shows printouts from a sonogram, used to determine if a fetus has a disability
Photo credit: Stephen Cummings, flickr creative commons

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By Rose Hoban

With U.S. Senate confirmation hearings on Judge Brett Kavanaugh underway, advocates for abortion rights are expressing concern over what his confirmation might mean for access to the procedure in the future. Some have suggested that if the landmark 1972 decision Roe vs Wade were overturned, abortion policy would devolve to being determined more at the state level than at the national level.

In past six years since Republicans have had supermajorities in the North Carolina General Assembly, lawmakers have enacted more restrictions on access to abortion in North Carolina. In 2015, lawmakers imposed a 72-hour waiting period before a woman can obtain an abortion. Legislators also passed a law requiring physicians to report abortion procedures to the state Department of Health and Human Services and that increases inspections on clinics. Physicians are also required to tell a woman that she can see a sonogram of her fetus and provide women with counseling materials that encourage carrying a pregnancy to term.

Over the past decade, the number of abortions in North Carolina has ticked up only slightly, even as the population has increased quickly, meaning that, in general, abortion rates have decreased. Although the number of pregnancies has ticked upwards, the overall rate of pregnancies in the state has ticked downward.

Fewer teens are having abortions, in large part because fewer teens are getting pregnant, said Elizabeth Finley from SHIFT NC, a reproductive rights organization focused on North Carolina teens.

“We definitely know that the primary reason for the drop is the increased use of contraception in general and LARCs (long-acting reversible contraceptives),” she said. “Compared to 10, 15 years ago, young people are more likely to contracept and to use long-acting contraceptives.”


A note about this map: Numbers shown in county data reflect total pregnancies as reported to the N.C. State Center for Health Statistics. However, more women become pregnant, but those data may never have been reported because their pregnancies ended in early miscarriage.
Data sources: NC State Center for Health Statistics, US Census

Finley attributed some of this drop in the teen pregnancy rate to a growing use of clinic-based initiatives and comprehensive sex education, both developed using a growing body of evidence-based research on how to get through to kids.

Long-acting reversible contraceptives have gained popularity since 2008, with use almost doubling, even as permanent methods of contraception, such as sterilization, decreased, according to data compiled by the Guttmacher Institute, which tracks reproductive health statistics.

“Even small improvements in contraceptive use among women at highest risk for unintended pregnancy may have had a substantial impact on recent declines in unintended pregnancy,” said study author Megan Kavanaugh in a Guttmacher press release on the research.

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Another Guttmacher researcher, Laura Lindberg, recently analyzed surveys that found that fewer adolescents are getting pregnant, even as the rate of sexual activity remained about the same. In a study published in the Journal of Adolescent Health, Lindberg looked at the National Survey of Family Growth, which found that each of the survey years 2007, 2009, 2012 and 2014, about a third of females aged 15-19 reported being sexually active. But during that time, the number of young women using no birth control dropped from 22 percent down to 12 percent, and the number of young women using two or more methods to prevent pregnancy grew from 24 to 33 percent.

Lindberg noted that a different long-term study, the biennial Youth Behavior Risk Survey, finds a decrease in the number of teens having sex.

Finley said SHIFT NC’s analysis has found that teens are delaying the initiation of sexual activity somewhat.

“A lot has to do with how they’re spending their time,” she said. “They have far less unsupervised, unscheduled time than their peers did in the past. That’s a huge component, fewer kids alone after school, fewer going out alone on dates.”

She also said online culture could be contributing to a decrease in the number of kids having sex.

“If you wanted to hang out with friends on Friday, you were physically out with your friends on Friday night and that could go in a lot of directions,” Finley said. “Now you can hang out with your friends on Snapchat and you’re home in your own room.”

Kids are more risk averse, too, she noted.

“For lots of risk behaviors, you see a downward trend: drinking, smoking, sex. Researchers attribute it to the combination of the scary things you’re exposed to on the Internet, plus helicopter parenting and this constant exposure to things that could be harmful,” she said. “So they’re just generally a slightly more worried group of young people.”

Jared Weber contributed to data compilation.

Characteristics of NC Women Receiving Abortions

NC RESIDENT ABORTIONS: Characteristics of Women Receiving Abortions, NC Residents, 2016

NUMBER PERCENT
TOTALS 23,070 100.0
LOCATION OF PROCEDURE
North Carolina 22,452 97.3
Out of State 618 2.7
AGE
14 and under 61 0.3
15-19 2,019 8.8
20-24 6,943 30.1
25-29 6,481 28.1
30-34 3,985 17.3
35 and over 3,017 13.1
Unknown 564 2.4
RACE
White Non-Hispanic 7,810 33.9
Af. Am. Non-Hispanic 10,536 45.7
Other Non-Hispanic 795 3.4
Hispanic 2,573 11.2
Unknown 1,101 4.8
MARITAL STATUS
Married 3,148 13.6
Unmarried 18,261 79.2
Unknown 1,661 7.2
YEARS OF EDUCATION
Not completed high school 2,214 9.6
High school graduate 5,946 25.8
Some college 13,403 58.1
Unknown 1,507 6.5
NUMBER OF LIVING CHILDREN
None 7,137 37.1
1 5,307 26.2
2 or more 8,146 35.3
Unknown 791 1.5
NUMBER OF PREVIOUS ABORTIONS
None 12,725 55.2
1 4,950 21.5
2 2,012 8.7
3 or more 1,051 4.6
Unknown 2,332 10.1
WEEKS OF GESTATION
First trimester 0-12 weeks 20,087 87.1
13-20 2,233 9.7
Greater than 20 weeks* 36 0.2
Unknown 714 3.1
TYPE OF PROCEDURE
Any Surgical 12,610 54.7
Medical (nonsurgical) 9,748 42.3
Other/Unknown 712 3.1
*In-state occurrence = 1
Out-of-state occurrence = 35

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

2 replies on “NC Pregnancy, Abortion Rates Continued to Tick Down in 2016”

  1. Hi Rose,
    I’m probably overly sensitive to this, but the references in the lead paragraphs of this article describe changes in regulations related to abortions and seems to connect those changes to the decline in the rate of abortions in NC. However, the further body of the article describes very different factors that have contributed to the reduction, including birth control utilization among other factors.

    Is there data to support the implication that the new regulations have actually reduced abortions? There is compelling data for the other causes in reduction in abortions that you report in your article, but your lead implies that the new rules in the State may be the cause.
    Steve

    1. When you write a news story, you look for a “peg” that current thing that explains, “Why this story now?” The Kavanaugh confirmation hearings and the possibility of further statutory regulation lead me to putting moves made by our legislature at the top of the content.

      However, If there is data that new regulations are causing a drop in rates, that’s harder to find. I did intend, though, to note all factors that might be contributing to changes, including legislation. It’s really hard to measure “intent” and whether more people carried pregnancies to term based on legislative action. Did waiting three days make people change their minds? I’m not sure that’s measured anywhere.

      As I was formatting the story yesterday evening, one very interesting thing did jump out at me though. Down at the *very* bottom of the page, there’s an asterisk noting that of the vanishingly small number post-20 week abortion procedures for North Carolina women, all but one were performed out of state. That was *not* seen in prior years’ data. That suggests – to me – legislation has had the effect of making health care providers very wary of providing this service.

      But that would be different story for me to write!

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