Abortion rates are at their lowest since 1973, when the Roe v. Wade court decision made the procedure legal, according to figures released by the Guttmacher Institute earlier this year.
Michelle Stranger-Hunter, executive director of NARAL and the Oregon Reproductive Health Foundation, noted that the study in question covers the years between 2008 and 2011. Between 2011 and 2013, more than 205 abortion restrictions passed in different states nationwide – more than in the previous decade, Stranger-Hunter said. (None of them passed in Oregon, which is the only state not to have passed any restrictions on abortion since Roe.)
Stranger-Hunter said she will be interested to see what the national data look like in a few years in states where access has been restricted, but the recent study shows an increase in the number of family planning clinics, an increase in the number of women using contraceptives and reduced birth rates at the same time abortion rates dropped in the state.
“I really took [2008-11 data] as very good news, particularly when I was looking at Oregon,” Stranger-Hunter said, saying she thinks the fact that both birth rates and abortion rates are dropping means more pregnancies are planned and wanted. “What that speaks to then, is that more women are having planned, wanted pregnancies and who doesn't think that's a good idea? It's the best thing for the woman's health and for the health of the child, of the baby.”
She noted that more women are using long-term, reversible forms of contraception, such as implants or intrauterine devices, likely contributing to the reduction in pregnancies. According to the Guttmacher Institute, in 2009, 8.5 percent of American women using contraceptives used either implants or IUDs, up from 5.5 percent in 2007 and 2.4 percent in 2002. Oral contraceptives are still popular, but less effective, and Stranger-Hunter noted that the average number of days women go between filling prescriptions is 38: “That's where a lot of unplanned pregnancies come from.”
In 2011, about 10,690 Oregon women had abortions, or 14 abortions per 1,000 women of reproductive age, according to the Guttmacher data. In 2008, the number of women who had abortions was 17 per 1,000 – so the drop constitutes an 18 percent decrease over three years, even though the number of clinics that provide abortions increased, she said.
“There's such a myth that by adding restrictions, you're going to reduce the number of abortions because you're going to make women ponder it longer,” Stranger-Hunter said. “The rate in Oregon went down, and it went down at least as much in those states that have restrictions if not more.”
Still, the number of unintended pregnancies is still high, with the American College of Obstetricians reporting that 50 percent of pregnancies in the United States were not planned. Stranger-Hunter is hopeful that Affordable Care Act reforms – including the mandate that insurers cover family planning services without copay, and the Medicaid expansion – will bring that number down. The state Medicaid expansion expanded eligibility for the Oregon Health Plan, where for years prior to the Affordable Care Act's passage young, healthy women could only get on the state health plan if they won the state health lottery became pregnant. Those that became pregnant lost OHP coverage six weeks postpartum, though children are still covered.
Stranger-Hunter is hopeful that the number of unintended pregnancies will go down as a result of that and a campaign called One Key Question, which started after a series of meetings with primary care providers in Oregon and has spread to several states. NARAL is encouraging primary care providers to ask young women if they intend to become pregnant in the next year. If the answer is yes, providers talk to them about how to ensure a healthy pregnancy, encouraging them to take appropriate supplements. If the answer is no, providers ask women if they are using contraceptives and whether they are happy with the method they are using.
The idea is to support women who want to become pregnant as well as those who don't, she said, and make sure pregnancies are as healthy and problem-free as possible, and the campaign has been adopted in 10 states, in some cases as a teen pregnancy prevention tool. “So many of the problems that are happening due to the poor health of the mother when she's already conceived,” Stranger-Hunter said.
Christen can be reached at [email protected].