A new report in the USA shows how the Dobbs decision last year, led to 32,000 less abortions in the following six months. Average monthly abortion totals have fallen by about 6% and are now back to the levels reported in 2020, reversing a multi-year increasing trend.
#WeCount is a national abortion reporting effort that aims to capture the shifts in abortion access by state following the June 24, 2022 Dobbs v Jackson’s Women’s Health Organization Supreme Court decision. The report PDF can be downloaded here.
These numbers and findings are estimates, building on the Abortion Facility Database from ANSIRH and using data reported by known/invited abortion providers; not all providers participated, and perhaps not all providers are known to or included by this team, some data have been modelled to fill in the known gaps. The authors note: “Facilities known to #WeCount that did not participate in this effort provided an estimated 17% of all abortions in the US.”
Given these gaps and the level of modelled data, we should treat the findings with some caution. These are probably good enough to give us a sense of ‘direction of travel’ but we really need more actual data and to continue the analysis of these over the rest of this year to increase certainty.
The key finding from the #WeCount report is that in the six months following the Dobbs decision, July – December 2022, the total number of abortions fell by 32,000. The average monthly number before Dobbs was 82,000, and for the six months following it was 77,000. This represents a fall in total abortions of about 6% and in effect reverses the previous increasing trend in the total number abortions, coming back down to broadly the same as reported in 2020, when the monthly average was 77,500.
The authors note the national abortion rate has, as a result, decreased from 13.2 per 1,000 women of reproductive age in the month April 2022 to an average over the six months July-December of 12.3 per 1,000 women.
Changes to abortion laws in many States across the USA in the six months following the Dobbs decision have led to a 6% reduction in the monthly average number of abortions, a total of 32,000 less in the period July – December 2022, reversing the prior increasing trend.
#WeCount tracks the shift in abortion care toward virtual telehealth providers, which increased significantly in the six months following the decision. This shows how some women who want an abortion but live in a State with abortion restrictions, are overcoming these restriction by using telehealth providers located in permissive States. The percentage of total monthly abortions by telehealth was just 4% in April 2022, and has increases to an average of 9% in the six months July – December.
The total increased numbers by telehealth for these six months is 18,000. This is a significant number when compared to the overall drop in total of 32,000. It shows the increasing importance of telehealth and legal self-managed medical abortion.
The authors note other research that shows perhaps as many as 6,000 illegal self-managed medical abortions each month with Aid Access, and there is little doubt that some women will have used this or a similar abortion provider organisation that operates beyond the legal restrictions. It’s likely that an increase in provision by Aid Access and other abortion organisations operating outside the official healthcare system is already offsetting the reported drop in numbers.
- We should continue to gather data about the increasing numbers of women choosing self-managed medical abortion through telehealth services and the outcomes from these, especially given the current discussions about safety and effectiveness of the abortion pills.
- Any new legal restrictions on telehealth abortion would have a significant impact on total numbers of abortions.
- Questions will be asked about the potential impact on the lives and livelihoods of the 32,000 women, who are counted now as not having had access to a ‘wanted’ abortion. This would be a good time to consider the findings from the Turnaway Study and reviews of this research.
In summary, these data indicate a fall in the overall number of abortions because of various State enacted restrictions but there is an increasing trend towards remote provision of self-managed medical abortion to circumvent these restrictions.
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