Number of abortions in Iowa continue to decrease...but why?

Is it a cultural shift or a sign that pregnancies are down?

Anti-abortion and abortion rights supporters hold signs and chant Monday, Feb. 27, 2017, as a Senate subcommittee discus
Anti-abortion and abortion rights supporters hold signs and chant Monday, Feb. 27, 2017, as a Senate subcommittee discusses a bill that would make “life begin at conception” a the Iowa State Capitol in Des Moines.

DES MOINES — The number of surgically and medically induced abortions performed in Iowa dropped last year to the lowest level since health officials were directed to begin keeping annual data in 2003.

Preliminary data compiled by the state Department of Public Health shows that 2,849 pregnancies were terminated in 2018 — the lowest total since 6,728 abortions were reported in 2006 and the 12th consecutive year of annual declines.

“There has been a dramatic reduction in the number of elective terminations,” said Debbie Kane, the Iowa Department of Public Health’s maternal and child health epidemiologist.

Reasons given for the steady decline vary — ranging from advances in contraceptive awareness, education and effectiveness to improvements in ultrasound imaging technology and what groups against abortion rights perceive as a cultural shift.

Kane said a number of factors likely have contributed to the downward trend, but a leading influence has been a concerted effort to better connect women of childbearing age to family planning services and effective contraceptives that have lowered the number of unintended pregnancies in Iowa.

“There is a lot more education around sexuality and decision-making and healthy relationships, so I think to attribute it to one thing would be really hard,” Kane said.

Iowa was part of a five-year demonstration project starting in 2007 that introduced women between the ages of 18 and 35 to long-acting reversible contraceptive methods — like implants and intrauterine devices — that independent research indicates lowered the number of unintended pregnancies by 14 percent by 2011 and dropped the ratio of pregnancies terminated by abortion in Iowa by 21 percent during the study.


“It was dramatically effective,” said Sally Pederson, a former Iowa lieutenant governor who served as executive director for the Iowa Initiative to Reduce Unintended Pregnancies. “If you have fewer people with unintended pregnancies, there’s going to be fewer abortions.”

Although the initiative ended in 2012, Kane said many of the contraceptive methods were good for up to five years or longer and also have been promoted later as effective and affordable ways to avoid unintended pregnancies.

The result has been a year-by-year reduction in the number of elective abortions performed in Iowa, according to health department data that gradually has lowered the annual total by 3,879 over the last 12 years.

Induced termination is defined by the agency as “abortion brought on intentionally by medication or instrumentation.” The department began tracking medically induced terminations based on legislation enacted in 2003, according to officials.

The new data comes amid a national debate over a growing number of state restrictions being enacted with the goal of getting the issue back before the U.S. Supreme Court. In 1973, justices struck down state laws banning abortion in the Roe v. Wade decision.

Iowa laws impose restrictions including banning procedures after 20 weeks of pregnancy, setting parental notification guidelines for minors seeking to terminate a pregnancy, requiring an abortion provider to perform an ultrasound on each person seeking an abortion and offering the pregnant woman the opportunity to view the image, and restricting public funding for abortions only in cases of life endangerment, rape, incest or fetal anomaly where the governor must approve each Medicaid-funded procedure.

However, Planned Parenthood of the Heartland, the American Civil Liberties Union of Iowa and others have successfully challenged as unconstitutional recent legislation that would have banned most abortions once a fetal heartbeat is detected, typically about after six weeks of pregnancy, and a separate law that would have required a woman seeking abortions at any stage of pregnancy to undergo a 72-hour waiting period.

Last month, a Polk County District judge temporarily blocked enforcement of a law set to take effect July 1 that would cut Planned Parenthood off from federal sex education funding.


The law, signed by Gov. Kim Reynolds, would exclude any organization that “provides or promotes abortion” from receiving two grants that support sex education and related services to Iowa youth.

A lawsuit filed by the American Civil Liberties Union of Iowa on behalf of Planned Parenthood of the Heartland argues the law is unconstitutional.

The Family Leader conservative organization, which has pushed for defunding Planned Parenthood, welcomed the latest data as a sign of a cultural shift.

“Of course, we’d like the number be zero. We’d like to see all of life protected but seeing that number go down when we’re looking at trends, that’s good news,” said Drew Zahn, communications director for the Family Leader. “When you see numbers declining that significantly over a long period of time steadily, we believe that’s more of an indication of changing attitudes about abortion than it is individual programs.”

Zahn said people have grown up with ultrasound technology more available and affordable. When Iowans experience “hearing the heartbeats of their younger brothers and sisters in the womb, they are much less likely to choose abortion as an option.”

Erin Davison-Rippey, Planned Parenthood state executive director for Iowa, noted that the number of live births in Iowa also has been declining, from 39,685 in 2014 to the preliminary total of 37,690 last year — which points to fewer women getting pregnant.

“With both births and abortions decreasing, it does kind of tell that story of the arc of fewer people getting pregnant and that is in line with what we’ve seen across the country,” she said.

Davison-Rippey said public opinion surveys continue to show strong support for the Roe v. Wade decision, adding “there is no data to support their claim” from Family Leader officials that the decline points to a cultural shift.


The Planned Parenthood official said the health agency numbers continue to indicate that fewer surgically induced abortions are taking place while abortions through medication — such as via telehealth services offered at her organization’s clinics — have sharply increased over the past decade.

Republicans in the 2017 Legislature took action that then-Gov. Terry Branstad approved to set aside $3 million in state money to create a new Family Planning Program with providers that don’t offer abortions — a move to defund Planned Parenthood that resulted in the organization closing facilities in Sioux City, Burlington, Bettendorf and Keokuk.

Davison-Rippey said participation rates in the new state program are down and only time will tell what impact that might have on future data, given that some clients were able to access long-acting reversible contraceptives with effectiveness spanning a number of years.

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