Crunched: US abortion law, what the numbers tell us
Abortions legislation is becoming more restrictive in the US - but rates are following a different trend. The FT's John Burn-Murdoch and Federica Cocco look at the cold data behind this polarising issue
Produced and directed by Juliet Riddell, filmed and edited by Richard Topping
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Abortion has been in the news recently. And a lot of that is because over the last few months several US states have tried to restrict the situations when women can have an abortion.
Yeah, and I'm really puzzled by this because you'd think that there would be a reaction to abortion rates going up. But in fact, they're going down.
So the question is, why are these restrictions coming in? So this week, we're going to look at the cold facts on what's really going on behind these new restrictions on abortion. Let's begin in the US. Just in the year to date 2019 we've seen nine states passing bills to limit the circumstances under which women can have an abortion.
So the chart here, horizontally, is showing the number of weeks since the woman's last period under which an abortion would be permitted. So we've got from one week here on the left to about 24 weeks here on the right. The significance of that 24 weeks is that that's when people, medical professionals, talk about the foetus being viable. So it could survive outside of the womb with some assistance.
I'll put a couple of other markers in here. So six weeks, 12 weeks, and 18 weeks. Now, the standard has been for states to allow abortion up to around 24 weeks. But, in nine states they want to change that.
So we've got Alabama. Pretty extreme. Wants to roll down..
One week after your last period?
You're not even pregnant then.
Exactly. So that is essentially, for all intents and purposes, a ban on abortion. Alabama there is trying to roll that right back from 24 weeks to one week. Then we've got another five states trying to bring things back to six weeks.
Six to eight weeks is the period when a foetal heartbeat can be detected. So that's why we get a big clustering around there. Now, is there anything that you notice about those nine states?
They are all red states, aren't they?
They are all red states. That wasn't just an accident colouring them in red. So these are all states where Donald Trump won the majority vote in 2016. They've got Republican legislatures. So there's a sort of political slant here to what's going on.
And there's another stat here which is significant that shows that there's a political aspect to this. So 59 per cent of Republicans believe that abortion should be illegal in most, if not all, cases. But it's only 21 per cent of Democrats. So there's a clear political slant going on here.
And in the meantime Democratic states are actually relaxing the restrictions. So the country is just going in two different directions, which kind of proves your point that this seems to be more political. A lot of women won't know that they're pregnant at six weeks.
So some women have irregular periods. So they might not have had a missed period. Or they might not think anything about it. I mean, there's a lot of complications involved. It's not as cut and dried as these legislations seem to present it.
Yeah. So you'd have very little time to actually make that very difficult decision. And in the US, in some cases the nearest abortion clinic is 100 miles away, anyway. So it's...
Especially in these states.
OK, so let's have a look at what's happened in the US. I've got statistics on the abortion rates in the US going back to 1970, just before Roe v. Wade was introduced and passed in the Supreme Court. So this is abortions per 1,000 live births.
So obviously they weren't reporting illegal abortions back then, so the numbers are a bit flaky. But what happened is they were here in 1973, when Roe v. Wade passed. And then they shot up. Did they shoot up because more women were having abortions or because it was reported more efficiently? Your guess is as good as mine.
But they just stay like this, stable. And then they go down, down. And it's a long-term decline to about 20 per 1,000 live births. And so that's where we are now. But as you can see, they are going down, which is why I ask myself why are they introducing these legislations now? Because clearly, with the advent of contraception and women making more empowered decisions on their lives, maybe being even more aware of their periods through apps and so on, what's happening is that it's declining on its own without any need for the state to intervene.
But what's interesting is, let's look at another country, because in the UK the trend is actually very different from this, even though we're a liberal country where abortions are allowed and paid for by public healthcare. We're going to have a look at stats from the same period.
And this is abortions per 1,000 women. So not quite the same rate. But we're interested in the trend. Two, four, et cetera.
Abortion was introduced around the same period in the UK. So we have a low reporting date. And then it was introduced. And they go up. They go up and up and up and up. And then around 2000 they sort of hit a lull. We see them starting to go down.
And going back up again. The long-term trend, if we compare it with the US, is inverted completely because it's going up. So we have a permissive state where abortion rates are going up. So what's going on?
And so this is where we need to start talking about some peculiarities, as it were, of the UK. So the UK, we've got Britain. We've also got Northern Ireland. And the key factor here is the very different laws in Northern Ireland. So you might look at that little upward spike in 2017.
Let's do what I like to call a Cocco loop.
Fantastic. Not seen one of those in while.
We zoom in. And we create a separate chart.
Where we look at what's going on in here.
So these are stats by quarter.
Right. So the really interesting thing here is a small percentage, but a significant number nonetheless, of the abortions here taking place in Great Britain are women who've come over from Northern Ireland. And the significance of that little spike in 2017 is that in June 2017, the UK government passed a law which stated that the British government will now pay for women to come to Britain from Northern Ireland and will pay for the abortion procedure as well.
So when we look at the numbers of Northern Irish women who've been coming to the UK for abortions, in Q1 2016 that was about 200. It was then just under 200 in Q2. And then to around 150 in the third and fourth quarters. First quarter of 2017 up a little bit. Second quarter, up to about 150.
This was when the law then came in, paying for Northern Irish women to come over. And we get a big jumps So both on the previous quarter and compared to the year before, we are now getting a couple of hundred more Northern Irish people coming over every three months to have abortions here. So one possible reason that what had been a slight decline from 2007 to 2016, one potential reason that that has now gone back in the other direction is Great Britain now allowing or making it easier for people to come in from outside the country and get the procedure done in a safer and more friendly environment.
So what we have here clearly is an established phenomenon in this country which is women crossing borders to a place where they can have a safe abortion, which is, I wouldn't say incentivised, but it's increased by the fact that the state is also paying for it now. This phenomenon means that restricting abortions is effectively brushing the problem under the carpet. Let someone else take care of it. And we have evidence that this is starting to happen in the United States as well.
That's right. So this is where I'm going to reach over and get our friendly globe prop. What we've done here, in Blue Peter fashion, here's what I prepared earlier. We've got some pins here showing a selection of the US states where there are fairly restrictive laws in place around abortion.
And what you'll notice is these form a ring. And in the centre of that ring, we have the state of Illinois, where Chicago is. And that has essentially become seen as a bit of a safe haven for women in the surrounding states who want to get an abortion. So in 2017, there were almost 6,000 women who came into Illinois to get an abortion from the surrounding states.
From one of these states.
From one of these states into the middle. So it's clear that wherever we are in the world, as you were saying beforehand, by imposing tighter restrictions on abortion you're not stopping them happening. You're simply pushing them elsewhere, using other people's resources and forcing people to go on long, expensive, stressful journeys to have a procedure which otherwise could have been had more easily.
And the second thing that happens is that when people do have abortions, because this still happens, then these become much less safe procedures. So the Guttmacher Institute, which is a think-tank that focuses on abortion, has looked at what's happening worldwide. And they grouped countries by how restrictive their abortion laws were. And then they looked at what percentage of abortions in those countries, in those groups of countries, were safe.
So we've got three sets of countries, least restrictive, moderately restrictive, and then most restrictive. In the least restrictive countries, a minimal slice are unsafe. Safe abortions would be ones where you have a trained practitioner carrying out the abortion and using safe methods. Less safe are where only one of these categories are met. And least safe are where two of these categories aren't met.
So in least restrictive countries, we have around 1 per cent of these abortions being least safe. So that's the most dangerous category. In moderately restrictive countries, the pie looks a bit larger. It's 17 per cent. And in the most restrictive countries, it's nearly a third. So it's 31 per cent.
So in these countries where there are heavy restrictions on when and how a woman can have an abortion, almost one in three of those are carried out in dangerous circumstances. So as you were saying, the current moves to make abortion more restrictive, more difficult to obtain in, for example, parts of America, one of the products of that is likely to be putting women in more dangerous situations.
This chart alone, and the others that we've looked at, show that restricting abortion is just brushing the issue under the carpet. Women are still going to require to have abortions. They might not be equipped to have a family. They might require them for health reasons. Or maybe they've been raped.
Who knows? Life is complex. And the public healthcare system needs to help them rather than make these procedures so unsafe and requiring them to cross borders.
Right. And as we've seen earlier, the abortion rates have been falling anyway. So it's not as though by making restrictions more liberal and by making procedures safe, it's not as though that has led to this continuous increase in the number of people having abortions.
So to sum up, I guess, what we're seeing here is more restrictions - but restrictions that seem to be motivated primarily by political reasons and restrictions that are either simply going to force women to take stressful, dangerous and expensive trips elsewhere - are going to force them to have those same abortions that they need in more dangerous situations. So what we're essentially talking about is legislators pushing at an open door to reduce abortion rates, which are already falling. And then they're still having this side effect of making it more expensive and dangerous.