General Information / History / Stats / Types

The Ultrasound’s Role in the Decline in Abortions

As the U.S. Supreme Court begins its new term this week, pro-life advocates hold a prayer vigil on the plaza of the high court in Washington, Oct. 4, 2014.

Abortions have declined in states where new laws make it harder to have them – but they’ve also waned in states where abortion rights are protected, an Associated Press survey finds. (J. Scott Applewhite, The Associated Press)

The young woman drew a sharp breath and her eyes grew wide. The boyfriend, no longer silent and detached, murmured, “Oh, wow,” at the tiny heartbeat blinking rhythmically on the black and white monitor.

In the dim glow of the ultrasound machine, I saw uncertainty give way to wonder.

When we met up again, the young woman told me she was having a girl. There were still many challenges ahead, but wonder had blossomed into joy.

That grainy yet luminous silhouette had softened the hearts of two scared college students and enabled them to choose life for the child they had conceived together.

The ultrasound image, posted to Facebook, hung on refrigerator doors and taped to scrapbooks, has changed hearts and minds.

Obstetrician Ian Donald, one of the pioneers of the clinical ultrasound back in the 1950s, understood the implications of his invention:

The ultrasound humanizes the hidden form of the unborn child.

Donald rejoiced in how the images forged an emotional connection between a mother and the child within her.

Now ubiquitous, this technology has no doubt contributed to the societal shift underway regarding abortion in the United States.

While the number and rate of abortions have been falling for more than three decades, recent decreases in abortion rates were so significant as to grab headlines last week.

An Associated Press survey reported that the U.S. has experienced a 12 percent decrease since 2010. In Colorado, the abortion rate fell 9 percent.

Rates dropped in states with strong protections for women and children as well as in states with liberal abortion laws.

Hawaii (30 percent), New Mexico (24), Nevada (22), Rhode Island (22) and Connecticut (21) experienced the greatest decreases. Rates fell in all but two states for which data are available.

The AP survey results are good news for unborn children and their advocates and for pro-choice Americans who want abortion to be safe, legal and rare.

Although the abortion rate still tops 1 million a year, it is declining and will likely continue to do so.

Abortion advocates and opponents offer different reasons for the decline in the procedures, which are less frequent now than when abortion was legalized in 1973. Advocates contend that the increased usage of long-acting reversible contraception (LARC), such as intrauterine devices (IUDs) and contraceptive implants, is responsible.

Opponents point to state laws protecting women and unborn children.

Neither of these reasons, however, fully explains the decline.

Planned Parenthood, the nation’s largest abortion and birth control provider, has witnessed a 91 percent increase in LARC usage since 2009. The long-term decline in the abortion rate, however, precedes the recent uptick in LARC usage, which accounts for about 10 percent of all birth control use.

In Colorado, where a privately funded program provides free or low-cost LARC to low-income teens, the abortion rate for teens declined in counties where the program was available and where it was not available by similar percentages.

Nationwide, teen pregnancy and abortion have been in decline since the late 1980s.

Also, birth control has been widely available for some time.

Condoms, diaphragms and IUDs became available in the 19th century. The pill and a greatly improved IUD debuted in the 1960s.

Birth control pills are inexpensive and likely to become moreso if they become available over-the-counter. Suffice it to say, widespread birth control options cannot explain the decline in abortion.

Similarly, the increase in state laws cannot fully explain abortion trends because states with few limits such as Colorado have also experienced a decline.

Colorado laws limiting public funding (1988) and requiring parental notification for minors (2003) passed years ago.

Other states, however, have actively pursued changes to abortion laws.

Since 2011, 31 states have added 267 abortion regulations. The most common legislation concerns limits on abortion after 20 weeks, clinic standards, and hospital admitting privileges for abortion providers.

Some clinics have closed as a result. For example, Texas laws requiring increased medical standards for clinics and operators (which were upheld last week by the 5th U.S. Circuit Court of Appeals) have resulted in the closure of half of the state’s abortion facilities.

This may have contributed to the decline in abortions, but it does not explain declines in states that have made no changes to their laws.

In terms of public opinion, the nation remains divided on the issue. A Pew Research Center poll found 50 percent of women and 48 percent of men believe abortion is morally wrong.

In terms of legal status, Gallup polling shows 29 percent of Americans want no limits on abortion, 51 percent want limitations, and 19 percent want abortion to be illegal.

These results are strikingly similar to results found in the mid-1970s when Gallup first started polling the issue.

That polling also shows a majority of Americans support laws requiring parental consent for teens, waiting periods, limits on abortions after the first three months, and the provision of an ultrasound and information regarding risks and abortion alternatives to patients.

Interestingly, millennials are more prolife than their parents’ generation. They are more pro-life than their youthful counterparts in 1973 and in the early ’90s when approval for abortion peaked.

Millennials grew up seeing ultrasound pictures of their siblings. Their friends have posted their children’s first photo via ultrasound to announce the news on Facebook.

They’ve seen photos of unborn children and animals.

They’ve seen documentaries about fetal development and surgery. They know about fetal pain and have seen premature babies survive at increasingly younger ages.

They’ve seen their own ultrasound pictures taped to a baby scrapbook.

Perhaps a picture is worth more than a thousand words of advocacy. Perhaps that grainy but luminous image is the biggest reason that abortion is in decline.

[13 June 2015, Krista Kafer, ]