Abortions decline by nearly 37 percent in Shelby County

Aug. 28--The number of abortions performed in Shelby County fell sharply during the past five years as highly effective contraceptives became more accessible and state lawmakers pushed for tougher laws to limit the procedures.

Between 2011 and 2014, the most recent year for which figures are available, abortions in the county declined by 36.6 percent, from 4,595 to 2,914, according to Tennessee Department of Health figures. The ratio of abortions per 1,000 live births showed a similar drop -- from 326.4 in 2011 to 208.2 three years later.

Abortions also have declined nationally and statewide, but not nearly as dramatically as in Shelby County. Across the U.S., there was 12 percent drop between 2010 and 2014, The Associated Press reported last year, while Tennessee saw a reduction of 20.3 percent from 2011 to 2014.

The reasons for the decline are disputed among representatives of anti-abortion and pro-abortion rights groups, although both sides agree that one factor has been increased use of so-called long-acting reversible contraceptives, such as implants and intrauterine devices. Anti-abortion groups also contend that stricter laws restricting abortion, along with programs aimed at persuading women to avoid the procedure, have contributed to the decline.

Under the Affordable Care Act, insurers must cover most types of contraceptives with no co-pay. Locally, women without insurance can get free contraceptives with the help of programs that reimburse the clinics distributing them.

Many women are getting the contraceptives, local providers say.

"Our numbers have probably increased by tenfold, so I think that explains a lot of (the abortion decline)," said Dr. Sarah Wallett, medical director for Planned Parenthood Greater Memphis Region.

Planned Parenthood, one of two abortion-providers in Memphis, offers contraceptives as well as family-planning help, screenings for sexually transmitted diseases as well as other services.

Claudia Haltom, founder and CEO of A Step Ahead Foundation, a nonprofit group that works with clinics and programs to provide long-acting reversible contraceptives, said women formerly had to pay about $1,500 to get products such as Nexplanon, an implant that lasts up to three years. That cost was beyond the reach of many, she said.

The free contraceptives have been especially important in preventing second, third and fourth abortions among individual women, Haltom said. After paying for an initial abortion, women often would turn to cheaper, less effective contraceptives, such as the birth-control pill, and get pregnant again.

"A woman who walks in for an abortion is clearly sexually active and very likely will remain sexually active," Haltom said.

"The cheapest option is often the pill, but the hardest thing to keep up with is the pill."

Anti-abortion groups say their efforts have played a part, too, in reducing abortions.

Brian Harris, president of Tennessee Right to Life, said campaigns like the one that brings mobile ultrasounds to pregnant women so they can "see the humanity of their unborn child" have averted many abortions.

"There is no longer a debate about whether this is a human child," he said.

Legislative efforts to curb abortion also have had an impact, Harris said. In 2014, Tennessee voters approved Amendment 1 to the state Constitution, which empowered the Legislature to enact, amend or repeal laws regarding abortion. The amendment, drafted in response to a 2000 State Supreme Court ruling that had struck down several laws restricting abortions, cleared the way for enforcement of requirements such as a 48-hour waiting period and counseling before women undergo the procedure.

"The passage of pro-life laws save lives and it protects women, girls and families from an industry that targets them," Harris said.

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