The Christian Science Monitor

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A declining abortion rate

Amid all the fierce debate and violence surrounding abortion clinics and doctors, the number and rate of abortions in America has steadily declined. The reasons are hotly debated. Prochoice advocates credit the growth of emergency contraception, a high-dose birth-control pill a woman can take after unprotected sex to prevent pregnancy. In general, a wider range of contraceptive choices means women are doing a better job of using contraception, they say.

Both abstinence and the use of contraceptives are on the rise among teenagers, in particular, so fewer are getting pregnant to begin with. Among girls aged 15 to 19, the abortion rate has been dropping since the late 1980s - and fell another 27 percent between 1994 and 2000.

Another factor that may be contributing to the overall decline in abortions is the availability of ultrasound technology, showing the earliest fetal development - which, some observers suggest, leads some women to think twice about ending pregnancies.

But the bottom line is that the US still has one of the highest abortion rates in the industrialized West. And the abortion war is only intensifying.

Now that Republicans control both the White House and Congress, abortion opponents are readying a major push for new restrictions, starting with a ban on so-called "partial birth abortions." Another bill would ban transporting a minor across state lines for an abortion so that she can avoid parental-notification laws; a third would criminalize harming a fetus during an attack on a pregnant woman.

Laws protecting clinic entrances have helped reduce clinic violence, and litigants have successfully used racketeering laws to thwart some of the most extreme antiabortion activists. Since 2000, US government approval of medical abortion through the use of mifepristone (RU486) has given women an alternative to surgical abortion.

Yet abortion-rights leaders still feel they are losing ground, and acknowledge that their opponents have gotten savvier about shaping public opinion and "chipping away" at abortion rights. Since 1982, the number of abortion providers has been declining.

But there are still young people eager to join the shrinking ranks, inspired by stories of risky, sometimes deadly, abortions before legalization.

Angel Foster, a medical student at Harvard University, is training for a career in women's reproductive health - including providing abortions. As a young adolescent, she learned of her mother's illegal, pre-Roe abortion.

"That experience was extremely traumatic for her - not the abortion itself, but what she had to do to get it," says Ms. Foster, who, as president-elect of Medical Students for Choice, is working to beef up medical-school curricula on abortion and other issues of women's reproductive health.

Foster has also worked in countries where abortion is illegal, such as Egypt, and seen firsthand what she calls the "psychological and physical consequences of a shortage of reproductive services." But is she really willing to risk her life, working in a clinic in this country? "Even when I have kids, I can imagine doing this," she says. "My husband and I have discussed this."

Could Roe be overturned?

To some abortion-rights advocates, the Supreme Court is only one vote away from undoing 30 years of nationwide legalized abortion. But more likely, say legal scholars, there would need to be a larger shift in the court's composition for such an earthshaking ruling. And even if the court eventually had a solid majority of justices who believed Roe v. Wade was improperly decided, it's unclear that it would undo what many analysts, including antiabortion conservatives, call "settled law."

"What's hard for people who lack an acquaintance with the Supreme Court to understand is what a tremendously negative institutional, historical impact there would be on the stature of the court if they were to overturn it," says David Garrow, a historian at Emory Law School in Atlanta. "That's why I think it could never happen."

But if that day were to come, the legality of abortion would once again vary state by state. According to NARAL Pro-Choice America, 17 states currently have greater protection for reproductive choice than the federal Constitution; 17 other states "could face sweeping criminal bans on abortion" if Roe were reversed.

Conservative writer Marvin Olasky prefers to look at the movement through a cultural lens. The culture that accepts abortion is changing, he says, and the current view that Roe is acceptable will eventually seem untenable. That, he suggests, could eventually lead to a legal shift. "How long did it take the court to overturn Plessy v. Ferguson?" he asks, referring to the 1896 case that endorsed racial segregation. "That took 60 years. We're halfway there."

By the numbers ...

Worldwide, about 46 million abortions occur each year. Twenty million are illegally obtained.

Among American women, almost half of pregnancies are unintended. About half of those end in abortion - 1.3 million annually.

Between 1994 and 2000, the US abortion rate fell more than 10 percent, in part because of the growing availability of emergency contraception.

Abortion rates are at their lowest levels since 1974. They peaked in 1980-1981.

Of American women obtaining abortions, 52 percent are under 25. Women aged 20 to 24 account for 33 percent of abortions, and women under 20 obtain 19 percent of abortions.

In 2000, 87 percent of US counties had no abortion clinic, and 34 percent of women of childbearing age lived in those counties. In addition, 31 percent of US metropolitan areas had no abortion facilities.

Between 1996 and 2000, the number of abortion providers declined 11 percent. It's been dropping since 1982.

In 1997, 57 percent of obstetrician/ gynecologists performing abortions were aged 50 or older.

Eighty-two percent of large, nonhospital abortion facilities were harassed in 2000; most clinics are picketed at least 20 times a year. From 1985 to 2000, the proportion of large providers reporting bomb threats dropped from 48 percent to 15 percent.

The 1996-2000 abortion rate was highest in Washington, D.C. - 68.1 abortions per 1,000 women - and lowest in Wyoming, where 1 in 1,000 women had an abortion.

Source: The Alan Guttmacher Institute

ADAM WEISKIND - STAFF SOURCE: THE ALAN GUTTMACHER INSTITUTE