What the data show on striking down Roe

The Supreme Court has spoken: Abortion is no longer a constitutional right. This permits states to be the ultimate arbiter of abortion, creating a red and blue collage of abortion access across the nation. 

Putting aside for the moment the moral, ethical and religious debates surrounding abortion, what does the data say that can help guide us as we move forward from this decision? Like all laws and policies, there are certain to be unintended consequences. 

Trends: The number of reported legal abortions in the United States peaked in 1990 at around 1.6 million, according to the Guttmacher Institute. Since that time, the annual numbers have steadily declined, reaching a low of around 900,000 in 2018. The abortion rate (abortions per 100,000 women of childbearing age) has followed a similar downward trajectory. It remains to be seen how overturning Roe v. Wade will change this. 

Comparisons: To place the number of reported legal abortions in perspective (930,160 in 2020), it is more than the number of deaths attributed to heart disease (696,962) and cancer (602,350). This places it as an event that significantly ends a large number of potential lives. However, this is an unfair comparison since it is impossible to capture the lives that would have been lost if abortions were not accessible.

Responses: When Roe v. Wade became law in 1973, the number of abortions reported in the United States approximately doubled over the following seven years. In contrast, over the past three decades, there has been a steady and persistent decline in such numbers. Whether this is due to more restrictions imposed by states, which does not appear to be a primary factor, better access to and education on birth control or people simply being less sexually active, the abortion numbers reported have dropped to levels last reported in the mid 1970s. Moreover, given the larger population, the abortion rate is now below the rate when Roe v. Wade became law. 

What the data does not reveal is how many such abortions also saved people’s lives. In particular, a pregnancy may be life-threatening to a woman. In such a case, a decision may need to be made as to whether to save the mother’s life or save the child’s life. Who is most qualified to make such a decision? No matter what the decision, a life would be lost. 

Several states have “trigger laws,” that will either immediately ban abortions or ban them after a short delay now that the right recognized via Roe v. Wade has ended. This means that people with scheduled abortions in the very near future in such states may find themselves unable to gain access. Will this lead to unintended deleterious consequences for such women? 

The number of births in the U.S. has hovered around 4 million per year since 1990, which translates into a shrinking birth rate, given the growing population. This also means that the ratio of abortions to births has fallen, although this trend reversed itself in 2020, with fewer births and more abortions. 

The takeaway from the Supreme Court decision is that its full ramifications will not be felt or observed for many years, if not a decade or more. Kneejerk reactions to such a viscerally charged issue may do more harm than good. 

The data discussed provides just a snapshot of insights. The nation when Roe v. Wade was enacted was very different than the nation today. This is why setting laws and policies to ensure the safety and well-being of everyone are so difficult.  

Sheldon H. Jacobson, Ph.D., is a professor in Computer Science and the Carle Illinois College of Medicine at the University of Illinois Urbana-Champaign. A data scientist, he applies his expertise in data-driven risk-based decision-making to evaluate and inform public policy.