Abortion numbers drop 40% in seven years in Iowa

The number of Iowa women obtaining abortions continues to plummet, even as national arguments over abortion rekindle.

The abortion rate decline is dramatic, if unheralded.

The number of abortions performed in Iowa dropped nearly 9 percent from 2013 to 2014, according to figures released last week by the Iowa Department of Public Health. The 2014 total of 4,020 reflects a 40 percent decline since 2007, when 6,649 abortions were performed in the state.

The drop in abortions is not mainly due to more pregnant women choosing to give birth, the new statistics suggest. In fact, Iowa’s birth rate has remained fairly flat since falling during the recession starting in 2008.

In 2014, the number of babies born here crept up less than 2 percent, to 39,685, the health department says. The annual total remained nearly 3 percent lower than the 2007 total of 40,835.

“Abortion is going down because women are able to avoid unintended pregnancies,” said Rachel Jones, a researcher for the Guttmacher Institute.

The abortion decline coincides with a continued plunge in the number of Iowa teens giving birth. It also has happened as access to abortion services has expanded.

A controversial telemedicine system, which started in 2008, allows patients at small-town clinics to obtain abortion pills via a video linkup with doctors at urban offices at Planned Parenthood, which is the state’s main abortion provider. Although Planned Parenthood has closed several of the rural clinics using that system, abortion services are available in several more Iowa towns today than in 2007.

The tumbling rates, including last year’s 9 percent drop in Iowa, bring rare joint applause from activists on both sides of the debate.

“That’s a big number. It’s definitely moving in the right direction,” said Jenifer Bowen, executive director of Iowa Right to Life. Bowen said she’s always a bit skeptical of state abortion statistics, because they rely on reports from Planned Parenthood and other abortion providers. But she said figures nationally reflect similar shifts.

“It’s obviously a positive trend, no matter how you look at it,” she said.

Bowen believes at least part of the reason for the decline is that more Americans are deciding abortion is wrong.

Planned Parenthood leaders say that while they vigorously support women’s right to choose abortion, they also try to help women avoid having to make that decision.

“We’ve been working hard over lo these many years to prevent unplanned pregnancy,” said Penny Dickey, chief clinical officer of Planned Parenthood of the Heartland.

RELATED: Iowa teen birth rate hits record low

Dickey said her Des Moines-based agency sees the falling abortion rate as a sign of progress. “It’d be nice if it dropped another 40 percent,” she said. “The fewer abortions women seek, the fewer abortions we’ll perform. That’s fine with us.”

Jones, the researcher for Guttemacher, which supports abortion rights, said it’s impossible to judge if Iowa’s latest abortion decline is steeper than that of other states. The most recent data are from 2011, but abortion clearly is becoming rarer across the country, she said.

Several experts credit increased use of long-term forms of birth control, such as intrauterine devices or hormone implants, for the abortion decline. Those methods can last for several years and are more foolproof than others, such as condoms or birth control pills, they said.

Debra Kane, an epidemiologist who works on child and maternal issues for the Iowa Department of Public Health, noted that an independent group did extensive work to encourage the use of long-term contraceptives in Iowa. The group, called the Iowa Initiative, used about $35 million in private grants to provide free long-term birth control devices to Iowa women between 2008 and 2012.

Although the project has wound down, Kane said, it encouraged many clinics to be involved in helping women obtain the more reliable contraceptives. “We were curious to see if the interest would drop after the funding ended, but the interest really has continued,” she said.

Long-term contraceptives, including intrauterine devices, were dogged by safety concerns years ago. But Kane and others said modern versions are much safer and are increasingly popular. “They’ve become really acceptable to women of all ages, including teenagers,” she said.

Dickey added that more insurance plans, including private carriers and Medicaid, are covering such devices. The increased coverage is partly due to rules in the Affordable Care Act, also known as Obamacare. Insurance coverage is important, because the devices can cost up to several hundred dollars, she said.

Some critics contend intrauterine devices essentially cause abortions by making the uterus an inhospitable place for a fertilized egg to implant.

“It depends on how you define when life begins,” said Maggie DeWitte, executive director of Iowans for Life. “In our definition, that’s an abortion, because we define life as starting at conception.”

No one counts how many fertilized eggs are expelled because of IUDs, she said, so the health department's abortion numbers don’t reflect the whole picture. However, she agreed with Bowen that if the new statistics are accurate, they could be good news. “Any time the number of abortions is down, that’s a win for everybody,” she said.

Supporters of IUDs dispute the notion that they mainly work by preventing implantation of fertilized eggs. They say the main effect of the devices is to prevent ovulation of eggs before fertilization.

Bowen said she hopes that when 2015’s abortion rate is published, Iowans will see an even bigger drop. She noted the recent national controversy over Planned Parenthood, fueled by videos that opponents say show agency leaders dickering over prices for parts of aborted fetuses to be used for research.

Those videos are making more women question the agency, she said. “They’re not comfortable with where Planned Parenthood is,” she said.

Bowen also said she hopes to see results from a bill the Legislature passed last spring, requiring abortion providers to offer women the chance to see an ultrasound image before undergoing the procedure.

Abortion-rights supporters say patients already were routinely offered the opportunity to see ultrasounds. They also say the undercover videos of Planned Parenthood officials were heavily edited to falsely imply the agency was breaking the law instead of simply trying to cover the cost of retaining tissue for legitimate medical research.

Planned Parenthood of the Heartland, which is Iowa's chapter, says that while it supports such research, it does not provide tissue for it.