Not surprisingly, in the wake of the June 2022 Dobbs v Jackson Supreme Court decision, the expected number of clinician-assisted abortions decreased in states that have restricted abortion rights, while the expected number increased in states that have retained abortion rights. But the overall abortion picture is still a bit murky.
In recent days, news media have been reporting the results of a study published by an organization called the Society of Family Planning. The study looked at the number of clinician-assisted abortions in the United States during the period from July 2022 through June 2023. That is the one-year period immediately after the Supreme Court announced its decision in the Dobbs case on June 24, 2022. Dobbs overturned Roe v Wade and Planned Parenthood v Casey.
The study doesn't simply measure the number of abortions over that time period; it attempts to assess, state by state, whether the number of abortions were what would have been expected in a pre-Dobbs world. To establish the pre-Dobbs baseline, the study looked at the number of abortions in each state during the two months prior to Dobbs: April and May of 2022.
Here are a few of the study's key findings:
- Overall there were a net of 2,200 more abortions in the US during the 12 months post-Dobbs than would have been expected pre-Dobbs
- 2,200 incremental abortions does not seem like a large divergence from expectations; it is about 0.4% of the number of abortions performed annually in clinical settings (in recent years, 600K+ abortions have been performed annually in the US). But that small percentage is misleading, because it is represents the combination of a steep decline in the number of abortions in abortion-restrictive states, coupled with a sharp increase in the number of abortions in abortion-permissive states:
- Abortion-restrictive states had 114,590 fewer abortions post-Dobbs than expected pre-Dobbs
- Abortion-permissive states had 116,790 more abortions post-Dobbs than expected pre-Dobbs
- In other words: the decrease in expected abortions in restrictive states represents a -19% divergence from the annual total number of abortions, while the increase in expected abortions in permissive states represents a +19.4% divergence of the national total.
- Of those states that experienced more abortions than expected, the five with the largest increases are identified in the report as "surge states": Illinois, Florida, North Carolina, California and New Mexico
At the same time, it's worth noting that, following many years of gradual reductions in the number of abortions in the US (all while Roe v Wade was still in effect), the total number of abortions has been increasing modestly since 2017. (For some details on abortion trends over time, the Centers for Disease Control and Prevention site has many numbers, although it takes some delving to see the trends.) An increase of a couple of thousand abortions during this study period seems to be in line with that recent trend of gradual increases. But of course, pro-life activists had been hoping that overturning Roe would sharply disrupt that trend.
It seems reasonable to hypothesize that, in a post-Dobbs environment, many women who want abortions have both the motivation and the means to obtain one, even if it requires traveling out of state. The experience of the "surge states" supports that hypothesis: all five had abortion-permissive laws during the study period (although North Carolina's laws became more restrictive in July, after the study period ended, and Florida's laws would be more restrictive if the state courts would permit it; you can visit this Center for Reproductive Rights site to quickly see state-by-state abortion-law summaries). All of the "surge states" except California share one or more borders with abortion-restrictive states. And in the age of airline travel, California doesn't need a border with a restrictive state to position itself as an abortion destination.
One more note on the study: it measured clinician-assisted abortions. Those are abortions obtained through the formal medical system. That includes surgical abortions performed at a clinic, hospital or similar provider, as well as medication-induced abortions overseen by clinicians. (The CDC data indicates that a large percentage of abortions overseen by clinicians are now medication-induced, especially those that are provided at or earlier than 9 weeks' gestation; this study reports that much of this clinical oversight of medication-induced abortions is via telemedicine.) But the study does not measure abortions that bypassed the formal medical system. That includes abortions that utilize abortion-inducing medications obtained via mail order. (The study also mentions such methods as using herbs, or using medications obtained from friends.) My sense is that nobody really knows how many abortions are being performed via medications obtained via mail order and similar methods. The frequency of abortion could be considerably higher than researchers have been able to identify.
It is not altogether clear to me what the real goals of anti-abortion politicians and other activists are. I used to discuss the issue on a pretty serious website, and some of the abortion opponents claimed they would legally ban abortions even if the ban paradoxically wound up increasing the number of abortions. Now and then there have been proposals to decrease the number of abortions that one would think both pro-life and pro-choice advocates could support. But there never seems to be agreement on simply reducing abortions. It's really more about banning them (or so it seems to me).
ReplyDeleteI think with pro-life politicians there are two kinds. With one kind it's a deeply held conviction. With the other it's more cynical, a move to get them votes. Donald Trump is in this latter category, having been pro-choice until his candidacy. And he still waffles back and forth.
DeleteI think any legislation that helps children could be sold as being pro-life; such as Medicaid expansion or a child tax credit.
David - to your point, there are some policy interventions such as subsidized contraception which almost certainly would reduce abortions (and pregnancies), but which some culturally conservative people who self-identify as pro-life would not find appealing. That said: I don't think there is much of a constituency to broadly roll back the Obamacare contraception mandate (with the exception of protecting the conscience rights of employers). From what I can tell, free contraception is every bit as popular as any of us would have predicted it would be.
DeleteMany politically conservative people are reflexively anti-government-spending. So they can be expected to oppose public assistance programs which are primarily intended to relieve poverty and which might, as one of their consequences, also reduce the number of abortions.
David, I have encountered this, too. Many people see supporting laws that ban abortions as an important step in affirming the United States as a Christian nation (never mind that Christian sects do not always agree about abortion). They are under no illusion that large numbers of women and practitioners won't seek and perform abortions illegally. The point is not to stop abortion but to criminalize it and place it outside the realm of acceptable American behavior.
DeleteI sense that the same argument is at work in opposing gay marriage, the Equal Rights Amendment (remember that?), transitioning treatment for trans people, certain books in schools, sex education, birth control, Sunday liquor sales, etc.
P.S., possibly the attitude I describe above also explains the Christian Right's unwillingness to curtail gun rights: As a Christian nation, we condemn killing and punish murderers. Beyond that, people sin. Nothing we can do about that. Owning an arsenal for your personal enjoyment and protection is not a problem unless you cross the line.
DeleteRe: gun rights: I do suppose that many people who purchase guns do so because they are fearful and paranoid: think the world is full of criminals who are seeking to victimize them, and don't trust that the police will protect them.
DeleteI don't find it incredible that I could be in a life situation where I may wish to own a gun for self-protection.
Our society is pretty dysfunctional and stressed out right now. I think that explains the mass shootings plus a mimetic factor. I own guns and a carry permit but I rarely carry. If someone breaks into my house, I'm prepared but would have to load. The best approach, in my opinion, is to ban semi-automatic weapons. Revolvers are good enough for self defense but not good for mass shootings. The other things would be a more mutually caring, democratic socialist society and universal health care including mental health.
DeleteAs for mass shootings, in the meantime, if people kept green laser pointers handy, and could keep presence of mind, they could dazzle any shooter so he couldn't see and then hopefully be overcome and disarmed. Animals know to go for the eyes. I bring a laser pointer to church but I'm not sure one would be effective enough. I've taken a couple of milliwatts in the eye and it hurts and, like the old flash bulbs, it persists in the visual field for a while.
Yeah, I'm not talking about some Yuppie getting a .38 to scare off burglars. That's pretty much everybody in the Detroit 'burbs.
DeleteJust trying to make the point that conservative Christians (mostly, but not exclusively, Protestants) are interested in using the law to reflect their idea of Christian values and to position the U.S. as a Christian nation. It goes along with their idea of God's anointing us as some kind of paragon in the world.
The Christian Right often reads disasters and tragedies as God punishing us for allowing gay marriage, abortion, etc. This ilk of Christians are less interested in preventing evils than they are in telegraphing their obedience to an angry Almighty, and being able to lock up the worst offenders where they won't corrupt others.
You'll often see these Christians lobbying for very long harsh sentences, and having little interest in funding rehabilitation programs unless they come with a heavy overlay of religious hellfire.
A lot of them see the world as a place where perverts and pagans are trying to get them to renounce their beliefs, by force if necessary, and they are armed up against it.
Stanley, I did not know that about green laser pointers. Something to keep in mind. A non-violent self defense move to buy a few seconds of time in a threatening situation.
DeleteKatherine, green is best since the eye's sensitivity peaks in that spectral region. As I said, I'd feel more confident if there were several people with them. I am going to practice on a face-sized target to see how well I can illuminate the eyes. There is usually an adjustable lens to control the divergence (spread) of the beam. Wide enough to illuminate the target but not so much as to reduce the effect. I'll probably test it on me (attenuated) to see how effective it is. After I get the output measured.
DeleteI'm also going to look into LED flashlights. They're pretty good, too.
DeleteJean certainly is accurate in the type of right-wing Christian she is describing.
DeleteAnother alternative to owning a gun for protection is to get a dog or two.
If I had kids in my house, I definitely wouldn't have guns, even locked up.
DeleteJim, interesting statistics. They should convince some church people that "changing hearts and minds" is more effective than blocking access.
ReplyDeleteI think you are right that we don't know how many abortions are happening under the radar by stuff obtained on the Internet or with herbs and such. Hopefully not that many, because people don't really know what they are getting; similar to street drugs laced with fentanyl. With herbal stuff, just because it's "natural" doesn't mean it's not harmful. I'm thinking of one in particular that is known in folk medicine, where the distance between an effective dose and needing a liver transplant is a hair's breadth thin.
"interesting statistics. They should convince some church people that "changing hearts and minds" is more effective than blocking access."
DeleteRe: changing hearts and minds: fwiw, I attended a pro-life event last weekend. It was fine. But I'm sort of coming around to something that bugs my wife: pro-life activists are a little...what is the word I want...weird? Strange? Off-putting? Hey - probably they're just fine, and they consider me to be weird/strange/off-putting. But while I share many of their convictions, I don't live in their bubble. I am not a MAGA head, I don't watch Fox News, and I don't think my political opposites are the spawn of the devil.
Any attempt by some of these folks to change the hearts and minds of, say, my daughters and their friends, would be monumental failures, because of the weird/strange/off-putting factor.
I really think this is a much bigger factor than many people appreciate.
About the off-putting vibe, I think that came about when the pro-life people aligned with right wing politics for common cause. The result now is that anyone who isn't MAGA or MAGA adjacent, even though pro-life, feels alienated to a degree. For sure that would be true of young people who aren't MAGA ( and how many of them are?). I think the pro-life movement needs to tack more in a "seamless garment" direction, because it's more a consistent witness.
DeleteSeamless garment - much better.But the MAGAs all love guns, the death penalty, war, and not having their money used to help poor people. Many commenters at America say that this use of their tax money is theft. It’s THEIR money, not the governments.
Delete"But the MAGAs all love guns, the death penalty, war, and not having their money used to help poor people. Many commenters at America say that this use of their tax money is theft. It’s THEIR money, not the governments."
DeleteI think there are two types of conservatives in this camp. One is the anti-tax type: s/he is not necessarily opposed to helping poor people, but don't want the government to extract taxes from them for that purpose. Conceptually (if not always in practice), they may be willing to donate voluntarily.
The other type is the libertarian who objects to helping poor people; they need to help themselves by getting jobs.
I guess there is a third type, too: the cruel, stupid types (like Trump) who revile anyone who isn't as 'successful' as s/he is. Or maybe that type intersects the other two types.
In his four principles for a better society, Francis says that both ideas and realities are important but ideas have to adapt to realities.
ReplyDeleteMuch of the “cultural wars” seems to be about ideas rather than realities. Both the right and the left are attempting to put their ideas into law rather than to effect realities which often might be achieved by indirect means.
The constitutional issues around abortion here in Ohio seem to be about ideas more than realities. The left wants to limit the legislature ability to make laws about abortion. The right wants to deny those limitations. They each have their version of what the constitutional amendment will mean.
What everyone should be working for is a society in which there are incentives for having children and supports for raising them.
Perhaps if we started killing fewer humans we can see, we might kill fewer of the humans in utero we can't see. The rushing to war I'm seeing lately and over the last 35 years gives the message human life is cheap anyway. And this country is always at war. And we have the CIA running around stirring things up for the next conflict.
ReplyDeleteStanley, good point about respect for human lives that we can see leading to more respect for the ones we can't see.
DeletePope Francis would agree with you about war.
Yes. Francis also would agree that we need to look at issues like abortion holistically with other moral issues, such as our disrespect for our common home.
DeleteJack, everything ok at your house? I have been waiting for you to summarize the Synod report.
ReplyDeleteSorry it is only in Italian on the website. They should have it in English within a few days. Of course, the reporters who regularly cover the Vatican can read Italian so that is why you are seeing some summaries.
DeleteAt forty pages I double many people are going to read it. What ever happened to their early resolve to write 10 page syntheses. While Francis himself is regularly inspirational, I have my doubts that anything in the document will be inspirational. If the Holy Spirit was in the assembly, we will probably have to take their word for it.
In the last almost six weeks I have realized how important a sense of home is for me. Not being able to return to the home that my husband had built for us during our engagement has broken my heart and made me feel very lost. I am grieving for it. So I pray for all the refugees in Gaza and elsewhere - more than 60 million - who have had to flee their own beloved homes. The other night at the hospital I was waiting for the elevator ( one is broken so waits can be long) with a Catholic priest - he looked so familiar - tall, full head of white hair, and very Irish looking. He reminded me of my Catholic home, one where I used to feel safe. Chatting with him reminded me of that feeling of home. I do like Pope Francis. Maybe I’ll go back at some point - go back to where it feels like home. If I can find a good parish and not a JPII/B16 parish. When the priest exited the elevator, a man in a wheelchair did too. He said hello to the priest and said “I’m Catholic too” as he wheeled himself away. Every day is hard right now, so maybe I’m wrong to think of returning under these circumstances. Returning for the wrong reasons maybe. I still don’t accept many teachings, still angry about the misogyny and clericalism and hypocrisy. But that priest chatting with me in the elevator lobby reminded me of home. Please keep up the prayers.And pray for the millions of displaced people who can never go home.
DeleteI laughed at this and look forward to your commentary.
“While Francis himself is regularly inspirational, I have my doubts that anything in the document will be inspirational. If the Holy Spirit was in the assembly, we will probably have to take their word for it.”
Anne, I hear you about the sense of home being so important, and how lost one can feel without it. I have felt it to a degree just moving to a different town; I can only imagine how it must be under traumatic circumstances like yours.
DeleteI hope there is someone around whom you can talk to, maybe a counselor or social worker. You are dealing with a lot of loss and trauma right now.
As far as churches or parishes, ask around, because there is a lot of variation
I feel so sorry for the refugees from war, whose homes no longer exist. Praying for them, and also you and your family. Keep us posted on how things are going.
It's not "wrong" to seek God in the familiar during times of trouble. I regularly take my rosary to the hospital. Could I pray just as well some other way? Sure, but that rosary got me thru two miscarriages, a C-section, umpteen worries about The Boy, my parents' sicknesses and deaths, Raber's heart attack, and various hospital runs. It's familiar and how I try to channel my faith. I don't think God thinks my Hail Marys are worthless whatever the Good Catholics might think about the state of my soul.
DeleteJean’ you call yourself a Bad Catholic.Well, I’m a much worse Catholic. But I’ve said more rosaries in the last 6 weeks than in the previous many years. I sit in my husbands room and say it, I pray myself to sleep with it every night. My husband is getting stronger physically but weaker in spirit. So depressed. It’s so hard. So I repeat the Hail Mary - it’s a mantra and I hope someone is listening.
DeleteIt’s sort of sad that the security guard at the checkin desk starts writing our hospital passes as soon as the elevator doors open and he sees us ( my son and me)
Delete