Abortion Reporting: South Dakota (2019)

Tessa Longbons  

South Dakota’s provisional 2019 abortion report was published by the South Dakota Department of Health in June 2020, and the final report was released in September. The final report shows that chemical abortions in South Dakota remain low.


Changes in South Dakota Abortions, 2018-2019

Information on Planned Parenthood’s South Dakota market share is not included in the report, but the South Dakota legislature estimates that Planned Parenthood performs 98 percent of the abortions in the state.


Abortion Totals and Trends


There were 414 abortions reported in South Dakota in 2019. This was an increase of eight percent from the unusually low 382 abortions reported in 2018, but still lower than the 2017 total (Fig. 1). Chemical abortions demonstrated little change, increasing by just five abortions (four percent) from 136 in 2018 to 141 in 2019. In 2019, chemical abortions made up 34 percent of all abortions in South Dakota. Charlotte Lozier Institute (CLI) estimates that South Dakota’s abortion rate increased from the year before but was still extremely low at 2.6 abortions per 1,000 women ages 15 to 44 (Fig. 2). South Dakota’s 2019 abortion report is marked as provisional, and numbers may be updated in the future.


State Report Summary


A relatively large proportion of South Dakota abortions are performed on women from other states. Eighty percent of the abortions were performed on resident women, and 20 percent were performed on nonresidents. Of the 82 abortions performed on nonresident women, 40 were on women from Iowa, 33 were on women from Minnesota, and nine were on women from other states.


Ten percent of South Dakota abortions were performed on girls under the age of 20. Over half the abortions (59 percent) were on women in their twenties, with 31 percent on women ages 20 to 24 and 28 percent on women ages 25 to 29. Twenty-six percent of the abortions were on women in their thirties, and five percent were on women age 40 or older. Of the 14 girls under the age of 18 who obtained abortions in South Dakota in 2019, 13 had their parents notified before their abortions were performed and one obtained a judicial waiver of the parental notification requirement.


Forty-nine percent of the abortions were performed on women who had a high school education or less, while 24 percent were on women who had attended college and 27 percent on women with college degrees. Sixty-three percent of the abortions reported in South Dakota were performed on non-Hispanic white women. Eleven percent were on non-Hispanic black women, nine percent on non-Hispanic Native American women, and eight percent on Hispanic women. Five percent of the abortions were performed on non-Hispanic Asian women and three percent on women of multiple races. Seven abortions (two percent) were performed on women whose race was not reported.


Twenty-one percent of the abortions were on married women, and 79 percent were on women who were not married. Most of the abortions were on women who already had children: 18 percent were on women with one child, and 42 percent were on women with two or more children. However, over two-thirds of the abortions were on women with no previous abortions. Twenty-one percent were on women with one prior abortion, and just 10 percent were on women with more than one previous abortion. Nineteen percent of the abortions were obtained by women who had previously experienced miscarriages.


The majority of the abortions occurring in South Dakota, 83 percent, were self-funded. Thirteen percent were covered by private insurance, and just under five percent were funded by a public health plan, defined by South Dakota as “any plan established or maintained by a state, county, or other political subdivision of a state that provides health insurance coverage to enrolled individuals.” Seventy percent of the abortions reported in South Dakota cost between $600 and $699. Twelve percent cost less than $600, and 18 percent cost $700 or more.


Nearly a third of the women who obtained abortions in South Dakota did not use any anesthesia. Sixty-six percent had a local anesthetic, 1.4 percent underwent conscious sedation, and half a percent had a regional anesthetic. Most of the abortions (79 percent) were performed by OB-GYNs. Twenty-one percent were performed by doctors who specialized in family medicine, and just 0.2 percent were performed by doctors who specialized in maternal and fetal medicine. The report indicates that four abortion complications were reported in 2019.1


Thirty-four percent of the unborn babies killed by abortion weighed less than 100 grams, and 13 percent weighed 100 grams or more. Weight was not reported for 52 percent of the babies. Sixty-six percent of the unborn babies’ bodies were incinerated, two percent were buried, and 32 percent were discarded as medical waste or via unknown means. Seven of the abortions were performed on unborn babies who had anomalies.


South Dakota asks women to report their reasons for choosing abortion, and women can select more than one reason. According to the report, 41.3 percent of the women provided multiple reasons. In 2019, as in previous years, the majority of women (70 percent) chose abortion because they did not desire the child. Forty-eight percent could not afford the child, and 21 percent underwent abortion for their emotional health. Fifteen abortions (four percent) were performed because of a serious risk to a major bodily function, and eight abortions (two percent) were due to rape or incest. Seventeen percent of the abortions were performed for other reasons.


Sixteen percent of the abortions were performed at six weeks of gestation or earlier. Thirty-nine percent were performed between seven and eight weeks, and 23 percent occurred from nine to 10 weeks. Fifteen percent of South Dakota abortions were performed between 11 and 12 weeks and seven percent were performed at 13 weeks of gestation or later. South Dakota’s only abortion center, Planned Parenthood Sioux Falls, performs abortions through 13 weeks. Sixty-six percent of the abortions were performed surgically, and 34 percent were chemical abortions. The month of August had the most abortions (62) and November had the least (11).


Informed Consent


South Dakota’s informed consent process is one of the strongest in the country. Abortion facilities are required to provide women with information on their rights and options, including the fact that their relationships with their unborn children are constitutionally protected. In order to allow women to make informed decisions free of coercion, women must then be given 72 hours, excluding weekends and holidays, to consider their choices before an abortion may be performed. In 2019, the South Dakota Department of Health received 492 informed consent forms, of which 414 indicated that the women went on to get abortions and 78 showed that the women did not get abortions. Of the 414 women who underwent abortions in 2019, 411 received the required informed consent information, while three did not receive the information due to medical emergencies or risk to a major bodily function.


Starting on July 1, 2019, women undergoing abortions in South Dakota were offered the opportunity to listen to their babies’ heartbeats. In 2019, 72 women took advantage of the opportunity to listen to the heartbeat.


In 2018, the South Dakota legislature criticized Planned Parenthood’s implementation of the informed consent law. The legislature passed a bill, which was signed into law, establishing its findings that Planned Parenthood was undermining the informed consent process and ignoring the spirit of the law in the way information was presented to women considering abortion. According to the legislature’s findings, Planned Parenthood performs around 98 percent of all South Dakota abortions. In 2019, South Dakota enacted a law requiring abortion providers to use the state’s informed consent form.


State Ranking


In 2016, CLI evaluated state abortion reporting across the country, and South Dakota’s reporting tied for 7th best. For some data points, South Dakota reports the percentage of abortions, but not the actual numbers; South Dakota could report the actual numbers to allow for easier comparisons from year to year. Additionally, South Dakota could report the number of abortions performed at each type of abortion facility, including hospitals and abortion centers, and could provide more clarity on the methods used to dispose the bodies of unborn babies by creating a separate category for chemical abortions. South Dakota could improve its abortion complication statistics by collecting data from both abortion facilities and other health care facilities, such as emergency departments and urgent care clinics.

  1. Statistics on abortion complications reported here represent a minimal number of deaths and complications, as this data is collected in a non-systematic and non-verifiable way. As such, this data cannot be used to calculate either an accurate abortion mortality rate or an accurate abortion complication rate for the state.
  2. 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 South Dakota ÷ number of resident women ages 15-44) x 1,000. Rates may differ slightly from previous CLI articles due to revised population estimates.

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