US Abortion Rate Lowest Since Legalization; Racial Disparities Persist

The 2004 abortion rate in the United States is the lowest it has been since national legalization, but the overall rate masks stark disparities in the abortion rate among different racial and ethnic groups, a study released today by the Guttmacher Institute found.  Hispanic women obtained abortion at a rate three times the rate of non-Hispanic white women; the rate among black women was five times the rate of non-Hispanic white women.  But abortion rates have fallen since 1980 for all racial and ethnic groups - white women saw a drop of 30%, Hispanic women 20%, and black women 15%.

Why the dramatic racial disparities? "Behind virtually every abortion is an unintended pregnancy. And because women of color are much more likely to experience unintended pregnancies than any other group, they are also more likely to seek and obtain abortions," Rachel Jones, Guttmacher Institute senior research associate, said in a statement.

Study authors Stanley Henshaw and Kathryn Koch note that while the abortion rate in the US is now comparable to the rate in other developed nations, the wider economic inequality at home, "the size of the economically deprived population, the number and size of ethnic minority groups, and the extent to which population subgroups differ from the majority in their access to jobs, housing, education and health services" results in a wide disparity in the abortion rate.  The study observes that black women have a very high rate of unintended pregnancy - 70% - and suggests that lower levels of contraceptive use, higher failer rates and the use of less effective methods likely accounts for the disparity in the unintended pregnancy rate.  Previous Guttmacher research done by Susan Cohen shows that 15% of black women were not using contraception and were at risk for unintended pregnancy, compared to 12% of Hispanic women and 9% of white women. In a recent article for RH Reality Check, Dr. Melissa Gilliam, analyzing the higher abortion rate among African-American women, wrote, "Behind virtually every abortion is an unintended pregnancy. African American women have higher abortion rates than their white peers because they have much higher rates of unintended pregnancy--three times higher than those of white women."

But the high rate of abortion and of unintended pregnancy among black women must be put into context of disparities in health outcomes across the board, underscoring the need for reproductive justice advocates to focus on all aspect of access to care for women of color.  As Dr. Gilliam notes, "...there's more to the story. Across the board, African Americans often have worse sexual and reproductive health outcomes than people from other racial groups. For example, we experience much higher rates of sexually transmitted infections. These disparate rates reflect broader health disparities that can be seen in high rates of diabetes, obesity, heart disease or cancer."  Dr. Gilliam calls for a stop to funding for ineffective abstinence-only programming, which offers no accurate information about contraceptives, and a move toward comprehensive sex ed for young adults.  She also points out that increased funding for Title X services such as contraceptives, STI testing and counseling is proven to prevent pregnancies. Writes the Guttmacher Institute's Susan Cohen, "Reproductive health policies...must be considered in the broader health, social and economic context of women's lives -- especially the lives of poor and low income women who are disproportionately minority -- and interconnected with other critical life needs and aspirations."

Guttmacher's study also produced a wealth of data about the age of women seeking abortion, the gestational age at time of termination, and the availability of abortion nationwide.  The overwhelming majority of abortions occur in the first trimester (89%) and despite decreasing accessibility and increased state restriction and regulation, the rate of second-trimester abortion is virtually unchanged.  Only 0.2% of abortion are sought after 24 weeks; 1.4% occur after 20 weeks.

The share of abortions obtained by women who had already given birth climbed dramatically since the 1980s, and by 2004, 60% of women seeking abortion had already given birth. The study notes that while 47% of abortions obtained in 2004 were sought by women who had already had an abortion, there was no indication that women were using abortion as a primary method of birth control.

Ninety percent or more counties in 26 states have no known abortion provider.

The abortion rate peaked in 1980, at a rate of 29 abortions per 1,000 women aged 15 to 44.  In 2004, the most recent year for which there is data, 20 women per 1,000 obtained abortions.