Apart from some radical outliers, most folks with pro-choice views regard abortion as a necessary evil. Apart from moral considerations, it’s evil because for the mother it’s gut-wrenching, risky and stigmatized. But it’s necessary because there are so many of these women.

It’s a curious fact, but despite the intensity of the debate over abortion in the United States, not much is known about women who have abortions. Public policy is shaped by assumptions supported by many poignant anecdotes, but not by much rigorous data.

For instance, last year the New York Times asked “who gets abortions in America?” That’s a big question for a country of 330 million, but two of its answers stand out.

First, America’s newspaper of record states that: “Six in 10 women who have abortions are already mothers, and half of them have two or more children”.

Second, “25 percent of women will have an abortion by the end of their childbearing years”.

This is a fair summary of the conventional wisdom. Most women who have abortions are mothers and a huge proportion of women will have an abortion at some point in their lives. Since the numbers are so huge and the procedure is so common, abortion is clearly a necessary evil.

Questioning the narrative

But what if the conventional wisdom is not true?

In 2021 several scholars, mostly associated with the Charlotte Lozier Institute, a pro-life think tank, studied Medicaid data on women who had abortions between 1999 and 2014. Their analysis, with the formidable title of “Estimating the Period Prevalence of Mothers Who Have Abortions: A Population Based Study of Inclusive Pregnancy Outcomes”, was published in the journal Health Services Research and Managerial Epidemiology.

They examined numbers representing 15 years of the reproductive histories of 4,884,101 women with 7,799,784 “pregnancy outcomes” — meaning births, abortions, miscarriages, and “unknown”.

What they found differed radically from the media consensus. Why? One reason is that they relied on Medicaid data. Most statistics cited in the media are based on surveys of women’s intentions or memories, rather than what actually happened. But the Medicaid data represents real confirmed events. “No survey data comes close in terms of face validity or granularity,” the lead author of the Charlotte Lozier Institute study, James Studnicki, told MercatorNet in an email.

So, are most abortion patients really mothers, as the New York Times says? The media frequently makes claims like “the typical abortion patient is a mother.” But this is not what the Medicaid data showed. Here are the marquee results:

• Women who had live births but no abortions represented 74.2% of the study population and accounted for 87.6% of total births. In other words, three-quarters of women who become pregnant never have an abortion.

• Only 5.7% of the study population had both births and abortions; these women have 7.2% of total births. This shoots down the notion that “the typical abortion patient is a mother.”

• Women who have only abortions but no births constitute 6.6% of the study population, but they are 53.5% of women with abortions and have 51.5% of all abortions.

Let that sink in.

This is an astounding figure. If it is correct, there are women who have abortion after abortion after abortion. Some must be having as many as 10 or a dozen. Even a diehard supporter of abortion must surely concede that a dozen abortions could be damaging to a woman’s mental and even physical health.

Are these women being abused by boyfriends or pimps? Are they suffering from mental health disorders? Why aren’t abortion rights activists campaigning to rescue these women? They are not an insignificant statistical sliver. If the Medicaid data is right, they accounted for half of America’s abortions.

Public policy on abortion in the United States may be seriously misguided. When it is government funded, only small percentage of women “benefit”. But some of those have so many abortions that that they clearly need social or psychological help, not the phone number of a Planned Parenthood clinic.

Normalizing abortion

What about the normalization of abortion – the often-cited figure that one woman in four will eventually have one? This is a meme which is based on a 2017 study published in the American Journal of Public Health. It was written by researchers from the Guttmacher Institute, an abortion rights think tank, and based on data from the period between 2008 and 2014. Their surveys found that “nearly one in four women in the United States (23.7%) will have an abortion by age 45.”

That’s not what the Medicaid data showed.

After crunching the data, it appeared that only 12.3% of women have ever had an abortion, including both those with and without children. The authors admit that the two figures are not directly comparable, but they point out that “this number is half the estimate of the often-reported lifetime abortion incidence (24%), also derived from projections based on survey data.”

Yes, the Medicaid database has limitations. The authors acknowledge this. Amongst them is the fact that it tends to capture the experience of low-income women. Higher-income women who pay out of pocket are invisible.

But this also means that abortion is not as “necessary” for low-income women as abortion activists would have us think. Three-quarters of them are unlikely ever to have an abortion. In fact, the authors say flatly that “abortion among low-income women with children is exceedingly uncommon, if not rare.”

The picture painted by the media – that abortion ought to be legal, safe and accessible – normalizes this choice. It happens to everyone; it’s part of life; mothers need them to take better care of the kids they already have.

But it’s false.

This study ought to ring alarm bells across America. If it is true, much of what Americans have believed about women’s need for abortion crumbles.

Most recent developments

Unfortunately, recent moves by the US Food and Drug Administration to make medication abortion, the so-called abortion pill, available in pharmacies will change the abortion landscape in unpredictable ways. Even though mifepristone and misoprostol are potent drugs, it will become harder to track their use if they are dispensed through tele-medicine.  

Chemical abortion is an “existential threat to abortion science”, Dr Studnicki told MercatorNet. It currently accounts for more than half of all abortions in the United States. “Unless we develop a national registry of pregnancy outcomes which can be linked to other datasets (health services, death registration, etc), soon we will literally have no idea how many induced abortions are occurring nor will we be able to track their adverse outcomes.”

“At that point,” he warns, “the abortion industry will be able to create its own narrative, unchallenged by objective, data-driven science.”

Michael Cook

Michael Cook is the editor of MercatorNet. He lives in Sydney, Australia.