Republican States Declare Zero Abortions. A Pink-State Physician Calls That ‘Ludicrous.’

By Sarah Varney

In Arkansas, state well being officers introduced a shocking statistic for 2023: The full variety of abortions within the state, the place some 1.5 million girls stay, was zero.

In South Dakota, too, official information present zero abortions that 12 months.

And in Idaho, dwelling to abortion battles which have not too long ago made their solution to the U.S. Supreme Courtroom, the official variety of recorded abortions was simply 5.

In practically a dozen states with whole or near-total abortion bans, authorities officers claimed that zero or only a few abortions occurred in 2023, the primary full 12 months after the Supreme Courtroom eradicated federal abortion rights.

These statistics, the latest out there and revealed in authorities information, have been celebrated by anti-abortion activists. Medical professionals say such accounts usually are not solely unfaithful however essentially dishonest.

“To say there are no abortions going on in South Dakota is ludicrous,” stated Amy Kelley, an OB-GYN in Sioux Falls, South Dakota, citing feminine sufferers who’ve come to her hospital after taking abortion tablets or to have medical procedures meant to stop loss of life or finish nonviable pregnancies. “I can think of five off the top of my head that I dealt with,” she stated, “and I have 15 partners.”

For some information scientists, these statistics additionally counsel a troubling pattern: the potential politicization of significant statistics.

“It’s so clinically dishonest,” stated Ushma Upadhyay, a public well being scientist on the College of California-San Francisco, who co-chairs WeCount, an instructional analysis effort that has saved a tally of the variety of abortions nationwide since April 2022.

The zeroing out is statistically unlikely, Upadhyay stated, and likewise runs counter to the truth that being pregnant “comes with many risks and in many cases emergency abortion care will be needed.”

“We know they are sometimes necessary to save the pregnant person’s life,” she stated, “so I do hope there are abortions occurring in South Dakota.”

State officers reported a pointy decline within the official variety of abortions after the Supreme Courtroom overturned Roe v. Wade in June 2022.

Arkansas reported zero abortions in 2023, in contrast with 1,621 in 2022.
Texas reported 60 in 2023, after reporting 50,783 abortions within the state in 2021.
Idaho reported 5 in 2023 in contrast with 1,553 in 2021.
South Dakota, which had severely restricted abortions years forward of the Dobbs ruling, reported zero in 2023 in contrast with 192 abortions in 2021.

Anti-abortion politicians and activists have cited these statistics to bolster their claims that their decades-long campaign to finish abortion is successful.

“Undoubtedly, many Arkansas pregnant mothers were spared from the lifelong regrets and physical complications abortion can cause and babies are alive today in Arkansas,” Rose Mimms, govt director of Arkansas Proper to Life, stated in a press assertion. “That’s a win-win for them and our state.”

A spokesperson for the Arkansas Division of Well being, Ashley Whitlow, stated in an electronic mail that the division “is not able to track abortions that take place out of the state or outside of a healthcare facility.” State officers, she stated, accumulate information from “in-state providers and facilities for the Induced Abortion data reports as required by Arkansas law.”

WeCount’s tallies of noticed telehealth abortions don’t seem within the official state numbers. For example, from April to June 2024 it counted a mean of 240 telehealth abortions a month in Arkansas.

Teams that oppose abortion rights acknowledge that state surveillance stories don’t inform the total story of abortion care occurring of their states. Mimms, of Arkansas Proper to Life, stated she wouldn’t anticipate abortions to be reported within the state, for the reason that process is illegitimate besides to stop a affected person’s loss of life.

“Women are still seeking out abortions in Arkansas, whether it’s illegally or going out of state for illegal abortion,” Mimms instructed KFF Well being Information. “We’re not naive.”

The South Dakota Division of Well being “compiles information it receives from health care organizations around the state and reports it accordingly,” Tia Kafka, its advertising and marketing and outreach director, stated in an electronic mail responding to questions concerning the statistics. Kafka declined to touch upon particular questions on abortions being carried out within the state or characterizations that South Dakota’s report is flawed.

Kim Floren, who serves as director of the Justice Empowerment Community, which supplies funds and sensible assist to assist South Dakota sufferers obtain abortion care, expressed disbelief within the state’s official figures.

“In 2023, we served over 500 patients,” she stated. “Most of them were from South Dakota.”

“For better or worse, government data is the official record,” stated Ishan Mehta, director for media and democracy at Frequent Trigger, the nonpartisan public curiosity group. “You are not just reporting data. You are feeding into an ecosystem that is going to have much larger ramifications.”

When there’s a mismatch within the information reported by state governments and credible researchers, together with WeCount and the Guttmacher Institute, a reproductive well being analysis group that helps abortion rights, state researchers must dig deeper, Mehta stated.

“This is going to create a historical record for archivists and researchers and people who are going to look at the decades-long trend and try to understand how big public policy changes affected maternal health care,” Mehta stated. And now, the recordkeepers “don’t seem to be fully thinking through the ramifications of their actions.”

A Tradition of Concern

Abortion rights supporters agree that there was a steep drop within the variety of abortions in each state that enacted legal guidelines criminalizing abortion. In states with whole bans, 63 clinics have stopped offering abortions. And docs and medical suppliers face felony fees for offering or aiding in abortion care in a minimum of a dozen states.

Practitioners discover themselves working in a tradition of confusion and concern, which may contribute to a hesitancy to report abortions — regardless of some state efforts to clarify when abortion is allowed.

For example, South Dakota Division of Well being Secretary Melissa Magstadt launched a video to make clear when an abortion is authorized underneath the state’s strict ban.

The process is authorized in South Dakota solely when a pregnant lady is dealing with loss of life. Magstadt stated docs ought to use “reasonable medical judgment” and “document their thought process.”

Any physician convicted of performing an illegal abortion faces as much as two years in jail.

Within the place of dependable statistics, educational researchers at WeCount use symbols like dashes to point they will’t precisely seize the truth on the bottom.

“We try to make an effort to make clear that it’s not zero. That’s the approach these departments of health should take,” stated WeCount’s Upadhyay, including that well being departments “should acknowledge that abortions are happening in their states but they can’t count them because they have created a culture of fear, a fear of lawsuits, having licenses revoked.”

“Maybe that’s what they should say,” she stated, “instead of putting a zero in their reports.”

Combined Mandates for Abortion Information

For many years, dozens of states have required abortion suppliers to gather detailed demographic data on the ladies who’ve abortions, together with race, age, metropolis, and county — and, in some circumstances, marital standing and the explanation for ending the being pregnant.

Researchers who compile information on abortion say there could be sound public well being causes for monitoring the statistics surrounding medical care, particularly to judge the impression of coverage modifications. That has develop into significantly necessary within the wake of the Supreme Courtroom’s 2022 Dobbs determination, which ended the federal proper to an abortion and opened the door to legal guidelines in Republican-led states limiting and generally outlawing abortion care.

Isaac Maddow-Zimet, a Guttmacher information scientist, stated information assortment has been utilized by abortion opponents to overburden clinics with paperwork and pressure sufferers to reply intrusive questions. “It’s part of a pretty long history of those tools being used to stigmatize abortion,” he stated.

In South Dakota, clinic workers members have been required to report the load of the contents of the uterus, together with the lady’s blood, a requirement that had no medical objective and had the impact of exaggerating the load of being pregnant tissue, stated Floren, who labored at a clinic that offered abortion care earlier than the state’s ban.

“If it was a procedural abortion, you had to weigh everything that came out and write that down on the report,” Floren stated.

The Facilities for Illness Management and Prevention doesn’t mandate abortion reporting, and a few Democratic-led states, together with California, don’t require clinics or well being care suppliers to gather information. Every year, the CDC requests abortion information from the central well being companies for each state, the District of Columbia, and New York Metropolis, and these states and jurisdictions voluntarily report aggregated information for inclusion within the CDC’s annual “Abortion Surveillance” report.

In states that mandate public abortion monitoring, hospitals, clinics, and physicians report the variety of abortions to state well being departments in what are usually referred to as “induced termination of pregnancy” stories, or ITOPs.

Earlier than Dobbs, such stories recorded procedural and drugs abortions. However following the elimination of federal abortion rights, clinics shuttered in states with felony abortion bans. Extra sufferers started accessing abortion treatment by on-line organizations, together with Assist Entry, that don’t fall underneath obligatory state reporting legal guidelines.

At the least six states have enacted what are referred to as “shield laws” to guard suppliers who ship tablets to sufferers in states with abortion bans. That features New York, the place Linda Prine, a household doctor employed by Assist Entry, prescribes and sends abortion tablets to sufferers throughout the nation.

Requested about states reporting zero or only a few abortions in 2023, Prine stated she was sure these statistics have been incorrect. Texas, for instance, reported 50,783 abortions within the state in 2021. Now the state stories on common 5 a month. WeCount reported a mean of two,800 telehealth abortions a month in Texas from April to June 2024.

“In 2023, Aid Access absolutely mailed pills to all three states in question — South Dakota, Arkansas, and Texas,” Prine stated.

Texas Lawyer Common Ken Paxton filed a lawsuit in January in opposition to a New York-based doctor, Maggie Carpenter, co-founder of the Abortion Coalition for Telemedicine, for prescribing abortion tablets to a Texas affected person in violation of Texas’ near-total abortion ban. It’s the primary authorized problem to New York’s protect regulation and threatens to derail entry to treatment abortion.

Nonetheless, some state officers in states with abortion bans have sought to choke off the provision of treatment that induces abortion. In Could, Arkansas Lawyer Common Tim Griffin wrote stop and desist letters to Assist Entry within the Netherlands and Selections Ladies’s Medical Heart in New York Metropolis, stating that “abortion pills may not legally be shipped to Arkansas” and accusing the medical organizations of probably “false, deceptive, and unconscionable trade practices” that carry as much as $10,000 per violation.

Good-government teams like Frequent Trigger say that the risks of officers counting on deceptive statistics are myriad, together with a disintegration of public belief in addition to ill-informed laws.

These considerations have been heightened by misinformation surrounding well being care, together with an entrenched and vocal anti-vaccine motion and the objections of some conservative politicians to mandates associated to covid-19, together with masks, bodily distancing, and faculty and enterprise closures.

“If the state is not going to put in a little more than the bare minimum to just find out if their data is accurate or not,” Mehta stated, “we are in a very dangerous place.”

KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Study extra about KFF.

Subscribe to KFF Well being Information’ free Morning Briefing.

This text first appeared on KFF Well being Information and is republished right here underneath a Inventive Commons license.

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