Number Of Abortion Providers Research Articles

Data discrepancies: Italian ministry reports on abortion, contextualised

The Italian Ministry of Health reports annually on activities related to abortion and fertility, providing quantitative data that looks ripe for analysis. Actors ranging from activists to medical providers to...

Factors Affecting the Availability of Abortion Providers

This study, using state data, empirically examines the factors affecting the availability of abortion providers over the period 1992–2011. The empirical results found that the labor force participation of women and the percentage of women of reproductive age in the 18–24 age group were positively associated with the number of abortion providers in a state. The level of antiabortion activities and antiabortion attitudes were negatively associated with the number of abortion providers in a state. Also, a state’s abortion rate was positively associated with the number of abortion providers. The enforcement of a parental involvement law by a state significantly deters physicians or organizations from becoming or remaining abortion providers. JEL Classifications: I11, I18, K32, K38

Measuring the Chilling Effect

Supreme Court doctrine grants special protection against laws that “chill” protected speech, most prominently via the overbreadth doctrine. The overbreadth doctrine permits persons whose own speech is unprotected to challenge laws that infringe the protected speech of third parties. The Court has not generally applied overbreadth and the other speech-protective doctrines to other constitutional rights even though other rights could also be subject to a chilling effect. The case law simply assumes that the chilling effect only acts on the exercise of speech, and that this justifies treating speech differently from other rights.We tested these assumptions with respect to abortion rights. By comparing abortion rates with state laws over a two-decade-plus period, we found a statistically significant correlation between laws forbidding late-term abortions and the reduction of not only late-term but also “near-late-term” abortions, i.e., abortions in the roughly one month before the period in which abortions are forbidden. That effect persists even after controlling for potentially confounding variables, such as the number of abortion providers and pro-life public opinion. Moreover, the effect is not limited to the year of enactment or associated with failed policy initiatives, suggesting that the impact is due to the law itself rather than associated publicity. These findings are consistent with, and strongly suggestive of, a chilling effect on abortion providers and/or women seeking abortions. This result undermines the implicit assumption that the chilling effect is unique to laws regulating speech and vindicates the general proposition that laws can chill the exercise of constitutional rights beyond their literal coverage.

The Impact of Antiabortion Criminal Activities and State Abortion Policies on Abortion Providers in the United States

This study empirically examined whether acts of antiabortion criminal activities and restrictive state abortion laws had an impact on the number of abortion providers. Using a unique data set, the Feminist Majority Foundation’s 2000 survey of antiabortion criminal acts directed at clinics, providers, healthcare workers and patients, the empirical results showed that acts of violence and harassment reduced the number of abortion providers offering abortion services. An increase in the likelihood of violence or harassment by 10 % reduced the number of abortion providers per 100,000 women of reproductive age by 5.6 and 3.7 %, respectively and the number of abortion providers per 100,000 pregnancies by 7.8 and 5.9 %, respectively. In addition, antiabortion criminal acts were more likely in states with greater economic participation by women, higher levels of sexual violence against women, and western states.

Research Note: Ecological Study of Selected Predictors and Abortion Rates by State, 2005

This ecological study compares 2005 abortion rates by state to a number of variables thought to be related to abortion. Higher abortion rates were observed in states having: 1) larger vote for Democratic Party candidate for president, 2) higher percent Catholic population, 3) higher black population, 4) lower income, and 5) higher number of abortion providers.

The Relationship Between State Abortion Policies and Abortion Providers

This study empirically examines whether restrictive state abortion laws have an impact on the number of abortion providers over the period 1982–2005. The empirical results find that medicaid funding restrictions, parental involvement laws and targeted regulation of abortion providers (TRAP laws) annual licensing fees significantly deter physicians or organizations from becoming or remaining abortion providers. The numerical impact of a Medicaid funding restriction, parental involvement law and a TRAP licensing fee is to reduce the number of abortion providers per 100,000 pregnancies by 12.8, 19.6 and 15.5, respectively, as compared to states without these restrictive abortion laws. The empirical results also show that parental notification laws have a significantly larger negative impact on the number of abortion providers than parental consent laws.

Trends in Abortion in the United States

The US abortion rate peaked soon after 1973, remained fairly constant through the 1980s, and began a steady decline to 2005. A substantial drop in the abortion rates of teenagers and women ages 20 to 24 accounts for much of the decline from 1989 to 2004. All race and ethnic groups experienced declines in abortion rates over the past 30 years, but the rate of black, and to a lesser extent Hispanic, women remains higher than that of non-Hispanic whites. The number of abortion providers has declined in recent decades, but the introduction of early medical abortion may have slowed this trend.

The Role of Advanced Practice Clinicians in the Availability of Abortion Services in the United States

Although abortion is one of the most common surgical procedures performed in the United States, the number of abortion providers is declining. Advanced practice clinicians, including nurse practitioners and certified nurse-midwives, may help to alleviate this shortage. However, some states bar nonphysicians from performing abortions. Not only should training in abortion techniques be made available to nonphysician providers who desire it, but legal obstacles must also be overcome in order to allow advanced practice clinicians the right to provide abortion services.

Regulation and the optimal size and type of abortion provider

Between 1973 (the year the Supreme Court ruled in Roe v. Wade that women have the right to decide whether or not to terminate their pregnancies) and 1982, the number of abortion providers increased by 81 per cent. However, between 1982 and 1992, a period of increasing state-level abortion regulation, the number of abortion providers decreased by 18 per cent. We know very little about the factors that influence the willingness and ability of hospitals, clinics, and physicians to provide abortion services over time. Based on state data from 1978 to 1992, the results of this paper suggest that large abortion providers are better able to compete and survive in the market. Also clinics and physicians' offices appear to be gaining market share relative to hospitals. Further, this paper includes analysis of the impact of state-level Medicaid funding regulations on the number, size, and type of abortion provider. These results have important implications for women's access to abortion services and thus have important implications for infant and maternal health.

Abortion Incidence and Services in the United States, 1995-1996

In the 1980s, the number of abortion providers in the United States began to decline, and more recently, so has the number of abortions performed. Whether the decline in service providers, which was last documented in 1992, is continuing and whether this influences the availability and number of abortions is of public interest. In 1997, the Alan Guttmacher Institute conducted its 12th survey of all known abortion providers in the United States. The number and location of abortion providers and abortions were tabulated for 1995 and 1996, and trends were calculated by comparing these data with those from earlier surveys. Limited data were also gathered on types of abortion procedures. Between 1992 and 1996, the number of abortions fell from 1,529,000 to 1,366,000, and the abortion rate decreased from 26 to 23 per 1,000 women aged 15-44. The number of providers fell 14%, to 2,042, with the greatest decline among hospitals and physicians' offices rather than clinics. Eighty-six percent of counties had no known abortion provider, and 32% of women aged 15-44 lived in these counties. Of the country's 320 metropolitan areas, 89 had no known abortion provider, and for an additional 12, fewer than 50 abortions each were reported. Seventy percent of abortions were performed in specialized clinics and only 7% in hospitals. In the first half of 1997, early medical abortions were being offered in about 160 facilities, virtually all of which were also providers of surgical abortions. While abortion services in some areas of the country have declined since 1992 and many women continue to have limited access to providers, other factors have probably had more influence on the level of abortions performed. Early medical abortion methods are too new to be a measurable factor in abortion access.

The impact of state-level restrictions on abortion

This research examines 23 different laws passed by state governments in an effort to restrict the number of abortions. It assesses both laws passed and laws actually enforced after the Supreme Court permitted states to restrict access to abortion in 1989. None of the policy actions by state governments has had a significant impact on the incidence of abortion from 1982 to 1992. Abortion rates continue to reflect past abortion rates, the number of abortion providers, whether the state funds abortions for Medicaid-eligible women, urbanism, and racial composition of the population. Recent restrictive policies have not affected these trends.

Restrictions on Medicaid Funding of Abortion: Effects on Birth Weight and Pregnancy Resolutions

This study uses individual data from the 1980-89 National Longitudinal Survey of Youth (NLSY) and state and county level data on Medicaid funding for abortion and access to abortion services and prenatal care from the Alan Guttmacher Institute. The NLSY sample overrepresents the poor and African-Americans. This study estimates the probability that a pregnancy is carried to term and the effects of restrictions on Medicaid funding of abortion on birth weight and low birth weight. Reduced form models are used in the analysis. The analytical framework is based on models developed by Grossman and Joyce. Four models are used in the analyses. Findings indicate that restrictive laws had no significant effect on birth weight. The number of abortion providers was associated with significantly higher birth weights particularly among African-American women and low income women. The example of the effects among African American births of a 13 ounce gain revealed a decline in low birth weight from 11% to 4%. Other community measures with a statistically significant impact were the number of hospitals with prenatal care services in a county and the percentage of births to unmarried women which reduced birth weight by 14 ounces among low income women. Higher birth weight was associated with higher income the presence of a partner maternal height and maternal educational status. Lower birth weight was associated with being African-American and smoking during pregnancy. Southern African-American women and Southern low income women had higher birth weights. Results confirm that laws restricting Medicaid funding increased the probability that a pregnancy was carried to term particularly among some groups. Restrictive laws had little effect on birth weight or the incidence of low birth weight. Restrictive laws and enjoined laws had the same effect among White and high income women when the number of abortion providers was controlled for. Underreporting due to stigma is attributed to the finding that Medicaid funding had an effect on birth probabilities among high income women.

Abortion Services in the United States, 1991 and 1992

According to a survey by The Alan Guttmacher Institute, 1,529,000 abortions were performed in 1992, the lowest number of abortions since 1979. The abortion rate has gradually declined, from a high of 29 per 1,000 women of reproductive age in 1981 to 26 per 1,000 in 1992. The number of hospitals, clinics and physicians' offices that provide abortions--2,380 in 1992--has been declining at a rate of about 65 a year. Most of the decline has occurred among hospitals; the number providing abortions decreased by 18% between 1988 and 1992. Most U.S. counties (84%) have no known abortion provider, and in nonmetropolitan areas, 94% of counties have no provider. Among metropolitan areas, 33% have either no abortion provider or none that serves at least 50 women per year. Among states, North Dakota and South Dakota have only one provider each. Most abortions (69%) are performed in abortion clinics, and only 7% are performed in hospitals. Fewer than 1% of women who have an abortion are hospitalized for the procedure.

An epidemic of antiabortion violence in the United States

From 1977 to 1988, an epidemic of antiabortion violence took place in the United States, involving 110 cases of arson, firebombing, or bombing. The epidemic peaked in 1984, when there were 29 attacks. Nearly all sites (98%) were clinics that provided abortions. Facilities in 28 states and the District of Columbia were involved. The national rate of violence was 3.7 per 100 abortion providers and 7.2 per 100 nonhospital abortion providers. The national ratio of violence per 100,000 abortions performed was 0.6 Arson was both the most frequent (39% of all cases) and the most damaging (mean cost $141,000) type of violence. The epidemic appears partially attributable to multiple point-source outbreaks of violence caused by small numbers of individuals or groups. Thirty-three persons have been convicted to date. Vigorous prosecution of perpetrators and the reemergence of clinics after damage probably helped to curb the epidemic.

Abortion Services in the United States, 1984 and 1985

In 1984 and 1985, the number of abortions, the abortion rate and the abortion ratio stayed at approximately the same levels as in the previous three years. Just under 1.6 million abortions were performed, about three percent of women of reproductive age obtained an abortion, and about 30 percent of pregnancies (excluding those ending in stillbirths and miscarriages) were terminated by abortion. However, the number of abortion providers declined by five percent between 1982 and 1985, and the geographic distribution of abortion services continued to be markedly uneven. Eighty-two percent of all U.S. counties--50 percent of those classified as metropolitan and 91 percent of those classified as nonmetropolitan--lacked an abortion provider in 1985. The long-term trend away from hospital abortions persisted during the period: Eighty-seven percent of the abortions performed in 1985 were done in nonhospital facilities, an increase of five percentage points over the 1982 level. Although abortion clinics constituted only 15 percent of all providers, they were responsible for 60 percent of the procedures performed in 1985. Among all abortion facilities, only 43 percent provided services to women after the 12th week of pregnancy. Abortion clinics were far more likely to offer second-trimester procedures than were other types of abortion providers (75 percent, compared with 13-50 percent). As of mid-1986, charges for a first-trimester nonhospital abortion ranged from $75 to nearly $900. The average amount paid was $213. In 1985, only 39 percent of nonhospital abortion facilities accepted state reimbursement for abortions provided to low-income women, and only 55 percent of facilities offered some reduction in charges to such women.