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01.13.2014
Resources

Abortion and Young People in the United States

Also available in [PDF] format.

One in Three Women Will Have an Abortion In Her Lifetime

Abortion has always been a part of women’s lives. Nearly 700,000 women in the United States seek abortion care each year, the majority of these under age 30 [1]. Increasingly, these young women face challenges to accessing safe abortion care, including near-constant legislative attacks and cultural stigma. Yet, Millennials, the generation born after 1980, are among the most supportive of the right to safe abortion care.

ABORTION STATISTICS

• Abortion surveillance for 2012, released in 2015, found that although abortion rates have decreased overall since 2001, a significant percentage of women, including young women, need abortion care each year.[1]

o Young women in their twenties have the highest abortion rates and account for 58 percent of abortions. Those ages 20-24 account for 33 percent of abortions and have an abortion rate of 23.3 abortions per 1000 young women.[1]

o Young women ages 15-19 account for 12.2 percent of abortions and have an abortion rate of 9.2 abortions per 1000 young women.[1]

o Young women under 15 account for only 0.4 percent of abortions, with an abortion rate of 0.8 abortions per 1000 young women.[1]

• Pregnancy rates for women under age 30, including teens, have also declined greatly in the last three decades. The pregnancy rate for teens ages 15-19 has declined by 50 percent since 1990, and the pregnancy rate for young women ages 20-24 has declined by 27 percent. [2]

• White women account for most (51 percent) abortions compared to African Americans (40.5 percent) and all other races (8.5 percent).[1] African Americans had the highest rate of abortions (24.6 per 1000 women); the abortion rate is 7.1 for white women and 14.5 for Hispanic women.[1]

• One in three women will have an abortion in her lifetime.[3]

SINCE ROE V. WADE, MANY STATES HAVE RESTRICTED ACCESS TO ABORTION

    • In 2012 alone, 57 new restrictions on abortion care were enacted in 17 states.[4]
    • At least 24 states have “Targeted Regulations of Abortion Providers,” known as TRAP laws. TRAP laws place undue burdens on abortion providers and are intended to drive them out of business; they regulate things like water fountains and parking lot size, and are applied only to facilities which offer abortions, not to comparable offices and clinics. [5,6] Yet, abortion is very safe; fewer than 0.05 percent of abortion patients experience major complications.[7]
    • Twenty-seven states require a waiting period before abortions, with fourteen of these having waiting periods long enough for a woman to have to make two separate trips to the clinic to receive the procedure.[8] Additionally, due in large part to burdensome restrictions, 87 percent of counties in the United States lack an abortion provider – meaning women face long and costly travel in addition to the cost of abortion, for no medical reason.[9]
    • Young women in particular are unlikely to have the means of transportation, time off from school, and ability to pay for incidental expenses necessary to travel across the state or across state lines to receive the abortion care they need, particularly if they are located in rural areas and are hesitant to ask for help from their parents.[10]
    • Women need abortion regardless of legality. Research has found that legal restrictions do not reduce the need for abortion, but rather, drive women to seek out illegal and potentially dangerous abortions.[11]

LOW INCOME WOMEN ARE UNFAIRLY IMPACTED BY FUNDING RESTRICTIONS

Shortly after the Supreme Court made its Roe v. Wade decision legalizing abortion in every state, Congress enacted the Hyde Amendment to the appropriations bill, which bars the use of federal funds to pay for abortions except in cases of rape and incest. The Hyde Amendment has been renewed each year since 1976.[12] Young women are disproportionately impacted by funding bans because they are less likely to have a steady source of income and more likely to be uninsured than women of all ages.[10] The cost of an abortion ranges from $350 t0 $1000.

    • Funding restrictions force one in four women to carry unwanted pregnancies to term, with the proportion higher among younger women. A literature review on Medicaid funding found that younger women are disproportionately affected by the restrictions and are more likely to carry unwanted pregnancies to term.[13]
    • Sixteen percent of women rely on Medicaid for health care – leaving thousands without abortion coverage.[14]
    • The Affordable Care Act allows states to ban abortion coverage in insurance marketplaces and allows health care providers to refuse to provide abortion care. Alongside the law, President Obama issued an Executive Order further requiring health plans to segregate funds for abortion coverage while reaffirming that the Hyde Amendment still stands.[15]
    • In addition to Hyde, 32 states and the District of Columbia prohibit using state funds to pay for abortions except in cases of rape, incest, and the life of the mother. [12]

TEENS FACE ADDITIONAL BARRIERS TO ACCESS

The majority of states – thirty-nine as of January 2014 – currently enforce laws that require a young woman to notify or obtain consent from one or both parents before she can receive abortion care. These laws endanger young women’s health and safety, while having no clear impact on birth rates or abortion rates.[17]

    • Most young women do consult their parents before seeking abortion care, but those who do not may face dangerous circumstances at home.[18] Fifty percent of pregnant teens have experienced violence [19] ; thirty percent of teens who do not tell their parents about their abortions feared violence or being forced to leave home.[20]
    • Parental involvement laws often delay young women’s abortion care, leading to riskier, later-term abortion procedures.[17]
    • Parental notification laws do not guarantee that a minor will talk to her parents before she has an abortion. Research shows parental notification laws have almost no effect on a young woman’s decision to talk with her parent or guardian about her decision prior to an abortion. The chief factor determining whether a teen consulted her parent was, not legislation, but the quality of the teen’s relationship with her parent.[21]

ABORTION STIGMA IS A STRONG CULTURAL FACTOR; Storytelling can contribute to more positive views

While legal restrictions create many barriers, cultural factors also impact women’s ability to access abortion and lead to an atmosphere of silence and stigma around abortion. Many clinics are regularly visited by protestors; politicians and other public figures routinely condemn abortion as murder; and many religions forbid abortion. The result is fear of being judged and secrecy around abortion.

    • In one study, 66 percent of women (Whites, 75 percent; African Americans, 52 percent; Hispanics, 67 percent) said they thought they would be looked down on by people if they knew they had had an abortion.[22]
    • The same study found that 17 percent of women felt their regular healthcare provider would treat them differently if they knew they had had an abortion.
    • Fifty-eight percent of women indicated a need to keep their abortions secret.
    • In another study of the level of stigma women had experienced, women ages 19-24 experienced more stigma and had more worries about being judged than women in other age groups.[23]
    • To counter the stigma, abortion care advocates are increasingly focusing on storytelling – people sharing their real experiences with abortion. Research has found that under certain conditions , hearing from someone who has experienced abortion can contribute to increased support for access to abortion care.[24]

MILLENNIALS ARE SUPPORTIVE OF ABORTION RIGHTS

Millennials, or young people born after 1980, are one of the most pro-sexual-health generations in history and are committed to the availability of abortion.

    • A majority of Millennials believe abortion should be available in all (22 percent) or most (33 percent) cases, comparable with other generations, Fifty-five percent believe abortion should be available in their community. Among Millennials of color, a majority believe abortion should be legal in all or most cases.[25]

CONCLUSION

Despite legal and cultural barriers, hundreds of thousands of women seek out abortion care each year, with young women, low-income women, and women of color most strongly affected by restrictions. To protect women’s health and lives, activists must strive for good reproductive health care law, as well as work for cultural changes to underpin the legal and policy work to ensure abortion care is available and affordable.

Written by Emily Bridges, MLS
Advocates for Youth © August 2016


[1] Pazol K et al. Abortion Surveillance – United States, 2012. Morbidity and Mortality Weekly Report, 2015: 64(ss10): 1-40. Accessed 8/15/2016 from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6410a1.htm

[2] Curtin SC, Abma JC, Kost K. 2010 pregnancy rates among U.S. women. NCHS health e-stat. 2015, Accessed from https://www.cdc.gov/nchs/data/hestat/pregnancy/2010_pregnancy_rates.pdf on 8/15/2016. Accessed 1/8/2013 from http://www.cdc.gov/nchs/data/databriefs/db136.htm.

[3] Jones RK and Kavanaugh ML, Changes in abortion rates between 2000 and 2008 and lifetime incidence of abortion, Obstetrics & Gynecology, 2011, 117(6).

[4] Guttmacher Institute, Laws affecting reproductive health and rights: 2015 state policy review, 2015. Accessed August 16, 2016 from https://www.guttmacher.org/laws-affecting-reproductive-health-and-rights-2015-state-policy-review html.

[5] Center for Reproductive Rights. Targeted Regulation of Abortion Providers (TRAP). Accessed 8/15/2016 from http://reproductiverights.org/en/project/targeted-regulation-of-abortion-providers-trap

[6] Guttmacher Institute.. State Policies in Brief: Targeted Regulation of Abortion Providers. Accessed 8/15/2016 from https://www.guttmacher.org/sites/default/files/pdfs/spibs/spib_TRAP.pdf

[7] Weitz TA, et al., Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver, American Journal of Public Health, 2013, 103:454-461.

[8] Guttmacher Institute. State Policies in Brief: An Overview of Abortion Laws. Accessed 8/15/2016 from http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

[9] Jones RK and Kooistra K, Abortion incidence and access t o services in the United States, 2008, Perspectives on Sexual and Reproductive Health, 2011, 43(1):41–50.

[10] National Network of Abortion Funds. Abortion Funding: A Matter of Justice. Accessed 1/8/2014 from http://www.fundabortionnow.org/sites/default/files/exec_summary_abortion_funding_a_matter_of_justice.pdf

[11] Sedgh G et al. Induced abortion: estimated rates and trends worldwide. The Lancet, 2007: 370(9595).

[12] Guttmacher Institute. State Policies in Brief: State Funding of Abortion Under Medicaid. Accessed 8/15/2016 from http://www.guttmacher.org/statecenter/spibs/spib_SFAM.pdf

[13] Henshaw SK et al. Restrictions on Medicaid Funding for Abortions: A Literature Review. New York: Guttmacher Institute,2009.

[14] Kaiser Family Foundation. Women’s Health Insurance Coverage, February 2016. Accessed 8/15/2016 from http://kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage-fact-sheet/

[15] The White House. Executive Order 13535– Patient Protection and Affordable Care Act’s Consistency with Longstanding Restrictions on the Use of Federal Funds for Abortion. Accessed 1/8/2014 from http://www.whitehouse.gov/the-press-office/executive-order-patient-protection-and-affordable-care-acts-consistency-with-longst.

[16] Guttmacher Institute. State Policies in Brief: An Overview of Minors Consent Law.Accessed from https://www.guttmacher.org/sites/default/files/pdfs/spibs/spib_OMCL.pdf on 8/15/16.

[17] Dennis A et al. The Impact of Laws Requiring Parental Involvement for Abortion: A Literature Review, New York: Guttmacher Institute, 2009.

[18] Dailard C and Richardson CT. “Teenagers’ Access to Confidential Reproductive Health Care Services.” The Guttmacher Report on Public Policy, 2005: 8(4).

[19] American Psychological Association, Parental Consent Laws for Adolescent Reproductive Health Care: What Does the Psychological Research Say? (Feb. 2000), citing A.B. Berenson, et al., Prevalence of Physical and Sexual Assault in Pregnant Adolescents, 13 J. of Adolescent Health 466-69 (1992).

[20] Martin Donohoe, Parental Notification and Consent Laws for Teen Abortions: Overview and 2006 Ballot Measures MEDSCAPE Ob/Gyn & Women’s Health, February 9, 2007

[21] Davis AR, Beasley AD. Abortion in adolescents: epidemiology, confidentiality, and methods. Curr Opin Obstet Gynecol. 2009;21(5):390–3

[22] Shellenberg K and Tsui A. “Correlates of perceived and internalized stigma among abortion patients in the USA: An exploration by race and Hispanic ethnicity.” International Journal of Gynecology and Obstetrics 118, Supplement 2 (2012) .

[23] Cockrill K et al. “The Stigma of Having an Abortion: Development of a Scale and Characteristics of Women Experiencing Abortion Stigma.” Perspectives on Sexual and Reproductive Health, 45: 2.

[24] Cockrill K. “Abortion Stigma Webinar, #2.” Accessed 1/8/14 from http://www.ansirh.org/library/presentations.php

[25] Public Religion Research Institute. Survey – How Race and Religion Shape Millennial Attitudes on Sexuality and Reproductive Health. 2015.

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