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This week’s news [see below] that the abortion rate in the US has fallen to its lowest level in 40 years – since Roe v. Wade – was welcomed by both sides of the abortion debate. But they immediately began to fight over why it had declined. Broadly speaking, there are two explanations.

The first, offered by the Guttmacher Institute, the abortion think tank which produced the statistics, is that more young women are using long-term contraceptive devices and medical abortions.

The second is that 40 years of incremental restrictions on abortion and pro-life activism are finally beginning to bear fruit. As statistician Priscilla Coleman notes, “Nationally, the abortion rate declined by 13 percent, with particularly steep declines in mid-western states that enacted laws during the study period, regulating service provision and reporting (e.g., Kansas down 35 percent and South Dakota down 30 percent).”

The Guttmacher Institute insists that these laws are not having much impact. But this doesn’t square with complaints from the abortion clinics for whom it lobbies.

As we report in a story below, abortion providers in the northeastern US are incensed at the behaviour of Stephen Bingham, a doctor who runs a network of shoddy clinics in at least six states which have poor standards and bad business practices. “The more expensive and inaccessible that abortion becomes,” one provider told the New York Times, “the more it creates a space for a [Kermit] Gosnell or a Brigham to operate.” [SEE BELOW]

My impression is that the abortion industry may be caught in a vicious circle of decline. Slowly growing support for the pro-life cause eventually brings about stiffer laws, despite Roe v. Wade. An unfavourable legal climate makes abortion an unpopular speciality for competent doctors and shonky operators step in to fill the gap. This tarnishes the image of abortion and makes it possible for politicians to enact even more restrictions.

My feeling is that abortion in the US is on the skids. What do you think?

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Abortions Declining in U.S., Study Finds

The abortion rate among American women declined to its lowest level in more than three decades in 2011, according to a new report released Monday that is widely considered the country’s most definitive examination of abortion trends.

The 1.1 million abortions reported in 2011 represented a rate of 16.9 per thousand women of childbearing age, down from 2008, when a similar study estimated that 1.21 million abortions were performed at a rate of 19.4 per thousand women.

Resuming a long-term downward trend that stalled in the middle of the last decade, the 2011 rate was far below the peak, in 1981, of 29.3 per thousand, according to the report from the Guttmacher Institute, a private research group that supports abortion rights.

The decline in abortions from 2008 to 2011 was mirrored by a decline in pregnancy rates. The report did not include a detailed analysis of the reasons for these trends, which pose complicated research issues.

But the decline in abortions, the researchers said, appears in part to reflect the growing use, especially among younger women, of nearly foolproof long-term contraceptives like intrauterine devices. It may also reflect the impact of the recession and economic uncertainty, which can lead to fewer pregnancies, births and abortions, according to the authors, Rachel K. Jones and Jenna Jerman.

The authors concluded that anti-abortion laws had only a minimal impact on the number of women obtaining abortions during the study period. For one thing, many of the state laws most likely to curb abortions were passed in 2011 or later. In addition, the report notes, large declines were recorded in states with relatively liberal abortion laws, like California, New Jersey and New York.

But they added: “Some of the new regulations undoubtedly made it more difficult, and costly, for facilities to continue to provide services and for women to access them.” The researchers said that future studies would need to monitor the effects of laws that restrict abortions.

Responding to an advance copy of the report, Americans United for Life, an anti-abortion group, called it “long on strained conclusions” and said it understated the impact of anti-abortion education and laws.

Carole Joffe, a sociologist at the University of California, San Francisco, and a historian of abortion, said that while the effects were difficult to quantify, the anti-abortion movement had “been very successful at stigmatizing abortion” and that this had most likely influenced the long-term downward trend.

But Dr. Joffe agreed with the report that the wider use of contraceptives — IUDs that can prevent pregnancy for up to 10 years and injectable hormonal drugs that do so for months — appears to be an important factor in the reported recent decline.

These long-term, more reliable methods can have high upfront costs, Dr. Joffe noted. The cost may be a factor in the significantly higher rates of abortion among black and Hispanic women and the poor compared with white women, she said, and also points up the importance of providing health insurance that covers contraception to low-income women.

To conduct the study, which will be published in the March issue of Perspective on Sexual and Reproductive Health, the Guttmacher Institute contacted every known clinic, hospital and independent physician performing abortions with questionnaires and follow-up calls.

The data are more comprehensive than those collected by the federal government, which receives incomplete reports from some state governments and none from California. But it might still be an undercount, the researchers said, to the extent that they did not learn about private doctors who quietly offer nonsurgical medication abortions.

One striking development revealed in the survey is the rising use of medication abortions, normally within the first nine weeks of pregnancy. In 2011, medication abortions accounted for 23 percent of abortions reported by clinics and private doctors. Several states have recently acted to limit access to such abortions.