U.S. report eyes abortion trends

According to a new report released by the Guttmacher Institute, the rate of abortion in the United States is at its lowest level since 1974.1 However, this overall trend masks large disparities in rates of unintended pregnancy and abortion across demographic subgroups.

While abortion rates have declined among all racial and ethnic groups, Hispanic and black women are obtaining abortions at rates three and five times higher, respectively, than non-Hispanic white women, the report shows. Between 1994 and 2004, the abortion rate for Hispanic women fell by 20%, from 35 to 28 per 1,000 women ages 15-44. This decrease was less than the 30% decline among non-Hispanic white women (from 15 to 11 per 1,000), but more than the 15% decline among black women (from 59 to 50 per 1,000). These variances in rates reflect disparities in unintended pregnancy, as well as in access to the most effective contraceptive methods, the report states.

"After so many years of family planning progress, it is disheartening to see the gaps in reproductive health outcomes widening again," states Sharon Camp, PhD, president and chief executive officer of the Guttmacher Institute. "Clearly, we need to re-energize the public commitment to quality contraceptive services for all American women."

A substantial drop in the abortion rates of teenagers and women ages 20-24 accounts for much of the overall decline in abortions from 1989 to 2004. During this period, the abortion rate of women in their 30s changed little, while the rate of women ages 40 or older slightly increased. Despite the increase, women ages 40 or older have consistently been those with the lowest abortion rate, the report notes.

Women in their 20s account for the majority (57%) of abortions, the report shows. Minors account for fewer than 7% of all abortions.

Abortion is far more common among unmarried women than married women, although rates for both groups have dropped significantly in the past 15 years. When looking at race and ethnicities, black women account for 37% of abortions, non-Hispanic white women for 34%, Hispanic women for 22%, and women of other races for 8%.

Medication abortion procedures appear to have affected abortion practice, the report states. The proportion of procedures performed in the earliest weeks of pregnancy (before nine weeks of gestation) has increased from about 50% in the early 1980s to 61% in 2004. The proportion of abortions performed after 12 weeks of pregnancy has changed little, and less than 0.2% take place after 24 weeks, the analysis shows. "The continuing trend toward very early abortions ought to help us refocus the public debate away from the controversial, but very small, number of late-term abortions," says Camp.

Over the past three decades, the proportion of abortions obtained by teens has dropped steadily, from 33% in 1974, to 25% in 1989, then to 17% in 2004. In 2004, more than half of all abortions (57%) were obtained by women in their 20s, the report states. Teen abortion rates also have declined, dropping from 42 per 1,000 women ages 15-19 in 1989 to 20 in 2004.

A large part of the decline in abortions among teens is likely attributable to increased use of contraceptives and use of more effective methods, the report states. However, the decrease in the abortion rates among teen-agers and women ages 20-24 from the early 1990s to 2001 was accompanied by an increase in the proportion of unintended pregnancies ending in birth.2 This finding suggests that part of the decline among these women might be due to an increase in the proportion of unintended pregnancies continued to a birth, the report notes.

Behind the vast majority of abortions is an unintended pregnancy. Because women of color are much more likely to experience unintended pregnancies than any other group, they also are more likely to seek and obtain abortions, says Rachel Jones, PhD, senior research associate at the Guttmacher Institute.

Previous Guttmacher research has found that unintended pregnancy and abortion rates also are increasing among poor and low-income women, states Jones. Research released earlier this year indicates that half of women at risk are not fully protected from an unplanned pregnancy: 8% use no contraception at all, 15% have gaps in use, and 27% use their method inconsistently or incorrectly.3

"Policy-makers at the state and federal levels should be asking themselves what can be done to help poor women and women of color prevent unintended pregnancies and achieve better health outcomes more generally," Jones states.

References

  1. Henshaw SK, Kost K. Trends in the Characteristics of Women Obtaining Abortions, 1974 to 2004. New York City: Guttmacher Institute; 2008.
  2. Finer LB, Henshaw SK, Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health 2006; 38:90-96.
  3. Frost JJ, Darroch JE, Remez L. Improving Contraceptive Use in the United States. New York City: Guttmacher Institute; 2008.