Pressure Drop

Abortion rates have fallen even more in Washington than nationwide. A possible reason: more guilt.

It caught many people by surprise when Aradia Women's Health Center, a longtime Seattle abortion clinic, announced earlier this month that it would close at the end of January. But it shouldn't have. Nationally and locally, abortion clinics have been squeezed by dropping abortion rates. In this state, Department of Health statistics show that the rate has dropped by nearly 30 percent since 1990, to 18.9 abortions per 1,000 women of childbearing age—an even bigger decline than experienced nationally.

At Aurora Medical Services, another prominent abortion clinic a few blocks from Aradia, owner and medical director Deborah Oyer says that she has cut her staff by about 20 percent in recent years due to a gradual falloff of patients. "It's certainly more difficult financially than it used to be," she says. While Aurora is not on the ropes, according to Oyer, it has diversified its services in part to beef up its client base. The clinic has started offering intrauterine (or artificial) insemination, targeting lesbian couples in particular.

Beverly Whipple, executive director of the Feminist Women's Health Center, which runs three abortion clinics around the state, including in Renton, says her organization has also downsized due to dropping numbers.

At Aradia, the situation was complicated by the fact that the drop in abortions, at least nationally, has been driven by affluent women. Among low-income women, the abortion rate has actually increased, according to the Guttmacher Institute in New York. "Aradia kind of become known as the place where lower-income women could go," says spokesperson Amie Newman. And so it was left with a lot of patients who couldn't pay for its services.

That was the troubling news that made the press in the days after the announcement. But even some abortion-rights advocates agree that the drop in abortion rates overall is good news, even if it hurts their business. "We're happy about this," says Cam McIntyre, medical director of Planned Parenthood of Western Washington. "Our mission is to prevent unintended births."

Neither McIntyre nor anybody else can say with certainty why abortion rates are dropping. People in the field tick off a variety of likely reasons: new and improved methods of contraception like the vaginal patch and ring, more consistent use of contraception in the age of AIDS, and a striking increase in abstinence among teens, as shown by the National Survey of Family Growth, conducted by the government. (A Guttmacher study released this month attaches far more importance to better birth-control use than to abstinence in analyzing the related decline in teen pregnancy rates.)

Oyer, who started performing abortions in 1991—the same year voters passed Initiative 120 codifying Roe v. Wade into state law—notices something else. "Women are coming in with more guilt and angst than they used to," she says. The other day, one of her abortion patients asked her: "What do you think of a woman like me?" Another common question, she says: "Do you think I'm going to hell?"

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