The Abortion Rate in the US is at Its Lowest since Roe v Wade, But Access to Contraception May Become Difficult

by Amna El Tawil
The abortion rate in the United States reached the lower level in 2014 compared to any other year since the procedure gained a legal status. The decline is thought to be strongly associated with the widespread use of contraception according to a study carried out by Guttmacher Institute’s researchers, Rachel K Jones and Jenna Jerman.
The study, published in the Perspectives on Sexual and Reproductive Health showed that 19% of pregnancies ended in abortion in 2014 – the lowest abortion rate since the Supreme Court handed down Roe vs Wade in 1973, legalizing the procedure – and the number of abortions between 2011 and 2014 also fell, by 12%.
The researchers made an estimate of the number of abortions by evaluating local health department data and abortion clinics, which may be hampered by clinics that did not respond. The decline in the rate of abortions was the highest in the Midwest, south and northeast. Abortion is a common procedure – in 2014, Jones and Jerman estimate, US women had 926,200 abortions – but there were nevertheless shifts in how abortions were performed. The number performed with medication, which is only effective early in a pregnancy, rose 7% to account for 31% of abortions outside a hospital setting.
However, if the drop in abortion rate is due to contraception, it would have alarming implications for Republicans’ campaign to repeal the ACA. The law says that most health insurance plans must cover a broad range of contraceptive drugs and devices at no copay – the so-called contraception mandate. Public health advocates have credited this provision with an explosion in women’s access to more affordable and more effective birth control.
If Trump and his administration were to repeal Obamacare, it is not clear that their replacement would contain a similar provision. Tom Price, Trump’s nominee to lead the HHS, has put forth several proposals for an Obamacare replacement that do not contain a contraception mandate.
Joerg Dreweke, of Guttmacher, wrote: “Their agenda … could stop or reverse progress in empowering women to meet their childbearing goals, including by avoiding unintended pregnancy. There is strong evidence from recent abortion declines that supporting women’s decision-making across the spectrum of reproductive healthcare is very much compatible with reducing abortion incidence.”
On the other hand, anti-abortion campaigners claim that the lower rates of procedures are linked to stronger restrictions.