USA has abortion clinics shutting down at an alarming rate, with more than 50 last year in blue and red states. The decline in demands of abortion as well as high costs incurred owing to treatment of low-income individuals has forced this state.
A total of 288 new regulations related to this issue have been adopted until now.
A Planned Parenthood clinic in Colorado reopened last week, months after a gunman killed three people and wounded nine at the clinic, angry at the abortion services provided there.
That the clinic in Colorado Springs, Colo., reopened at all makes it something of an oddity. Abortion providers across the US are closing at a record pace, according to data analysis from Bloomberg Businessweek, and the closures are not limited to the conservative states that have been passing regulations – the US Supreme Court will hear oral arguments on Texas’s controversial House Bill 2 next week – over when and how abortions can be carried out.
Since 2011, 21 abortion providers have opened, while at least 162 have shut or stopped offering the procedure, Bloomberg reported. Both supporters and critics of abortion attribute the decline to a range of factors, from high operating costs and reduced demand, to the rise of strict state regulations. And both sides say the abortion debate in America is reaching a seminal moment.
The vast majority – 94 percent – of pregnancy terminations are conducted in stand-alone clinics, as opposed to hospitals or doctor’s offices. The number of these facilities that perform 400 or more abortions a year has dropped from a peak of 705 in the late 1980s to 553 in 2011, according to the Guttmacher Institute, a think-tank that supports reproductive rights.
The closures have been felt in all corners of the country. While many of the clinics have shuttered in states that have adopted new regulations on abortion clinics, a broader array of pressures are taking their toll on clinics in states that are friendlier to them.
Texas lawmakers have passed 13 such regulations between 2011 and 2015 – the constitutionality of aspects of one bill are now being challenged in the Supreme Court – during which time 30 abortion providers in the state have shut down. Yet in California, which Guttmacher says “doesn’t have any major types of abortion restrictions,” a dozen providers have closed since 2011, according to Bloomberg.
“It is difficult to be an abortion provider in the United States regardless of what state you live in,” says Vicki Saporta, president and CEO of the National Abortion Federation, a trade association with 400 members in North America.
Even if clinics in states like California don’t have to contend with strict regulations on how they operate, there are still basic economic challenges that come with being an abortion provider. Many clinics in blue states lose money performing abortions for poor women on Medicaid, with states often reimbursing only a portion of the cost of each procedure. Clinics also have costs other medical practices don’t have to worry about, Ms. Saporta says, from extra security to securing a bank loan.
“You can have the same economic challenges even if you don’t live in a state where you have the onerous regulatory challenges,” she adds. “Security costs alone are astronomical, and you have those costs whether you’re providing care in Colorado Springs or in California, because you don’t know whose going to target who [and] when.”
Of the more than 50 abortion clinics that closed in 2014, “a little more than half were located in blue states,” the Guardian’s Molly Redden reported last November.
Paradoxically, wrote Ms. Redden, abortion clinics in red states have fewer cash flow problems because, with access limited, more women are discouraged from having an abortion. Those who aren’t tend to be those who can pay for the procedure.
“By the time a woman arrives for her abortion [in a red state], she is able to pay full freight,” wrote Redden.
In blue states, clinics serve more, often poorer women, and take a loss of hundreds of dollars on each procedure, while still dealing with the same political scrutiny as abortion providers anywhere, according to Redden.
“In blue states, cash-strapped abortion clinics must look for ways to cut costs internally,” she wrote. “And every cut comes under a microscope.”
Another factor behind the sharp decline in abortion providers has been a decline in demand for abortions, a fact abortion opponents have pointed out.
A survey from the Associated Press found that abortions declined 12 percent from 2010 to 2015, with five of the six states with the biggest declines passing no recent regulations. The teen birth rate has declined almost continuously over the past 20 years, according the to US Department of Health and Human Services. The teen birth rate declined from 31.3 births for every 1,000 adolescent females ages 15 to 19 in 2011 to 24.2 in 2014, according to the DHHS and the US Centers for Disease Control and Prevention. That’s a drop of 22 percent.
Abortion Clinics Are Closing at a Record Pace
Abortion access in the U.S. has been vanishing at the fastest annual pace on record, propelled by Republican state lawmakers’ push to legislate the industry out of existence. Since 2011, at least 162 abortion providers have shut or stopped offering the procedure, while just 21 opened.
At no time since before 1973, when the U.S. Supreme Court legalized abortion, has a woman’s ability to terminate a pregnancy been more dependent on her zip code or financial resources to travel. The drop-off in providers—more than one every two weeks—occurred in 35 states, in both small towns and big cities that are home to more than 30 million women of reproductive age.
No region was exempt, though some states lost more than others. Texas, which in 2013 passed sweeping clinic regulations that are under scrutiny by the Supreme Court, saw the most: at least 30. It was followed by Iowa, with 14, and Michigan, with 13. California’s loss of a dozen providers shows how availability declined, even in states led by Democrats, who tend to be friendly to abortion rights.
Stand-alone clinics, not doctors’ offices or hospitals, perform the vast majority of pregnancy terminations. They account for the vast majority of the tally, which was compiled by Bloomberg News over the past three months and builds on a similar undertaking from 2013.
Typically defined by medical researchers as facilities that perform 400 or more abortions per year, the ranks peaked in the late 1980s at 705, according to the Guttmacher Institute, a New York-based reproductive-health research organization. By 2011, the most recent year for which Guttmacher has data, that number had fallen to 553.
Bloomberg’s reporting shows that the downward trend has accelerated to the fastest annual pace on record since 2011, with 31 having closed or stopped performing the procedure each year on average.
State regulations that make it too expensive or logistically impossible for facilities to remain in business drove more than a quarter of the closings. Industry consolidation, changing demographics, and declining demand were also behind the drop, along with doctor retirements and crackdowns on unfit providers.
Texas stands as a case study in the way abortion opponents have changed strategies, opting for legislative action over the clinic blockades and violence of the past.
Most providers there closed after the state became the largest and most populous in the U.S. to require that they become hospital-like outpatient surgical centers, which can cost millions to buy or build. The state also mandates that doctors have admitting privileges at nearby hospitals. The drop-off in access has helped depress the abortion rate in the state by 13 percent, according to a July study, and providers there say full implementation of the law would leave almost a fifth of Texas women 150 miles or more from a facility.