2020 PA Abortion report - good news, obvious and hidden

The Good News, Obvious and Hidden, in the PA Health Department’s Abortion Report for 2020
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The PA Abortion Report for 2020 is not good news overall, but there’s good news for Allegheny County.  The bad news from Philly may be hiding the good effects of advertising, even there.
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Abortions Down Again for Allegheny County Residents

At first glance, abortion statistics for Pennsylvania in 2020 are reasons for dismay: numbers are up. A close look at Allegheny County, however, shows that the number of abortions for residents actually dropped, while ratios remained the same. How is that possible? Birth numbers dropped, and abortion ratios are – wait for it – the ratios of abortions to births. So both abortions and births decreased proportionately in the County.

Philadelphia’s numbers were more discouraging at first glance. Both resident abortions and abortion ratios were up over the last few years, including 2020. On the surface, one might conclude that Vision for Life’s advertising was having no effect there. However, if one compares Philly not with Allegheny County, but with all the other counties, including neighboring counties, the picture is much brighter. It is quite likely that advertising pregnancy medical centers in Philadelphia County reduced the increase in abortion numbers and ratios of abortions to births.

First, the bad news: Abortion numbers for Pennsylvania residents were both up, for the third time since 2017.

​The ratio of abortions to births measures the proportion of women who choose life. That ratio was up again for PA women in 2020. That is, more PA women who were pregnant chose abortion that year. This was the pattern statewide since 2018.

​The good news, however, is that abortions to Allegheny County residents, after rising slightly in 2019, went down again in 2020, from 3,265 to 3,083.

​How can the numbers of abortions drop from the previous year, yet the abortion ratios remain the same? 2020 was “the year of the fear.” Birth numbers for Allegheny County residents dropped sharply.

​So abortions were down, but so were births, and the ratio of the first to the second remained the same. It is our contention that, without our advertising, abortion numbers and abortion ratios would have been up in Allegheny County, as they were in the rest of PA.
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Compare the abortion ratios of Allegheny County residents to the residents of all other counties.

The abortion ratios for Allegheny County increased 8.1% from the low point of 2018 to 2020; in the rest of Pennsylvania the ratios from the low point of 2017 to 2020 increased 12.9%. Advertising makes a difference to demographics

What’s Happening in Philadelphia?

Mark Twain quoted British Prime Minister Benjamin Disraeli: “There are three kinds of lies: lies, damned lies, and statistics.” Anyone familiar with the use of statistics (especially in political controversy) can see why this quotation is remembered. Well, we do not want to use statistics to mislead you, so here’s the truth: the numbers for Philadelphia County, where we have been working since 2018, do not look good by comparison with Pittsburgh.

​As you can see, abortion numbers actually rose after we started advertising there. Abortion ratios for Philadelphia County also look disappointing.

​The increase in abortion ratios between 2018 and 2020 for Philadelphia County residents was 2.1%. If we go back to 2017 and compare the ratio of the earlier year with 2020, the increase was 8.5%.
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Increases in abortion ratios can reflect an increase in the number of abortions, but they can also chiefly reflect, as we saw in Allegheny, a drop in birth numbers. Here are the birth numbers for Philadelphia.

The decline in birth numbers in Philadelphia County for 2017–2020 was not precipitous – 3.1%; this was less than the drop from 2012 to 2013 of 3.9%. The decline of previous years continued, however. From a comparison of abortion numbers and birth numbers over the years, we can conclude that the increase in abortion numbers in Philadelphia County played the larger role in the increase in abortion ratios than the decrease in births.

It appears, then, that our advertising was not having the effect we were looking for. There may be a few of reasons for this. For one, Philadelphia is a bigger “market” than Allegheny County, with 1.6 million people to Allegheny’s 1.2 million. Our ad spending in Philly was not commensurate with this difference in population. For another, the pregnancy medical centers in Philadelphia were not as prepared to handle abortion-determined women as were the centers in Pittsburgh. Finally, the year 2020 was an anomaly: in the midst of Covid fears, the centers in Pittsburgh remained open for business, while those in Philadelphia had restricted services.

Comparing Philadelphia to Other Counties Changes the Picture

Could our advertising have affected abortion numbers, despite the increase? Did it hold abortion numbers down? A comparison of Philadelphia’s numbers with those of the other counties (besides Philadelphia and Allegheny counties) suggests it did.

What do we find when we look outside Allegheny and Philadelphia counties? The number of births fell in these counties, 4.9% from 2017 to 2020, and 3.6% between 2018 to 2020. The drop in births in 2020 is sharp, if not unprecedented, and responsible for a big part of those years’ decreases.

​The really remarkable difference is the increase in abortion numbers and ratios in these other counties in 2020. Here are charts of the abortion numbers, followed by the ratios of abortions to births.

Abortion numbers and ratios increased sharply outside of the counties in which we advertise pregnancy medical centers, Allegheny and Philadelphia counties. From 2017 and 2018, to 2020, abortion ratios for counties other than Allegheny and Philadelphia rose from 135 to 158 per 1,000 births, or 17.0%. How does that compare with the abortion ratios for Philadelphia County?

In the chart below we see how the increases in abortion ratios of women in other counties compares with the increase in Philadelphia County, for the periods 2017 to 2020, and 2018 to 2020. (The low points in abortion ratios in the recent past vary from 2017 to 2018, hence the inclusion of both. The longer period, 2017 to 2020, is more significant, but our advertising in Philadelphia County began in earnest in 2018).

Counties                        % Increase in the Ratio of                  Difference Between the
                                              Abortions to Births                    Other Counties' Abortion
                                                       2017-2020                               Ratios and Philadelphia
                                                       2018-2020                                             County's Ratios
                                       
Philadelphia County                8.5% (2017 – 2020)
                                                    2.1% (2018 – 2020)

All Counties Other than            17.0% (2017 – 2020)                                               +8.5%
Allegheny and Philadelphia      17.0% (2018 – 2020)                                               +14.9%

​The difference between the increase in Philadelphia County and its closest county neighbors (geographically, and in terms of abortion ratios) also suggests that advertising reduced the increase in abortion numbers and ratios there. The increase in the abortion ratios in Philadelphia County from 2017 to 2020 was greater than that in Allegheny County, but from 2018 to 2020, while our advertising was running, the increase in Philadelphia was smaller – by 6% (see the chart below).

Counties                        % Increase in the Ratio of                   Difference Between the
                                              Abortions to Births                      Other Counties' Abortion
                                                       2017-2020                                Ratios and Philadelphia
                                                       2018-2020                                             County's Ratios

 Philadelphia County             8.5% (2017 – 2020)
                                                 2.1% (2018 – 2020)

Delaware County                  7.7% (2017 – 2020)                                                –.8%
                                                7.7% (2018 – 2020)                                                +5.6%
                                               
Montgomery County            15.0% (2017 – 2020)                                            +6.5%
                                                 5.6% (2018 – 2020)                                             +3.5%

Allegheny County                 4.9% (2017 – 2020)                                              –3.6%
                                                8.1% (2018 – 2020)                                               +6.0%

Summary for 2020

Abortion ratios for Allegheny County residents fell from 2010 to 2013, and stayed relatively low and stable for years. The ratios dipped in 2017 and 2018, but rose to the same generally low level in 2019. Remarkably, those ratios remained stable in “the year of the fear,” 2020, because, though birth numbers fell, so did abortion numbers. Advertising continues to affect the thinking of abortion-vulnerable and abortion-determined women in Pittsburgh. The effects of advertising show up in demographics.

Abortion numbers and ratios for Philadelphia County rose overall in the period 2017 or 2018 to 2020, a gloomy picture indeed. When we compare the County to other Pennsylvania counties (that is, all other counties except Allegheny County), things look much better, however. Both Philadelphia County and Allegheny County saw half the increase in abortion ratios that the other counties had between their low points (either 2017 or 2018) and 2020. To put it another way, other counties in PA had double the increase in abortion ratios, compared to Allegheny and Philadelphia counties, from the latter counties’ low points to “the year of the fear,” 2020.

By comparison with Philadelphia County, from 2018 to 2020 the increase in abortion ratios in counties other than Allegheny County and Philadelphia County was almost 8.5% higher. Comparisons of Philadelphia County with its nearest neighbors reinforce the conclusion that Philadelphia’s increase in abortion numbers and ratios lagged that elsewhere.

No doubt, those who are well-versed in statistical methods could find more elegant ways to establish whether or not the small increase in abortion ratios in Philadelphia County from 2018 to 2020 was statistically significant, and, if significant, how much so. While the above comparisons do not let us quantify the likelihood that our efforts made a difference, they give us good reason to think that our advertising helped cap the increase in abortion numbers and ratios in Philadelphia County over this period. Our advertising, then, acted like a sea anchor, which (Wikipedia tells us) is deployed from a ship in a storm, and “provides hydrodynamic drag, thereby acting as a brake.”

What if Vision for Life had not been advertising in these periods? Would Allegheny County’s abortion numbers have been much higher? Almost certainly. Would Philadelphia’s ratios of abortions to birth have increased much more than they did? We can’t be as confident, but it is quite likely.
 
What Else Do We Learn from the PA Abortion Report That Is Helpful for Our Work?

In order to reach women thinking about abortion, especially with our under-two-minute video ads that run on Facebook, Instagram, and Facebook’s Audience Network, we need to know something about their situations. We learn a lot from sociological studies of abortion patients and their demographics, and also from the pregnancy medical centers, who have first-hand experience with women contemplating abortion. We also learn from the Pennsylvania Annual Abortion Reports, especially about things like race, age, number of previous children, and number of previous abortions. So from the 2020 PA Health Department’s Abortion Report, we learn that a majority of abortion patients are not scared teenagers, but women 25 years and older.

​This trend has been going on for some time.

Each multi-colored column in the chart above shows an age group over nine years (2012 to 2020). Within those columns, the colors apply to the particular years. As you can see above, within the muti-colored columns (Under 15, 1–17, 18–19, and 20–24), from the dark blue column on the left (2012) to the light green column on the right (2020), the trend is a decline in the numbers, except for the 20–24 group, which showed a slight increase in 2020. Among the older cohorts 30–34 and 35–39, the trend is an increase in the numbers of abortions, generally year after year. Among women 40 years old and above, the much smaller abortion numbers declined until 2018, and then rose slightly the next two years. So abortion patients are becoming older.
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They are also more likely to be mothers of another child or of children.

Of the total number of abortions to residents in 2020, mothers of one or more children were the following percentages:
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One previous birth – 26%
Two previous births – 21%
Three previous births – 10%
Four previous births or more – 6%
Mothers with no previous births were only 36% of the total.
 
Abortions to women who had no previous abortion had been in decline for years, until they started to rise in 2018. The same was generally true for women who had one or more previous abortion(s).

​Close to half of all abortions in 2020 were to women had had 1 or more abortion(s) – 47%.

​In summary, we are grateful that abortion numbers fell in Allegheny County in 2020, and that abortion ratios did not increase, as they did elsewhere. We are disappointed to see that we have not brought down abortion numbers and ratios in Philadelphia as we had hoped, but encouraged by the fact that numbers and ratios did not increase at the same rate as they did in the rest of the State, or at the rate of the surrounding counties with significant abortion numbers. We are persuaded that advertising is responsible for keeping abortion ratios down, and have expanded in 2022 to Cleveland, Ohio, whose abortion rate is close to that of Pittsburgh when we began there. Pray that God may bless our work, and that many more moms and babies are saved from abortion.