little since 1992. The gestational age at which an abortion is obtained can be influenced by several factors in addition to those for which surveillance data are available (age of the woman, race, marital status). These additional factors include level of education, availability and accessibility of abortion services, timing of confirmation of pregnancy, timing of personal decision-making, timing of prenatal diagnosis, level of fear of discovery of pregnancy, and denial of the pregnancy.
  • Since the mid-1990s, two medical regimens --- methotrexate and mifepristone, each used in conjunction with misoprostol --- have been tested in clinical trials and used by clinical practitioners to perform early medical abortions. CDC surveillance data indicate that >50% of all U.S. abortions are performed at <8 weeks of gestation, which is the timing of the regimen approved for both mifepristone and methotrexate. The medical procedures reported most often for abortions performed early in gestation (<7 weeks) are use of methotrexate with misoprostol and mifepristone with misoprosto. Mifepristone for medical abortion was approved by the Food and Drug Administration (FDA) for use and distribution in the United States in September 2000. This approval might result in early medical abortions becoming more widespread (37,38). The FDA-approved protocol can be initiated up to 49 days of gestation and requires three office visits by the patient: administration of oral mifepristone, administration 48 hours later of oral misoprostol in the health care provider's office, and a follow-up visit in approximately 14 days. Clinical studies of alternative medical abortion regimens have been performed in various countries and are ongoing.
  • The percentage of abortions known to be performed by curettage (which includes dilatation and evacuation [D&E]) increased from 88% in 1973 to 98% in 2000, while the percentage of abortions performed by intrauterine instillation declined sharply, from 10% to 0.4%. The increase in use of D&E is likely due to the lower risk for complications associated with the procedure (48,49). The percentage of abortions performed by D&E (curettage) at >13 weeks' gestation increased from 31% in 1974 (the first year for which these data were available) to 96% in 2000; the percentage of abortions performed by intrauterine instillation at >13 weeks' gestation decreased from 57% to 1.7%.
  • The differential between the abortion ratio for black women and that for white women has increased from 2.0 in 1989 (the first year for which black and other races were reported separately) to 3.0 in 2000. In addition, the abortion rate for black women has been approximately 3 times as high as that for white women (range: 2.6--3.1) since 1991 (the first year for which rates by race were published) (52). These rates by race are substantially lower than rates previously published by NCHS and suggest that the reporting areas for the 2000 report might not be fully representative of the U.S. black female population of reproductive age. Census Bureau estimates and birth certificate data indicate that the large majority of Hispanic women report themselves as white. Therefore, data for some white women actually represent Hispanic women.
  • In 2000, 41 states, the District of Columbia and New York City reported Hispanic ethnicity of women who obtained abortions. Because of concerns regarding the completeness of such data (>15% unknown data) in certain states, in 2000, data from only 29 states, the District of Columbia, and New York City were used to determine the number and percentage of abortions obtained by women of Hispanic ethnicity. These geographic areas represent approximately 46% of all reproductive-age Hispanic women in the United States for 2000 and approximately 47% of U.S. Hispanic births. Thus, the number of Hispanic women who obtain abortions is underestimated, and the number, ratio, and rate of abortions for Hispanic women in this report are not generalizable to the overall Hispanic population in the United States.
    The abortion ratio for Hispanic women (225 per 1,000 live births) was lower than the ratio for non-Hispanic women (233 per 1,000 live births). This differs from the findings for abortions performed in 1999 and reflects a return to the previously observed pattern among Hispanic women of slightly lower or similar ratios to those for non-Hispanic women. As in the past, the abortion rate per 1,000 Hispanic women was higher than the rate per 1,000 non-Hispanic women. This finding is consistent with another study but differs substantially from abortion rates by ethnicity that were published previously by NCHS. The differences are likely due to the method used to account for underreporting of abortions by adjusting CDC tabulations to national totals. This finding also suggests that the reporting areas for the 2000 report are not fully representative of the U.S. Hispanic female population of reproductive age. Race-specific and ethnicity-specific differences in legal induced abortion ratios and rates might reflect differences among groups in factors such as socioeconomic status, access to family planning and contraceptive services, contraceptive use, and incidence of unintended pregnancies.
  • Compared with 1972, the annual number of deaths associated with known legal induced abortion in the late 1990s has decreased by approximately 70%. In 1972, 24 women died from causes known to be associated with legal abortions and 39 died as a result of known illegal abortions. In 1999, four died as a result of legal induced abortion and none died as a result of illegal induced abortion. Numbers of legal, induced abortion-related deaths for 1998 and 1999, identified for all 52 reporting areas, are similar to those reported over the previous 18 years. However, national case-fatality rates for 1998 and 1999 cannot be calculated because a substantial number of abortions occurred in four nonreporting states, and the total number of abortions (the denominator) is unknown.
  • Despite these limitations, findings from ongoing national surveillance of legal induced abortion are useful for several purposes. First, public health agencies use data from abortion surveillance to identify characteristics of women who are at high risk for unintended pregnancy. Second, ongoing annual surveillance is used to monitor trends in the number, ratio, and rate of abortions in the United States. Third, statistics regarding the number of pregnancies ending in abortion are used in conjunction with birth data and fetal death computations to estimate pregnancy rates (e.g., pregnancy rates among adolescents). Fourth, abortion and pregnancy rates can be used to evaluate the effectiveness of family planning programs and programs for preventing unintended pregnancy. Fifth, ongoing surveillance provides data for assessing changes in clinical practice patterns related to abortion (e.g., longitudinal changes in the types of procedures and trends in weeks of gestation at the time of abortion). Finally, numbers of abortions are used as the denominator in calculating abortion mortality rates (29).
  • A reduction in unintended pregnancy, and thus abortion, will require several complex strategies. In a study of abortion patients conducted during 2000--2001, 54% of patients reported that they were using contraception during the month they became pregnant. However, their use of contraception might have been inconsistent or incorrect (18). In 1995, when the most recent NSFG was conducted, approximately 29% of sexually active U.S. women who used only oral contraceptives for birth control reported that they missed a birth-control pill one or more times during the 3 months before their NSFG interview. In addition, approximately 33% of U.S. women who were using only coitus-dependent contraceptive methods†† during the 3 months before the interview used these methods inconsistently (9). Not all health insurance plans provide contraceptive benefits. Therefore, education regarding abstinence, contraceptive use and practices as well as access to and education regarding safe, effective, and affordable contraception and family-planning services might help reduce the incidence of unintended pregnancy and, therefore, the number of legal induced abortions in the United States.

"Supreme Court Strikes Down Louisiana Abortion Restrictions" (June 29, 2020)[edit]

Liptak, Adam (June 29, 2020). "Supreme Court Strikes Down Louisiana Abortion Restrictions". The New York Times. (Published June 29, 2020Updated May 17, 2021)

  • WASHINGTON — The Supreme Court on Monday struck down a Louisiana law that could have left the state with a single abortion clinic, dashing the hopes of conservatives who were counting on President Trump’s appointments to lead the court to sustain restrictions on abortion rights and, eventually, to overrule Roe v. Wade.
    Instead, conservatives suffered a setback, and from an unlikely source. Chief Justice John G. Roberts Jr. added his crucial fifth vote to those of the court’s four-member liberal wing, saying that respect for precedent compelled him to do so, even though he had voted to uphold an essentially identical Texas law in a 2016 dissent.
  • Conservatives reacted with fury. “Chief Justice Roberts is at it again with his political gamesmanship,” Senator Ted Cruz, Republican of Texas, said on Twitter. “This time he has sided with abortion extremists who care more about providing abortion-on-demand than protecting women’s health.”
    Progressive groups countered that the court’s decision was a routine application of precedent.
    “Today’s ruling, while incredibly important, should not be surprising,” Elizabeth Wydra, the president of the Constitutional Accountability Center, a liberal group, said in a statement. “In fact, this case should have been one of the easiest for the court to dispose of this term.”
    “This was really just ‘Supreme Court 101’ for all nine of the justices,” she said, “but only five of them were prepared to show fidelity to law and precedent instead of politics.”
  • Justice Stephen G. Breyer, writing for the four liberals who joined with the chief justice in the majority, said the Louisiana law was “almost word-for-word identical” to the one from Texas that the Supreme Court struck down in the 2016 decision, Whole Woman’s Health v. Hellerstedt.
    Both laws required doctors performing abortions to have admitting privileges at nearby hospitals. And in both cases, Justice Breyer wrote, the laws put an undue burden on the constitutional right to the procedure.
    The court’s decision to revisit the issue of admissions privileges had worried proponents of abortion rights given Chief Justice Roberts’s support for the Texas law. Since that ruling, Justice Anthony M. Kennedy, who had voted to overturn the law, was replaced by the more conservative Justice Brett M. Kavanaugh.
    But in the end, Chief Justice Roberts’s commitment to precedent sank the Louisiana law. “I joined the dissent in Whole Woman’s Health,” he wrote on Monday, “and continue to believe that the case was wrongly decided. The question today, however, is not whether Whole Woman’s Health was right or wrong, but whether to adhere to it in deciding the present case.”
    “The Louisiana law imposes a burden on access to abortion just as severe as that imposed by the Texas law, for the same reasons,” the chief justice wrote in a concurring opinion that did not adopt Justice Breyer’s reasoning. “Therefore Louisiana’s law cannot stand under our precedents.”
  • Kayleigh McEnany, the White House press secretary, expressed disappointment in Monday’s decision.
    “In an unfortunate ruling today,” she said in a statement, “the Supreme Court devalued both the health of mothers and the lives of unborn children by gutting Louisiana’s policy that required all abortion procedures be performed by individuals with admitting privileges at a nearby hospital.”
    Joseph R. Biden Jr., the presumptive Democratic presidential nominee, issued a statement saying that “women’s health care rights have been under attack as states across the country have passed extreme laws restricting women’s constitutional right to choice under any circumstance.”
    Justice Breyer wrote that the Louisiana law, which was enacted in 2014, imposed great burdens on access to abortion but did nothing to protect women’s health, its ostensible goal. He wrote that hospitalizations after abortions were rare, that women would receive medical care at hospitals whether their doctors had admitting privileges or not and that abortion providers were often unable to obtain admitting privileges for reasons unrelated to their competence.

A Major Ruling on Abortion (June 30, 2020)[edit]

Adam Liptak in ‘The Daily’ “The New York Times”, (June 30): A Major Ruling on Abortion, hosted by Michael Barbaro; produced by Luke Vander Ploeg and Michael Simon Johnson; with help from Asthaa Chaturvedi; and edited by M.J. Davis Lin; as quoted in Liptak, Adam (June 29, 2020). "Supreme Court Strikes Down Louisiana Abortion Restrictions". The New York Times. (Published June 29, 2020Updated May 17, 2021)

  • Michael Barbaro: Adam, we have talked about admitting privileges for doctors who performed abortions in the past. But as a reminder, what is the idea behind them?
Adam Liptak: It’s a kind of business relationship between a doctor and a hospital. It allows doctors to admit and care for their patients at given hospitals. Supporters of admitting privileges laws say that it’s a kind of credentialing function, that you are likely to be a slightly better doctor if a nearby hospital kind of vouches for you by giving you admitting privileges. Opponents of admitting privileges laws say they’re a bit of a scam, that abortion is very safe. If you do have to go to a hospital, they say you’re going to be admitted, whether you have a doctor with admitting privileges or not.
  • Adam Liptak: Well, what would have been really striking in Louisiana is what would have happened if the case went the other way. Louisiana currently has three abortion clinics. That would have gone to one. And it currently has about five doctors who are willing to provide abortion. And that also would apparently have gone to one. So it would have required every woman in the state to travel to New Orleans to get abortions. And it’s not clear that that clinic would have had the capacity to serve those women, even if they could make what, in some instances, would be a very long drive — five hours each way — and do it twice. Because Louisiana also has a law requiring a waiting period between the initial consultation and the procedure itself.

"Roe v. Wade at 40: Most Oppose Overturning Abortion Decision" (January 16, 2013)[edit]

Joseph Liu, "Roe v. Wade at 40: Most Oppose Overturning Abortion Decision". Pewresearch.org, (January 16, 2013).

  • The latest national survey by the Pew Research Center, conducted Jan. 9-13 among 1,502 adults, finds that abortion is viewed as a less important issue than in the past. Currently, 53% say abortion “is not that important compared to other issues,” up from 48% in 2009 and 32% in 2006. The percentage viewing abortion as a “critical issue facing the country” fell from 28% in 2006 to 15% in 2009 and now stands at 18%.
    However, the public continues to be divided over whether it is morally acceptable to have an abortion. Nearly half (47%) say it is morally wrong to have an abortion, while just 13% find this morally acceptable; 27% say this is not a moral issue and 9% volunteer that it depends on the situation. These opinions have changed little since 2006.
  • Slightly more than half of adults (53%) say that abortion is not that important compared with other issues. About a quarter (27%) say abortion is one among many important issues facing the country, while 18% view abortion as a critical issue.
  • Nearly three-in-ten white evangelical Protestants (29%) view the issue of abortion as critical, compared with just 13% of white mainline Protestants and white Catholics. Majorities of white mainline Protestants (61%) and white Catholics (59%) say abortion is not that important compared with other issues. An even higher percentage of religiously unaffiliated Americans (71%) say abortion is relatively unimportant.
    Nearly half of Americans (47%) say they personally believe that it is morally wrong to have an abortion, compared with 27% who say it is not a moral issue, 13% who find it morally acceptable and 9% who volunteer that it depends. These opinions have changed only modestly in recent years.
  • Most white evangelical Protestants (73%), as well as 55% of white Catholics and 53% of black Protestants, say it is morally wrong to have an abortion. That compares with 36% of white mainline Protestants and just 20% of the religiously unaffiliated.
    A majority of Republicans (63%) view having an abortion as morally wrong, compared with 45% of independents and 39% of Democrats.
    Relatively small percentages of people in all religious, partisan and demographic groups say it is morally acceptable to have an abortion. However, nearly half of Democrats say either that having an abortion is morally acceptable (17%) or that it is not a moral issue (31%). Among independents, roughly four-in-ten say it is either morally acceptable (12%) or that abortion is not a moral issue (30%).
  • The survey finds that 41% say that the Democratic Party can do a better job of representing their views on abortion; nearly as many (36%) say the Republican Party could do better.
    Last March, the Democratic Party held a 16-point advantage as better representing people’s views on abortion (47% to 31%). In October 2011, the Democrats led by eight points on this issue (44% to 36%).

”Abortion and the Politics of Motherhood” (1984)[edit]

Kristin Luker, ”Abortion and the Politics of Motherhood”, University of California Press, (1984)

  • At the opening of the nineteenth century, no statue laws governed abortion in America. What minimal legal regulation existed was inherited from English common law tradition that abortion undertaken before quickening was at worst a misdemeanor. ‘’Quickening’’, as that term was understood in the nineteenth century, was the period in pregnancy when a woman felt fetal movement though it varied from woman to woman (and even from pregnancy to pregnancy in the same woman), it generally occurs between the fourth and the sixth month of pregnancy. Consequently, in nineteenth-century America, as in medieval Europe, first trimester abortions and a goodly number of second trimester abortions as well, faced little legal regulation. Practically speaking, the difficulty of determining when conception had occurred, combined with the fact that the only person who could reliably tell when the pregnancy had “quickened” was the pregnant woman herself, meant that even this minimal regulation was probably infrequent. In 1809, when the Massachusetts state Supreme Court dismissed an indictment for abortion because the prosecution had not reliably proved that the woman was “quick with child,” it was simply reiterating traditional common law standards.
    In contrast, by 1900 every state in the Union has passed a law forbidding the use of drugs or instruments to procure abortion at any stage of pregnancy, “unless te same be necessary to save the woman’s life.” Not only were those who performed an abortion liable for a felony (usually manslaughter or second degree homicide), but in many states, the aborted woman herself faced the possibility of criminal prosecution, still another departure from the tolerant common law tradition in existence at the beginning of the century.
    Many cultural themes and social struggles lie behind the transition from an abortion climate that that was remarkably open and unrestricted to one that restricted abortions (at least in principle) to those necessary to save the life of the mother. The second half of the nineteenth century, when the bulk of American abortion laws were written, saw profound changes in the social order, and these provided the foundation for dramatic changes in the status of abortion Between 1850 and 1900, for example the population changed from one that was primarily rural and agricultural to one that was urban and industrial, and birth rate fell accordingly, declining from an estimated average completed fertility for whites of 7.04 births per woman in 1800 to an average of 3.56 births in 1900. The “great wave” of American immigration occurred in this period, as did the first feminist movement.
    • pp.14-15
  • The most visible interest group agitating for more restrictive abortion laws was composed of elite or “regular” physicians, who actively petitioned state legislatures to pass anti-abortion laws and undertook through popular writings a campaign to change public opinion on abortion. The efforts of these physicians were probably the single most important influence in bringing about nineteenth-century anti-abortion laws. (Ironically, a century later it would be physicians who would play a central role in overturning these same laws.)
    • p.16
  • With respect to abortion, as with respect to physicians, modern-day stereotypes about the nineteenth century can easily lead us astray. Contrary to our assumptions about “Victorian morality,” the available evidence suggests that abortions were frequent. To be sure, some of these abortions may have been disguised (or rationalized) by those who sought them. Early in the century, a dominant therapeutic model saw the human body as an “intake-outflow” system and disease as the result of some disturbance in the regular production of secretions. Prominent among medical concerns, therefore, was “blocked” or “obstructed” menstruation, and the nineteenth-century pharmacopoeia contained numerous emmenagogues designed to “bring down the courses,” that is, to reestablish menstruation. However, since the primary cause of “menstrual obstruction” in a health and sexually active woman was probably pregnancy, at least some of these emmenagogues must have been used with the intent to cause an abortion. Especially in the absence of accurate pregnancy tests, these drugs could be used in good faith by physicians and women alike, but the frequent warnings that these same drugs should not be used by “married ladies” because they would cause miscarriage made their alternative uses quite clear.
    Similarly, newspaper advertisements for patent medicines designed to bring on “suppressed menses” were common during the era; according to a number of sources, such advertisements appeared even in church newspapers. Discreet advertisements for “clinics for ladies” where menstrual irregularities “from whatever cause” could be treated (and where confidentiality and even private off-street entrances were carefully noted in the advertisement itself) were common.
    • p.19
  • As the noted medical historian Richard Shryock has observed: “One of the most striking and common forms of quack advertising in the United States was that of abortifacient drugs; a fact which seems hardy consistent with out notion of Victorian propriety. . . . The common form of the ‘ads’ was something of this sort: ‘Dr,-‘s Female Pills, one dollar a box, with full discretions. Married ladies should not use them. Sent by mail.’ “ Shryock validates a commonly heard complaint by noting: “Similar announcements and other quack appeals filled not only the daily and weekly papers, but the ‘family newspapers’ and even the religious press.”
    Aside from the use of these emmenagogues to bring on “delayed” menstruation, various attempts were made during this period to estimate the frequency of induced abortion as we not understand it. These estimates were primarily the work of physicians who wanted to convince the public that abortion was a problem of great magnitude, and so their estimates must be treated cautiously. Nonetheless, estimates from differing sources yield roughly comparable results. An Ohio medical investigation concluded that one-third of all “live births” (sic) ended in induced abortion. Dr. Horatio Storer, one of the most visible anti-abortionists of the era, estimated that there was one abortion for every four pregnancies; a survey of Michigan physicians found between 17 and 34 percent of all pregnancies ending in abortion; and an 1871 American Medical association committee concluded that 20 percent of all pregnancies were deliberately aborted.
    • p.19
  • This tolerant common-law standard was still in effect in nineteenth century America when state legislatures began to pass the very strict anti-abortion laws that the Supreme Court later overturned in Roe v. Wade. Indeed, as James Mohr writers, “American courts pointedly sustained the most lenient implication of the quickening doctrine even after the British themselves had abandoned them.”
    I shall return to this point shortly. For the moment, note as well that the Catholic position was still undergoing change. In 1591, Pope Gregory XIV restricted the penalty of excommunication to only those responsible for aborting an animated fetus. Starting in the seventeenth century, however, increasing medical knowledge about reproduction and embryology leg to growing doubts about the doctrine of delayed animation. Fetal growth appeared more and more a continuous matter, with no significant breaks between conception and birth. In 1863, Ferdinand Kember discovered that conception is produced by the male sperm entering the female ovum. Since, in Aristotelian doctrine, the male sperm carries the soul, this discovery implied that ensoulment takes place at conception. Increasingly, the Roman Catholic Church insisted that abortion is gravely wrong at any point after conception. In 1869 Pope Pius IX removed the distinction between animated and unanimated fetuses from the canon law, this providing excommunication for causing abortion at any stage of fetal development.
    • p.23
  • In the new American nation, because the lenient common-law standard prevailed, the situation at the beginning of the 19th century was quite tolerant regarding abortion. “Consequently” writers Luker, “in nineteenth-century America, as in medieval Europe, first trimester abortions, and a goodly number of second trimester abortions as well, faced little legal regulation” Numerous home medical manuals-frequently written expressly for women-contained information about how to induce abortion, often in the form of advice on how to remove blockages to normal menstrual flow. Among tese were William Buchanan’s Domestic Mediine (probably the most widely consulted one; continually reprinted from 1782 through 1850), Samuel K. Henning’s Married Lady’s Companion (which “had its second printing in 1808 and was intended for women in rural areas”), Joseph Brevitt’s Female Medical Repository (1810), and Thomas Ewell’ Letter to Ladies (1817). Ewell was “a surgeon at Navy Hospital in Washington, D.C. . . . , who wrote forthrightly about unblocking obstructed menses.” Like the other books just mentioned, Ewell’s
    urged hot sitz baths, doses of aloe, and a number of training exercises. Walking, horseback riding, and jumping, the more the better, ll helped bring on abortion, he counseled, especially at the tie menses would normally have occurred had the last period not been missed. Ewell [also[ thought electricity through the thighs might end a suppression [of menstrual flow[ and that light bleeding could be beneficial. To those rather elemental staples Ewell added some medically more advanced ideas including internal douching with trong brandy, water as hot as could be tolerated, vinegar, wine, or strong brine.
    • pp.23-24
  • In addition to early-nineteenth-century home medical manuals, Americans seeking information about abortifaients, as well as abortion themselves could consults midwives and herbal healers (“so-called Indian doctors”). Mohr speculates that, because of the impossibility of confidently diagnosing pregnancy in its early stage and because of the common acceptance of procedures to treat for amenorrhea (blocks menses), many regular (formally trained or apprentices) physicians performed early abortions. And, says Mohr, “this practice was neither morally nor legally wrong in the eye of the vast majority of Americans, provided it was accomplished before quickening.” Leslie Reagan maintains that both the willingness of physicians (in private) to perform early abortions and the popular view that these abortions were morally acceptable continued throughout the period of legal repression that was to come.
    • pp.24-25
  • The first American statue concerning abortion was enacted by Connecticut in 1821. Prior to that date, there appears to have been no prosecution of abortion under the common law. The Connecticut statute itself did little more than restate the common-law rule as interpreted by Blackstone, inasmuch as it provided punishment only for abortions performed after quickening. Over the next two decades, seven more states passed abortion laws similar to Connecticut’s.
    Things began to change in the 1840s. According to Mohr, “Medical writers throughout the period [agreed] unanimously . . . that the incidence of abortion rose dramatically around 1840.” Moreover, abortion became more publicly visible. “During the 1840s, Americans . . . learned for the first time not only that many practitioners would provide abortion services, but that some practitioners had made the abortion business their chief livelihood. Indeed, abortion became one of the first specialties in American medical history[!] The business of selling abortifacient medicines also boomed, as evidenced by the rising number of advertisements for such products as “Madame Restell’s Female Pills,” each said to produce miscarriage, though this advice was sometimes couched as a “warning” to pregnant women not to take the pills.
    Also starting in the 1840s, there was a change in the social character of abortion, or at least in the perception of its social character. Whereas, prior to this era, abortion had been seen as the recourse of unmarried women desperate to avoid the stigma of unwed motherhood, now it seemed that more married women were resorting to abortion to limit family size. This, at least, was the opinion widely held by regular physicians. Regular physicians also believed that abortion was far more prevalent among Protestant women than among Catholics and, though numerous immigrant abortionists catered to other immigrants, more prevalent among native-born than among immigrant women. Similarly, the medical profession was sure that the practice was growing among middle- and upper-class women, and the relatively high pries of the procedure supply some support for this view. There is demographic evidence of a steep drop in the birthrate for native-born women (as distinct from immigrant women) after 1840, a drop large enough to lead to an overall decline in the birthrate throughout the nation compared to earlier in the century. However, the evidence that this was due to abortion is based largely on the opinions of regular physicians, who were, s we shall see, not disinterested observers.
    • pp.25-26
  • In 1840, Maine became the first state to clearly prohibit abortion at any stage of pregnancy. It’s statute provided: <br Every person, who shall administer to any woman pregnant with child, whether such child be quick or not, any medicine, drug or substance whatever, or shall use or employ any instrument or other means whatever, with intent to destroy such a child, and shall thereby destroy such child before its birth, unless the same shall have been done as necessary to preserve the life of the mother, shall be punished by imprisonment in the stae prison, not more than five years, or by fine, not exceeding one thousand dollars, and imprisonment in the county jail, not more than one year.
    This statute was still in force when the U.S. Supreme Court issued its decision in Roe v. Wade 113 year later. Note that, though the statute treats abortion as a crime at any time after conception, it does not treat it as equivalent to murder. The penalties are much lighter than those normally provided for murder, and an exception is allowed for abortions needed to save the life of the pregnant woman. Moreover, at least until the 1850s, successful prosecutions for pre-quick abortions under this and similar laws were extremely rare due to the difficulty of proving intent In light of the presumed legitimacy of operations to remove “unnatural obstruction of the menses,” it was necessary to prove that the alleged abortionist intended to abort the fetus rather than only to restore menstrual flow.”
    New laws, although still relatively lenient, began to be passed in other states In 1845, Massachusetts made attempted abortion a misdemeanor and, if the attempt resulted in the death of the woman, a felony. However, the law was not very effective. “Between 1849 and 1857 there were only thirty-to trials in Massachusetts for performing abortions and not a single conviction.” New York also passed new abortion legislation in 1845 Its law made no reference to quickening and took “the unprecedented step” of making women “liable for seeking and submitting to an abortion or for performing one upon [themselves].” But this provision was never enforced against women in the nineteenth century. Mohr speculates that the aim of the law was to get at commercial abortionists and that the innovation of ending the immunity that women had had under the common law was due to belief that abortion was no longer limited to desperate unmarried women who were unlikely to be deterred by legal threat.
    Michigan in 1846, Virginia in 1848, and New Hampshire in 1849, made abortion at any stage punishable, nut provided severer penalties if it occurred after quickening. Other states and even federal territories passed anti-abortion statues in the 1850s. The anti-abortion laws passed between 1840 and 1860 were, according to Mohr, “limited and cautious” responses to the increased number and visibility of abortions that characterized the period: “[O]nly three states stuck the immunities traditionally enjoyed by American women in cases of abortion. . . . [A]nd thirteen of the thirty-three states in the Union by 1860 had yet to pass any statutes on the subject of abortion.” Mohr writes, “The advent of more comprehensive and forceful anti-abortion laws throughout the United States still awaited a major campaign. . . on the part of a politically conscious organization with a vested interest in placing . . . less permissive statutes on the books.”
    • pp.26-27
  • Reformers were becoming more vocal about the problems of criminal abortion at a time when criminal abortion was probably becoming less lethal to women. Largely because of the increasing use of antibiotic drugs, overall maternal mortality had been steadily declining for many years and had begun to drop dramatically after World War II. For example between 1915, and 1919 there were 727.9 maternal deaths nationwide per 100,000 live births. In 1945, by contrast, there were only 207.2 such death, and by 1960 there were only thirty-seven maternal deaths per 100, 000 live births.
    • p.74
  • The presence of a strict law satisfied those who wanted to believe that virtually all abortions should be outlawed whereas the much broader interpretation of the law in actual medial practice satisfied those who felt that embryos were only potential persons and that embryonic rights were far less compelling than the rights of mothers. Since the fundamental ideological differences between the two views were hidden from the public ( to be weighed in individual cases by individual doctors), this form of compromise worked reasonably well for many years.
    It is therefore of great historical importance that in the early 1960s the efforts of the first reform constituency-the persons concerned with the problems of illegal abortion-came to be supported by a more actively involved interest group whose stake in the issue was more direct. This new group prefigured by the two obstetricians who testified at the 1962 hearings, was composed of physicians who saw the ideological consensus within the medical profession breaking down and sought to have explicit new ground rules on abortion spelled out.
    The consensus was being broken down by several forces. First, and probably foremost, was the improvement in obstetrical science, which by the 1950s had virtually eliminated the need to perform abortions simply in order to save the life of the mother. In California, as elsewhere, abortions were usually undertaken because of psychiatric indications. For reasons outlined in the previous chapter, once the “cover” of strictly medical conditions began to evaporate, physicians began to make abortion decisions that were perceived by their colleagues and the general public alike as less “technical” than moral.
    • pp.76-77
  • Here is how one physician, who became one of the earliest and most prominent abortion law reformers of the early 1960s, described the situation in the 1950s:
    I wasn’t really interested in reshaping the law; ‘’I considered what I was doing was acting within the law then.’’ You have to realize we lived in an entirely different legal climate then. . . . There were malpractice, illegal activity, and professional liability aspects, but [they were[ relatively rare. It should have to be that somebody died [in an abortion] under most unusual circumstances. Doctors were not being sued like they are now, but there was always the rumbling in the background- “if the district attorney hears about this, we might be faced with criminal charges.” . . . When we’d consult [our lawyers] and say, “We think this patient should be aborted, but we don’t know if this is life-threatening or not,” they’d say, “Well, you might be sued” You don’t know anything about the disease and its relation to pregnancy. What effect does the pregnancy have on the disease? What effect doe the disease have on the pregnancy? And so we would go ahead on the basis that it was a life-threatening disease or situation. But [such cases] were rare, you might have one or two in the hospital in a year, and it took a great deal of work to accumulate even six or eight cases. But there was always the implication in the background that the district attorney, if he decided to make an issue of this, it could be a legal problem because even the district attorney couldn’t interpret the law.
    As this statement suggests, the early physician-activists were primarily interested in securing legal backing for what they were already doing. They were in effect already using a “broad construction”” of the law, which they believed was accepted by their colleagues as ethical; they wanted ]their decision-making rights explicitly written into law, just to be on the safe side.
    • p.78
  • Once there came to be an obvious difference of opinion among physicians about the moral status of abortion rather than the technical grounds for it, the control of abortion was open to new claims. It is not surprising that after one group of physicians (the “broad constructionists”) asked state legislature to make some changes in the law, other interest groups were encouraged to press their demands. In other words, it is conceivable that the public movement on abortion might never have been successful had physicians not sought to amend the law that gave them the right to control abortion in the first place. Had the medical profession been able to maintain its consensus that abortion was an appropriate enterprise for physicians (and only physicians) and had it not sought legal sanction for one interpretation of the law, non professionals might have had little luck with their claim that abortion was a woman’s right.
    Perhaps the point can be made in yet another way, by comparing the success of the abortion reform activists with the relative failure of those who claim that control over the experience of childbirth is a woman’s right. Despite considerable public discussion by feminists about the need for women to seize control of labor and delivery, the fact remains that for the overwhelming majority of pregnancies, physicians have the upper hand when it comes to decision-making. Managing pregnancy, birth, and delivery continues to be almost unanimously claimed by the medical profession as a technical enterprise. However much the physician may wish to please a pregnant woman, the physician can still claim to be the possessor of technical information beyond the ken of the lay person and must therefore be the ultimate decision-maker “for the patient’s own good.”
    Thus before abortion could become a “women’s issue,” the medical profession had to give up or lose its claim to technical control over abortion. As soon as some physicians were willing to publicly criticize the practice of colleagues on grounds of principle, the legitimate control over abortion by physicians was at an end, an the field was cleared for new contenders.
    • pp.109-110
  • The rhetoric of liberal physicians in support of the Beilenson bill was a signal to interested groups that physicians were no longer in agreement about their control over abortion and that there was room for change. However much women as a group may have wanted to seek control over abortion, they were largely without influence until they took up the new tactics introduced by groups like SHA across the United States: civil disobedience, public speaking to any group that would listen, and, most important, use of the rhetoric that women had a right to abortion. These tactics transformed the debate. Now women who wanted abortions were no longer victims, a less-than-legitimate group of rule breakers who wanted the rules changed simply because they had “gotten caught.” Rather, they were women who were crusading for a basic civil right-the right of a woman to “own the flesh she stands in,” as one of them had put it.
    It was of central importance that by the time physicians began to visibly relinquish their control over abortion, SHA’s “consciousness raising” activities throughout the state had created a group of women ready to accept a new “”definition of the situation.” They were no longer interested in simply expanding the legal grounds on which doctors could perform abortions. They wanted to make women, not doctors, the ultimate decision-makers about abortion.
    • p.110

"'Sanctuary city for the unborn': All-male city council in Texas town bans most abortions" (6/13/2019)[edit]

Miller, Ryan W. "'Sanctuary city for the unborn': All-male city council in Texas town bans most abortions". Usatoday.com. (6/13/2019)

  • A small town in Texas has declared itself the state's first "sanctuary city for the unborn" after its city council, made up solely of men, passed a resolution banning most abortion procedures.
    Waskom, Texas, has no abortion services available, but supporters of the ordinance wanted a measure to prevent an abortion clinic from being able to open in the city of roughly 2,000, KTAL-TV reported.
  • According to KETK-TV, the Waskom measure calls Roe v. Wade and laws that permit abortion "unconstitutional usurpations of judicial power ... and are null and void in the City of Waskom.”
    Before the vote, Mayor Jesse Moore told the city council and residents that the town probably would face a lawsuit for the ordinance but that it couldn't afford to lose the challenge.
    Moore said he hoped the Supreme Court would use a legal challenge to the declaration to look at Roe v. Wade again. However, it's not clear whether the nation's highest court will take on any case that could potentially reverse the Roe decision. Abortion-rights groups have already filed challenges to recent laws in states such as Alabama and Ohio.
  • "We decided to take things into our own hands and that we have got to do something to protect our cities and to protect the unborn children," Mark Lee Dickson, director of East Texas Right to Life, said, according to KETK-TV.
  • Waskom is just a short drive from Shreveport, Louisiana, and Moore said that he feared a Louisiana abortion clinic may want to move to Waskom after the law passed, the Longview (Texas) News-Journal reported.

"The Supreme Court hands down its first anti-abortion decision of the Amy Coney Barrett era" (January 13, 2021)[edit]

Millhauser, Ian (January 13, 2021). "The Supreme Court hands down its first anti-abortion decision of the Amy Coney Barrett era". Vox. Retrieved January 13, 2021.

  • On the surface, the Supreme Court’s decision in FDA v. American College of Obstetricians and Gynecologists, which was handed down Tuesday evening, is fairly minor.
    The case involves a Food and Drug Administration requirement that a pill used in medication abortions must be distributed to patients directly by health providers and not by retail or mail-order pharmacies. A lower court temporarily suspended this requirement during the pandemic; the Supreme Court’s decision effectively reinstates the requirement.
    The Court released no majority opinion, which means that the decision in American College does not explicitly change existing legal doctrine.
  • Read between the lines, however, and American College warns of a dark future for abortion rights.
    The premise of pro-abortion rights decisions like Roe v. Wade (1973) is that the Constitution provides special protection to the right to an abortion that it doesn’t provide to other elective medical procedures. Yet, as Justice Sonia Sotomayor explains in dissent, American College effectively rules that a commonly used abortion drug may be regulated more harshly than any other legal medication.
    Although Chief Justice John Roberts wrote an opinion explaining that he would decide the case on very narrow grounds — holding that courts should defer to public health agencies during the pandemic — no other justice in the majority joined this opinion.
  • While mifepristone is often taken at home, the Food and Drug Administration only allows the drug to be dispensed at hospitals, clinics, or other medical offices. It is not available at retail or mail-order pharmacies.
    This limit on who can dispense mifepristone has been in effect for more than 20 years, and it’s ordinarily a fairly minor limit on abortion rights. During the Covid-19 pandemic, however, it is potentially a significant burden on patients’ ability to terminate their pregnancies.
    In the midst of a deadly pandemic, any trip outside of the home — including a trip to an abortion clinic — can potentially expose individuals to the coronavirus. Moreover, as Justice Sotomayor explains in her dissent, “three-quarters of abortion patients have low incomes, making them more likely to rely on public transportation to get to a clinic to pick up their medication.”
    That means that these patients “must bear further risk of exposure while they travel, sometimes for several hours each way, to clinics often located far from their homes.”
  • Indeed, in no small part due to concerns that patients who need to travel in order to pick up medications could become infected with Covid-19, the FDA has eased many restrictions on prescription drugs for as long as the pandemic rages.
    The federal government, Sotomayor notes, “has urged healthcare providers and patients to take advantage of telemedicine.” It has “waived many in-person drug distribution requirements because they could ‘put patients and others at risk for transmission of the coronavirus,’” and it has also waived certain mandatory tests that ordinarily must be conducted before certain drugs can be prescribed.
    And yet, under the Trump administration, the FDA has refused to relax restrictions on mifepristone. It even appears to have singled mifepristone out for particularly restrictive treatment. As Sotomayor writes, “of the over 20,000 FDA-approved drugs, mifepristone is the only one that the FDA requires to be picked up in person for patients to take at home.”
  • Instead of holding that abortion is a constitutional right entitled to special protection by the courts, the decision in American College suggests that the government may treat abortion-related treatments more harshly than any other medical treatment.
  • Of the six conservative justices, only Chief Justice John Roberts explained why he voted the way he did, and Roberts’s opinion, for what it’s worth, disclaims any suggestion that American College is a broad attack on abortion rights.
    “The question before us is not whether the requirements for dispensing mifepristone impose an undue burden on a woman’s right to an abortion as a general matter.” Rather, Roberts writes, he believes that “courts owe significant deference to the politically accountable entities with the ‘background, competence, and expertise to assess public health’” when deciding how the government should respond to the pandemic.
    But Roberts is the most moderate member of the Court’s Republican majority. And his views matter far less than they used to, now that a majority of the Court is more conservative than he is. The five most conservative justices — a bloc of judges that is large enough to hand down binding decisions with or without Roberts — did not join Roberts’s opinion or otherwise explain their votes.

“Abortion in America The Origins and Evolution of National Policy 1800-1900” (1978)[edit]

James C. Mohr, “Abortion in America The Origins and Evolution of National Policy 1800-1900”, Oxford University Press, (1978)

  • In the absence of any legislation whatsoever on the subject of abortion in the United States in 1800, the legal status of the practice was governed by the traditional British common law as interpreted by the local courts of the new American states. For centuries prior to 1800 the key to the common law’s attitude toward abortion has been a phenomenon associated with normal gestation known as quickening. Quickening was the first perception of fetal movement by the pregnant woman herself. Quickening generally occurred near the midpoint of gestation, late in the fourth or early in the fifth month, though it would and still does vary a good deal from one woman to another. The common law did not formally recognize the existence of a fetus in criminal case until it had quickened. After quickening, the expulsion and destruction of a fetus without due cause was considered a crime, because the fetus itself had manifested some semblance of a separate existence: the ability to move. The crime was qualitatively different from the destruction of a human being, however, and punished less harshly. Before quickening, actions that had the effect of terminating what turned out to have been an early pregnancy were not considered criminal under the common law in effect in England and the United States in 1800.
    • pp.3-4
  • An ability to suspend one’s modern preconceptions and to accept the early nineteenth century on its own terms regarding the distinction between quick and unquick was absolutely crucial to an understanding of the evolution of abortion policy in the United States. However doubtful the notion appears to modern readers, the distinction was virtually universal in America during the early decades of the nineteenth century and accepted in good faith Perhaps the strongest evidence of the tenacity and universality of the doctrine in the United States was the fact that American courts pointedly sustained the most lenient implications of the quickening doctrine ever after the British themselves had abandoned them. In 1803 Parliament passed a law, the details of which will be discussed in the next chapter, that made abortion before quickening a criminal offense in England for the first time. But the common law in the United States, as legal scholars have pointed out, was becoming more flexible and more tolerant in the early decades of the nineteenth century, especially in sex-related areas, not more restrictive.
    • p.5
  • In 1812 the Massachusetts Supreme Court made clear the legal distance between the new British statute on abortion and American attitudes toward the practice. In October of that year the justices dismissed charges against a man named Isaiah Bangs not on the grounds that Bangs had not prepared and administered an abortifacient potion; he probably had. They freed Bangs because the indictment against him did not aver “that the woman was quick with child at the tie.” In Massachusetts, the court was asserting, an abortion early in pregnancy would remain beyond the scope of the law and not a crime. Commonwealth v. Bangs remained the ruling precedent in cases of abortion in the United States through the first half of the nineteenth century and, in most states, for some years beyond midcentury.
    Prosecutors took the precedent so much for granted that indictments for abortion prior to quickening were virtually never brought into American courts. Every time the issue arose prior to 1850, the same conclusion was sustained: the interruption of a suspected pregnancy prior to quickening was not a crime in itself.
    • pp.5-6
  • Because women believed themselves to be carrying inert non-beings prior to quickening, a potential for life rather than life itself, and because the common law permitted them to attempt to rid themselves of suspected and unwanted pregnancies up to the point when the potential for life gave a sure sign that it was developing into something actually alive, some American women did practice abortion in the early decades of the nineteenth century. One piece of evidence for this conclusion was the ready access American women had to abortifacient information form 1800 onward. A chief source of such information was the home medical literature of the era.
  • p.6
  • Home medical manuals characteristically contained abortifacient information in two different sections. One listed in explicit detail a number of procedures that might release “obstructed menses” and the other identified a number of specific things to be avoided in a suspected pregnancy because they were thought to bring on abortion. Americans probably consulted William Buchan’s Domestic Medicine more frequently than any other home medical guide during the first decades of the nineteenth century. Buchan suggested several courses of action designed to restore menstrual flow if a period was missed. These included bloodletting, bathing, iron and quinine concoctions, and if those failed, “a tea-spoonful of the tincture of black hellebore [a violent purgative]. . . twice a day in a cup of warm water.” Four pages later he listed among “the common causes” of abortion “great evacuations [and] vomiting,” exactly as would be produced by the treatment he urged for suppressed menses Later in pregnancy a venturesome, or desperate, woman could try some of the other abortion inducers he ticked off: “violent exercise; raising great weights; reaching too high; jumping, or stepping from an eminence; strokes [strong blows] on the belly; [and] falls.”
    American women of the early nineteenth century who wanted more detailed information could consult books like Samuel K. Jennings’s The Married Lady’s Companion. The Jennings volume, which billed itself in subtitle as a Poor Man’s Friend, had its second printing in 1808 and was intended for women in rural areas, where there were no physicians, and for families unable to afford a doctor’s fee. The book was remarkably straightforward about advising otherwise healthy girls afflicted with “what you call a common cold.” “Taking the cold” was a common nineteenth century euphemism for missing a menstrual period, and there can be no doubt that Jenning’s italics sufficiently alerted his readers. Jennings favored bleeding from the foot, hot baths, doses of calomel and aloes. Calomel was prescribed for almost anything in the early decades of the nineteenth century; aloes, another strong cathartic, remained a standard ingredient in abortifacient preparations for the next hundred years.
    Like most early abortion material, Buchan’s and Jenning’s advice harked back to almost primordial or instinctual methods of ending a pregnancy. Bloodletting, for example, was evidently thought to serve as a surrogate period; it was hoped that bleeding from any part of the body might have the same flushing effect upon the womb that menstrual bleeding was known to have. This primitive folk belief lingered long into the nineteenth century, well after bleeding was abandoned as medical therapy in other kinds of cases, and it was common for abortionists as late as the 1870s to pull a tooth as part of their routine. This procedure had been given learned sanction in 1808, when the first American edition of John Burns’s classic Observations on Abortion appeared. Burns, a Glasgow medical professor whose volume remained a standard for half a century, was primarily concerned with spontaneous miscarriage rather than induced abortion, but twice in different contexts stated: “The pulling of a tooth . . . sometimes suddenly produces abortion.” Aside from the pain and shock of an extraction without anesthetic, which probably could induce miscarriage in some women, the process must have been psychologically akin to pulling a plug for the patient. In later years it also offered the sophisticated abortionist a medical camouflage upon which he or she might blame possible postoperative complications. Similarly, bathing, though it may have had some abortive effect as a muscle relaxer and a source of internal infection, probably went back to primitive beliefs that the pregnancy could simply be washed away, physically expunged. Finally, Jennings, recommendations of calomel and aloes paralleled Buchan’s reliance on black hellebore. These substances were ingested on the reasonably plausible theory that a sufficiently violent disruption of the lower digestive tract might cause the uterus to empty its contents also. This belief became the basis of a booming pharmaceutical business in abortifacient preperations, which will be discussed later in another context.
    • p.6-8
  • Joseph Brevitt’s The Female Medical Repository, which was published in Baltimore in 1810, made many of the same points that Buchan and Jennings made, but added some significant details. Brevitt liked hellebore and aloes, but he considered savin especially effective. Savin, as Brevitt’s work reminded American women, had a tremendous advantage in the United States over hellebore or aloes because any woman could easily obtain some simply by extracting the oil from one of the common juniper bushes that grew wild all over North America. Both black hellebore and aloes, on the other hand, had to be imported and were, as a result, expensive. Reports of attempted abortion by ingesting savin, and of accidental death from savin overdoses, reained common throughout the nineteenth century. There can be little doubt that juniper extract was the single most commonly employed folk abortifacient in the United States during the early decades of the nineteenth century. Jalap, scammony, and bitter apple could also be tried in a pinch, according to ‘’The Female Medical Repository’’. Brevitt asserted that the French referred horehound, and he believed, wrongly, that amdder root worked directlyupon the muscles of the uterus itself. He cautioned against cantharides, or Spanish fly, because he considered it dangerous to the urinary tract, but the fact that he made such a warning suggests that at least some women were trying it for abortifacient purposes. “Electricity”, he added, “generally and sometimes locally applies, has frequently been known to restore the discharge.” This idea, too, was subsequently picked up by later nineteenth-century entrepreneurs, who developed a number of galvanic contraptions designed to aid women who were “obstructed”.
    After listing the usual “external causes” of abortions, which included riding, jumping, falls, and the like, Brevitt added an asterisk and a footnote that helped confirm further the fact that Americans from an early period were practicing abortion: “I feel constrained to note here, the horrid depravity of human weakness, in wretches lost to every sense of religion, morality, and that natural attachment from a mother to her offspring, and every tender tie in nature, seek the means to procure abortion: nor are there wanted, in the other sex, infernals wicked enough to aid their endeavors.” Considering the detailed abortifacient information that Brevitt’s own volume contained, that statement might appear singularly disingenuous. But it probably was not. In Brevitt’s terms the word “abortion” implied the termination of a pregnancy ‘’after’’ the pregnancy was certain, that is, after quickening. He was testifying that even ‘’illegal’’ abortions were being performed in the United States in 1810, abortions after quickening, and that some physicians were willing to provide abortion services for women at virtually any stage of gestation. The procedures Brevitt counseled, even though they were designed to bring on what the twentieth century would call an abortion, were not considered criminally abortifacient either in Brevitt’s terms or in the opintion of hiss readers, unless a woman persisted in them after she quickened.
    • pp.8-10
  • The Virginian Thomas Ewell, a surgeon at Navy Hospital I Washington, D.C., was another who wrote forthrightly about unblocking obstructed menses in his Letter to Ladies, published in 1817. Like many before him, he urged hot sitz baths, doses of aloes, and a number of straining exercises. Walking, horseback riding, and jumping, the more the better, all helped bring on abortion, he counseled, especially at the time menses would normally have occurred had the last period not been missed. Ewell, too, thought electricity through the thighs might end a suppression and that light bleeding could be beneficial. To those rather elemental staples, however, Ewell added some medically more advanced ideas including internal douching with strong brandy, water as hot as could be tolerated, vinegar, wine, or strong brine. Considering that the book appeared in 1817, this was reasonably sophisticated advice. Though Ewell could not have known anything about bacteria, each of the douches he recommended (assuming that the water was cooled from a boil) was fairly antiseptic. Moreover, he correctly speculated that the douches were not abortifacients themselves but provoked menstrual flow by causing cervical irritation, as in fact, they might have done. If forced into the uterus itself after cervical dilation, which was something medical practitioners knew how to do, such solutions would almost certainly have been effective abortifacients and not prohibitively unsafe.
    • pp.10-11
  • In addition to home medical guides and health manuals addressed to women, abortions and abortifacient information were also available in the United States from midwives and midwifery texts. Midwives has long enjoyed a dubious reputation as abortion procuresses both in England and in America This led to difficult problems for male physicians like valentine Seaman, who wanted to upgrade America’s midwife corps. Seaman, who was physician to the lying-in (maternity) ward of the New York city Almshouse and also associated with New York Hospital, taught midwifery. In his classes he had to instruct midwives on how to perform abortions in order that they might meet such crises as the death of a fetus in utero or an incomplete spontaneous abortion or a badly handled intentional abortion begun by someone else. But when he published his lectures in 1800, he was at considerable pains to point out that he cautioned new midwives against prescribing for obstructed menses on their own, lest they inadvertently becomes the dupes of women who already knew they were pregnant and wanted abortions. Again the caution suggests that some American women were approaching midwives for abortifacient services.
    Herbal healers, the so-called Indian doctors, and various other irregular practitioners also helped spread abortifacient information in the United States during the early decades of the nineteenth century. Their surviving pamphlets, of which Peter Smith’s 1813 brochure entitled “The Indian Doctor’s Dispensary” is an example, contained abortiacient recipes that typically combined the better-known cathartics with native North American ingredients thought to have emmenagogic properties. For “obstructed menses” Smith recommended a concoction he called “Dr Reeder’s chalybeate.” The key ingredients were myrrh and aloes, combined with liquor, sugar, vinegar, iron dust, ivy, and Virginia or Seneca snakeroot. A sweet-and-sour cocktail like that may or may not have induced abortion, but must certainly have jolted the system of any woman who tried one.
    • pp.11-12
  • The snakeroot to which Smith referred appears to have been another of the popular folk abortifacients used in the United States early in the nineteenth century. When Thomas Massie, a medical student at the Uniersity of Pennsylvania, wrote his 803 doctoral dissertation on the properties of ‘’Polygala Senega’’, he quoted a letter from an eminent medical man in Hartford Country, Maryland, to the effect that Seneca snakeroot was frequently used among the illiterate rural population of his area “intentionally to destroy the foetus in utero.”” Massie’s thesis, subsequently selected for publication in 1806, put forward the likelihood that Seneca acted directly upo the uterus itself, as he and Brevitt and others also believed madder did, and that regular physicians might ‘administer it “with great advantage… to those laboring under obstructed catamenia.” Thirty years later John B Beck, by then the nation’s leading authority on the medical jurisprudence of abortion, confirmed that Seneca “has now been known and used in this country for a number of years, for the purpose of acting on the uterine organ, with a view of restoring menstrual secretion.” Beck added along the same line that folk doctors also liked common North American black cohosh, sometimes called squawroot, for the ssame purpose. Native Indian women evidently employed an herbal brew of cohosh as an emanagogue and, according to Beck, the same brew for the same purpose was “a good deal used by our American practitioners.”
    • pp.12,14
  • Finally, and most importantly, America’s regular physicians, those who had formal medical training either in the United States or in Great Britain or had been apprenticed under a regular doctor, clearly possessed the physiological knowledge and the surgical techniques necessary to terminate a pregnancy by mechanical means. They knew that dilation of the cervix at virtually any stage of gestation would generally bring on uterine contractions that would in turn lead to the expulsion of the contents of the uterus. They knew that any irritation introduced into the uterus would have the same effect. They knew that rupturing the amniotic sac, especially in the middle and later months of pregnancy, would usually also induce contractions and expulsion, regardless of whether the fetus was viable. Indeed, they were taught in their lecture courses and in their textbooks various procedures much more complex than a simple abortion, such as in utero decapitation and fetal pulverization, processes they were instructed to imply in lieu of the even more horribly dangerous Caesarean section. Like the general public, they knew the drugs and herbs most commonly used as abortifacients and emmenagogues, and also like the general public, they believed such preparations to have been frequently effective.
    Moreover, there is little reason to doubt that American physicians sometimes used their knowledge to terminate unwanted pregnancies for their patients. Walter Channing, who lectured on midwifery and the diseases off women and children at the Harvard Medical School during the 1820s, taught his students that pregnancy was impossible to diagnose with complete accuracy during the early months of gestation. Textbooks repeated the same dictum. Even John Beck, an opponent of induced abortions at any stage of gestation, had to assert unequivocally that pregnancy could not be legally determined beyond all doubt prior to quickening. As a medical student reminded himself in his lecture notebook very early in the nineteenth century: “When reliance can be put on the account of ye patient, there is no fear of confounding this disease [amenorrhea or blocked menstrual flow] with any o[ther]. [W]e cannot always determine the state of the patient, the Menses should be wanting during pregnancy, and those who want to conceal pregnancy often pretend that they are subject to a variety of symptoms in on sequence of the obstructed menses.”
    This placed great pressure on physicians to provide what amounted to abortion services early in pregnancy. An unmarried girl who feared herself pregnant, for example, could approach her family doctor and ask to be treated for menstrual blockage If he hoped to retain the girl and her family as future patients, the physician would have little choice but to accept the girl’s assessment of the situation, even if he suspected otherwise. He realized that every member of his procession would testify to the fact that he had no totally reliable means of distinguishing between an early pregnancy, on the one hand, and the amenorrhea that the girl claimed, on the other. Consequently, he treated for obstruction, which involved exactly the same procedures he would have reused to induce an early abortion, and wittingly or unwittingly terminated the pregnancy. Regular physicians were also asked to bring to safe conclusion abortions that irregulars or women themselves had initiated. The Medical Recorder of Philadelphia detailed exactly such a case in 1825 and the regular who was called upon, despite some moral qualms, considered it is his duty to finish the job for the young woman involved. And through all of this the physician might bear in mind that he could never be held legally guilty of wrongdoing. No statues existed anywhere in the United States on the subject of abortion, and the common law, as reaffirmed in America in the Bangs case, considered abortion actionable only after a pregnancy had quickened. No wonder then that Heber C. Kimball, recalling his courtship with a woman he married in 1822, claimed that she had been “taught…in our young days, when she got into the family way, to send for a doctor and get rid of the child’’; a course that sh followed.
    • pp.14-16
  • In summary, hen, the practice of aborting unwanted pregnancies was, if not common, almost certainly not rare in the United States during the first decades of the nineteenth century. A knowledge of various drugs, potions, and techniques was available from home medical guides, from health books for women, from midwives and irregular practitioners, and from trained physicians. Substantial evidence suggests that many American women sought abortions, tried the standard techniques of the day, and no doubt succeeded some proportion of the time in terminating unwanted pregnancies. Moreover, this practice was neither morally nor legally wrong in the eyes of the vast majority of Americans, provided it was accomplished before quickening.
    The actual number of abortions in the United States prior to the advent of any states regulating its practice simply cannot be known. But an equally significant piece of information about those abortions can be gleaned from the historical record. It concerns the women who were having them. Virtually every observer through the middle of the 1850s believed that an overwhelming percentage of the American women who sought and succeeded in having abortions did
    • p.16
  • [T]he regulars bitterly opposed what they regarded as quack theories, though in truth many of the irregulars advocated courses of treatment less detrimental to health than the regulars’ own.
    There was more at stake for regulars, however, than matters of principle and questions of theory, important as they were. The unrestricted entry of irregulars into the medical field, particularly between 1820 and 1850, also produced an intense competition for paying patients that hurt the regulars badly. As Edward C. Atwater made clear in a fine study of this phenomenon in a single small city, Rochester, New York, the problem was very real. Doctors’ incomes fell sharply and regular physicians were being driven not only from high social status, but out of the profession itself.
    In the face of such crises many regular physicians in the United States decided to try to defend both their medical theories and their material livelihoods in the best way they could: through the state legislatures. The regulars perceived that their educational credentials, their persuasive powers, and their generally well-established social background would, in the long run, give them something of an advantage over their rivals in those public forums. Their ongoing and ultimately successful efforts to influence medical related legislation of all kinds became crucial to the evolution of abortion policy at the state level because, unlike most of their irregular rivals and unlike a majority of the American people, regular physicians opposed abortion not only after quickening but before quickening as well.
    • p.34
  • The regulars’ opposition to abortion was partly ideological, partly scientific, partly moral, and partly practical. Ideologically, one of the things that distinguished the regulars was their adherence to the Hippocratic Oath, and the Hippocratic Oath condemned abortion. In this respect the father of medicine had also held a distinctly minority view in his own society; both Plato and Aristotle, for example, condoned the practice. Yet Hippocrates’s creed had become one of the touchstones of regular medicine in the United States by the early nineteenth century, and the oath was considered the basic platform upon which the regulars were attempting to upgrade the ethical standards of their profession in a host of different areas, not just in regard to abortion. Since opposition to abortion was in that creed, the regulars tried to stick by it. In one of the earliest cases of ethical self-regulation in the United States, the Oneida County (New York) Medical Society expelled an unwanted member in 1834 on the official pretext that he had performed an abortion.
    • pp.34-35
  • Scientifically, regulars had realized for some time that conception inaugurated a more or less continuous process of development, which would produce a new human being if uninterrupted. Consequently, they attacked the quickening doctrine on the logical grounds that quickening was a step neither more nor less crucial in the process of gestation than any other. John Beck, for example, in his long-standard 1823 discussion off abortion from the standpoint of medical jurisprudence, put forward two different theories to explain the physiology of quickening in an effort to lessen its importance, though he admitted that the continued viability of that doctrine had a “direct tendency . . . to countenance . . . abortion, at least in the earlier stages of pregnancy.” Before Beck, Burns, too, had denied that there was anything physiologically special about quickening, and had opposed any attempt to “prevent life from continuing, until it arrive at perfection” once conception had taken place.
    From the scientific reasoning stemmed the regulars’ moral opposition to abortion at any stage in gestation. If society considered it unjustifiable to terminate a pregnancy after the fetus had quickened, and if quickening was a relatively unimportant, almost incidental step in the overall gestation process, then it was just as wrong to terminate pregnancy before quickening as after quickening. Regulars believed it immoral, in other words, to make a life or death decision on the basis of a distinction that they could demonstrate to have very little relation to life or death.
    • pp.35-36
  • There was more to the physicians’ moral opposition to abortion than scientific logic, however, for another dimension also emerged forcefully form their writings throughout the nineteenth century. The nation’s regular doctors, probably more than any other identifiable group in American society during the nineteenth century, including the clergy, defended the value of human life per se as an absolute. Scholars interested in the medical mentality of the nineteenth century will have to explain the reasons for this ideological position. It may have been related to the physicians’ role as social and intellectual modernizers in a world that still took largely for granted the assumption that a widespread and routine destruction of life was part of the human condition; it may have been related to the fact that physicians tended to be men who wished to find secular absolutes to replace spiritual ones; it may have been related to the physicians’ psychological commitment as ministers and defenders of life against the forces seen and unseen trying to snuff it out; or it may have been related to factors that historians simply do not yet fully understand. But whatever the reasons, regular physicians felt very strongly indeed on the issue of protecting human life. And once they had decided that human life was present to some extent in a newly fertilized ovum, however limited that extent might be, they became the fierce opponents of any attack upon it.
    • p.36
  • Practically, the regular physicians saw in abortion a medical procedure that not only gave the competition an edge but also undermined the solidarity of their own regular tanks. If a regular doctor refused to perform an abortion, he knew the woman could go to one of several types of irregulars and probably receive one. And, as the regulars themselves pointed out, it was not so much the short-term loss of a fee for the abortion that upset them, but the prospects of a long-term loss of patients. As more and more irregulars began to advertise abortion services openly, especially after 1840, regular physicians grew more and more nervous about losing their practices to healers who would provide a service that more and more American women after 1840 began to want. Yet, if regular gave in to the temptation to perform an occasional discreet abortion, and physicians testified repeatedly that this frequently happened among the regulars, he would be compromising his own commitment to an American medical practice that would conform to Hippocratic standards of behavior. The best way out of these dilemmas was to persuade state legislators to make abortion criminal offense. Anti-abortion laws would weaken the appeal of the competition and take the pressure off the more marginal members of the regulars’ own sect. For all of these reasons, regular physicians became interested in abortion policy from an early date and repeatedly dragged it into their prolonged struggle to control the practice of medicine in the United States. At times abortion policy became a focal point in that struggle, at times an incidentally affected by-product, but the struggle itself was always there in the background.
    • p.37
  • Consider the situation in New York once again in this context. The regular physicians there, by controlling through the speaker of the assembly all appointments to the standing committee on medical practice, had pushed through the legislature in 1827 the toughest medical regulation law the state had ever had, tougher than the so-called Anti-Quack Act of 1819. The 1827 law granted great power to the regular physicians, who were organized as the state medical society, by declaring the unauthorized practice of medicine a misdemeanor. There is every reason to believe that these regulars, who were still influential in Albany the following year, were the “old and experienced surgeons” to whom the revisers of 1828 said they listened when they drew up the medically related sections of the state code, including the specially set aside section proscribing abortion for the first time in the United States in terms approaching Ellenborough’s. Moreover, not only does the proscription of abortion itself make sense in this context of a temporary ascendancy of the regulars in their long battle to control medical practice at the state level, but so also does the sudden appearance for the first time of a therapeutic exception that stipulated consultation with at least “two physicians” before performing an abortion for medical reasons.
    • p.37
  • By the early 1840s, between 30,000 and 40,000 people were said to have signed petitions opposed to the rigid regulation and regularization of medicine in New York. Under these circumstances, New York’s statutory prohibition of abortion, which could have been interpreted to cover abortions before quickening as well as after quickening, lay buried in code, unenforced. A precedent has been established for future abortion policies, but the practice of abortion itself was little affected by the legislation of 1828 in New York.
    The decade of the 1830s, generally speaking, was one of wide-open medical practices throughout the nation, not just in New York. New York’s foray into medical regulation was not widely imitated elsewhere, and those states that had passed medical practice acts similar to New York’s 1827 law repealed them during the 1830s. Consequently, it is not surprising that the period was not one of vigorous anti-abortion activity in state legislatures. One of the exceptions was Ohio. In 1834 legislators there made attempted abortion a misdemeanor without specifying any stage of gestation, and they made the death of either the mother or the fetus after quickening a felony.
    • p.39

“The making of pro-life activists: how social movement mobilization works” (2008)[edit]

Munson, Ziad W. (2008). “The making of pro-life activists: how social movement mobilization works”. University of Chicago Press. ISBN 978-0-226-55120-3. Retrieved 31 December 2011.

  • The partisan valence of the abortion issue had not yet developed in these early years of the pro-life movement. Today pro-life political views are strongly tied to the Republican Party, while pro-choice views are tied to the Democrats. This had not always been true. The Republicans first adopted a pro-life position in their national party platform in 1980. At the same time, longtime Democrat Jesse Jackson spoke out consistently against abortion rights throughout the late 1970s and early 1980s. In a 1977 article written for the NRLC newsletter, Jackson explained that “human beings cannot give or create life by themselves, it really is a gift from God. Therefore, one does not have the right to take away (through abortion) that which he does not have the ability to give.” Prominent pro-life leaders have also been committed Democrats. Jackie Schweitz, who led MCCL for eighteen years until 2001, was active in the Democratic the Democratic Party through the 1980s.
    • pp.86-87
  • Although the contours of the conflict looked different in the first fifteen years of the movement, the political and legal story of abortion since 1973 had shown a consistent pattern of slow but steady erosion of the rights granted to women by the landmark Supreme Court decisions. At the same time, the basic finding of those decisions-that women have a legal right to abortion at least under some circumstances-has been consistently and repeatedly confirmed. State legislatures, the U.S. Congress, and the courts were the primary venues in the battle over abortion beginning in 1973. Both the legislative and judicial systems have faced an avalanche of abortion-related bills and cases since that time. Legislatures in all fifty states review hundreds of new pieces of legislation annually that affect abortion services.
    • p.87
  • Abortion is one of the most common medical procedures in the United States. More than one pregnancy in five is ended by abortion, a total of 1.29 million abortions in 2002 and more than 42 million since the procedure was legalized in 1973 (Finer et al 2005). Before the age of forty-five, fully a third of all U.S. women will have one or more abortions (Henshaw 1998). The ubiquity of abortion in American life has done little to reduce the controversy that continues to surround it. Survey evidence suggests that abortion is one of the only morally charged social issued about which American opinion has become more polarized over the last three decades (DiMaggio, Evans, and Bryson 1996; Hour 1999; Evans 2003). The battle over the issue is evident in the political realm: state legislatures considered more than 1,120 pieces of legislation related to abortion in 2006 alone (NARAL 1007). Abortion was the central focus of the debates over the confirmation of Supreme Court justices John Roberts and Samuel Alito in 2005 and 2006. The 2007 Supreme Court decision overturning the constitutional requirement for a health exception in any state abortion ban has once again put the issue squarely at the top of the national agenda.
    • p.89
  • The absolute number of abortions as well as the abortion rate grew steadily after 1973. The highest recorded number of reported abortions (1.61 million) occurred in 1990; the highest abortion rate (29.3 per one thousand women of childbearing age) occurred in 1981 (Jones et al. 2008). Since that time, both the number of abortions and the abortion rate have steadily declined. In 2005, there were an estimated 1.21 million abortions and an abortion rate of only 19.4 per one thousand women (Jones et al. 2008). The causes of this decline are hotly debated and include changes in ideas about abortion, couples’ contraceptive habits, and young women’s demographic situations. It may also be affected by the availability of abortion services in different parts of the country, a factor that has been influenced by the political and social debates over legalized abortion.
    There are in fact, substantial obstacles to obtaining a legal abortion today, in comparison to the availability of other gynecological obstetric services. The vast majority of counties in the United States-87 percent-have no abortion provider at all. Almost a quarter of women who have an abortion travel more than fifty miles to obtain one, and the costs of abortion-which start at about four hundred dollars-have risen 9 percent in recent years (Finer and Henshaw 2003). Clinics are also subject to increasing pressure by pro-life protesters. Although the incidence of violence against abortion clinics has declined in recent years as, the amount of pro-life picketing has steadily increased There were more than ten thousand cases of picketing in front of clinics in 2007 (National Abortion Federation 2008).
    Despite these changes, public opinion about abortion has remained remarkably stable.. Since 1972, the number of Americans who believe abortion should be legal in cases where there is a high chance of fetal defects has remained between 78.5 percent and 85.5 percent (see figure 4.1). Since 1977, the number of Americans who support legalized abortion for any reason has stayed consistently between 33.3 percent and 43.5 percent. Results are similar for other variations on poling questions. Despite all their efforts over the last three decades, neither the pro-choice movement nor the pro-life movement has succeeded in shifting the weight of public opinion on abortion even as the social, political, legal, economic, and medical contexts of legalized abortion in the United States have all changed over the same period.
    • p.90
  • The legal status of abortion following Roe v. Wade and Doe v. Bolton was the most permissive since the first statues outlawing abortion were passed in the early 1800s. Since that time, new federal and state laws, along with a whole series of Supreme Court rulings that support them, have generally imposed new limits on the availability of legal abortions. This pro-life movement that has mobilized and pushed for these restrictions is today a well-institutionalized and heterogeneous phenomenon. It includes a whole range of organizations both nationally and in cities and towns across the country.
    • p.95

"Supreme Court affirms abortion protections, strikes down Louisiana abortion law" (June 29, 2020)[edit]

Najmabadi, Shannon (June 29, 2020). "Supreme Court affirms abortion protections, strikes down Louisiana abortion law". The Texas Tribune.

  • The U.S. Supreme Court struck down a Louisiana law Monday that would have curtailed access to abortions in the state and that was nearly identical to a measure the court overturned in Texas in 2016.
    The ruling is a win for advocates of abortion access, who feared the case could quickly pave the way for states to impose greater restrictions on the procedure. But legal and legislative battles over the procedure are sure to continue, including in Texas, where there are more than 6 million women of reproductive age. More than 53,800 abortions were performed in Texas in 2017, including 1,1,74 for out-of-state residents, according to government data.

Chief Justice John G. Roberts Jr. joined the liberal justices in a 5-4 decision that struck down a Louisiana law that would have required doctors who perform abortions to have admitting privileges at a nearby hospital. Roberts had dissented in the 2016 decision that found Texas’ restrictions placed an undue burden on a woman’s constitutional right to an abortion. He did not agree with the liberal justices’ reasoning Monday, instead citing the precedent set by the previous case.
"The result in this case is controlled by our decision four years ago invalidating a nearly identical Texas law," Roberts wrote.

  • State officials say requirements for admitting privileges are meant to protect women’s health and ensure doctors are qualified. Advocates of abortion access counter that these privileges are medically unnecessary because the procedure rarely results in hospitalization and when complications do arise, they often occur after the woman has left the clinic. Doctors may have their admitting privileges denied for reasons unrelated to ability or experience, including not having a track record of admitting patients due to the relative rarity of complications requiring hospitalization, critics of the Louisiana law say.
    Lawyers challenging the law argued it was a carbon copy of the Texas requirement overturned in 2016. The Supreme Court said in its decision then that there was “sufficient evidence” showing that the requirement for admitting privileges shut down about half the abortion clinics in Texas — more than quadrupling the number of reproductive-age women living more than 150 miles away from one — with no proof they better protected women’s health.
  • During the period in which the requirement was in effect in Texas, the number of abortions performed in the state declined from around 63,000 in 2013 to 54,000 the next year, government data shows. In neighboring Louisiana, where some 10,000 women seek abortions each year, one clinic and one doctor would be left to perform the procedure if the requirement for admitting privileges went into effect, the law’s challengers said.
  • Texas Attorney General Ken Paxton said the court should have upheld the "commonsense" Louisiana law. "Instead, in striking down these basic health-and-safety regulations, the Supreme Court has allowed abortion clinics to endanger women," he said in a statement.
  • While advocates for abortion access celebrated the ruling, they expressed worry about future fights over the procedure.
    “We’re relieved that the Louisiana law has been blocked today, but we’re concerned about tomorrow,” said Nancy Northup, head of the Center for Reproductive Rights, a nonprofit that represented the Louisiana abortion providers. “Unfortunately, the court’s ruling today will not stop those hell bent on banning abortion.”
  • The Texas Democratic Party said the decision underscores the need to elect Democratic politicians who support "every woman’s right to choose."
    "Our fight for choice and quality access to health care continues this November," Texas Democratic Party senior brand director Brittany Switzer said.

"Lubbock votes to become the state's largest "sanctuary city for the unborn" (May 1, 2021)[edit]

Najmabadi, Shannon. "Lubbock votes to become the state's largest "sanctuary city for the unborn". The Eagle. (May 1, 2021)

  • The push to declare Lubbock a “sanctuary city for the unborn” began in the last two years and was galvanized by the arrival of a Planned Parenthood clinic in 2020. Anti-abortion activists gathered enough signatures to bring the ordinance to the City Council — where it was voted down for conflicting with state law and Supreme Court rulings — and to then put it to a citywide vote.
    Ardent supporters of the measure, who liken abortion to murder, say it reflects the views held by many in conservative Lubbock. They believe the ordinance would stand up in court and say they have an attorney who will defend the city free of charge if it is challenged.
    But the strategy of bringing the abortion fight to the local level has divided even staunch anti-abortion activists, and Texas towns like Omaha and Mineral Wells have voted down similar ordinances or walked them back under advice from city attorneys.
  • The American Civil Liberties Union of Texas, which previously sued seven East Texas towns that passed similar ordinances, has said they were watching the vote closely and hinted at a lawsuit in a statement Saturday.
    Drucilla Tigner, a policy and advocacy strategist with the organization, said the “ACLU has a long history of challenging unconstitutional abortion bans and will continue to fight to protect the fundamental rights of the people of Lubbock.”
  • A spokesperson for Planned Parenthood, which has provided birth control and other health services in Lubbock since last fall, said “we are committed to expanding access to abortion and will provide abortion services when possible in Lubbock.”
    “We want Lubbock residents to know: Our doors are open and we will continue to advocate for our patients, no matter what,” said Sarah Wheat, a spokesperson for Planned Parenthood of Greater Texas.
  • Richard D. Rosen, a constitutional law professor at Texas Tech University, expects someone would sue Planned Parenthood and the legal fight would go from there.
    “As long as Roe is good law I think these suits will ultimately fail, but it [could make] abortion providers ... expend money for attorneys fees and it takes time,” he said.
  • “Today is a victory for life and proof that the silent majority will still stand up for its Christian conservative values,” state Rep. Dustin Burrows, a Lubbock Republican, said in a statement Saturday.
    Mark Lee Dickson, an East Texas pastor behind the “sanctuary city for the unborn” movement, helped push the ordinance in Lubbock and said he was “grateful that the voters of Lubbock voted so overwhelmingly to outlaw abortion.”
    “Planned Parenthood and its supporters also worked hard to get their supporters to the polls, and we congratulate them on their efforts,” he said Saturday night. “Now that the voters have spoken, we expect Planned Parenthood to respect the outcome of this election and cease providing abortions at its Lubbock clinic.”
  • Without the recently opened Planned Parenthood location, the closest abortion clinics are a five-and-a-half hour drive away, said Marilyn Mathew, co-founder of a “Medical Students for Choice” group at Texas Tech University Health Sciences Center. That could prove to be a cost-prohibitive journey for people needing to stay overnight to comply with state abortion regulations, she said.
    “I’m worried about how this is going to play out in the long run,” she said.

"Access to Abortion" (2003)[edit]

"Access to Abortion" (PDF). National Abortion Federation. 2003. Archived (PDF) from the original on June 19, 2007. Retrieved June 17, 2007.

  • The Supreme Court confirmed women’s right to choose abortion in 1973, and the courts have upheld that finding in subsequent cases. But access to abortion has been severely eroded. The most recent survey found that 87% of all US counties have no identifiable abortion provider In non-metropolitan areas, the figure rises to 97%. As a result, many women must travel long distances to reach the nearest abortion provider.
    But distance is not the only barrier women face. Many other factors have contributed to the current crisis in abortion access, including a shortage of trained abortion providers; state laws that make getting an abortion more complicated than is medically necessary; continued threats of violence and harassment at abortion clinics; state and federal Medicaid restrictions; and fewer hospitals providing abortion services.
    • p.1
  • In 1973 the Supreme Court struck down state laws that had criminalized abortion. Doctors working in hospital emergency rooms and ob/gyn units before that time knew first-hand about the medical devastation that women suffered as a result of self induced abortions or black market abortions performed by unlicensed practitioners. Today, many of those doctors are retiring. The younger physicians replacing them have little direct experience with the consequences of illegal abortions and the public health benefits of ensuring that safe abortions remain available.
    Even those young doctors who are committed to providing safe abortions to their patients may have trouble getting the training they need. A survey in 1998 revealed that first trimester abortion

techniques are a routine part of training in only 46% of America's ob/gyn residency programs. About 34% offer this training only as an elective, and 7% provide no opportunity at all for young doctors to learn to do safe abortions.
In 1996, the agency responsible for accrediting medical residency programs (the Accreditation Council for Graduate Medical Education) took steps to correct this problem. It now requires ob/gyn residency programs to include family planning and abortion training for their students. It is too soon to tell whether this will result in better preparation of ob/gyns in the future to provide safe abortion services, but it is clear that doctors who don't get this training are not in a position to provide the full range of care that their patients will need.

    • p.1
  • National polling consistently shows that the majority of Americans support a woman's right to choose, but many legislators are committed to bringing an end to legal abortion and have passed laws that have drastically diminished access to abortion. These include:
    * Parental Consent or Notification Laws which are now enforced in over half the states can violate the privacy of young women by forcing them to involve their parents in their decisions, even when they have strong objections to doing so. As a result, some women to travel to other states that do not require parental involvement; others have

resorted to illegal abortions rather than comply with a legal requirement that puts them in jeopardy.
* Mandatory Waiting Periods require women to wait some period of time (up to 24 hours) between a state mandated counseling appointment and their abortion. Many of these laws require the counseling be done in person rather than on the phone. These laws imply that women come to abortion clinics without having seriously considered their options. As a result of these waiting periods, a woman's abortion is often delayed much longer than 24 hours, particularly if she has to take time off from work, arrange for child care, travel a long way, and perhaps stay overnight in a distant city. These factors can significantly increase the cost as well.
* Biased Counseling Laws require that clinic personnel lead their patients through detailed, state prescribed "scripts" that promote childbearing. Abortion providers have long been at the forefront of developing and delivering sound and effective options counseling to their patients. They consider these scripts "biased" because they contain information that is designed to frighten and dissuade women from having abortions. These coercive scripts are completely incompatible with the goal of true informed consent.

    • p.1
  • The cost of a first trimester abortion has increased only slightly since 1973 (see Fact Sheet: Economics of Abortion), but many women still cannot afford the fee. The Hyde Amendment denies federal Medicaid funding for abortions except in specific, rare circumstances, and most states have similar laws restricting financial help to women who need abortions. More than 2/3 of women must initially pay for their abortions themselves -- only 13% of abortions are paid for with a state's public funds2, and only

13% are covered by a woman's private insurance at the time of her abortion. A small number of women may be reimbursed by insurance after their abortion.
The result is that too many women who need abortions must wait while they raise funds, postponing their abortions until later in their pregnancies, when the costs of these more complicated abortion procedures are higher. For the women who are struggling to make ends meet and who do not have insurance that covers abortion, the legal right to have an abortion does not guarantee that they will have access to it.

    • p.2
  • Today, about 95% of women who need abortions have them in clinics or in private doctor's offices where costs can be kept low without increasing health risks.
    This pattern of abortion service delivery represents a significant shift away from hospital provided abortion care, which was far more common in the early years after the laws criminalizing abortion were struck down. "According to the American Hospital Association, there were 5,801 hospitals in the United States in

2001. However, a 2001-2002 study by the Alan Guttmacher Institute identified only 603 hospitals that provided abortions in 2001." This has serious implications for abortion access. Women in rural areas where there are no abortion clinics, and low-income women who depend on hospital emergency services for medical care, are left unserved when hospitals do not provide abortions. When hospitals do not offer abortions, young physicians they train have no opportunity to learn to perform safe abortions.

    • p.2
  • The National Abortion Federation's Access Initiative Project was created specifically to address the escalating problem of limited access to abortion in the US. The Access Initiative Project works with medical residency programs, educational institutions, health care associations, legal experts, public policy organizations, and interested individuals to ensure that qualified clinicians are able to

get the training they need to provide safe abortions and that women can continue to have access to the quality health care they deserve.

    • p.2

"The Safety and Quality of Abortion Care in the United States” (2018)[edit]

National Academies of Sciences, Engineering; Division, Health Medicine; Board on Health Care Services; Board on Population Health Public Health Practice; Committee on Reproductive Health Services: Assessing the Safety Quality of Abortion Care in the U.S (2018). "The Safety and Quality of Abortion Care in the United States”, at NAP.edu. doi:10.17226/24950. ISBN 978-0-309-46818-3. PMID 29897702

  • Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed.
    • ch.2, p.45
  • In the more than 40 years since national legalization of abortion, investigators have conducted randomized controlled trials (RCTs), large retrospective cohort studies, patient and provider surveys, systematic reviews, and other types of research on abortion care and its health effects on women, resulting in an extensive literature.
    • ch.2, p.45
  • The committee’s review emphasizes contemporary approaches to abortion care because abortion methods have been refined in response to new evidence. Some research conducted before 2000 is unlikely to reflect the outcomes of how abortions are typically performed in the United States today. As discussed below, for example, the U.S. Food and Drug Administration (FDA)-approved protocol for medication abortion was updated in 2016 based on extensive research showing improved outcomes with a revised regimen. Techniques used in aspiration procedures are also safer and more effective than in the past. Sharp metal curettes, once commonly used, are considered obsolete by many professional groups, and their use is no longer recommended for abortion because of the increased (albeit rare) risk of injury. New approaches to cervical preparation and the use of ultrasound guidance have also improved abortion safety.
    • ch.2, p.46
  • Induction abortions are rarely performed in the United States; in 2013, they accounted for approximately 2 percent of all abortions at 14 weeks’ gestation or later. For many women in the United States, D&E is often the preferred alternative because induction is more painful, its timing is less predictable and slower (sometimes taking more than 24 hours), and it is more expensive (see below). In some clinical settings, however, D&E is not an option because the available clinicians lack the necessary experience and/or training in D&E procedures. In addition, D&E abortions are illegal in Mississippi and West Virginia.
    • p.66
  • Death associated with a legal abortion in the United States is an exceedingly rare event. As Table 2-4 shows, the risk of death subsequent to a legal abortion (0.7 per 100,000) is a small fraction of that for childbirth (8.8 per 100,000). Abortion-related mortality is also lower than that for colonoscopies (2.9 per 100,000), plastic surgery (0.8 to 1.7 per 100,000), dental procedures (0.0 to 1.7 per 100,000), and adult tonsillectomies (2.9 to 6.3 per 100,000). Comparable data for other common medical procedures are difficult to find.
    • pp.74-75
  • Unlike other health care procedures provided in office-based settings, abortions are subject to a wide array of regulations that vary by state. Except for abortion, states typically regulate individual, office-based health services only when the service involves using sedation or general anesthesia (and depending on the level of sedation). Twenty-five states regulate office-based procedures (other than abortion). In 23 of these states, the regulation is triggered by the level of sedation, and in most cases, it requires that the facility be either accredited or licensed by the state in order to offer patients moderate or deep sedation.
    • p.76
  • The clinical evidence presented in this chapter on the provision of safe and high-quality abortion care stands in contrast to the extensive regulatory requirements that state laws impose on the provision of abortion services. These requirements may influence the efficiency of abortion care by requiring medically unnecessary services and multiple visits to the abortion facility, in addition to requiring that care take place in costlier and more sophisticated settings than are clinically necessary. These requirements go beyond the accepted standards of care in the absence of evidence that they improve safety. Some requirements, such as multiple visits and waiting periods, delay abortion services, and by doing so may increase the clinical risks and cost of care. They may also limit women’s options for care and impact providers’ ability to provide patient-centered care. Furthermore, many of these laws have been documented to reduce the availability of care by imposing unneeded regulations on abortion providers and the settings in which abortion services are delivered. The implications of abortion-specific regulations for the safety and quality of abortion care are described below.
    • p.77
  • The clinical evidence makes clear that legal abortions in the United States—whether by medication, aspiration, D&E, or induction—are safe and effective. Serious complications are rare; in the vast majority of studies, they occur in fewer than 1 percent of abortions, and they do not exceed 5 percent in any of the studies the committee identified. However, the risk of a serious complication increases with weeks’ gestation. As the number of weeks increases, the invasiveness of the required procedure and the need for deeper levels of sedation also increase. Thus, delaying the abortion increases the risk of harm to the woman.
    State regulations that require women to make multiple in-person visits and wait multiple days delay the abortion. If the waiting period is required after an in-person counseling appointment, the delay is exacerbated. Restrictions on the types of providers and on the settings in which abortion services can be provided also delay care by reducing the availability of care.
    Financial burdens and difficulty obtaining insurance are frequently cited by women as reasons for delay in obtaining an abortion. As noted in Chapter 1, 33 states prohibit public payers from paying for abortions, and other states have laws that either prohibit health insurance exchange plans (25 states) or private insurance plans (11 states) sold in the state from covering or paying for abortions, with few exceptions.
    • pp.77-78
  • Long-established ethical and legal standards for informed consent in health care appear to have been compromised in the delivery of abortion care in many areas of the country. Thirty-five states have abortion-specific regulations requiring women to receive counseling before an abortion is performed, and abortion patients in many of these states are offered or given inaccurate or misleading information (verbally or in writing) on reversing medication abortions, risks to future fertility, possible breast cancer risk, and/or long-term mental health consequences of abortion. As noted earlier in this chapter, the principal objective of the informed consent process is that patients understand the nature and risks of the procedure they are considering. However, legally requiring providers to inform women about risks that are not supported and are even invalidated by scientific research violates the accepted standards of informed consent. For example, some states require that providers inform women that abortion puts them at greater risk for breast cancer; mental health disorders; and difficulties in having a healthy, successful pregnancy. Three states require providers to inform women that a medication abortion can be reversed after the woman takes mifepristone. This information is not supported by research that meets scientific standards.
    • pp.78-79

"The Hyde Amendment"[edit]

"The Hyde Amendment" (PDF). National Committee for a Human Life Amendment. April 2008. Archived from the original (PDF) on November 16, 2009. ===

  • The Hyde Amendment has been enacted into law in various forms since 1976, during both Democratic and Republican administrations. In 1980, the Supreme

Court affirmed the constitutionality of the Hyde Amendment. In Harris v. McRae the Court ruled that government may distinguish between abortion and “other medical procedures, because no other procedure involves the purposeful termination of a potential life.”
In addition to the life of the mother exception, the Senate had attached exceptions to the Hyde Amendment for rape and incest (FY 1977 to 1980) and for cases where there would be “severe and physical health damage” to the mother if the pregnancy were carried to term (FY 1977 to 1979). However, the 1980 elections brought enough new pro-life members to the Senate to produce a strong Hyde Amendment as part of Supplemental Appropriations and Rescission Act of 1981 (signed into law June 5, 1981 and effective thereafter):
None of the funds appropriated under this Act shall be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.
This language remained constant from 1981 to 1993, though pro-abortion Members made several unsuccessful attempts to weaken the amendment. In 1989, Congress sustained President Bush’s veto of an appropriations bill that contained weakened language.
In 1993, pro-abortion advocates intended to use parliamentary rules of the House to eliminate the Hyde Amendment altogether and open the door for funding abortion on demand. To avoid this outcome, the Hyde Amendment was rewritten in a new format and the exceptions were expanded beyond “life of the mother” to cases of rape or incest. This wording of the Hyde Amendment then became law: None of the funds appropriated under this Act shall be expended for any abortion except when it is made known to the federal entity or official to which funds are appropriated under this Act that such procedure is necessary to save the life of the mother or that the pregnancy is the result of an act of rape or incest.

    • p.1
  • In 2004, Reps. Henry Hyde and Dave Weldon (R-FL) offered what is known as the Hyde/Weldon Conscience Protection Amendment, which was enacted into law as part of the Fiscal Year 2005 Omnibus Appropriations Bill (Public Law 108-447). The amendment protects health care providers from gaps in the law that could be used to force all health care providers to participate in abortion.
    • p.2
  • As found in the Consolidated Appropriations Act, 2008 (H.R. 2764), signed into law December 26, 2007 (Public Law 110-161), the text of the Hyde Amendment law reads as follows: SEC. 507. (a) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated under this Act, shall be expended for any abortion.
    • p.2
  • SEC. 508. (a) The limitation established in the preceding section shall not apply to an abortion-
    (1) if the pregnancy is the result of an act of rape or incest; or
    (2) in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed.
    • p.2
  • [M]ost Americans agree with the Hyde Amendment and other abortion funding restrictions. Numerous polls show that people are not in favor of the government using tax dollars to fund abortions. For example, a CBS/New York Times poll of 1,368

adults in 1993 illustrated to the nation that 72% of Americans do not want to see their tax dollars being used for abortions. A Zogby International poll in 2004 showed that 74% of Americans oppose the use of public funds to pay for abortions.

    • p.3
  • According to an estimate by the Alan Guttmacher Institute, the cost to the federal government of funding poor women’s abortions in FY 1994 if the Hyde Amendment were repealed would have been between $62.5 million and $75 million for 312,000

abortions. This estimate is very low. Others estimate that 500,000 or more abortions would have been funded by Medicaid in FY 1994 if the Hyde Amendment were repealed.

    • p.3
  • In 1993, Congress added to the Hyde Amendment funding for abortion also in cases of rape or incest. The laws and policies of many states traditionally allowed funding for abortion only when the mother’s life was in danger. President Clinton said he would interpret the Medicaid statute to permit but not require state funding of abortion in the additional cases of rape or incest. But after Congress passed the

revised Hyde Amendment, he reversed his interpretation and insisted that states must fund all abortions that are eligible for federal funds. He also interpreted the “rape and incest” standard very broadly, so an abortionist could claim reimbursement even if no rape or incest had ever been reported to law enforcement or public health authorities.
As a result of the Clinton administration’s determination, several states were formally threatened with loss of all Medicaid funds unless they complied with the new federal standard, even if their own stricter policy against abortion funding was in their state constitutions. Some of these states’ laws had even been passed by public referendum. At the time the Clinton administration set this mandate, 32 states had laws prohibiting public funding for abortion except in cases where the life of the mother would be endangered. Battles over coercing the states raged in federal and state courts. Many states were forced to fund abortions against their will; some courts invalidated state laws in their entirety, requiring states to fund abortions without meaningful restriction. As of 1998, every state engaged in a law suit had lost in court. The outcome is that the states must now comply with the Clinton Administration mandate.

    • p.3
  • Prior to 1976, the federal Medicaid program paid for about 300,000 abortions a year. However, after the Hyde Amendment went into effect for FY 1977, the funding levels dropped dramatically. In FY 1977, 182,000 abortions were funded. In FY 1986, the number was 232; in FY 2000, 109; in FY 2004, 159.
    • p.3
  • Several studies, conducted in states where both state and federal Medicaid abortion funding has been cut off, have indicated that there is no increase in the

numbers of illegal abortions. One of these studies was conducted by the Texas Department of Health in cooperation with the Centers for Disease Control. The results were published in the CDC’s June 8, 1980 Morbidity and Mortality Weekly Report. The study concluded:
The present study in Texas found more than one-third of the legal abortions expected among Medicaid-eligible women were not obtained in the post funding restriction period. The data cited from the present study are consistent with those from a previous investigation in Texas, which found approximately 40% of the expected number of subsidized abortions were not being obtained in the interval after the funding restriction . . . In Texas, pregnant, low-income women who do not have federal or state funds for abortions do not appear to be resorting to illegal abortions to terminate unwanted pregnancies . . . These findings are consistent with those from a national monitoring system, which also could not document that the restriction of public funds for abortion caused a large percentage of Medicaid-eligible women to choose self-induced or non-physician-induced abortions.

    • p.3-4
  • Pro-abortion advocates claim that because wealthy women can easily pay for an abortion, it is the government’s duty to pay for abortions for women who cannot afford them. But it does not improve the circumstances of the poor to help them kill their children simply because the wealthy may do so. Abortion is itself the most severe form of discrimination, since it is aimed at the most helpless and takes away the most fundamental right, the right to life. Public funds are better directed to efforts that really help poor women and their children.
    Furthermore, a Wirthlin Poll of May 1992 found that people making less than $15,000 per year oppose tax-funded abortions 2 to 1 (63% to 32%). The wealthier, earning more than $60,000 per year, support funding by a margin of 57% to 41%. Thus, the very group that would allegedly benefit from certain tax-funded abortions rejects the idea of using public money for the procedure. When abortion is publicly funded, the poor are offered the abortions favored by the rich.
    • p.4
  • Proponents of public funding have employed the grotesque argument that Medicaid abortion funding is cheaper than childbirth. The Alan Guttmacher Institute, the research arm of Planned Parenthood, argues that:
    If public funds are not available to pay for abortions, a far greater amount of money will be spent to provide maternity care, medical care for the infant . . . and nutritional assistance to women on Medicaid. (Abortion and Women’s Health).
    This cost-benefit analysis of the worth of human life is degrading and absurd. It establishes a frightening precedent for looking at a human life not as something precious but simply as an economic

commodity. As columnist William Raspberry wrote, “It also costs less to kill children than to educate them, but that’s hardly a persuasive argument for infanticide.”

    • p.4
  • Pro-abortion advocates have long sought to make abortion not only legal but funded to the greatest extent possible. Since the Supreme Court has defined

“health” so broadly in the context of abortion to include social and emotional “well-being” (Doe v. Bolton), abortion advocates try to insert “health” or “medically necessary” into abortion funding policies in order to eliminate all meaningful restrictions on public funding. As the National Abortion Rights Action League puts it, “medically necessary” is “a term which generally includes the broadest range of situations for which a state will fund abortion.” (Who Decides? A Reproductive Rights Issues Manual, NARAL, 1990).
Even more ominous than the expansion of Medicaid funding for abortion on demand was the proposal during 1994 to mandate abortion coverage in every American’s health insurance policy through a national health care plan. While most of the reform bills offered in Congress mandated abortion coverage, none of the measures passed.

    • p.4

"Louisiana's Democratic governor signs abortion ban into law" (May 30, 2019)[edit]

"Louisiana's Democratic governor signs abortion ban into law". NBC News. Associated Press. May 30, 2019.

  • BATON ROUGE, La. — Louisiana's Democratic governor signed a ban on abortion as early as six weeks of pregnancy Thursday, a move that puts him squarely in line with the leaders of other conservative Southern states while provoking anger from members of his own party.
    With his signature, Gov. John Bel Edwards made Louisiana the fifth state to enact a law prohibiting abortion when a fetal heartbeat is detected, joining Mississippi, Kentucky, Ohio and Georgia. Alabama's gone further, outlawing virtually all abortions .
  • The bill's signing, however, won't limit the state's three abortion clinics anytime soon. Louisiana's law takes effect only if the law in neighboring Mississippi, which was recently blocked by a judge , is upheld by a federal appeals court.
    Edwards, a Catholic running for reelection this year, didn't hold a public bill signing, instead announcing his action through his office. He had repeatedly said he intended to sign the measure, citing his faith and saying his views match those of people in his conservative, religious state, who he described as "overwhelmingly pro-life."
    Louisiana legislators overwhelmingly supported the ban , with a 79-23 House vote and 31-5 Senate vote.
  • Louisiana's law includes an exception from the abortion ban to prevent the pregnant woman's death or "a serious risk of the substantial and irreversible impairment of a major bodily function" — or if the pregnancy is deemed "medically futile." But it does not include an exception for a pregnancy caused by rape or incest, drawing criticism that the law forces continued trauma on women who have been victimized.
    Under the bill, a doctor who violates the prohibition could face a prison sentence of up to two years, along with medical license revocation.
  • The abortion-rights debates that divide state Capitols across the nation cause fewer ripples in the Louisiana Legislature. It is one of the country's most staunchly anti-abortion states, with a law on the books that immediately outlaws abortion if Roe v. Wade is ever overturned. State lawmakers annually enact new regulations seeking to curb access with bipartisan support.
    Louisiana's latest abortion ban won support from many Democrats and was sponsored by Democratic Sen. John Milkovich, from northwest Louisiana.
    Although Edwards is rarity in the national Democratic Party, he's consistently run as an anti-abortion candidate. When he ran for governor in 2015, his campaign had a prominent TV ad that showed his wife, Donna, describing being advised to have an abortion because of their daughter's spinal birth defect. The Edwardses refused, and the ad showed a grown-up Samantha.
    The bill signing from Edwards, who faces two Republicans on the ballot this fall, is expected to help shore up his position with some voters at home, even if it puts him at odds with national Democratic Party leaders and donors.
    Still, the governor faced an outcry of anger on social media from Democrats who objected to his support for the abortion ban.
  • The chair of Louisiana's Democratic Party, Sen. Karen Carter Peterson, has been regularly slamming the bill. She's posted opposition messages on Twitter, such as: "Roe vs. Wade should be respected not undermined! Right to privacy!" But she hasn't directly criticized Edwards by name, and the party is supporting him for reelection.
    The governor was reluctant to address the abortion ban on Thursday. “The bill has been signed and I’m not going to get into that further today,” Edwards told NBC News.

"Men, Women Generally Hold Similar Abortion Attitudes" (June 14, 2018)[edit]

Frank Newport, "Men, Women Generally Hold Similar Abortion Attitudes". News.gallup.com. (June 14, 2018).

  • WASHINGTON, D.C. -- Many U.S. political leaders may think of abortion as a key "women's issue," but it is not an issue about which women have substantially different attitudes than men. A Gallup analysis shows that differences in views on the legality of abortion between men and women have been relatively narrow for decades, going back to the 1970s. Additionally, there are only slight differences in men's and women's descriptions of themselves as pro-choice or pro-life.
    Gallup's 2010 comprehensive analysis of gender differences in views of abortion concluded, "Over the past three decades, men and women have consistently held similar views about the extent to which abortion should be legal." The current update, adding in data for the years 2010-2018, shows a continuation of this same general pattern.
  • Since 1990, the average gender difference in the view that abortion should be legal in all circumstances is four percentage points, with women more likely than men to hold that attitude. For the past four years, an average of 31% of women and 26% of men have held this view.
    Gender differences in the view that abortion should be illegal in all circumstances are even smaller, with an average gap of two points since 1990. For the past four years, there has been no difference, with 19% of both men and women saying that abortion should be totally illegal.
    The modal choice for both men and women is the view that abortion should be legal, but only in certain circumstances. Men have been slightly more likely than women to hold this view since the 1980s, including by a five-point average difference over the past four years.
  • There is a narrow gender gap in Americans' descriptions of themselves as either pro-choice or pro-life. Gallup began asking this question annually in 2001 as part of Gallup's Values and Beliefs survey, and since that time, men have been slightly more likely than women to choose the pro-life descriptor. The gap has been between three and four points since 2010 -- including the most recent period from 2015-2018, with 47% of men and 44% of women choosing the pro-life label.
    The slight male edge in identification as pro-life reflects women becoming slightly more pro-choice in recent years, with 50% of women and 46% of men choosing the pro-choice label over the past four years. Similarly small differences were evident in previous years, including an even tie in self-descriptions as pro-choice between 2005 and 2009.
    The net result of these attitudes is that men are divided in their self-identification -- 47% pro-life and 46% pro-choice, while women tilt toward describing themselves as pro-choice, 50% to 44%.
  • Educational attainment is a significant predictor of Americans' position on abortion, with college graduates more likely than those with less education to favor abortion being legal in all circumstances.
    There has been and continues to be a significant gender gap on this measure among college graduates, with female graduates more likely than male graduates to favor abortion being legal in all circumstances. This pattern has been constant over the past decades, despite modest fluctuations in the overall percentages favoring legalized abortion. Most recently, over the past four years, 42% of female college graduates have chosen the "legal in all" alternative, versus 32% of male college graduates.

"In Texas, Oklahoma, Women Turned Away Because Of Coronavirus Abortion Bans" (4/2/2020)[edit]

"In Texas, Oklahoma, Women Turned Away Because Of Coronavirus Abortion Bans". NPR.org.

  • The doors at the Trust Women clinic in Oklahoma City were locked on Tuesday, when the young woman arrived for her appointment. Over the phone, a clinic worker told her the news – the facility had to shut down because of an order from Gov. Kevin Stitt banning most abortions.
    "And immediately I just, like, broke down," she said. "I just lost my job because of the coronavirus. I already have a 10-month-old daughter. I don't know what I'm gonna do, you know?"
    "M" asked us not use her full name because she's concerned about how her family would react to her seeking an abortion. She's 30, with two kids. She said she lost her job in the retail industry a couple of weeks ago after business suddenly vanished.
    "M" said she was able to get an appointment for the next day at a clinic in Wichita, Kan. She doesn't have a reliable car, so a friend drove her there – a two-and-a-half-hour trip each way.
    "There were so many people there from so many different states, and I only think about how many couldn't make it," she said.
  • Republican officials in several states are trying to ban abortion during the coronavirus crisis. They say the procedure should be suspended during the pandemic, except for emergencies, to help preserve medical supplies like surgical masks and hospital gowns.
    Federal courts have blocked such orders in Ohio and Alabama. Officials in Iowa agreed to allow doctors to determine when an abortion is needed. A federal court briefly blocked a ban in Texas, before that decision was overturned on appeal. Litigation is ongoing.
  • Reproductive rights groups say hundreds of patients have been turned away in Texas, and in Oklahoma.
    Becca Walker, a counselor at Southwestern Women's Surgery Center in Dallas, said many patients "panic" when they hear the news that their procedures are being cancelled. She said some patients are particularly afraid of being pregnant during a pandemic.
    "Sometimes you're just guiding them through breathing on the phone because it's such a moment of panic and crisis for them," Walker said. "And then you just have to give them the referral, and the next referral is not good news."
  • Abortion rights opponents argue the bans are necessary and appropriate during a pandemic.
    "We are setting aside all kinds of what would otherwise be considered essential healthcare – I would say more essential healthcare than abortion, certainly – cancer screenings," said Dr. Christina Francis, an OB/GYN in Indiana and board chair at the American Association of Pro-Life Obstetricians & Gynecologists.
    "Abortion is not essential healthcare; it doesn't treat a disease process," Francis said. "It's a social solution, and there are other solutions that we can provide to women who find themselves in very scary and uncertain circumstances right now."
  • Many doctors say denying an abortion can put patients at risk. The American Medical Association released a statement accusing some elected officials of "exploiting this moment," and saying the decision should be left to patients and doctors.
  • Dr. Bhavik Kumar, who provides abortion services at a Planned Parenthood clinic in Houston, said in the midst of a pandemic, many patients seeking abortions feel desperate enough to consider dangerous home remedies.
    "The scary part is a lot of my patients are asking us what they can do themselves, how they can use things at home, different herbs or vitamins or objects to help them not be pregnant," Kumar said. "They are scared."

"While some states try to ban abortion, these states are expanding access" (June 12, 2019)[edit]

North, Anna (June 12, 2019). "While some states try to ban abortion, these states are expanding access". Vox.

  • [E]arlier this month, Maine’s Democratic Gov. Janet Mills signed into law a bill that will actually expand abortion access in the state by allowing nurse practitioners and physician assistants, not just doctors, to perform the procedure. As clinics in other states are at risk of closing, the Maine law will increase the number of clinics able to perform abortions.
    Soon after, Mills signed a second bill that will require public and private insurance plans in the state to cover abortion. Meanwhile, last week, New York City officials announced that they would allocate $250,000 to pay for low-income patients to get abortions.
    These moves are part of a bigger trend, as legislators and advocates in blue states back legislation to lift abortion restrictions. These laws are still outnumbered by anti-abortion bills, but they’re becoming more and more common — about a quarter of the provisions to expand abortion access since 2011 have passed in the past three weeks alone, according to an analysis by FiveThirtyEight.
  • In years past, “states did not feel the threat to abortion rights and did not want to expend the political capital to pass these laws,” Elizabeth Nash, senior state issues manager at the Guttmacher Institute, a nonprofit focused on reproductive health policy research, told Vox. But with Donald Trump in the White House, Justice Brett Kavanaugh on the Supreme Court, and a potential challenge to Roe v. Wade on the horizon, that’s changing. Now states like Maine, Illinois, and Vermont are taking steps to shore up abortion access, with the understanding that federal protections for the procedure may soon be under threat.
  • Mills, the state’s first female governor, on June 10 signed LD 1261, which allows nurse practitioners, physician assistants, and other trained medical providers to perform abortions. Previously, only physicians could perform abortions in Maine.
    Opponents of the measure said it would put patients at risk, according to the Portland Press-Herald. But research shows that advanced practice clinicians, a category that includes physician assistants, nurse practitioners, and nurse midwives, provide the same level of abortion care as doctors, Nash said.
    The measure could increase the number of clinics performing aspiration abortion, the most common type of in-clinic procedure, from three to 18, according to ThinkProgress. The law will have an especially big impact on Maine’s many rural residents, who may live far away from clinics staffed by doctors, Nash said.
  • A few days later, Mills signed another bill, this one requiring all public and private insurance plans that cover prenatal care to cover abortion as well. Previously, Maine’s state Medicaid program, MaineCare, only covered abortion in cases of rape, incest, or a threat to the pregnant patient’s life.
    Opponents of taxpayer funding for abortion criticized the bill, according to the Associated Press, but reproductive rights groups applauded its passage, saying it would expand access to abortion for low-income patients.
    “As states like Alabama, Georgia, and Missouri are in a race to the bottom to ban abortion and put politics over the lives and well-being of women and their families, Maine has recognized that no one should be denied coverage for abortion care just because they’re poor,” said Destiny Lopez, co-director of All* Above All, a group that advocates for public insurance for abortion, in a statement when the bill was signed.
  • New York’s Reproductive Health Act, passed in January, has gotten a lot of attention because it allows abortions after 24 weeks if the fetus is not viable or there is a threat to the mother’s health. Opponents have cast this provision as extremism on the part of Democrats, but supporters of the measure say it is necessary because previous New York law forced patients to travel out of state and pay thousands of dollars to obtain an abortion when they were seriously ill or carrying a fetus that could not survive after birth.
    The Reproductive Health Act, like the Maine law, also allows advanced practice clinicians to perform abortions. Though it’s gotten less attention, abortion law experts say this provision may affect even more patients than the one affecting abortions later in pregnancy. “Most abortions do take place earlier in pregnancy,” Nash said, “and if you expand the pool of providers, then that potentially has more of an impact.”
    Still, she added, “these protections work together to make sure people have access.”
  • Democratic Gov. J.B. Pritzker on June 12 signed into law the state’s Reproductive Health Act, which makes reproductive health care, including abortion, contraception, and maternity care, a fundamental right in the state, according to Guttmacher. The law protects access to abortion up to viability (which experts say is around 24 weeks’ gestation) and after that if deemed medically necessary by a doctor. The change ensures that abortion will remain legal in Illinois even if Roe v. Wade, which established the right to an abortion nationwide in 1973, is overturned.
    The law also requires public and private insurance plans in the state to cover abortion, and allows advanced practice nurses and physician assistants to provide the procedure.
    Anti-abortion groups have criticized the new law. “While a growing number of states are working to advance popular pro-life laws, Illinois is trying to outdo New York’s abortion extremism — and unborn children and their mothers will pay the price,” Jill Stanek, the national campaign chair for the Susan B. Anthony List, told the Chicago Sun-Times.
    But doctors and reproductive rights advocates have praised the legislation. “This landmark legislation means that an individual’s health, not politics, will govern decision-making,” Erica Hinz, an OB-GYN in Illinois and a fellow with the group Physicians for Reproductive Health, said in a statement on Wednesday.
  • Republican Gov. Phil Scott on June 10 signed into law a bill that, like the Illinois law, makes abortion and other reproductive health care a fundamental right in the state. The Vermont law goes beyond the Illinois measure because it protects abortion access throughout pregnancy, including after viability, Nash said.
  • On June 19, Rhode Island joined New York, Illinois, and Vermont in codifying the right to an abortion in state law. The Reproductive Privacy Act, signed by Democratic Gov. Gina Raimondo, prohibits the state government from interfering with a patient’s decision to get an abortion before viability. After viability, abortion is prohibited except where necessary to protect the life or health of the pregnant person, according to the Boston Globe.
  • The Trust Nevada Women Act, signed by Democratic Gov. Steve Sisolak in May, removes a number of restrictions on abortion. It gets rid of a requirement that doctors tell patients about the “emotional implications” of an abortion, eliminates criminal penalties for patients who perform their own abortion without the advice of a doctor, and removes a requirement that doctors ask about a patient’s age and marital status before performing the procedure.
    “With our reproductive rights under constant attack across the country, we are proud that Nevada legislators voted to ensure that Nevada women and families are able to make the best decisions for their health and well-being,” said Caroline Mello Roberson, the state director of NARAL Pro-Choice Nevada, which advocated for the law, in a statement last month.
  • In addition to these laws, legislation to expand or protect abortion access is under consideration or could be forthcoming in Rhode Island, New Mexico, Washington, and Oregon, Nash said. “There could be momentum going into 2020.”

"Banning abortion, more Texas towns become 'sanctuary cities for the unborn'" (January 16, 2020)[edit]

Parke, Caleb (January 16, 2020). "Banning abortion, more Texas towns become 'sanctuary cities for the unborn'". Fox News. Retrieved January 23, 2020.

  • Starting last June with the city of Waskom, a total of eight cities have now declared themselves "sanctuary cities for the unborn."
    On Monday, Mark Lee Dickson, director of Right to Life of East Texas, pitched to Jacksboro; then on Tuesday, Colorado City and Big Spring, which is awaiting a second vote later this month. OnThursday night, he is headed to Gary, in east Texas.
    "We are preparing our cities for the overturning of Roe [v. Wade]," Dickson told Fox News on the phone, during his seven-hour drive from Big Spring to Gary, "But at the same time, it's completely right to say abortion is outlawed in these cities."
  • Abortion rights advocates argue the ordinances are dangerous and misleading to the public.
    "This extreme proposal is a tactic for abortion opponents to score political points and mislead Texans about their rights," Kamyon Conner, executive director of the Texas Equal Access Fund, told the Texas Tribune. "Access to reproductive care and abortion allows individuals and families to receive the support needed to thrive in our state."
  • But Dickson says there are immediate consequences to the ordinances regardless of whether or not Roe gets overturned.
    "To say we can't ban abortion is simply not true," Dickson argues that cities ban "legal" things all the time – from straws to smoking – in reference to Roe and Planned Parenthood v. Casey, both of which would have to be overturned by the Supreme Court in order for the ordinance to take full effect.
    Until then, however, Dickson said family members can sue an abortionist or anyone who aides an abortion within city limits, but no action can be taken against the mother herself.
    "We're passing laws because resolutions do not prevent abortion clinics from coming into cities, but ordinances, a law put in place, will."
    Three cities – Mineral Wells, Omaha and Jacksboro – have turned down the ordinance because of the threat of legal action or on advice from city lawyers, but that hasn't stopped Dickson.
  • "This is a strong stance that babies will not be murdered in our cities," Dickson said. "We need to stand up with our leaders in bringing this Holocaust to an end once and for all."

"Abortion surveillance - United States, 2009" (November 23, 2012)[edit]

Pazol, Karen; Creanga, Andreea A.; Zane, Suzanne B.; Burley, Kim D.; Jamieson, Denise J; Division of Reproductive Health (November 23, 2012). "Abortion surveillance - United States, 2009" (PDF). MMWR Surveillance Summaries. 61 (8): 1–44.

  • Results: A total of 784,507 abortions were reported to CDC for 2009. Of these abortions, 772,630 (98.5%) were from the 45 reporting areas that provided data every year during 2000–2009. Among these same 45 reporting areas, the abortion rate for 2009 was 15.1 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 227 abortions per 1,000 live births. Compared with 2008, the total number and rate of reported abortions for 2009 decreased 5%, representing the largest single year decrease for the entire period of analysis. The abortion ratio decreased 2%. From 2000 to 2009, the total number, rate, and ratio of reported abortions decreased 6%, 7%, and 8%, respectively, to the lowest levels for 2000–2009.
    In 2009 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas women aged ≥30 years accounted for a much smaller percentage of abortions and had lower abortion rates. In 2009, women aged 20–24 and 25–29 years accounted for 32.7% and 24.4% of all abortions, respectively, and had an abortion rate of 27.4 abortions per 1,000 women aged 20–24 years and 20.4 abortions per 1,000 women aged 25–29 years. In contrast, women aged 30–34, 35–39, and ≥40 years accounted for 14.7%, 8.8%, and 3.3% of all abortions, respectively, and had an abortion rate of 13.3 abortions per 1,000 women aged 30–34 years, 7.6 abortions per 1,000 women aged 35–39 years, and 2.7 abortions per 1,000 women aged ≥40 years. Throughout the period of analysis, abortion rates decreased among women aged 20–24 and 25–29 years, whereas they increased among women aged ≥40 years.
    In 2009, adolescents aged 15–19 years accounted for 15.5% of all abortions and had an abortion rate of 13.0 abortions per 1,000 adolescents aged 15–19 years. Throughout the period of analysis, the percentage of all abortions accounted for by adolescents and the adolescent abortion rate decreased.
    In contrast to the percentage distribution of abortions and abortion rates by age, abortion ratios in 2009 and throughout the entire period of analysis were highest among adolescents and lowest among women aged 30–39 years. Abortion ratios decreased from 2000 to 2009 for women in all age groups except for those aged <15 years, for whom they increased.
    In 2009, most (64.0%) abortions were performed at ≤8 weeks’ gestation, and 91.7% were performed at ≤13 weeks’ gestation. Few abortions (7.0%) were performed at 14–20 weeks’ gestation, and even fewer (1.3%) were performed at ≥21 weeks’ gestation. From 2000 to 2009, the percentage of all abortions performed at ≤8 weeks’ gestation increased 12%, whereas the percentage performed at >13 weeks’ decreased 12%. Moreover, among abortions performed at ≤13 weeks’ gestation, the distribution shifted toward earlier gestational ages, with the percentage of these abortions performed at ≤6 weeks’ gestation increasing 47%.
    In 2009, 74.2% of abortions were performed by curettage at ≤13 weeks’ gestation, 16.5% were performed by early medical abortion (a nonsurgical abortion at ≤8 weeks’ gestation), and 8.1% were performed by curettage at >13 weeks’ gestation.
    • p.1
  • Among abortions that were performed at ≤8 weeks’ gestation and thus were eligible for early medical abortion, 25.2% were completed by this method. The use of early medical abortion increased 10% from 2008 to 2009.
    Deaths of women associated with complications from abortions for 2009 are being investigated under CDC’s Pregnancy Mortality Surveillance System. In 2008, the most recent year for which data were available, 12 women were reported to have died as a result of complications from known legal induced abortions. No reported deaths were associated with known illegal induced abortions.
    Interpretation: Among the 45 areas that reported data every year during 2000–2009, the gradual decrease that had occurred during previous decades in the total number and rate of reported abortions continued through 2005, whereas year-to-year variation from 2006 to 2008 resulted in no net change during this later period. However, the change from 2008 to 2009 for both the total number of abortions and the abortion rate was the largest single year decrease during 2000–2009, and all three measures of abortion (total numbers, rates, and ratios) decreased to the lowest level observed during this period.
    Public Health Actions: Unintended pregnancy is the major contributor to abortion. Because unintended pregnancies are rare among women who use the most effective methods of reversible contraception, increasing access to and use of these methods can help further reduce the number of abortions performed in the United States. The data in this report can help program planners and policy makers identify groups of women at greatest risk for unintended pregnancy and help guide and evaluate prevention efforts.
    • p.2
  • This report is based on abortion data for 2000–2009 that were provided voluntarily to CDC by the central health agencies of 48 reporting areas (the District of Columbia; New York City; and 46 states, excluding California, Delaware, Maryland, and New Hampshire). Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. Following nationwide legalization of abortion in 1973, the total number, rate (number of abortions per 1,000 women aged 15–44 years), and ratio (number of abortions per 1,000 live births) of reported abortions increased rapidly, reaching the highest levels in the 1980s before decreasing at a slow yet steady pace. However, the incidence of abortion has varied considerably across demographic subpopulations, and recent reports through 2008 have suggested that the sustained pattern of decrease has leveled off. Continued surveillance is needed to monitor long-term changes in the incidence of abortion in the United States.
    • p.2
  • In most states, collection of abortion data is facilitated by the legal requirement for hospitals, facilities, and physicians to report abortions to a central health agency. These central health agencies voluntarily provide CDC aggregate numbers for the abortion data they have collected.
    Although reporting to CDC is voluntary, most reporting areas do provide aggregate abortion numbers: during 2000–2009, a total of 45 reporting areas provided CDC a continuous annual record of abortion numbers,† and in 2009, CDC obtained aggregate abortion numbers from 48 reporting areas (excludes California, Delaware, Maryland, and New Hampshire). However, the level of detail that CDC receives on the characteristics of women obtaining abortions varies considerably from year to year and among reporting areas. To encourage more uniform collection of these details, CDC has developed a model reporting form to serve as a technical guide (18). However, because the collection of abortion data is not federally mandated, many reporting areas have developed their own forms and do not collect all the information that CDC compiles.
    • p.2
  • Among the 48 reporting areas that provided data for 2009, a total of 784,507 abortions were reported. Of these abortions, 772,630 (98.5%) were from the 45 reporting areas that provided data every year during 2000–2009. These same 45 areas had an abortion rate of 15.1 abortions per 1,000 women aged 15–44 years and an abortion ratio of 227 abortions per 1,000 live births. Compared with 2008, the total number of abortions reported for the same 45 areas decreased 5% (from 810,403); the abortion rate for these areas also decreased 5% (from 15.9 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 2% (from 232 abortions per 1,000 live births). From 2000 to 2009, the total number of reported abortions decreased 6% (from 826,123), the abortion rate decreased 7% (from 16.2 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 8% (from 248 abortions per 1,000 live births). For both the total number and rate of abortions, the change from 2008 to 2009 was the largest single year decrease during the entire period of analysis. Moreover, for all three measures of abortion, the annual rate of decrease fitted from the regression analysis was greater during 2005–2009 than during 2000–2004. During 2005–2009, the number of reported abortions decreased by 7,538 abortions per year, the abortion rate decreased by 0.12 abortions per 1,000 women per year, and the abortion ratio decreased by 2.2 abortions per 1,000 live births per year. In contrast, during 2000–2004, the number of reported abortions decreased by 3,128 abortions per year, the abortion rate decreased by 0.06 abortions per 1,000 women per year, and the abortion ratio decreased by 1.8 abortions per 1,000 live births per year.
    • p.5
  • Abortion numbers, rates, and ratios have been calculated by individual state or reporting area of occurrence and the residence of the women who obtained the abortions. By occurrence, a considerable range existed in the total number of reported abortions (ranging from 769 in South Dakota to 119,996 in New York, including New York City and New York State combined), the abortion rate (ranging from 4.0 abortions per 1,000 women aged 15–44 years in Mississippi to 29.8 in New York [city and state combined]), and the abortion ratio (ranging from 57 abortions per 1,000 live births in Mississippi to 484 in New York [city and state combined]). Similarly, a considerable range existed by residence††† in the total number of reported abortions (ranging from 782 in Wyoming to 115,629 in New York [city and state combined]), the abortion rate (ranging from 5.7 abortions per 1,000 women aged 15–44 years in Utah to 28.7 in New York§§§ [city and state combined]), and the abortion ratio (ranging from 64 abortions per 1,000 live births in Utah to 466 in New York [city and state combined]). Because of the substantial variation that also occurred among reporting areas in the percentage of abortions obtained by out-of-state residents (ranging from none in Wyoming to 51.8% in the District of Columbia), abortion rates and ratios calculated by maternal residence might provide a more accurate reflection of population trends. However, these measures must be viewed with caution because states vary in the level of detail they collect on maternal residence and as a result, 11.4% of abortions were reported without a state, territory, reporting area, or country of maternal residence.
    • p.5
  • Among the 45 areas that reported by maternal age for 2009, women aged 20–29 years accounted for the majority (57.1%) of abortions and had the highest abortion rates (27.4 and 20.4 abortions per 1,000 women aged 20–24 and 25–29 years, respectively) (Figure 2, Table 3). Women in the youngest and oldest age groups (aged <15 or ≥40 years) accounted for the smallest percentage of abortions (0.5% and 3.3%, respectively) and had the lowest abortion rates (1.1 and 2.7 abortions per 1,000 women aged <15 and ≥40 years, respectively). Among the 42 reporting areas that provided data every year during 2000–2009, this pattern across age groups was stable, with the majority of abortions and the highest abortion rates occurring among women aged 20–29 years and the lowest percentages of abortions and abortion rates occurring among women in the youngest and oldest age groups. However, from 2000 to 2009 the abortion rate and percentage of abortions accounted for by younger women decreased, whereas the abortion rate and percentage of abortions accounted for by older women increased. Among women aged <30 years, abortion rates decreased both from 2000 to 2004 and from 2005 to 2009; decreases from 2008 to 2009 were greater than in any other year during the period of analysis (6%–8%). In contrast, among women aged ≥40 years, abortion rates increased both from 2001 to 2004 and from 2005 to 2009. Among women aged 30–39 years, abortion rates varied more from year to year, resulting in little overall change: although abortion rates increased among women aged 35–39 years from 2000 to 2004 this increase did not continue from 2005 to 2009.
    In contrast to the percentage distribution of abortion numbers and abortion rates, abortion ratios in 2009 were highest among adolescents aged ≤19 years and lowest among women aged 30–39 years. Among the 42 reporting areas that provided data for every year during 2000–2009, abortion ratios decreased among all women aged ≥15 years. For most age groups ≥15 years, abortion ratios decreased both from 2000 to 2004 and from 2005 to 2009. However for women aged 15–19 years, abortion ratios increased from 2000 to 2004 before they decreased from 2005 to 2009; among women aged 35–39 years abortion ratios decreased from 2000 to 2004 but not from 2005 to 2009.
    • pp.5-6
  • Among the 42 areas that reported age by individual year among adolescents for 2009, the adolescent abortion rate was 9.7 abortions per 1,000 adolescents aged ≤19 years. Adolescents aged 18–19 years accounted for the majority (63.9%) of adolescent abortions and had the highest adolescent abortion rates (18.4 and 22.9 abortions per 1,000 adolescents aged 18 and 19 years, respectively); adolescents aged <15 years accounted for the smallest percentage of adolescent abortions (3.0%) and had the lowest adolescent abortion rate (1.0 abortions per 1,000 adolescents aged <15 years). Among the 39 reporting areas that provided data for adolescents by individual year of age every year during 2000–2009, this pattern across age groups was stable, with older adolescents consistently accounting for the largest percentage of adolescent abortions and having the highest abortion rates (Table 6). Although the percentage of abortions accounted for by adolescents aged 19 years increased from 2000 to 2009, abortion rates decreased among adolescents of all ages, and these decreases occurred both from 2000 to 2004 and from 2005 to 2009. For adolescents in all age groups, the decrease in the abortion rate from 2008 to 2009 was the largest single year change during the entire period of analysis.
    The adolescent abortion ratio for 2009 was 326 abortions per 1,000 live births. Adolescent abortion ratios decreased with increasing age and were lowest among adolescents aged 19 years (Table 5). Among the 39 reporting areas that provided data for adolescents by individual year of age for every year during 2000–2009, abortion ratios among all adolescents aged >15 years were lower in 2009 than they had been in 2000, with the greatest decreases occurring among adolescents aged 18–19 years. For all adolescents aged 15–19 years this decrease occurred almost exclusively from 2005 to 2009 and not from 2000 to 2004.
    • p.6
  • Among the 39 areas that reported gestational age at the time of abortion for 2009, the majority (64.0%) of abortions were performed at ≤8 weeks’ gestation, and 91.7% were performed at ≤13 weeks’ gestation. Few abortions (7.0%) were performed at 14–20 weeks’ gestation, and even fewer (1.3%) were performed at ≥21 weeks’ gestation. Among the 30 reporting areas that provided data on gestational age every year during 2000–2009 (Table 8), the percentage of abortions performed at ≤13 weeks’ gestation increased only slightly. However, within this gestational age range, a shift occurred toward earlier gestational ages, with abortions performed at ≤8 weeks’ gestation increasing 12%. The percentage increase in abortions performed at ≤8 weeks’ was greatest from 2000 to 2004 but continued from 2005 to 2009. Throughout the period of analysis, the percentage of abortions performed at >13 weeks’ gestation remained low (<10%), and abortions performed at ≥16 weeks’ gestation decreased 13%–22% from 2000 to 2009.
    Among the subset of abortions performed at ≤13 weeks’ gestation in 2009, 35.2% were performed at ≤6 weeks’ gestation, and 34.6% were performed at 7–8 weeks’ gestation. Among the remaining abortions at ≤13 weeks’ gestation, the percentage contribution was progressively lower for each additional week of gestation: 10.2% were performed at 9 weeks’ gestation, whereas 3.0% were performed at 13 weeks’ gestation. Among the 30 areas that reported by the exact week of gestational age for every year during 2000–2009, the percentage of abortions shifted over time toward earlier gestational ages: among abortions performed at ≤13 weeks’ gestation, those that were performed at ≤6 weeks’ gestation increased 47%, whereas the percentage performed at 7–13 weeks’ gestation decreased up to 26% (Table 10); the percentage increase in abortions performed at ≤6 weeks’ was greatest from 2000 to 2004, but this increase continued from 2005 to 2009.
    • pp.6-7
  • Among the 38 areas that reported by method type for 2009 and included medical abortion on their reporting form for medical providers, 74.2% of abortions were performed by curettage at ≤13 weeks’ gestation; 16.5% were performed by early medical (nonsurgical) abortion, 8.1% were performed by curettage at >13 weeks’ gestation, and all other methods were uncommon. Among the 27 reporting areas that included medical abortion on their reporting form and provided this data for all 3 years of comparison (2001, the first full year following FDA approval of mifepristone for use in early medical abortion, as well as 2008 and 2009), the use of early medical abortion increased 10% from 2008 to 2009 and approximately 350% from 2001 to 2009 (from 3.4% of abortions in 2001 to 13.8% in 2008 and 15.2% in 2009). In contrast, use of curettage at ≤13 weeks’ gestation decreased 2% from 2008 to 2009 and 14% from 2001 to 2009 (from 87.3% of abortions in 2001 to 76.7% in 2008 and 75.5% in 2009). Use of curettage at >13 weeks’ gestation was stable from 2001 to 2008 but decreased 5% from 2008 to 2009 (from 8.6% of abortions in 2001 and in 2008 to 8.2% in 2009). All other methods consistently accounted for a small percentage of abortions (0.04%–0.9%).
    • p.7
  • Among the 29 areas that reported cross-classified race/ethnicity data for 2009, non-Hispanic white women and non-Hispanic black women accounted for the largest percentages of abortions (37.7% and 35.4%, respectively), whereas Hispanic women and non-Hispanic women in the other races category accounted for smaller percentages (20.6% and 6.3%, respectively). Non-Hispanic white women had the lowest abortion rates (8.5 abortions per 1,000 women aged 15–44 years) and ratios (140 abortions per 1,000 live births), whereas non-Hispanic black women had the highest abortion rates (32.5 abortions per 1,000 women aged 15–44 years) and ratios (477 abortions per 1,000 live births). Among the 24 areas that reported by race/ethnicity every year during 2007–2009, abortion rates decreased for all racial/ethnic groups. The abortion rate decreased 7% for non-Hispanic white women (from 9.1 abortions per 1,000 women in 2007 to 8.5 in 2009) and 6% for Hispanic women (from 20.5 abortions per 1,000 women in 2007 to 19.3 in 2009) but only 1% for non-Hispanic black women (from 34.6 abortions per 1,000 women in 2007 to 34.2 in 2009). In contrast, abortion ratios decreased among non-Hispanic white women but not among women in any other racial/ethnic group. For non-Hispanic white women, the abortion ratio decreased 3% (from 143 abortions per 1,000 live births in 2007 to 138 in 2009), whereas the abortion ratio increased 4% for non-Hispanic black women (from 481 abortions per 1,000 live births in 2007 to 501 in 2009) and 2% for Hispanic women (from 192 abortions per 1,000 live births in 2007 to 195 in 2009). Data also are reported separately by race and by ethnicity for 2009 and for 2000–2009.
    • p.7
  • Among the 37 areas that reported marital status for 2009, 15.0% of all women who obtained abortions were married, and 85.0% were unmarried. For the 28 reporting areas that provided these data for the relevant years of comparison, the percentage of abortions accounted for by unmarried women increased 4% from 2000 to 2009 (from 81.6% in 2000 to 85.0% in 2009); an increase occurred both from 2000 to 2004 and from 2005 to 2009.
    • p.7
  • Data from the 36 areas that reported the number of previous live births for women who obtained abortions in 2009 show that 40.2%, 46.3%, and 13.6% of these women previously had zero, one to two, or three or more live births, respectively. Among the 29 reporting areas that provided these data for the relevant years of comparison, little change occurred in the distribution of abortions by the number of previous live births: the percentage of women who had zero previous live births was 39.7% in 2000 and 40.1% in 2009; the percentage of women who had one to two previous live births was 48.0% in 2000 and 46.4% in 2009; and the percentage of women who had three or more previous live births was 12.4% in 2000 and 13.5% in 2009.
    Data from the 37 areas that reported the number of previous abortions for women obtaining abortions in 2009 show that the majority of women (55.3%) had not previously had an abortion; 36.6% had previously had either one to two abortions, and 8.1% had three or more abortions. Among the 30 reporting areas that provided data for the relevant years of comparison, the distribution of abortions by the number of previous abortions changed little: the percentage of women who had zero previous abortions was 55.0% in 2000 and 55.4% in 2009; the percentage of women who had one or two previous abortions was 37.3% in 2000 and 36.5% in 2009; and the percentage of women who had three or more previous abortions was 7.7% in 2000 and 8.2% in 2009.
    • pp.7-8
  • In some reporting areas, abortions that were categorized by maternal race and race/ethnicity were further categorized by maternal age and marital status. A consistent pattern existed for abortion by age across all racial and racial/ethnic groups, with the smallest percentage of abortions occurring among adolescents aged <15 years (0.3%–0.7%) and the largest percentage occurring among women aged 20–24 years (26.9%–33.8%). A consistent pattern also existed for abortion by marital status across all racial and racial/ethnic groups, with a higher percentage of abortions occurring among women who were unmarried (66.0%–91.3%) than among those who were married (8.7%–34.0%). However, although most abortions occurred among unmarried women in all racial/ethnic groups, this percentage was higher for non-Hispanic black women (90.6%) than it was for non-Hispanic white (83.3%) or Hispanic women (83.8%).
    • p.8
  • In some reporting areas, abortions that were categorized by weeks of gestation were further categorized by maternal age, race, and race/ethnicity. In every subgroup for these three variables, the largest percentage of abortions was obtained at ≤8 weeks’ gestation. However, whereas 46.5% of adolescents aged <15 years and 54.3% of adolescents aged 15–19 years obtained an abortion by ≤8 weeks’ gestation, 62.1%–71.2% of women aged ≥20 years obtained an abortion by this point in gestation (Figure 3; Table 22). Conversely, 19.0% of adolescents aged <15 years and 11.8% of adolescents 15–19 years obtained an abortion after 13 weeks’ gestation, whereas this percentage ranged from 6.5%–8.7% for adult women. By race/ethnicity, 58.4% of non-Hispanic black women obtained an abortion at ≤8 weeks’ gestation, whereas 66.5%–70.8% of women from other racial/ethnic groups obtained an abortion by this point in gestation. Non-Hispanic black women also obtained the highest percentage of abortions after 13 weeks’ gestation; however, differences across racial/ethnic groups were less apparent than differences across age groups.
    • p.8
  • Among abortions categorized by method type and gestational age, curettage accounted for the largest percentage of abortions within every gestational age category. At ≤8 weeks’ gestation, curettage accounted for a smaller percentage of abortions (74.5%) than at any other stage of gestation, and early medical abortion accounted for a comparatively high percentage of abortions (25.2%). At 9–17 weeks’ gestation, curettage accounted for 96.4%–98.3% of all abortions and then decreased to 94.7% of abortions at 18–20 weeks’ gestation and 91.4% of abortions at ≥21 weeks’ gestation. After the gestational age limit of ≤8 weeks’ gestation for early medical abortion, the use of medications to induce abortions through nonsurgical methods accounted for only 0.8%–2.9% of reported abortions at 9–20 weeks’ gestation and then increased to 6.9% of abortions at ≥21 weeks’ gestation. Throughout gestation, intrauterine instillations and abortions reported in the other methods category accounted for a small percentage (<0.01%–1.9%) of abortions.
    • p.8
  • Using national data from the Pregnancy Mortality Surveillance System, CDC identified 12 abortion-related deaths for 2008. These deaths were identified either by some indication of abortion on the death certificate, by reports from a health-care provider or public health agency, or from a media report. Investigation of these cases indicated that all 12 deaths were related to legal abortion and none to illegal abortion. The national legal induced abortion case-fatality rate for 2004–2008 was 0.64 legal induced abortion-related deaths per 100,000 reported legal abortions. Possible abortion-related deaths that occurred during 2009–2012 are under investigation.
    • p.8
  • For 2009, a total of 784,507 abortions were reported. Of these abortions, 772,630 (98.5%) were from the 45 reporting areas that submitted data every year during 2000–2009, thus providing the information necessary for evaluating trends. These 45 areas had an abortion rate of 15.1 abortions per 1,000 women aged 15–44 years and an abortion ratio of 227 abortions per 1,000 live births. Comparing 2008 with 2009, this represents the largest single-year decrease in the total number (a decrease of 5% from 810,403) and rate (a decrease of 5% from 15.9 abortions per 1,000 women) of reported abortions. Because of the size of the decreases that occurred from 2008 to 2009 for all three measures of abortion, the overall decrease in the total number, rate and ratio was greater during 2005–2009 than during 2000–2004. Hence, although recent variations had resulted in a leveling off from sustained decreases observed in the past, with no net decrease in the total number or rate of abortions occurring from 2005 to 2008, all three measures of abortion decreased in 2009 to the lowest level observed during the entire period of analysis.
    In addition to highlighting changes that occurred among all women of reproductive age, this report highlights important age differences in abortion trends. Throughout the period of analysis (2000–2009), women in their 20s consistently accounted for the majority of abortions (56%–57%) and therefore strongly influenced overall changes in abortion rates, including the observed decrease from 2008 to 2009. Conversely, women aged ≥35 years consistently have accounted for a small percentage of abortions (≤12% during 2000–2009) and have had a much smaller impact on overall abortion trends. Nonetheless, the persistent increase in abortion rates and high abortion ratios among women aged ≥40 years suggest that unintended pregnancy is a problem that women continue to face throughout their reproductive years.
    • p.9
  • The adolescent abortion trends described in this report are important for monitoring progress that has been made toward reducing pregnancies among adolescents in the United States. During 1990–2008, the pregnancy rate for adolescents aged 15–19 years decreased 40%. Although this decrease was associated with significant decreases in rates of live births and abortions, decreases during this period were even greater for abortions than live births; even during a brief 2-year increase from 2005 to 2007 in the adolescent birth rate, the adolescent abortion rate decreased by 1%. Data from this report indicate that the decrease in pregnancies among adolescents is continuing; the abortion rate for adolescents aged 15–19 years decreased 8% from 2008 to 2009, thus exceeding the 6% decrease in adolescent births for this year.
    • p.9
  • The findings in this report on race and ethnicity reflect differences in patterns of obtaining abortions that have been well-documented and observed for many years. Comparatively high abortion rates and ratios among non-Hispanic black women can be attributed to higher unintended pregnancy rates and a higher percentage of unintended pregnancies ending in abortion. Data from recent reports suggest that differences in measures of abortion between black women and women of other races have narrowed, although this pattern has not been observed in the data reported to CDC for 2009 or in previous years. High abortion rates among Hispanic compared with non-Hispanic white women have been attributed to high pregnancy rates among Hispanic women. However, abortion ratios in these two groups have been more comparable: Hispanic women have tended to have a slightly higher percentage of pregnancies that are unintended but are no more likely than non-Hispanic white women to end unintended pregnancies in abortion. Differences between non-Hispanic white and Hispanic women in abortion rates and ratios changed little from 2007 to 2009.
    The findings in this report indicate that more women are obtaining abortions earlier in gestation, when the risks for complications are lowest. Among the areas that reported data every year during 2000–2009, the percentage of abortions performed at ≤8 weeks’ gestation increased 12%. Moreover, among the areas that reported abortions at ≤13 weeks’ gestation by individual week, a clear shift in the distribution toward earlier weeks of gestation was observed: from 2000 to 2009, abortions performed at ≤6 weeks’ gestation increased 47%, whereas those performed at ≥8 weeks’ gestation decreased. However, these changes were greater from 2000 to 2004 than from 2005 to 2009, suggesting that the increase in the percentage of abortions performed during the earliest stages of gestation might have slowed in recent years. Moreover, the overall percentage of abortions performed at ≤13 weeks’ gestation changed little during 2000–2009, and findings from this report and other research suggest that delays in obtaining an abortion are more common among certain groups of women. Given the small but persistent percentage of women who obtain abortions at >13 weeks’ gestation, a greater understanding is needed of the factors that cause delays in pregnancy termination.
    • p.9
  • The trend of obtaining abortions earlier in pregnancy, although not observed equally among all subgroups of women, has been facilitated by changes in abortion practices. Curettage has remained the most common method for performing abortions. Although for many years this type of abortion was performed only after the initial weeks of gestation, the development of highly sensitive pregnancy tests and transvaginal ultrasonography increasingly have allowed clinicians to diagnose pregnancy and confirm its termination at ≤6 weeks’ gestation. In addition, the use of medical abortion might have contributed to the increasing percentage of abortions performed early in gestation. In September 2000, FDA approved mifepristone for use in early medical abortion, and the American College of Obstetricians and Gynecologists has endorsed an evidence-based protocol that can be used up to 63 days of gestation. In 2009, 64.0% of abortions were performed at ≤8 weeks’ gestation and thus were eligible for early medical abortion; 25.2% of these eligible abortions and 16.5% of all abortions were reported as early medical abortions. Moreover, the use of early medical abortion has increased substantially since FDA approval of mifepristone: from 2001 to 2009, the percentage of all reported abortions accounted for by this method increased approximately 350%. Furthermore, whereas the rate of increase leveled off after the initial years of approval, the proportional use of this method has continued to increase, with the percentage of all abortions reported as early medical abortion increasing 10% from 2008 to 2009.
    • pp.9-10
  • In 2008, 12 legal induced abortion-related deaths occurred; no women died as a result of a known illegal abortion. The annual number of legal induced abortions has fluctuated from year to year over the past 36 years. For example, 12 abortion-related deaths occurred in 1994, four deaths in 1995, and nine deaths in 1996. Because of this variability and the relatively small number of abortion-related deaths every year, national case-fatality rates were calculated for 5-year periods. The national legal induced abortion case-fatality rate was 0.64 legal induced abortion-related deaths per 100,000 reported legal induced abortions for both the most recent period (2004–2008) and the preceding 5-year period (1999–2003).
    • p.10
  • Ongoing abortion surveillance is important for several reasons. First, abortion surveillance is needed to guide and evaluate programs aimed at preventing unintended pregnancies. Pregnancy intentions are complex and difficult to assess; abortion surveillance provides an important measure of pregnancies that are unwanted. Second, routine abortion surveillance is needed to assess changes in clinical practice patterns over time. Information in this report on the prevalence of abortions performed through different methods (e.g., medical or curettage) and at different gestational ages provides the denominator data that are necessary for analyses of the relative safety of abortion practices. Finally, statistics on the number of pregnancies ending in abortion are needed in conjunction with data on births and fetal losses to more accurately estimate the number of pregnancies in the United States and determine rates for various outcomes (e.g., adolescent pregnancy rates).
    According to the most recent national estimates, 18% of all pregnancies in the United States end in abortion. Multiple factors are known to influence the incidence of abortion, including the availability of abortion providers; state regulations, such as mandatory waiting periods, parental involvement laws, and legal restrictions on abortion providers; increasing acceptance of nonmarital childbearing; shifts in the racial/ethnic composition of the U.S. population; and changes in the economy and the resulting impact on fertility preferences and access to health-care services, including contraception. However, despite these multiple influences, given that unintended pregnancy precedes nearly all abortions efforts to reduce the incidence of abortion need to focus on helping women avoid pregnancies that they do not desire.
    • p.11
  • Providing women and men with the knowledge and resources necessary to make decisions about their sexual behavior and use of contraception can help them avoid unintended pregnancies. However, efforts to improve contraceptive use and reduce the number of unintended pregnancies in the United States have been challenging. Findings from the National Survey of Family Growth (NSFG), the primary national source of data on unintended pregnancy in the United States, suggest that unintended pregnancy decreased during 1982–1995 in conjunction with an increase in contraceptive use among women at risk for unintended pregnancy. However, data from the 2002 and 2006–2010 NSFGs show that contraceptive use among women at risk for unintended pregnancy has decreased. Moreover, although use of the most effective forms of reversible contraception (i.e., intrauterine devices and hormonal implants, which are as effective as sterilization at preventing unintended pregnancy) has increased, use of these methods in the United States remains among the lowest of any developed country, and no additional progress has been made toward reducing unintended pregnancy. Research has shown that providing no-cost contraception increases use of t