Analysis Abortion

Pennsylvania Abortion Statistics: The Distorted View From the Anti-Choice Lobby

Tara Murtha

Anti-choice advocates and lobbyists are calling the slight decrease in the number of abortions performed in Pennsylvania in 2012 “good news for women.” Is it really?

According to a new report released by the Pennsylvania Department of Health, 34,536 abortions were performed in the state in 2012—a 4.8 percent decrease from the number of such procedures performed in the state in 2011.

To anti-choice advocates and lobbyists, this slight decrease means “more women are being empowered to make life-affirming decisions for themselves and their families” and “good news for women.”

But is that what it really means?

Although anti-choicers are working to “end abortion,” history—evidence of women commonly having abortions goes back much, much farther than American legal battles over it—and global public health data show us it is not possible to stop abortion. Their efforts, therefore, are capable only of reducing access to safe, legal abortion. The most straightforward way to do that is to criminalize the procedure. Studies show, however, that criminalizing abortion doesn’t even reduce its incidence. In fact, abortion rates are higher in countries where the procedure is illegal. The effect is that women in those countries just suffer more preventable medical injuries and death than women living in countries where abortion is legal.

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Since abortion is legal in the United States, anti-choice lobbyists and advocates have employed an incremental approach. This strategy relies on flooding state legislatures with boilerplate bills designed to make it harder for poor and working women in those states to find safe abortion services.

Some of these bills require medically unnecessary, prohibitively expensive facility renovations to force clinics to shut down; mandatory waiting periods that force women who have traveled from out of town (or out of state) to incur hefty travel expenses; prohibitions on insurance covering abortion services; and rigged bureaucratic hurdles like legislation forcing doctors to gain admitting privileges at hospitals even though this is not necessary for health or safety. The legislative strategies are diverse, but designed to work in tandem to restrict poor women’s access to abortion by creating logistical and financial burdens to getting to a clinic and paying for the procedure.

Back to Pennsylvania’s annual abortion statistics report: First, it’s not at all clear that the decrease in abortions in 2012 is statistically significant in context. The number of abortions performed in Pennsylvania peaked in 1980, with 65,777 procedures, and has been generally dropping ever since. In 1990, the number was 52,143. In 2000, it was 35,630, and has hovered in the mid- to upper-30,000s since then.

Hailing the decrease as significant, though, allows anti-choicers to reinforce rhetoric that closing clinics “ends” abortion by tying it to their biggest legislative accomplishment in recent years.

In December 2011, against the recommendation of every relevant state medical association, anti-choice lawmakers in Pennsylvania passed legislation that eventually lead to the closure of at least four clinics. The law required that freestanding abortion clinics adhere to guidelines established for ambulatory surgical facilities (ASF), sites where procedures far more complicated than abortion take place. Those guidelines happen to require expensive architectural renovations. No evidence exists that says requiring clinics adhere to ASF guidelines improves patient safety.

Ergo, the distorted view from the anti-choice lobby is that, by forcing clinics to close, they prevented 1,744 women who would have otherwise sought abortions from obtaining them.

The most overlooked factor in this analysis is the most obvious: We don’t know how many of these hypothetical women financially boxed out of obtaining hypothetical abortions successfully prevented pregnancy in the first place.

Abortion is, after all, most often a choice made by women and families dealing with an unplanned pregnancy. Low-income women disproportionately experience those unplanned pregnancies at a rate five times higher than women in the highest income bracket.

While criminalization doesn’t reduce the incidence of abortion, research shows that access to contraception does. It’s common sense, and also the conclusion of global health research conducted by the World Health Institute, which noted that “the availability of modern contraception can reduce, but never eliminate, the need for abortion.”

A study conducted last year by the Pennsylvania Department of Welfare demonstrated that increasing access to contraception prevents unplanned pregnancies, which subsequently prevents abortion and unplanned births.

In a waiver filed to showcase the success of a Medicaid demonstration project that provided free contraception to women who traditionally didn’t qualify for Medicaid, state data shows that between 2008 and 2010, the approximately $23.7 million spent on birth control and related services for 64,885 women earning between 100 percent and 185 percent of the federal poverty line prevented 7,061 unwanted pregnancies.

By focusing legislative efforts on limiting access to both abortion and contraception, though, Pennsylvania lawmakers ignore even their own data in favor of anti-choice platitudes: The program that funded this access, SelectPlan for Women, is scheduled to expire to make way for Healthy PA, Gov. Tom Corbett’s proposed Medicaid plan. If it passes as it is, Healthy PA will likely reduce poor women’s access to contraception. Meanwhile, half of all unplanned pregnancies in Pennsylvania end in birth, 37 percent in abortion, and the rest miscarriages.

While the new Medicaid plan will possibly reduce access to contraception, and only 13 freestanding abortion clinics are left in the state, Pennsylvania lawmakers are poised to spend 2014 focused on shutting down clinics: a bill to implement admitting privileges, similar to the one that shut down one-third of Texas’ clinics, has been introduced, and there has been talk of introducing a 20-week abortion ban.

In addition, in 2013 state legislators outlawed private insurers participating in the state’s health-care insurance exchange from covering abortion even when the mother’s health is threatened.

The bottom line is that Pennsylvania lawmakers are clearly devoted to implementing the anti-choice incremental strategy—earning the state the dubious distinction of earning very high marks from Americans United for Life, the anti-choice lobbying group responsible for some of those boilerplate bills clogging state legislatures. That means that what state lawmakers are not working on are policies that will reduce the number of abortions performed the only way possible: by reducing the number of unplanned pregnancies.

That means more girls and women experiencing unplanned pregnancies. There is no way to formally track the numbers, but given Pennsylvania’s trajectory and the testimony of abortion fund crisis hotlines, there are many women facing an unplanned pregnancy who can not afford an abortion. What happens to them?

A long-term study conducted by the University of California’s Advancing New Standards in Reproductive Health project found that two years after being economically forced into having a child they were not expecting, mothers were three times more likely to be living in poverty than women in similar circumstances who had an abortion.

In Pennsylvania, nearly one in five children live in poverty. And like everywhere else, poverty is linked with poor health.

And yet, despite the public health data, Pennsylvania legislators keep introducing more policies designed to reduce access to both contraception and abortion for low-income and working women in the state. And anti-choice lobbyists and advocates continue to cherry-pick statistics and tie them to a fairytale narrative that, when implemented in real life, results in more unplanned pregnancy, more families in poverty, and more poor health.

Is that what anti-choicers mean by “good news for women and families”?

Correction: A version of this article incorrectly noted that Pennsylvania lawmakers implemented legislation in December 2011 that resulted in at least four clinics shutting down. In fact, the legislation passed at that time. We regret the error.

News Politics

Democratic Party Platform: Repeal Bans on Federal Funding for Abortion Care

Ally Boguhn

When asked this month about the platform’s opposition to Hyde, Hillary Clinton’s running mate Sen. Tim Kaine (D-VA) said that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde Amendment.”

Democrats voted on their party platform Monday, codifying for the first time the party’s stated commitment to repealing restrictions on federal funding for abortion care.

The platform includes a call to repeal the Hyde Amendment, an appropriations ban on federal funding for abortion reimplemented on a yearly basis. The amendment disproportionately affects people of color and those with low incomes.

“We believe unequivocally, like the majority of Americans, that every woman should have access to quality reproductive health care services, including safe and legal abortion—regardless of where she lives, how much money she makes, or how she is insured,” states the Democratic Party platform. “We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment.”

The platform also calls for an end to the Helms Amendment, which ensures that “no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning.”

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Though Helms allows funding for abortion care in cases of rape, incest, and life endangerment, the Obama administration has failed to enforce those guarantees.

Despite the platform’s opposition to the restrictions on abortion care funding, it makes no mention of how the anti-choice measures would be rolled back.

Both presumptive Democratic nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) have promised to address Hyde and Helms if elected. Clinton has said she would “fix the Helms Amendment.”

Speaking at the Iowa Brown and Black Presidential Forum in January, Clinton said that the Hyde Amendment “is just hard to justify because … certainly the full range of reproductive health rights that women should have includes access to safe and legal abortion.” In 2008, Clinton’s campaign told Rewire that she “does not support the Hyde amendment.”

When asked this month about the platform’s opposition to Hyde, Clinton’s running mate Sen. Tim Kaine (D-VA) said in an interview with the Weekly Standard that he had not “been informed of that” change to the platform though he has “traditionally been a supporter of the Hyde amendment.”

“The Hyde amendment and Helms amendment have prevented countless low-income women from being able to make their own decisions about health, family, and future,” NARAL President Ilyse Hogue said in a statement, addressing an early draft of the platform. “These amendments have ensured that a woman’s right to a safe and legal abortion is a right that’s easier to access if you have the resources to afford it. That’s wrong and stands directly in contrast with the Democratic Party’s principles, and we applaud the Party for reaffirming this in the platform.”

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.