On Monday, the Guttmacher Institute released a study that seemed, at first blush, to vindicate the anti-choice movement’s increasingly feverish attempts to end abortion through state-level restrictions on women and providers. Using survey data from 2011, the research organization—which leans pro-choice—found that abortion rates have plummeted to a 30-year low. Since 2008, the number of abortions performed in the U.S. fell 13 percent.
Anti-abortion activists pounced to take credit, criticizing Guttmacher for “failing to acknowledge the impact of pro-life legislation” in its explanation for the sudden drop. The Guttmacher researchers point out, quite reasonably, that the most recent wave of anti-choice legislation began in earnest in the months after the 2010 midterm election, when abortion rates were already falling.
If anything, abortion’s decline was in spite of anti-choice sentiment, not because of it. As the abortion rate was falling, so was the birth rate. Fewer women were seeking abortion because they weren’t getting pregnant in the first place. The recession had something to do with that; so did the resurgence of long-term contraceptives like the IUD, which have less potential for user error than more popular forms of birth control like the pill. Ironically, conservatives are now fighting tooth-and-nail to keep insurance companies from covering the IUD, which they claim causes abortion. (The medical community, in near unison, disagrees.)
Nestled in the report is a data point that neatly illustrates the hypocrisy of the recent surge of anti-choice laws, which are always couched as measures to protect women’s health. In 2011, medication abortion—RU-486, the “abortion pill”—accounted for nearly one-quarter of abortions performed outside hospitals, a six-point jump since 2008. Medication abortion, which only works in the first nine weeks of pregnancy, is a popular choice for women who want to terminate their pregnancy as early as possible. That’s a good thing for those who care about women's well-being.
Yet in 2013, fourteen states passed laws designed to curb access to medication abortion. Four now require doctors to use the outdated “FDA protocol” when prescribing medication abortion. That's possible because the FDA’s regimen for the drug hasn’t been updated since 2000, when it was approved. Since then, doctors have discovered an “evidence-based protocol” that’s safer, more effective, and cheaper. The dose is lower, and the window in the pregnancy where the drug is available is two weeks longer. If it were any other drug, adapting to those discoveries would be routine; since ordering a new set of FDA trials is bureaucratic and expensive, many drugs are given “off label.” But anti-abortion lawmakers are increasingly overruling doctors, saying that straying from the FDA protocol puts women at risk. In a brief filed on behalf of John Boehner and nine other congressmen in the court battle over the legality of Ohio’s law mandating the use of the FDA protocol, Americans United for Life argued that the law “operates for the benefit, not the disadvantage” of women by preventing abortion providers from misusing the drug.
As part of the effort to quell medication abortions, fourteen states have passed laws requiring the prescribing doctor to be physically in the room with the patient. That essentially prohibits what’s known as “telemedicine abortion,” where abortion pills are given to the patient via teleconference. Telemedicine is especially helpful for rural women, who often postpone abortions because they’re scraping together money for a long drive to the nearest city.
The genius of these laws is that at first, they seem eminently reasonable: Who wouldn’t agree that doctors should follow government guidelines for prescribing drugs? But like the vendetta against IUDs, limits on medication abortion have little to do with promoting safety. If anything, by discouraging women from seeking abortion early in pregnancy when the risk of complications is much lower, the laws endanger women’s health.
We'll have to wait for future studies—stretching beyond 2011—to show the impact of the recent barrage of anti-choice laws. It seems likely that if long-acting contraceptives continue to be popular, the abortion rate will remain low, although some demographers say that as the recession ends, the fertility rate will begin rising again. This could mean an uptick in unintended pregnancies and unwanted births, or a spike in the abortion rate. But it’s clear that however eager anti-abortion advocates are to seize credit for the falling abortion rate, their goal is to end the procedure using whatever means they can—at the expense of women’s health, if necessary.
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