Abortion rates continue to drop in U.S. women
While U.S. abortion rates are dropping, particularly among teens, the decline is not equally shared among all women. Rates have increased among those who are economically disadvantaged, according to just-published research from the New York City-based Alan Guttmacher Institute (AGI).1
Declines in abortion rates were particularly steep among teens, especially among those ages 15-17, the data reflect. The rate for this age group fell to 15 abortions per 1,000 women in 2000 from 24 abortions per 1,000 women in 1994, a decline of 39%.
Both abortion rates and birth rates for teens have been dropping since the early 1990s, respectively, which indicates that fewer teens are becoming pregnant; however, the proportion of adolescent pregnancies ending in abortion remained stable from 1994 to 2000.1 Despite the declines, U.S. teen-agers have higher pregnancy rates, birthrates, and abortion rates than adolescents in other developed countries.2
The drop in adolescent abortion rates is not a recent phenomenon; the decrease in adolescent abortion rates started in the late 1980s, says Rachel Jones, PhD, senior research associate at the institute. The decline is not due to teens having more babies; the proportion of teen pregnancies ending in abortion remained at 33% in the current analysis, the same ratio found in 1994. The lack of change demonstrates that teens aren’t having fewer abortions because they are having more babies; rather, teens are having fewer pregnancies, says Jones.
"We have done good work as a nation — teens are increasingly making better decisions about their future — but we still have a long way to go," says Bill Albert, director of communications and publications for the Washington, DC-based National Campaign to Prevent Teen Pregnancy. The organization’s goal is to reduce the U.S. teen pregnancy rate by one-third between 1996 and 2005. "That’s one of our primary rallying cries: Not to get complacent about this issue."
Better methods, less sex
What is behind the decrease in teen pregnancy rates? Teens are making better choices about sex, whether they are choosing to abstain or to use contraception consistently and correctly, says Albert.
An AGI analysis examining the reasons for the decline in rates between 1988 and 1995 found that three-quarters of the decrease was due to improved contraceptive use, while one-quarter was due to delayed sexual activity.3
To see if the 75/25 ratio still is in place, AGI researchers plan to examine upcoming data from the upcoming National Survey of Family Growth (NSFG), a national data set from the Hyattsville, MD-based National Center for Health Statistics. For the first time, the 2002 NSFG will include information from men and women, with some 12,000 men and women ages 15-44 polled on such issues as contraceptive use, infertility, and parenting. Look for the first statistical reports from the survey to appear in early 2004, according to the national center.
Overall rates drop
The overall abortion rate in the United States decreased by 11% between 1994 and 2000, falling from 24 to 21 abortions each year per 1,000 women ages 15-44, according to an AGI analysis of a survey of more than 10,000 women obtaining abortions in 2000-2001.
While abortion rates have declined for most women, they have increased among the economically disadvantaged, according to the AGI analysis. According to the researchers, the findings indicate these women have high pregnancy rates, as well as a greater likelihood than women with higher incomes of ending a pregnancy in abortion.
What are the reasons behind this increase? Jones points to three possible factors, which AGI researchers hope to examine in further studies:
- Changes in welfare policies that occurred between 1994 and 2000 may have made it less feasible for economically disadvantaged women to carry unintended pregnancies to term.
- The decline in Medicaid access due to welfare reform may have resulted in decreased access to contraceptives and contraceptive services. While access to Medicaid for women was decreased, there was no substantial increase in Title X funding, which provides low-cost family planning services, notes Jones.
- The improved employment and educational opportunities seen in the 1990s may have made it less feasible for poor women to carry a pregnancy or an unintended pregnancy to term.
"Women may have felt that having a baby at this time in their life would have prevented them from taking advantage of employment and educational opportunities," says Jones.
1. Jones RK, Darroch JE, Henshaw SK. Patterns in the socioeconomic characteristics of women obtaining abortions in 2000-2001. Perspect Sex Reprod Health 2002; 34:226-235.
2. Alan Guttmacher Institute. Facts in Brief. Teenagers’ Sexual and Reproductive Health. Accessed at: www.agi-usa.org/pubs/fb_teens.html.
3. Darroch JE, Singh S. Why Is Teenage Pregnancy Declining? The Roles of Abstinence, Sexual Activity, and Contraceptive Use. Occasional Report, No. 1. New York City: Alan Guttmacher Institute; 1999.