Broadening The Focus: Reaching Older Women with Pregnancy Help
We have been very successful serving younger women. Now we need to reach out to their older peers.
Summary
- Fewer adolescent women (15–19) are having abortions, now only 9% of all.
- More than 60% of abortions are performed on women 25 and older.
- Pregnancy help has driven the decline in abortion numbers, especially with younger women.
- Now pregnancy help centers, and pregnancy center marketers, should intentionally broaden their outreach to the older demographic.
A few years back, the executive director of a local pregnancy help center observed that clients were becoming more “abortion-determined.” They weren’t calling up with questions about pregnancy and abortion, but asking how much an abortion would cost. They had made up their minds, and were just shopping.
Now some of this could be the result of changing mores, new attitudes to sex and relationships, or a changing sense among these young women of how one has to act in “the real world.” More likely, however, it is demographic changes in the pool of those considering abortion that have made the abortion-determined more obvious among those who contact the centers.
Let’s take a look at abortion numbers over the long term, to see the trend.
The most striking change since 1973, perhaps, is the proportion of abortion patients who are under 20 years old (the yellow bars), dropping from 33% then, to 9% in 2019 – a 73% decline. Greater, however, is the difference in the proportion of patients who were over 24, increasing from 36% to 63% (the blue bars) – an increase of 80%.
Put this data together with the decline in raw abortion numbers over the same period, and it is clear: not only is the proportion of younger women having abortions shrinking, but the number of them is decreasing, too. The following chart shows the pattern clearly: the trend lines showing the numbers of women 15–19 and 20–24 having abortions go down (the orange and gray lines). The trend lines for abortions among women 25–29 and 30–34 rise slightly (the yellow and blue lines).
Put this data together with the decline in raw abortion numbers over the same period, and it is clear: not only is the proportion of younger women having abortions shrinking, but the number of them is decreasing, too. The following chart shows the pattern clearly: the trend lines showing the numbers of women 15–19 and 20–24 having abortions go down (the orange and gray lines). The trend lines for abortions among women 25–29 and 30–34 rise slightly (the yellow and blue lines).
How do we explain the declining number of young women having abortions? Adolescents are less sexually active than in the past. In 1991, 54% of high school students had had sex; in 2019 that number was 38.4.[1] Many observers have seen a reduction in sexual activity generally, though it is most observable in younger women. A variety of reasons are given to explain it.[2] The result is fewer pregnancies that lead either to birth or abortion.
Less sex, and fewer pregnancies, however, doesn’t explain why, over the years, women 15–24 in particular gradually became a smaller proportion of all age groups having abortions. Nor does it explain the decline in the ratios of abortions to births for the same group until 2010 or so. (From then on, it appears that pregnancy rates and abortion rates per 1,000 women for those 15–24 have fallen, while ratios have been stable. Fewer women in that bracket are getting pregnant, and about the same proportion of those pregnant are having abortions.[3]). For those 15–19, those ratios per thousand births dropped over 50% from 1985 to 2007; for those 20–24, they dropped 29%. The decline for those 25–29 was 16%.[4]
Could it be that the cohort of women who were open to abortion years ago are just getting older and are still open to abortion, while younger women are less so? Changing practical attitudes to abortion may play a role, but the age trends are lasting much longer than the reproductive years of a given cohort. Something else is likely in play here.[5]
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[1] Kate Julian, “Why Are Young People Having So Little Sex?” The Atlantic, December 2018 (https://www.theatlantic.com/magazine/archive/2018/12/the-sex-recession/573949/); CDC, Youth Risk Behavior Survey: Data Summary and Trends Report, 2009–2019, p. 12 (https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf).
[2] Julian, op. cit.
[3] From “Table 4. Percentage, rate,* and ratio† of reported abortions, by known age group and year — selected reporting areas,§ United States, 2010–2019,” in the CDC Abortion Surveillance Report for 2019.
[4] Calculations were made using “Table 12 (page 1 of 2). Legal abortions and legal abortion ratios, by selected patient characteristics: United States, selected years 1973–2007,” from the 2011 CDC Abortion Surveillance Report (https://www.cdc.gov/nchs/data/hus/2011/012.pdf).
[5] I am indebted to my fellow Heartbeat International Board member Gary Thorne for this observation.
Less sex, and fewer pregnancies, however, doesn’t explain why, over the years, women 15–24 in particular gradually became a smaller proportion of all age groups having abortions. Nor does it explain the decline in the ratios of abortions to births for the same group until 2010 or so. (From then on, it appears that pregnancy rates and abortion rates per 1,000 women for those 15–24 have fallen, while ratios have been stable. Fewer women in that bracket are getting pregnant, and about the same proportion of those pregnant are having abortions.[3]). For those 15–19, those ratios per thousand births dropped over 50% from 1985 to 2007; for those 20–24, they dropped 29%. The decline for those 25–29 was 16%.[4]
Could it be that the cohort of women who were open to abortion years ago are just getting older and are still open to abortion, while younger women are less so? Changing practical attitudes to abortion may play a role, but the age trends are lasting much longer than the reproductive years of a given cohort. Something else is likely in play here.[5]
[Text continues below.]
[1] Kate Julian, “Why Are Young People Having So Little Sex?” The Atlantic, December 2018 (https://www.theatlantic.com/magazine/archive/2018/12/the-sex-recession/573949/); CDC, Youth Risk Behavior Survey: Data Summary and Trends Report, 2009–2019, p. 12 (https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf).
[2] Julian, op. cit.
[3] From “Table 4. Percentage, rate,* and ratio† of reported abortions, by known age group and year — selected reporting areas,§ United States, 2010–2019,” in the CDC Abortion Surveillance Report for 2019.
[4] Calculations were made using “Table 12 (page 1 of 2). Legal abortions and legal abortion ratios, by selected patient characteristics: United States, selected years 1973–2007,” from the 2011 CDC Abortion Surveillance Report (https://www.cdc.gov/nchs/data/hus/2011/012.pdf).
[5] I am indebted to my fellow Heartbeat International Board member Gary Thorne for this observation.
Abortion ratios are the best measurement of factors affecting the pregnancy decision. When the proportion of pregnant women choosing life goes up, one naturally looks for a cause. The most obvious cause of reduced abortion ratios across the country is the increase in pregnancy help centers and the advertising of them. Abortion numbers began falling in the mid-1980s, just as the number of pregnancy help centers began increasing sharply. The abortion numbers have continued to fall steadily to the present, as more centers go up and as advertising for those centers becomes more widespread.
Has pregnancy help had an outsized effect upon adolescents and younger women? It is almost certainly so, at least before 2011. When they become pregnant, younger women are more likely to be unsure of whether they are. When they have confirmation that they are pregnant, they are more likely to be uncertain of their next step, or of what they really want. They are more likely to be ambivalent about abortion, and find decision-making challenging.
This is reflected in the fact that younger women have a lower proportion of early abortions than older women, and a higher proportion of later abortions. Let us focus on the gestational ages when most abortions are performed: 9 weeks or under. In the chart below showing CDC data from 2019, you can see that about 36% of women 15–19 who had abortions (the blue line), had their abortions at 6 weeks or less. Of those women a little older, 20–24, 41% of those who had abortions (the orange line), had them within the same period. If you follow the six-weeks-and-under line (blue) to the right, you see that the older a woman was, the more likely it was that she had an abortion early in pregnancy.
Has pregnancy help had an outsized effect upon adolescents and younger women? It is almost certainly so, at least before 2011. When they become pregnant, younger women are more likely to be unsure of whether they are. When they have confirmation that they are pregnant, they are more likely to be uncertain of their next step, or of what they really want. They are more likely to be ambivalent about abortion, and find decision-making challenging.
This is reflected in the fact that younger women have a lower proportion of early abortions than older women, and a higher proportion of later abortions. Let us focus on the gestational ages when most abortions are performed: 9 weeks or under. In the chart below showing CDC data from 2019, you can see that about 36% of women 15–19 who had abortions (the blue line), had their abortions at 6 weeks or less. Of those women a little older, 20–24, 41% of those who had abortions (the orange line), had them within the same period. If you follow the six-weeks-and-under line (blue) to the right, you see that the older a woman was, the more likely it was that she had an abortion early in pregnancy.
The orange line for abortions in the 7–9 weeks gestational period shows that the older women were, the more likely it was that they had their abortions earlier in pregnancy. The same is shown by the line for 10–13 weeks gestation (gray) and, for the 15–19-year-olds versus the rest, the line for those 14–15 weeks (yellow).
So it appears that uncertainty and ambivalence regarding abortion is higher among younger women, than those a few years older. It is no surprise that younger women who have an opportunity to find support, have increasingly turned away from abortion over the years than older women. It is also no surprise that, as abortion numbers have gone down, our success has meant that more clients seem “abortion-determined” than ever.
Pregnancy help centers are staffed, in many cases, with older women who serve as advisors or mentors for women whose family situations make such mentors invaluable. I submit that these older women are effectively surrogate “moms,” taking the right amount of interest in the well-being of their clients, while respecting the freedom of these adult “children” to make their own decisions. These “moms” care, and inasmuch as their clients get to know them, their clients know that they care. It is this, and the information, practical advice, and moral and spiritual support that they provide, that has had the effects we see in my first two charts: younger women, women more ready to accept those falling into a “mom” role, are less likely to abort than those over 25.
The result, however, is that the women that pregnancy help centers have to reach are more and more “determined.” That is, they are more experienced, and less impulsive (something that both males and females face, as the brain matures in the twenties[1]). They are surer of themselves, and perhaps more cynical as a result of their experiences. About 60% are moms already, and over 40% have had one abortion or more before.
Without ceasing to appeal to those under 25 (aiming at the high schools and colleges, and so forth), pregnancy help centers would do well to reach out to older women, who in many cases face more complicated situations than their younger peers. Despite the challenges, many still respond when they have the opportunity.
Chris Humphrey, Ph.D.
Co-Founder, Vision for Life
Former Board Member, Heartbeat International
www.visionforlifepgh.org
Permission to reproduce or publish this article in any format is granted at no cost, so long as there are no material changes to it, and no fee is charged in such publication.
[1] https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know.
So it appears that uncertainty and ambivalence regarding abortion is higher among younger women, than those a few years older. It is no surprise that younger women who have an opportunity to find support, have increasingly turned away from abortion over the years than older women. It is also no surprise that, as abortion numbers have gone down, our success has meant that more clients seem “abortion-determined” than ever.
Pregnancy help centers are staffed, in many cases, with older women who serve as advisors or mentors for women whose family situations make such mentors invaluable. I submit that these older women are effectively surrogate “moms,” taking the right amount of interest in the well-being of their clients, while respecting the freedom of these adult “children” to make their own decisions. These “moms” care, and inasmuch as their clients get to know them, their clients know that they care. It is this, and the information, practical advice, and moral and spiritual support that they provide, that has had the effects we see in my first two charts: younger women, women more ready to accept those falling into a “mom” role, are less likely to abort than those over 25.
The result, however, is that the women that pregnancy help centers have to reach are more and more “determined.” That is, they are more experienced, and less impulsive (something that both males and females face, as the brain matures in the twenties[1]). They are surer of themselves, and perhaps more cynical as a result of their experiences. About 60% are moms already, and over 40% have had one abortion or more before.
Without ceasing to appeal to those under 25 (aiming at the high schools and colleges, and so forth), pregnancy help centers would do well to reach out to older women, who in many cases face more complicated situations than their younger peers. Despite the challenges, many still respond when they have the opportunity.
Chris Humphrey, Ph.D.
Co-Founder, Vision for Life
Former Board Member, Heartbeat International
www.visionforlifepgh.org
Permission to reproduce or publish this article in any format is granted at no cost, so long as there are no material changes to it, and no fee is charged in such publication.
[1] https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know.