Abortion Pill Use a Factor in Drop in U.S. Abortion Rate

The Supreme Court decision on the landmark Roe v. Wade case legalized abortion in America on January 22, 1973. That year, the legal abortion rate was 16.3 abortions per 1,000 women in the U.S. Since then, the abortion rate has fluctuated to as high as 19.4 in 2008 and to the current all-time low of 14.6 based on most recent data from 2014. While the exact reasons why the U.S. Abortion Rate Dropped 25% in Six Years have not yet been established, Support Circle has identified a number of contributing factors evidenced by recent data including:  Less Teen Intercourse, The Work of Pregnancy Centers, the Trend of Delayed Childbirth, and State Abortion Law Restrictions. The fifth factor is the rising popularity of the abortion pill.  Ironically, the growing prominence of the abortion pill has led to a burgeoning black market online for its illegal sale. This black market artificially masks the true U.S. abortion rate, as only legally obtained abortions count in the statistic.

There are two categories of abortion: surgical and medical.  Medical abortions are facilitated through the abortion pill.  More women seeking first trimester abortions are opting for medical abortions. According to Reuters research, medical abortions accounted for 43% of terminations at Planned Parenthood clinics in 2014, up from 35% from 2010. Medical abortions were performed more than surgical abortions in Michigan (55%) and Iowa (64%), states with few abortion restrictions.

California is another state with few abortion restrictions and where Medi-Cal pays abortion costs. For some women throughout the country, obtaining any type of abortion may not be as easy. Because of the barriers they face (i.e. state restrictions, limited abortion providers, living in remote locations, lack of finances, etc.) oftentimes, women may turn to online providers for the abortion pill.

FDA Regulations

Women who are less than 10 weeks pregnant may have a choice between a surgical abortion (D&C) performed in a licensed medical clinic or hospital, or a medical abortion which can be completed at home or outside a medical facility. The abortion pill is a two-drug regimen consisting of Mifepristone and Mifeprex, that have been approved by the Food and Drug Administration (FDA). The FDA-approved abortion pill process stipulates an ultrasound to date the pregnancy and confirm that it is not an ectopic pregnancy, obtaining the abortion pill regimen through a prescription from a medical provider, and a follow-up visit 7-14 days later to ensure the contents of the uterus were safely expunged. The FDA has approved this process for the safety of women’s health.

Black Market Skirts These Regulations

Abortion pills obtained on the internet without a prescription are illegal and potentially dangerous.  The allure is that they may be offered at a lower cost than local pharmacies and can be obtained in states with abortion laws restricting access to the abortion pill. Only legally obtained medical abortions are included in the official U.S. abortion rate, so, without regulation of online sales, it is difficult to gauge how much higher the abortion rate would be when taking into account black market abortion pills.

Disturbingly, black market abortion pills disregard the safety of women. Without regulation, the pills may not be exactly what the woman believes she ordered, ineffective, or cause adverse side effects. Abortion pills obtained online also bypass important safeguards including the ultrasound to verify and date the pregnancy as well as the follow-up visit to verify the contents of the uterus cleared completely.

Ultrasounds are important because the abortion pill does not work on ectopic pregnancies and the FDA has not approved the abortion pill for safe use after 10 weeks gestation.  Support Circle provides ultrasounds at no cost to our clients to officially verify and date pregnancies.

Without any data on how many abortion pills are sold online to women in America, it is impossible to make an accurate accounting of how many total abortions are performed each year. This means the U.S. abortion rate is most likely higher than assumed based on 2014 findings. But how much higher, we can’t know. Regardless, the general consensus is that the abortion rate has declined due to several concurrent factors, and the masking effect of the abortion pill black market does not negate this overall decline.


Helpful Links

US Abortion Rate Dropped 25% in Six Years

Factor One: Less Teen Intercourse

Factors Two and Three: Pregnancy Centers and Delayed Abortion

Factor Four: State Abortion Law Restrictions


Reference Links

FDA-Approved regimen to end early pregnancy

Reuters. Abortion by Prescription Rivals Surgery for U.S. Women. 2016

Cosmopolitan Magazine. Are abortion pills online safe?


State Abortion Law Restrictions a Factor in Drop in U.S. Abortion Rate


In our ongoing series on the factors behind why the US Abortion Rate Dropped 25% in Six Years, we have explored Factor One: Less Teen Intercourse, and Factors Two and Three: Pregnancy Centers and Delayed Childbearing. This article explores Factor Four: State Abortion Law Restrictions.

Since the Supreme Court passed Roe v. Wade in 1973, recognizing abortion as a woman’s constitutional right, thousands of laws have been brought before state and federal courts by each side of the abortion debate, either restricting abortions or permitting greater access to abortions. Restrictions vary from gestational limits, public and private insurance funding, provider refusal, counseling mandates, waiting periods, parental involvement, etc.

In recent years, there has been a steep increase in the number of abortion restrictions passed. A total of 231 new abortion restrictions were passed in the U.S. in the years 2011 to 2014. During this four-year period, state abortion restrictions were adopted at a faster rate than during the whole previous decade from 2001 to 2010 when a total of 189 restrictions were adopted.

The increase in state abortion restrictions does not appear to be slowing down. The Center for Reproductive Rights, which monitored over 2100 legislative proposals from 2010 to mid-2017, estimates that in 2016 alone, there were more than 500 abortion restrictions introduced by Republican state legislatures. Of those, 60 new restrictions passed in 19 states.

State abortion restrictions appear to have a clear correlation on the drop in the U.S. abortion rate. In 2014, the Centers for Disease Control (CDC) reported 652,639 legal abortions which is significantly less than the 730,322 legal abortions in 2011. This represents a faster four-year decrease in U.S. abortions than the previous decade from 2001 (853,485 abortions) to 2010 (765,651 abortions).

Although there has been a huge increase in state restrictions across the country, contributing to the drop in national abortion numbers, that is NOT the case here in California. California has not had as many abortion restrictions as other states. Interestingly, California’s abortion rate has not seen the same sharp decrease witnessed by the rest of the country, either. According to the Guttmacher Institute, which polls each abortion clinic in California every three years, California saw a slight decrease in 2014 with 157,350 legal abortions, from 181,730 legal abortions in 2011. During the previous decade from 2001 to 2010, California’s abortion rate ranged from 236,060 abortions in 2000 (closest year to 2001 data collected) to 191,550 abortions in 2010.

It will be interesting in the years ahead to see if there is a divergence between the California abortion rate and the overall U.S. abortion rate as California continues to experience all the other effects of the trends we have been talking about, including the work of pregnancy centers while abortion clinics are closing, less teen intercourse and delayed childbearing but NOT state restrictions. In fact, California has gone in the opposite direction of other states and passed laws to reduce restrictions on abortions.

There are multiple factors contributing to the decline in the U.S. abortion rate occurring concurrently. California is an instance where we can observe one factor in play while another is not. Going forward it will be interesting to see if the change in the California abortion rate has a noticeable difference compared to the other states since it has all the other factors in play but not the state abortion restrictions.


Helpful Links

  1. US Abortion Rate Dropped 25% in Six Years
  2. Factor One: Less Teen Intercourse
  3. Factors Two and Three: Pregnancy Centers and Delayed Abortion
  4. Schedule an Appointment



  1. Guttmacher Institute. State Policy Overview of Abortion Laws. 1/18
  2. Abortion Stats 2001 – 2014  CDC numbers do not include NH, CA, and at least one other state.
  3. Abortion bills by Congress
  4. Johnston Archive. California Abortion Historical Data
  5. Guttmacher Institute. Laws Governing Reproductive Health and Rights 2014 State Policy
  6. Center for Reproductive Rights. Evaluating Priorities Report v2. 8/17
  7. National Right to Life. Reported Annual Abortions 1973-2014 Guttmacher vs. CDC
  8. Californians for Life. California Abortion Facts
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How Do I Tell My Boss I Am Pregnant?

Pregnancy can be a wonderful time of hope and excitement while awaiting your newest family member. It can also be a time of uncertainty, especially where your employment is concerned. Some employers have positive attitudes and policies regarding maternity leave and parenting, while other employers have a less than welcoming approach. The good news is that there are laws to protect pregnant women and most employers fall somewhere in the middle of the extremes.

Often, telling our boss that we are pregnant can be the biggest stress hurdle. Here are some helpful tips to help you tell your employer that you are pregnant:

1. Know your rights. Read your company’s policy on maternity leave and parental leave and familiarize yourself with the federal Family and Medical Leave Act (FMLA) and state laws regarding maternity leave. The U.S. does not have paid maternity leave laws. California is one of only four states that have paid maternity leave laws in addition to FMLA. It might tip your hand to ask HR for the company’s maternity leave policies. You should be able to access company policies in your initial employment paperwork, by requesting a copy of the employee handbook/policy manual from HR, or it may be in an employee online portal.

2. When to tell. Many women wait until they are into the second trimester (four to six months) before telling an employer of their pregnancy. Often, this is when women begin to “show” but it is also considered a “safe” time since most miscarriages occur in the first trimester (three months) of a pregnancy. Some women have such severe morning sickness that they may need to share the news with their employer early in their pregnancy as it could become a medical issue impacting their performance.

Consider timing your announcement until after an upcoming performance review, project deadline or deal. Telling your supervisor before a pending company reorganization could be mutually beneficial if you don’t plan on returning after the baby is born. It could be a good time to part ways and possibly leave with a severance package or unemployment benefits instead of just quitting after the baby is born. Conversely, if you plan to return after the baby is born, you might consider holding off on sharing your pregnancy news. Employers are not legally permitted to fire you for being pregnant but they can let you go under the guise of the reorganization.

3. Who to tell. Often, co-workers are close friends so women are most likely share their pregnancy news with them first – or with social media. However, it would be best to share your pregnancy news with your direct supervisor or human resources first. Which leads us to best practices on how to tell your employer you are pregnant.

4. How to tell. Face-to-face is the best way to tell your employer. This enables you to gauge her reaction and give you an insight into how she and/or the company may feel about pregnant employees, maternity leave, and accommodating working parents. If you are concerned about your direct supervisor’s reaction, consider sharing the news with HR first or requesting a meeting with HR, you and your supervisor.

5. What to say. The initial announcement should be brief to share that you are pregnant and the baby’s due date. Don’t overshare about the details – save those for your personal friends over lunch or dinner. You may want to assure your employer that you have given this much thought but all of the logistics (like this maternity leave plan) can be worked out in the coming months. Don’t lock yourself into any promises or commitments early on (i.e. Do not say: “I plan to work right up until my due date,” or, “I will only need six weeks off.”) because you won’t know details until you and your doctor discuss your medical needs in the coming months.

6. Email Follow Up. It’s always good to have an electronic record of the date and nature of your conversation. The face-to-face should be followed up with a simple email the same day: “Susan, Thanks for your time today so I could share my pregnancy announcement with you. The baby’s due date is… I look forward to working out the logistics for my leave in the coming months.”

With a little advance planning, telling your boss that you are pregnant can be a simple and positive experience. If you are pregnant and unsure of your pregnancy decision, the client advocates at Support Circle can listen and help you make a decision that is in line with your values. We can also help prepare for your conversation with your employer by helping you to talk it through and role play.

To schedule an appointment at one of our three Bay Area clinics, call 888-252-1822 or visit: supportcircle.org/today.


Helpful Links
Overcoming Anxiety

Professional Counseling

Schedule an Appointment



Reference Links
Dept. of Labor. Federal Law on Maternity Leave

California Legislature. California Law on Paid Maternity Leave 

Fairy God Boss. How to Create a Maternity Leave Plan