There were many profoundly encouraging results in Guttmacher’s latest abortion report for 2011– 1.06 million abortions, a drop of 13% since 2008 and 550,000 fewer abortions than the high water mark of 1.6 million in 1990, along with abortion rates and abortion ratios lower than they had been since the early days of Roe.
The portents are not all good, however. One development documented in “Abortion Incidence and Service Availability in the United States, 2011” is the continued increase in the number of chemical abortions–and a sizeable number of clinics offering these even when they did not perform surgical abortions.
Chemical abortions involve the use of drugs to kill and expel the unborn child from the mother’s uterus. They are bloody, painful, and take a long time. But as long as nothing goes wrong (there are frequent complications), these promise clinics the chance at easy money, as these officially require no special surgical skills or facilities.
Growth in Chemical Abortion
According to Guttmacher, in 2008, there were 199,000 chemical or “early medication” abortions (about 16.4% of all abortions).
In this latest report looking at abortions in 2011, while abortions overall shrank by 13%, there was a large increase in chemical abortions–there were 239,400, to be specific. This is 20% more than there were just three years earlier. Chemical abortions now account for 22.6% of the total number of abortions.
This is only the latest spurt in steady growth that has been occurring for more than a decade, a decade which otherwise saw abortions drop from 1,313,000 abortions in 2000 to 1,058,490 for 2011.
The key event initiating this rising tide of chemical abortions was the approval of the abortifacient RU-486 (mifepristone) by the U.S. government in September of 2000.
Growth in early chemical abortions was slow, but steady. In 2001 there were about 70,500 chemical abortions (5.5% of the total). By 2005 the number had increased to 161,100 (about 13.4%). By 2011 we are already looking at nearly a quarter of a million.
Why is this important? It is not simply the increasing numbers of these abortions that are disturbing, but that this growing market is helping to maintain and restock the pool of abortionists that keep the industry going.
By 2005, the number of “providers” in the U.S. had dropped to 1,787, 2% percent less than the figure from 2000. But the number of those offering and performing chemical abortions had risen to 1,026, an increase of roughly 70%.
In its report for 2005, Guttmacher noted that the number of “providers” would have declined by 8% if not for the new doctors adding chemical abortions to what they were already doing.
Most of these were abortion clinics that added the chemical method to their surgical abortion offerings. But not all. Some represented doctors or health clinics who’d made the decision to become abortionists.
Guttmacher’s Rachel K. Jones and Jenna Jerman say that the number of overall abortion “providers” fell from 1,787 in 2005 to 1,720 in 2011, but their data show that the number of “providers” offering early chemical abortions was virtually unchanged:1,026 in 2005, 1,023 in 2011.
Caseloads offer a clue
Guttmacher sorts out its abortion “providers” by caseload—from very small to very large. And this yields some concerning information when it comes to chemical abortions.
Despite the aforementioned 13% drop in abortions from 2008 to 2011, the number of chemical abortions grew in virtually every category. (The only exception was for “providers” with caseloads of less than 30; these remained the same.)
Notice something critical, however. The 150,000 drop in overall abortions in that three year period occurred almost entirely among those “providers” with “caseloads” of a thousand or more abortions; there was a loss of 47 of those “providers” over this period. Despite that loss, this group saw its number of chemical abortions rise, from 139,300 in 2008 to 163,100 in 2011.
Meanwhile, the group of “providers” who performed 30-999 abortions a year was relatively unchanged; 759 in 2008, 761 in 2011. This group saw its chemical abortions increase by 25% during that same time frame, going from 58,600 to 73,400.
This hints at something very significant. Given the large increase in the number of chemical abortions across the board, had there not been an unexplained closure of several large abortion mills (as we discussed in Part Two), the number of abortions might not have gone down but up.
More ways to chemically kill
Since going on the U.S. market in 2000, RU-486 has become what most people think about when they think of chemical abortions. But as Guttmacher mentions in this latest report, there are other methods.
While Guttmacher says that 98% of “early medication abortions” were done with mifepristone (RU-486), it says that the rest were done with “methotrexate or misoprostol alone.” We don’t know how much rounding was involved, but 2% works out to about 4,788 abortions with these other chemical methods.
The use of methotrexate, an anti-cancer agent, for abortions largely disappeared when RU-486 gained approval. Methotrexate wasn’t as “effective” as the new drug; it took longer than RU-486 abortions; and abortionists were concerned about methotrexate’s inherent toxicity.
Guttmacher’s latest report tells us that there are still some abortionists using methotrexate, however. One we know of was Steven Brigham, the rogue abortionist recently featured in The New Yorker (see our review of that article here). According to reporter Eyal Press, Brigham was found to be using methotrexate in the chemical abortions his clinic was selling because it was cheaper. His patients were showing up at other abortion clinics still pregnant.
Misoprostol is a different story. Readily available as a common anti-ulcer drug, it came to be used in conjunction with RU-486 (mifepristone) because misoprostol possessed another important property: it was a prostaglandin that could be used to trigger powerful uterine contractions. Used together, the mifepristone would starve the child and misoprostol would expel the tiny corpse from the woman’s uterus.
What we read in Guttmacher’s report and know from evidence around the globe is that there are abortionists who are skipping the expensive mifepristone pill (about $90 a pill) and just using the much cheaper misoprostol.
Some of these are being prescribed in abortionist’s offices, but there are indications that these are also being sold on the black market, at flea markets and the like, to women who don’t want to deal with the time and expense of going to an abortion clinic.
Guttmacher admits at being unable to count these “do-it-yourself” abortions, though do not be surprised if more and more of these women show up at your local emergency rooms.