WASHINGTON — The number of abortion providers in the United States, depressed by the anti-abortion climate and the trend toward managed care, is at its lowest level since soon after the Supreme Court made abortion legal in 1973, the Alan Guttmacher Institute reported Thursday.
But the incidence of abortion, after falling steadily during the first half of the 1990s, has leveled off, according to the New York-based institute, a nonprofit group with expertise in reproductive health issues. About 26% of pregnancies now end in abortion, according to the institute.
The report found a partial return to the geographic availability of abortion immediately after the 1973 Roe vs. Wade ruling, with abortions readily obtainable in the biggest urban areas--particularly in California, Illinois and New York--but hard to come by in rural America.
"It is a question of attitudes in different parts of the country," said Stanley Henshaw, the report's author. "In conservative areas, you have women trying to avoid abortions and you have fewer providers."
California's Rate 4th in Nation
California's abortion rate was 33 per 1,000 women of child-bearing age, fourth in the nation after Nevada, New York and New Jersey. With 492 abortion providers, California had the most in the nation--nearly double that of runner-up New York and nearly one-quarter of all providers in the country. By contrast, North Dakota and South Dakota had one provider each.
Nationally, 86% of counties had no abortion provider in 1996, a figure that has been rising for two decades. Although most of those were rural counties, the report found that "abortion services were effectively unavailable in one-third of U.S. cities."
Altogether, nearly one-third of women live in counties without abortion providers--defined by the Guttmacher Institute as hospitals, clinics and doctors' offices. About 70% of all abortions in 1996 were performed at the nation's 452 abortion clinics. Only 16% of all short-term, general, nonfederal hospitals performed abortions that year.
Most of the drop in providers has been among hospitals and individual doctors. The drop in hospitals is partly a result of managed care, which encourages referrals to outpatient abortion clinics. It also may be attributable to increasing numbers of hospital mergers that, in many cases, have involved the takeover of nonprofit hospitals by Catholic hospitals, which will not allow abortion services.
