The explosion in numbers of Pregnancy Help Centers in the mid-1980s across America is likely the biggest factor in the reduction of abortion ratios since the early 1990s.

As you may know, Planned Parenthood is now pushing the argument that their contraceptive work has actually reduced unintended pregnancies in the very short term (2008-2011, and onward), and so has reduced the number of abortions. (They may offer rewards to employees who generate more abortions, but they know what sells in the political sphere.)

(Incident​ally, this is a fundamentally dishonest infographic, as they know that only one-half of unintended pregnancies end in abortion, so the increase in abortions, if the initial claim were true to begin with, would be about 7 to 8% more -- not 15%.)

To make their case, they have to run down what many fine people -- like those at #ChoicesPregnancyServices and #WomensChoiceNetwork -- are doing in the pregnancy help centers. So, one Guttmacher piece says, "Antiabortion activists routinely fail to acknowledge that abortion declines can result from fewer unintended pregnancies, and instead pretend that any decline in the number of abortions is the result of women opting, or being compelled, to give birth rather than have an abortion. These activists often seize on declines in the abortion ratio—the proportion of all pregnancies ending in abortion—to showcase the supposed impact of their efforts."

The problem for Planned Parenthood is that the decline in abortion ratios is long-term, and can't be explained by changes in contraceptive media or rates of contraceptive usage. The conclusion of the most recent annual report on abortion from the CDC does not put much stock in the notion that Long-Acting Reversible Contraceptives -- LARCs -- can be credited with the recent decline in abortion ratios. A big increase in the use of the relatively effective LARCs, if there were one, might make PP's case statistically for the recent past -- but the increase would be short-term, while the decline in abortion ratios precedes it by decades.

While, for example, “between 2002 and 2006–2008, the percentage of women who had ever used emergency contraception rose from 4% to 10% (5.2 million)" and "the percentage who had ever used the contraceptive patch rose from 1% to 10% (5.3 million),” (1) “changes in contraceptive method choice and use have not decreased the overall proportion of pregnancies that are unintended between 1995 and 2008 . . ." (2). If unintended pregnancies remained more or less stable, while the ratios of abortions to live births went down, then more women whose pregnancies were unintended must have been choosing life.

Through it all, the ratios went down. Here's the updated graph showing the long-term and short-term pictures.

These bars represent new centers, not just the total of existing ones. The effect of these centers on their communities likely grew over time, after an initial lag. While changes in contraception may be having some impact on unintended pregnancies in the last few years, and indirectly on abortion ratios, the biggest influence over time, and even now, is likely these centers -- and even on women who wouldn't go to one, but just know that they're there.