May 23, 2011 / 10:03 PM / in 8 years

U.S. abortion rate down, but up among poor women

NEW YORK (Reuters Health) - Abortion rates have gone down in most groups of U.S. women, but not among poor women, a new study shows. Among the lowest-income women, abortions are still on the rise.

The news about high levels of abortion use by poor women comes as the federal and state governments begin to make funding cuts that could limit this sector’s access to family planning services.

Between 2000 and 2008, for U.S. women ages 15 to 44, the national abortion rate declined from 21 abortions for every 1,000 women to 20 per 1,000.

The decline continued a pattern seen since 1990, with the overall abortion rate among U.S. women decreasing each year.

The exception, however, has been poor women, whose rate of abortion increased in the 1990s.

And the new study, reported in the journal Obstetrics & Gynecology, found that the trend is continuing.

Between 2000 and 2008, the abortion rate among the lowest-income women climbed from 44 to 53 abortions per 1,000 women.

The poorest women were those with a family income below 100 percent of the federal poverty line. By 2008, they accounted for 16 of every 100 U.S. women ages 15 to 44, but for 42 of every 100 abortions.

“We weren’t necessarily surprised by the findings, because they’re a continuation of what we’d seen in the 1990s,” said lead researcher Rachel K. Jones of the Guttmacher Institute, a New York-based non-profit organization that studies reproductive health issues.

It’s not clear why poor women are having more abortions even as the national rate falls, according to Jones.

One factor in recent years, she told Reuters Health, could be the economic recession, which likely hit the poorest women the hardest. They may have been less able to afford contraception, or to support a child.

Whatever the reasons, Jones said the current findings clearly underscore a need to prevent more unplanned pregnancies among poor women. “We have not been improving poor women’s ability to access family planning service,” she said. “In fact, we’ve been making it harder.”

The recent federal budget deal included a 5.5 percent cut in funding for Title X, a 40-year-old federal program that helps low-income women get birth control and other services (but not abortions) at family planning clinics.

And a number of states, including Indiana, Kansas, Wisconsin and Tennessee, have either passed or are considering measures to cut state funding for family planning services — on the basis that some clinics also perform abortions.

But the rising rate of abortion among poor women argues against such cuts, according to Jones. “We need to be increasing funding for family planning services,” she said, “not decreasing it.”

Public funding for family planning comes from several different sources. The biggest chunk comes from Medicaid, the federal health insurance program for the poor, which accounts for 71 percent of public spending on family planning services, according to the Guttmacher Institute.

The Title X program, in contrast, accounts for about 12 percent, while state appropriations contribute 13 percent.

But reproductive health advocates have argued that Title X is a vital source of revenue for many family planning clinics, giving them the resources for things like outreach to low-income women — something Medicaid coverage cannot do.

SOURCE: Obstetrics & Gynecology, online May 23, 2011.

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