A national analysis of abortions during 2020 and 2023 found an uptick in nearly every state with a near-total abortion ban, excluding Texas, Idaho and Oklahoma, which had the steepest decline.
Local and national reproductive health groups spoke to potential contributing factors to Oklahoma’s decline – like self-managed medication abortion care or increasing education on contraception – which was the most significant among ban states.
What does the data say?
The report comes from #WeCount, which is a project supported by the Society of Family Planning to capture quarterly shifts in abortion volumes by state following the overturning of Roe v. Wade.
#WeCount’s eighth report includes survey data from the Guttmacher Institute – a nonprofit reproductive health policy group – on the number of women traveling out of state for care. It was the first to include data from abortions in ban states under shield laws, which offer legal protections to providers who prescribe and send abortion pills via telehealth.
Dr. Ushma Upadhyay, a #WeCount co-chair, said reports gather data from abortion clinics and providers across the nation in a census. She said about 20% of identified providers do not participate, so they developed imputations to get a more complete picture of monthly abortion counts by state.
In one half of 2020, Oklahomans obtained an estimated 4,130 abortions – 3,940 of which were in-state, and 190 included interstate travel. In the second half of 2023, an estimated 1,820 residents traveled out of state for care, and 980 obtained abortion medications from health care providers operating under shield laws, equaling 2,800 abortions among Oklahoma residents.
That’s about a 32% decline in abortions between data recorded in 2020 and 2023. The 12-month total from 2020 was divided in half to get a six-month estimate, as was the 2023 travel data, according to the New York Times. The 2023 mail-order data from WeCount covers July through December 2023.
Overall, Upadhyay said the national number of abortions has gradually risen for over a year, despite state abortion restrictions.
“It is a testament to the continued need for abortion care across the country," Upadhyay said. "People are still accessing it, and in higher numbers.”
The #WeCount report notes the Guttmacher Institute Abortion Provider Census shows 2019 and 2020 had unusually high abortion data in Oklahoma compared to its data collection in 2017. Upadhyay said the Oklahoma findings have been difficult to comprehend.
Upadhyay, the Guttmacher Institute and Tulsa’s Take Control Initiative – a nonprofit that does not provide or refer for abortion care but works to provide free access to birth control locally – gave StateImpact context surrounding the data.
What factors could have contributed to Oklahoma’s decline in abortions?
Laura Bellis, the executive director of the Take Control Initiative, hypothesized the bump in 2020 could be attributed to the addition of a clinic. She said this was around the time Tulsa County’s Planned Parenthood began providing abortions before Roe v. Wade fell.
As for the decline in abortions last year in comparison to 2020, Bellis said there could be many contributing factors. She used Senate Bill 8 – a law banning abortion after six weeks of pregnancy that went into effect in Texas in 2021 – as an example.
She said pushing up a person’s decision timeline for an abortion can impact if and where they might seek one. This happened in Texas, which saw an increase in abortions out-of-state. She hypothesized that, in Oklahoma, a shorter decision timeline might mean more people accessed care outside of a clinical setting through self-administered abortion pills from online pharmacies or community networks.
Self-managed medication abortions are not reported by #WeCount.
Bellis also said the demand for birth control has never been higher through the Take Control Initiative. Post-Roe, she said her group thought there would be more of a bell curve where people panic-purchased birth control and it would eventually go down.
But the demand never ceased. She said increased contraception access could impact this data.
“We're able to, given our population, be able to work and partner to get people resources. … I think also you have, (in) the same (vein) when it comes to that decision timeline for folks that, they are pregnant – even in advance of that, it's on people's minds more. And we are seeing people much more proactively and consistently seeking out contraception.”
She said factors like Oklahoma’s teen birth rate continuing to steadily decline are a sign that education and contraception could be working.
Upadhyay said it could also be that more people are being forced to carry to term in Oklahoma. That’s her biggest fear – that the #WeCount report’s findings saying people in ban states are seeing an increase in abortions will make people think everyone is accessing care.
“That's why I think Oklahoma is a really helpful state to look at, because it is evidence that there's likely people there in the state that are not accessing abortion care, and it usually is the people that are most disenfranchised from health care, most marginalized from health care,” Upadhyay said. “They tend to be the poorest, tend to have … digital barriers, and they have the least amount of information about the legality of abortion and the available options to them.”
Rachel Jones, the principal research scientist at the Guttmacher Institute, said it’s important to focus on what is happening in Oklahoma now, which is that a significant amount of its residents are having to go out of state to access abortion care.
“I grew up in Wichita Falls, Texas, so by the border of Oklahoma. So, I know about all the difficulties that people have to face to get an abortion there, even prior to Dobbs. … More Oklahoma residents had to go out of state to access abortion care after Dobbs,” Jones said. “(They) were able to, but they shouldn't have had to.”
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