It’s been almost 49 years since the Supreme Court issued its ruling in Roe v. Wade on January 22, 1973. And in the half-century since abortion became a constitutional right, a lot has changed. Clinics have closed, restrictions have mounted and abortion has become one of the most polarizing issues in American politics. At the same time, women are receiving far fewer abortions than they were in the past.
But something else has changed, too: the women who are seeking abortions.
According to our analysis of data from the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, a research organization that supports abortion rights, the profile of women who receive abortions has changed in important ways since 1973. Some of those shifts reflect wider changes in the country’s population, but others cut against long-held stereotypes about abortion.
For instance, in the years after Roe v. Wade, the abortion rate spiked — but then it began to fall.
One obvious explanation for this trend is that state-level abortion restrictions started to ramp up in the 1990s and rose to a fever pitch after Republicans swept state legislatures in 2010 and began passing a barrage of anti-abortion legislation. Researchers who study abortion say that increases in contraceptive access — particularly long-acting contraceptives, like IUDs — are almost certainly contributing as well, by reducing the number of unplanned pregnancies.
But even though fewer women are relying on abortion, hundreds of thousands of pregnancies are still terminated every year. And as the number of abortions has shrunk, the population of women who receive abortions has grown less vulnerable in some ways — but much more vulnerable in others.
One of the most striking changes following Roe has been the dramatic decline in the share of abortion patients who are teenagers. This is one trend that doesn’t have much to do with abortion restrictions, either. It’s mainly that fewer teens are getting pregnant in the first place, while the population of women who get abortions is now skewing older.
The dramatic drop in the share of teen abortions isn’t an isolated occurrence — teen pregnancies and births have declined substantially over the past few decades. Both trends have a similar explanation, though. “It seems to be due to improved contraceptive use among adolescents,” said Rachel Jones, a researcher at the Guttmacher Institute. And it is likely also related to the fact that teenagers are just having less sex than they used to.
Although abortions are now tilted more toward older patients, the women who do choose to end their pregnancies are increasingly likely to be lower-income. The CDC doesn’t collect data about abortion patients’ income, so our ability to track this trend is more limited, but two decades of surveys by the Guttmacher Institute show a clear uptick in the share of abortion patients who are poor.
Part of this trend is likely due to growing economic inequality in the U.S.; there are more lower-income women now, so it makes sense they would take up a larger share. But there are lots of other reasons why poorer women would be increasingly likely to seek an abortion. For one thing, although the Affordable Care Act did make birth control more affordable, it’s still not as accessible for poor women. Not coincidentally, poorer women are also more likely to experience unintended pregnancies. Moreover, poverty itself is also a reason why many women end pregnancies; many abortion patients say that they’re ending their pregnancy simply because they can’t afford another child.
This is one reason why abortion restrictions are so difficult for women to navigate. State-imposed hurdles aren’t just inconvenient — they’re costly. Abortion is rarely covered by insurance, due to a web of state and federal restrictions. Because of this, women who might have already struggled to afford an abortion may also have to lose work hours or travel longer distances in parts of the country where there are few abortion clinics and/or states require multiple visits.
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Caitlin Myers, an economist at Middlebury College who studies reproductive policies, said that the fact that it is often poorer women who get an abortion contributes to a lack of awareness about just how difficult it is to get an abortion in the U.S. right now. “As [abortion] is concentrated among this group of poor and low-income women, the rest of us perhaps become more distant from it,” she said. And as a result, she added, it may be harder for most Americans to empathize with how difficult it is for many women who want an abortion to get one.
Given that lower-income women are also disproportionately likely to be women of color, the racial makeup of women who get abortions has also changed a lot. When abortion became nationally legal in 1973, most women who received abortions were white. Now, that share has decreased substantially.
One explanation for this trend is simple: Since the 1970s, the U.S. as a whole has gotten much more diverse. But it’s also reflective of the broader inequities that people of color face in all kinds of areas, including health care. The median wealth of white households is also much higher than the median wealth of Black and Hispanic households, and Black and Hispanic youth may be less likely to receive comprehensive sex education or have access to highly effective birth control. Additionally, women of color are generally more likely to have unintended pregnancies.
Other broad changes in American society have affected who gets abortions. Most women who have abortions are unmarried, and that’s been consistently true since abortion became legal. But according to the CDC, the share of married women who receive abortions has declined by almost half.
This makes sense, considering that Americans are much less likely to be married than they were 50 years ago. But it does mean that married women are underrepresented among people who have abortions, and unmarried women are overrepresented.
Being unmarried can mean a lot of things, though. Guttmacher’s 2014 survey of abortion patients helps fill in the picture a little more. About 31 percent of abortion patients in that survey were living with a partner; just over half weren’t living with a partner when they became pregnant. So while unmarried women are increasingly likely to have abortions, the shift isn’t as dramatic as it appears.
The political conversation about abortion in the U.S. often focuses on abortions performed later in pregnancy, but over time, most abortions have been happening earlier and earlier in pregnancy. Myers told us that’s for two reasons. “First, women have increased access to highly sensitive at-home pregnancy tests that make it easier for women to discover sooner that they’re pregnant,” she said.
The second reason is the introduction of medication abortion pills, which can be taken through most of the first trimester. “It makes abortion more accessible and also gives women an incentive to get it sooner,” Myers said.
In 2019, about four in 10 abortions happened at six weeks of pregnancy or earlier, according to the CDC, and more than 90 percent of abortions happened in the first trimester.
Meanwhile, second-trimester abortions — which were never very common — are happening even less frequently. In 1973, about 15 percent of abortions happened after 12 weeks, but the share that happened after 13 weeks was just 7 percent in 2019. One thing has been consistent over time, though — despite taking up an enormous amount of political oxygen — is that abortions after 20 weeks of pregnancy have always been exceedingly rare.
The fact that many abortions are happening in the earliest weeks of pregnancy helps explain why highly restrictive abortion laws, like a ban on abortion after about six weeks of pregnancy, which has been in place in Texas since September, haven’t completely stopped women from getting abortions. Most abortions these days, however, still happen after six weeks as some women don’t even know they’re pregnant at that point. And just because earlier abortions are still possible, that doesn’t make them easy. This is one reason why Texas’s law places an onerous burden on women, especially if they’re struggling to find money to pay for the procedure or get to a clinic.
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