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Wellness Corner by Dr. Gary Pace M.D.

How Relevant are Abortion Rights Today?

Jul 31, 2018
by Gary Pace M.D.

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With the Trump administration attempting to roll back many progressive measures, and with the possibility of a Supreme Court that is unfavorable to abortion rights, it seems useful to look at the current state of abortion access in the US. While this data is a few years old, it is the most recent available and comes mainly from a very reliable source, the Guttmacher Institute (although definitely “pro-choice”).

Who gets them?

  Nearly half (45%) of all pregnancies among U.S. women in 2011 were unintended, and four in 10 of these were terminated by abortion.

  Approximately 926,200 abortions were performed in 2014, down 12% from 1.06 million in 2011. In 2014, some 1.5% of women aged 15–44 had an abortion. Just under half of these women (45%) reported having a previous abortion.

The reasons patients gave for having an abortion:

  Concern for or responsibility to other individuals (75%)

  Inability to afford raising a child (75%)

  Belief that having a baby would interfere with work, school or the ability to care for dependents (75%)

  Did not want to be a single parent or were having problems with their husband or partner (50%).

  Fifty-one percent of abortion patients in 2014 were using a contraceptive method in the month they became pregnant, most commonly condoms (24%) or a hormonal method (13%).

Providers:

  The number of clinics providing abortion services declined 6% over this period (from 839 to 788). Ninety percent of all U.S. counties lacked a clinic in 2014, and 39% of women of reproductive age lived in those counties.

  84% of clinics reported at least one form of antiabortion harassment in 2011. Picketing was reported by 80%, and phone calls by 47%. Fifty-three percent of clinics were picketed 20 times or more in a year. Three percent of clinics reported receiving at least one bomb threat in 2011.

Medical Abortions

Since September 2000, medication abortion has been approved for abortions up to 10 weeks’ gestation. The protocol involves two drugs—mifepristone and misoprostol—one of which can be taken at home following a provider visit.

  Medication abortions accounted for 31% of all nonhospital abortions in 2014, and for 45% of abortions before nine weeks’ gestation.

  Medication abortions increased from 6% of all nonhospital abortions in 2001 to 31% in 2014, even while the overall number of abortions continued to decline.

Declining Abortion Rates

  A study in 2014 by the Guttmacher Institute showed the abortion rate had dropped 13% over 3 years. Pro-life activists said it was fewer terminations leading to more pregnancies, but the research showed that there were significant decreases in unintended pregnancy.

  More women are using contraception, and more women are using the most effective forms-- long-acting reversible forms, such as IUDs and hormonal implants.

Restrictions on Abortion

  The Hyde Amendment, in effect since 1977, bans federal dollars from being used for abortion coverage for women insured by Medicaid, the nation’s insurance program for low-income Americans. Despite this ban, states may use state funds. Seventeen states have a policy requiring the state to provide abortion coverage under Medicaid.

  As of January 1, 2018, all but 10 states had imposed at least one of five major abortion restrictions:

  unnecessary regulations on abortion clinics

  mandated counseling designed to dissuade a woman from obtaining an abortion

  a mandated waiting period before an abortion

  a requirement of parental involvement before a minor obtains an abortion

  prohibition on the use of state Medicaid funds to pay for medically necessary abortions.

Conclusions

The ability to safely terminate a pregnancy has been a very controversial topic in modern society, serving as a central political organizing point for conservative and religious groups. Yet women and couples from all walks of life can find themselves in a situation where an abortion seems like the best option.

Access to safe abortion services is becoming harder to find in many locales, and may become even more difficult in the coming years. The guarantee of the right by the US Supreme Court decision Roe vs. Wade may come into jeopardy due to the rightward swing of the Court. Access to good contraception seems to be a key aspect of lowering the abortion rate.

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