CDC Releases Its Annual ‘Abortion Surveillance’ Report

Amie Newman

The CDC releases its annual "Abortion Surveillance" report on abortion in the United States, for 2006. The report says the surveillance provides critical information needed to evaluate programs aimed at preventing unintended pregnancy.

Today, the CDC released its Abortion Surveillance report for
2006. Every year, since 1969, the CDC conducts this “abortion surveillance” to
“document the number and characteristics of women obtaining legal induced
abortions in the United States.” The information is obtained from abortion data
the CDC requests from 50 central health agencies in all fifty states plus
Washington DC and New York City.

 

The report provides critical information on how many abortions are performed in this country, at what gestational age, and with what medical procedure but also about who gets abortions in this country: broken down by age, ethnicity and race. 

According to the report, for 2006, a total of 846,181
abortions were reported to CDC. From that number, researchers found that the
abortion rate was 16.1 abortions per 1,000 women aged 15–44 years, and the
abortion ratio was 236 abortions per 1,000 live births. During the previous
decade (1997–2006), reported abortion numbers, rates, and ratios decreased 5.7%, 8.8%, and 14.8%, respectively. However, most
of these declines occurred
before
2001.

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In fact, from 1996-2000, the report finds that the number of
abortions decreased 20,605 per year, the abortion rate decreased 0.5 abortions
per 1,000 women per year, and the abortion ratio decreased 9.7 abortions per
1,000 live births per year. Reductions were much smaller on average during
2001–2006; the number of abortions declined 2,163 per year, the abortion rate
declined 0.1 per year, and the abortion ratio declined 3.3 per year.

The greatest increase could be seen from 2005-2006 when the
total number of abortions increased 3.1%, and the abortion rate increased 3.2%;
the abortion ratio was stable. Thee numbers seem to coincide with the increase
in the number of live births as well as the fertility rate, both of which
increased by 3% in 2006, “constituting the largest single-year increase in more
than 15 years. For this reason, the increase in the total number and rate of
abortions for 2006 might reflect a general increase in the number of
pregnancies of all outcomes (fetal losses, induced abortions, and live
births).”

The overall decrease in abortion numbers could be due to a
variety of factors, the report notes, including a “decline in the availability
of abortion providers; the adoption of 
legislative restrictions and barriers to abortion services like
mandatory waiting periods and parental involvement laws; and increasing
acceptance of nonmarital childbearing” among other reasons.

Other findings include:

  • 62% of
    abortions were done before eight
    weeks gestation. This percentage increased almost 11% since 1997.  And the percentage of abortions
    done before six weeks gestation increased a whopping 66.3%. This can, in
    part, be attributed to the rise in the availability of medication abortion
    (RU-486 or “the abortion pill”)
  • 5% of
    abortions were done after sixteen weeks gestation; of those, only 1.3% of
    abortions were done at 21 weeks gestation or later.
  • Almost
    30% of abortions were done earlier
    than 6 weeks gestation
  • Adolescent
    abortion rates increased during 2005–2006 after several years of decline.
  • Women
    ages 20-29 years old account for the majority of abortions at 56.8%
  • In
    2005, the most recent year for which data were available, seven women were
    reported to have died as a result of complications from known legal
    induced abortions.

 

Some of what is noteworthy about the above:

  • Women
    are having abortions earlier in their pregnancies when the risk of
    complication is lowest and the procedure is the safest.
  • Very
    few abortions are recorded for women in later stages of pregnancy, 16-20
    weeks or later, despite what anti-choice advocates attempt to convey.
  • While
    it is a tragedy when a woman dies from a legal abortion, according to the
    report, the annual number of deaths associated with known, legal abortions
    was more than two-thirds lower on average in the early 2000s than it was
    in the early 1970s.
  • I want to note what the Centers for Disease Control’s
    Division of Reproductive Health surmises from its own numbers and analysis:

Providing women with the knowledge and resources necessary
to make decisions about their sexual behavior and use of contraception can help
women avoid unintended pregnancies and thus reduce the number of abortions
performed in the United States.

Let’s be clear. The majority (if not all) of the leading
anti-choice advocacy organizations from Focus on the Family to the Family
Research Council do not support increased access to contraception or family
planning. They do not advocate for the use of or expanded access to
contraception for women in the United States, as a critical women’s health tool
or as a means to decrease the abortion rate. In fact, there is active
opposition to the use of contraception. In an op-ed on the Family Research
Council web site, from April 2009, titled “The Myth of the Contraceptive
Compromise”, Cathy and Austin Ruse write, “Let’s try contraception to end
abortion? Please.”

Crisis Pregnancy Centers, most often created and run as an
outreach arm of a faith-based, anti-choice organization, do not provide medical
care and so do not provide family planning or contraception services to
pregnant clients. Instead, they repeat falsities and lies claiming that birth
control methods like the pill or emergency contraception (Plan B) cause
abortions.

If there is anything we can take from reports like these it
is that an increased focus on ensuring that all women in this country have
access to the education and tools necessary to prevent unintended pregnancy
should be accessible health care for  all women of reproductive health age.

Culture & Conversation Media

TRAP Laws and the Abortion ‘Crisis’: A Conversation With Award-Winning Filmmaker Dawn Porter

Tina Vasquez

Recently, Porter spoke with Rewire about the inaccurate framing of abortion as a “moral” issue and the conditions that have created the current crisis facing providers and patients alike. Her film will air nationally on PBS’ Independent Lens Monday.

Dawn Porter’s documentary TRAPPED focuses on the targeted regulation of abortion providers (TRAP) laws designed to close clinics. But, as Porter told Rewire in a phone interview, TRAPPED is also about “normal people,” the providers and clinic staff who have been demonized due to their insistence that women should have access to abortion and their willingness to offer that basic health-care service.

Between 2010 and 2015, state legislators adopted some 288 laws regulating abortion care, subjecting providers and patients to restrictions not imposed on their counterparts in other medical specialties.

In Alabama, where most of the film takes place, abortion providers are fighting to keep their clinics open in the face of countlessand often arbitrary—regulations, including a requirement that the grass outside the facilities be a certain length and one mandating abortions be performed in far more “institutional” and expensive facilities than are medically necessary.

The U.S. Supreme Court is expected to issue a ruling this month on a Texas case regarding the constitutionality of some TRAP laws: Whole Woman’s Health v. Hellerstedt. The lawsuit challenges two provisions in HB 2: the admitting privileges requirement applied to Whole Woman’s Health in McAllen, Texas, and Reproductive Services in El Paso, Texas, as well as the requirement that every abortion clinic in the state meet the same building requirements as ambulatory surgical centers. It is within this context that Porter’s film will air nationally on PBS’ Independent Lens Monday.

Recently, the award-winning filmmaker spoke with Rewire about the Supreme Court case, the inaccurate framing of abortion as a “moral” issue, and the conditions that have created the current crisis facing providers and patients alike.

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Rewire: What has changed for the clinicians featured in TRAPPED since the documentary premiered at the Sundance Film Festival in January?

Dawn Porter: Now, in Alabama, the legislature has passed a law banning clinics within 2,000 feet of a school. There’s a lot of frustration because the clinicians abide by the laws, and then more are put in place that makes it almost impossible to operate.

Everyone has been really focused on Dalton Johnson’s clinic [the Alabama Women’s Center for Reproductive Alternatives] because the clinic he moved to was across the street from a school, but the law has also affected Gloria [Gray, the director of the West Alabama Women’s Center in Tuscaloosa, Alabama]and that’s not something a lot of us initially realized. She’s afraid this will shut her down for good. I would say this has been a very hard blow for her. I think Dalton was perhaps more prepared for it. He will fight the law.

The good news is that it’s not like either of these clinics will close tomorrow; this gets decided when they go back for relicensing at the end of the year. Right now, they’re in the middle of legal proceedings.

Of course, we’re all also awaiting the Supreme Court decision on Whole Woman’s Health. There’s a lot of uncertainty and anxiety right now, for these clinic owners in particular, but for all clinic owners [nationwide] really.

Rewire: Let’s talk about that. Later this month, the Supreme Court is expected to issue its ruling on that caseEven if the Supreme Court rules that these laws are unconstitutional, do you think the case will change the environment around reproductive rights?

DP: It really depends on how the Court writes the decision. There may be no case in which it’s more important for the Court to have a comprehensive decision. It’s a multiheaded hydra. There’s always something that can close a clinic, so it’s crucially important that this Court rules that nothing can hinder a woman’s right to choose. It’s important that this Court makes it clear that all sham laws are unconstitutional.

Rewire: We know abortion providers have been killed and clinics have been bombed. When filming, did you have safety concerns for those involved?

DP: Definitely. The people who resort to violence in their anti-choice activities areI guess the most charitable way to describe itunpredictable. I think the difficult thing is you can’t anticipate what an irrational person will do. We took the safety of everyone very seriously. With Dr. Willie Parker [one of two doctors in the entire state of Mississippi providing abortions], for example, we wouldn’t publicize if he’d be present at a screening of the film. We never discussed who would appear at a screening. It’s always in the back of your mind that there are people who feel so strongly about this they would resort to violence. Dr. Parker said he’s aware of the risks, but he can’t let them control his life.

We filmed over the course of a few years, and honestly it took me a while to even ask about safety. In one of our last interviews, I asked Dr. Parker about safety and it was a very emotional interview for both of us. Later during editing, there was the shooting at the Colorado clinic and I called him in a panic and asked if he wanted me to take our interview out of the film. He said no, adding, “I can’t let irrational terrorists control my life.” I think everybody who does this work understands what’s at risk.

Rewire: It seems Texas has become ground zero for the fight for abortion access and because of that, the struggles in states like Alabama can get lost in the shuffle. Why did you choose to focus on Alabama?

DP: I met Dr. Parker when he was working in Mississippi. The first meeting I did with him was in December 2012 and he told me that Alabama had three clinics and that no one was talking about it. He introduced me to the clinic owners and it was clear that through them, the entire story of abortion access—or the denial of itcould be told. The clinic owners were all working together; they were all trying to figure out what to do legally so they could continue operating. I thought Alabama was unexplored, but also the clinic owners were so amazing.

To tell you the truth, I tried to avoid Texas for a long time. If you follow these issues around reproductive rights closely, and I do, you can sort of feel like, “Uh, everyone knows about Texas.” But, actually, a lot of people don’t know about Texas. I had this view that everyone knew what was going on, but I realized I was very insulated in this world. I started with Texas relatively late, but decided to explore it because we were following the lawyers with the Center for Reproductive Rights and they were saying one of their cases would likely go to the Supreme Court, and Whole Woman’s Health was most likely. They, of course, were right.

When you’re making a film, you’re emerged in a world and you have to take a step back and think about what people really know, not what you think they know or assume they know.

Rewire: In TRAPPED, you spliced in footage of protests from the 1970s, which made me think about how far we’ve come since Roe v. Wade. Sometimes it feels like we’ve come very far, other times it feels like nothing has changed. Why do you think abortion is such a contentious topic?

DP: I don’t think it’s actually that contentious, to tell you the truth. I think there is a very vocal minority who are extreme. If you poll them, most Americans are pro-choice and believe in the right to abortion in at least some circumstances. Most people are not “100 percent, no abortion” all the time. People who are, are very vocal. I think this is really a matter of having people who aren’t anti-choice be vocal about their beliefs.

Abortion is not the number one social issue. It was pretty quiet for years, but we’ve seen the rise of the Tea Party and conservative Republicans heavily influencing policy. The conservative agenda has been elevated and given a larger platform.

We need to change public thinking about this. Part of that conversation is destigmatizing abortion and not couching it in a shameful way or qualifying it. Abortion is very common; many, many women have them. Three in ten U.S. women have had an abortion before the age of 45. I think that part of the work that needs to be done is around stigma and asking why are we stigmatizing this. What is the agenda around this?

Evangelicals have done a great job of making it seem like this is an issue of morality, and it’s just not. To me, honestly, it doesn’t matter if you’re pro-choice or anti-choice. Everyone is entitled to their own opinions and beliefs. I can respect different opinions, but I can’t respect someone who tries to subvert the political process. People with power and influence who tamper with the political process to impose their beliefs on other people—I really can’t respect that.

Rewire: There are a lot of entry points for conversations about abortion access. What brought you to focus on TRAP laws?

DP: People often discuss abortion in terms of morality, but that’s not what we should be talking about. The reason why these laws have been so effective is because they successfully harm the least powerful of the group they’re targeting. Who’s getting picked on, who’s suffering the most? Women of color, people who are low-income, people who don’t have health insurance. There’s something so unjust about how these laws are disproportionately affecting these populations, and that really bothered me. I’m certainly interested in abortion as a topic, but I’m also interested in politics and power and how those things take shape to hurt the most vulnerable.

Rewire: In TRAPPED, we get to see a very personal side of all the clinicians and providers. One clinician discusses having to be away from her six children all of the time because she’s always at the clinic. We get to see Dr. Willie Parker at church with his family. And it was amazing to learn that the remaining providers in Alabama are friends who regularly eat dinner together. Was it intentional to humanize providers in a way we don’t usually get to see?

DP: Absolutely. The anti-choice side has successfully painted the picture of an abortion provider as this really shady, sinister person. I spent three years embedded in these clinics, and that couldn’t be further from what I saw. These are passionate, brave people, but they’re also very normal people. They’re not superheroes or super villains. They’re just normal people. It’s not that they don’t think about what they’re doing; they’re just very resilient and courageous in a way that makes me very proud. I wanted people to see that.

Rewire: Honestly before watching TRAPPED, I never thought about the personal toll that pressure takes on providers. Dalton Johnson used his retirement funds in order to continue providing abortion care. In several scenes, we see an emotional Gloria Gray struggling with whether or not to keep fighting these laws. Do you think people generally understand what it’s costing providers—financially and emotionally—to continue operating?

DP: I don’t think a lot of us think about that. People like Dalton are saying, “I would rather cash out my retirement than give in to you people.” We should not be asking people to make that kind of sacrifice. That should not be happening.

We also don’t spend enough time thinking about or talking about all of the things that have happened to create the conditions we’re now dealing with. It’s like a perfect storm. Medical schools are not training abortion providers, and the abortion providers that are around are getting older and retiring. Of course laws keep getting passed that make it more and more difficult to run a clinic. In this kind of environment, can you really blame people for not wanting to be providers? Especially when there’s the added pressure of having to take not just your own safety into account, but the safety of your family.

Anti-choice people target the children of abortion providers. They target them at home. This is a hard job if you want to have a life. I mean that literally too—if you literally want to have your life.

This is why so few go into this field. As the number of providers in some states continues to get eliminated, the burden left on those standing is exponentially greater.

The reason why we have a crisis around abortion care is not just laws, but because we have so few physicians. There are all of these factors that have come together, and we didn’t even get to cover all of it in the documentary, including the fact that Medicaid doesn’t cover abortion [under federal law. Seventeen states, however, use state funds to cover abortion care for Medicaid recipients.] A lot of this is the result of conservative lobbying. People have to be aware of all the pressures providers are under and understand that we didn’t get to this point of crisis accidentally.

Rewire: It can feel hopeless, at least to me. What gives you hope when it comes to this unrelenting battle for reproductive rights in this country?

DP: I don’t feel hopeless at all. I feel like it’s really important to be aware and vigilant and connect these dots. I wanted to help people understand the complications and the challenges providers are up against.

These providers have done their part, and now it’s time for the rest of us to do ours. People can vote. Vote for people who prioritize providing education and medical care, rather than people who spend all of their time legislating an abortion clinic. Alabama is in a huge fiscal crisis. The education system is a mess. The Medicaid system is a mess, and the whole Alabama state legislature worked on a bill that would affect a couple of abortion clinics. Voters need to decide if that’s OK. I think this is all very hard, but it’s not at all hopeless.

Culture & Conversation Abortion

The Comic Book That Guided Women Through Abortion Months After ‘Roe’

Sam Meier

Abortion Eve used the stories of fictional girls and women to help real ones understand their options and the law. At the same time the comic explained how to access abortion, it also asserted that abortion was crucial to women's health and liberation.

“Can you picture a comic book on abortion on the stands next to Superman?”

In June 1973, Joyce Farmer and Lyn Chevli wrote to the National Organization for Women in Chicago, asking this question of their “dear sisters” and pushing them to envision a world where women’s experiences could be considered as valiant as the superhero’s adventures. They enclosed a copy of their new comic book, Abortion Eve.

Published mere months after the Supreme Court’s January 1973 Roe v. Wade ruling, Abortion Eve was intended to be a cheap, effective way to inform women about the realities of abortion. Like the few other contemporaneous comic books dealing with abortion, Abortion Eve‘s primary purpose was to educate. But for a comic dominated by technical information about surgical procedures and state laws, Abortion Eve nonetheless manages to be radical. Though abortion had so recently been illegal—and the stigma remained—the comic portrays abortion as a valid personal decision and women as moral agents fully capable of making that decision.

The comic follows five women, all named variations of “Eve,” as counselor Mary Multipary shepherds them through the process of obtaining abortions. Evelyn is an older white college professor, Eva a white dope-smoking hippie, Evie a white teenage Catholic, Eve a working Black woman, and Evita a Latina woman. Evelyn, Eve, and Evita are all married and mothers already.

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Their motivations for getting an abortion differ, too. Evita and Eve, for instance, wish to protect themselves and their loved ones by keeping their families smaller. Sixteen-year-old Evie is the poster child for sexual naiveté. Pregnant after her first time having sex, she spends most of the comic wrestling with guilt. “It’s all so ugly!” she exclaims. “I thought sex was supposed to be beautiful!”

Teenager Evie, one of the characters in the comic book Abortion Eve, breaks down as counselor Mary Multipary asks questions about her pregnancy. (Joyce Farmer)

Nonplussed, the older Eves talk her through her choices. As Eve reminds her, “Like it or not, you are a woman now, and you are going to have to decide.”

In an interview with Rewire, Farmer said that the plot of Abortion Eve was a direct outgrowth of her and Chevli’s experiences in the nascent women’s health movement. Both women had started working as birth control and “problem pregnancy” counselors at the Free Clinic in Laguna Beach, California, soon after it opened in 1970. Archival documents at Indiana University’s Kinsey Institute show that Chevli and Farmer visited Los Angeles abortion providers in December 1972, on a business trip for the Free Clinic. According to Farmer, one of the doctors they met approached the pair with the idea of doing a comic about abortion to publicize his clinic.

Earlier that year, the women had produced one of the first U.S. comic books written, drawn, and published by women, Tits & Clits alpha (the “alpha” distinguished the comic from subsequent issues). So they took the doctor’s idea and ran with it. They decided to use their newly founded comics publishing company, Nanny Goat Productions, to educate women, particularly teenagers, about abortion.

At the Free Clinic, Chevli and Farmer had seen all kinds of women in all kinds of situations, and Abortion Eve attempts to reflect this diversity. As Farmer noted in an interview, she and Chevli made sure that the Eves were all different races, ages, and socioeconomic backgrounds in order to demonstrate that all kinds of women get abortions.

Farmer had made the choice to get an abortion herself, when her IUD failed in 1970. The mother—of a 12-year-old son—who was putting herself through college at the University of California at Irvine, she decided that she couldn’t afford another child.

California had liberalized its abortion laws with the Therapeutic Abortion Act of 1967, but the law was still far from truly liberal. Before Roe, California women seeking abortions needed doctors (a gynecologist and two “specialists in the field”) to submit recommendations on their behalf to the hospital where the abortion would take place. Then, a committee of physicians approved or denied the application. Only women who could pay for therapeutic abortions—those needed for medical reasonscould get them.

For Farmer, as for so many others, the process was onerous. After an hour, the psychiatrist who had interviewed her announced that she would not be eligible, as she was mentally fit to be a mother. Stunned, Farmer told the doctor that if he denied her an abortion, she would do it herself. Taking this as a suicide threat, her doctor quickly changed his mind. She wrote later that this experience began her political radicalization: “I was astounded that I had to prove to the state that I was suicidal, when all I wanted was an abortion, clean and safe.”

Farmer and Chevli began work on Abortion Eve before Roe v. Wade, when abortion was still illegal in many states. After the Supreme Court’s decision, they added a page for “more info” on the ruling. Yet even as they celebrated Roe, the women weren’t yet sure what would come of it.

The comic reflects a general confusion regarding abortion rights post-Roe, as well as women’s righteous anger over the fight to gain those rights. On the day of her abortion, for example, Evita tells Eve that, at five months pregnant, she just “slipped in” the gestational limits during which women could have abortions.

Eve explains that women now have the right to an abortion during the first three to six months of a pregnancy, but that the matter is far from settled in the courts. After all, Roe v. Wade said that states did have some interest in regulating abortion, particularly in the third trimester.

“I get mad when they control my body by their laws!” Eve says. “Bring in a woman, an’ if the problem is below her belly button and it ain’t her appendix, man—you got judges an’ lawyers an’ priests an’ assorted greybeards sniffin’ an’ fussin’ an’ tellin’ that woman what she gonna do an’ how she gonna do it!”

Abortion Eve Dialogue

Abortion Eve confronts the reality that abortion is a necessity if women are to live full sexual lives. Writing to the underground sex magazine Screw in September 1973 to advertise the comic, Chevli noted, “Surely if [your readers] screw as much as we hope, they must have need for an occasional abortion—and our book tells all about it.”

Six months after they published the comic, in December 1973, Chevli and Farmer traveled to an Anaheim rally in support of Roe outside the American Medical Association conference. They were met by a much larger group of abortion opponents. Chevli described the scene in a letter to a friend:

300 to 8. We weren’t ready, but we were there. Bodies … acquiescing, vulnerable females, wanting to show our signs, wanting to be there, ready to learn. Oh, Christ. Did we learn. It was exhausting. It was exciting. We were enervated, draged [sic] around, brung up, made to feel like goddesses, depressed, enlightened … bunches of intangible things. I have rarely experienced HATE to such a massive extent. 

That wasn’t the last feedback that Chevli and Farmer received about their views on abortion. In fact, during the course of Nanny Goat’s publishing stint, the majority of complaints that the independent press received had to do with Abortion Eve. Several self-identified Catholics objected to the “blasphemous” back cover, which featured MAD Magazine‘s Alfred E. Neuman as a visibly pregnant Virgin Mary with the caption: “What me worry?”

As archival documents at the Kinsey Institute show, other critics castigated Chevli and Farmer for setting a bad example for young women, failing to teach them right from wrong. One woman wrote them a letter in 1978, saying “You have not only wasted your paper, time, money, but you’ve probably aided in the decision of young impressionable girls and women who went and aborted their babies.”

Farmer and Chevli responded to such charges by first thanking their critics and then explaining their reasons for creating Abortion Eve. In another response, also in the Kinsey archives, Chevli wrote, “Whether abortion is right or wrong is not our concern because we do not want to dictate moral values to others. What we do want to do is educate others to the fact that abortion is legal, safe, and presents women with a choice which they can make.”

Today, abortion opponents like Louisiana Rep. Mike Johnson (R) frame abortion as the “dismemberment” of unborn children, suggesting that women who seek abortions are, in essence, murderers. With Abortion Eve, Chevli and Farmer dared to suggest that abortion was and is an integral part of women’s social and sexual liberation. Abortion Eve is unapologetic in asserting that view. The idea that abortion could be a woman’s decision alone, made in consultation with herself, for the good of herself and of her loved ones, is as radical an idea today as it was in the 1970s.

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