The Charlotte Lozier Institute’s summary of Iowa’s 2020 abortion report is forthcoming.
Iowa’s 2019 abortion statistics were published by the Iowa Department of Public Health in October 2020. According to the report, Iowa abortions increased from the previous year.
Changes in Iowa Abortions, 2018-2019
Information on Planned Parenthood’s Iowa abortion market share is not included in the abortion report.
Abortion Totals and Trends
There were 3,566 abortions reported in Iowa in 2019, an increase of 25 percent from the previous year (Fig. 1). Chemical abortions rose by 24 percent, making up two-thirds of all abortions occurring in the state. The Charlotte Lozier Institute (CLI) estimates that Iowa’s abortion rate in 2019 was six abortions per 1,000 women ages 15 to 44. This was an increase of 25 percent from the 2018 abortion rate, but still less than half the national rate (Fig. 2).
State Report Summary
In 2019, 86 percent of the abortions reported in Iowa were performed on Iowa residents, while 14 percent were performed on nonresident women. Ten percent of the abortions were performed on girls under the age of 20, including three percent on girls under the age of 18. Over half (55 percent) were on women in their twenties: 27 percent were on women ages 20 to 24, and 28 percent were on women ages 25 to 29. Thirty percent of the abortions were on women in their thirties, and four percent were on women age 40 or older.
A majority of the abortions occurring in Iowa were performed on white women (72 percent). Eighteen percent were obtained by black women. A relatively small number were performed on women of other races, with just 0.6 percent on American Indian women and 0.5 percent on Asian women. Four percent were performed on women of other, unspecified races, one percent on women of multiple races, and four percent on women whose race was not reported. CLI estimates that Iowa’s black abortion rate was 19.5 abortions per 1,000 women ages 15 to 44, four times the white rate of 4.8.
Eighteen percent of the abortions were performed on married women, while 82 percent were on unmarried women. The majority (57 percent) were obtained by women who had completed at least some college; 41 percent were on women with nine to 12 years of education, and one percent were on women with eight years of education or fewer. In 2019, July had the fewest abortions (246), while May had the most (349).
In 2019, two-thirds of Iowa abortions were chemical, and almost a third were surgical. Less than one percent were performed using some other means. The vast majority, 94 percent, occurred at or before 13 weeks, while six percent were performed between 14 and 28 weeks of gestational age. Iowa limits abortion at 20 weeks postfertilization, or approximately 22 weeks of gestation.
The Increase in Abortions in Iowa
The rise in Iowa abortions between 2018 and 2019 was likely impacted by multiple factors. Some have attributed the increase to Iowa’s 2017 policy change that shifted family planning funding away from abortion provider Planned Parenthood. However, despite the increase in Iowa abortions between 2018 and 2019, both births and abortions in Iowa were far lower in 2019 than they were in 2016, the year before Planned Parenthood exited the family planning program.
The apparent increase in abortions in 2019 is partly due to a sharp temporary drop in abortions in 2018. As a result of the 2017 family planning law, four Planned Parenthood abortion centers closed in 2017, including one that finally halted chemical abortions in December 2017. These abortion center closures may have played a role in the low abortion numbers in early 2018: just 27 abortions were reported in Iowa in January 2018, an abrupt drop from the 302 abortions reported in December 2017.
Another factor contributing to the rise in Iowa abortions in 2019 may have been an expansion of the gestational age at which chemical abortions are performed in many of the abortion centers in the state. The surgical and other abortion total increased by 258 abortions between 2018 and 2019, while chemical abortions rose by 459 abortions. In 2018, Iowa’s Planned Parenthood abortion centers – which made up five of the six abortion centers in the state – performed chemical abortions through 9 weeks 0 days gestational age. However, in 2019, Planned Parenthood began advertising chemical abortions through 10 weeks 0 days. Early chemical abortions represent an unusually large portion of Iowa’s abortion total compared to other states, and the additional week may have accounted for some of the increase in chemical abortions.
In CLI’s 2016 survey of abortion reporting across the nation, Iowa’s reports tied for 33rd best. Iowa has made improvements to its reporting since then, undertaking initiatives to remind medical professionals of the reporting requirements and releasing the 2019 report ahead of schedule. To continue to improve its reporting, Iowa could report abortions by gestational age with more specificity instead of grouping 14 weeks together into one timeframe. Additionally, because chemical abortions have a higher complication rate than surgical abortions at the same gestational age and chemical abortions compose such a large proportion of Iowa abortions, Iowa could collect and report information on abortion complications caused by different types of procedures at different stages of pregnancy.
- Rates were calculated by CLI using population estimates from the United States Census Bureau. The rates were calculated using the following formula: (total number of abortions performed in Iowa ÷ number of resident women ages 15-44) x 1,000. Rates may differ slightly from previous CLI articles due to revised population estimates and abortion totals.