Enough has changed in who, when, and how women are obtaining abortions, that most of us have an outdated idea of abortion. Even within the last six years, substantial shifts have taken place. Abortion has changed.  
When most people think about abortion, they probably imagine a teenage girl who just found out she’s pregnant, is worried about telling her family, is too young to parent, and is secretly seeking a surgical abortion at the local abortion clinic. It still happens like that sometimes, but it’s now the exception rather than the rule.
In reality, women in their 20s now obtain the most abortions, with the highest numbers in the 25-30 age bracket. They typically already have a child, and most live below the poverty line.
They are also obtaining abortions earlier and differently than in the past. Just a few years ago, most were surgical. In 2020, that changed for the first time. Now, most abortions are completed using abortion pills. The “abortion pill” is really a course of two medications: mifepristone and misoprostol. Abortion pills are generally prescribed and taken before the baby is 11 weeks gestation, and 92% of all abortions happen before 13 weeks. Women can often access these drugs through an online prescription and have them mailed and taken at home. Now, a woman seeking an abortion can obtain one without going anywhere.

Rise in Abortion Rates

According to the latest available data, 53% of abortions are carried out via the abortion pill. However, this info draws from pre-pandemic datasets (before 2020). During the pandemic, loosening restrictions on in-person requirements for prescriptions, increasing telehealth services, and rising abortion rates overall likely mean that the proportion of abortions mediated by the abortion pill increased significantly.
And yes, you read that right. It appears that the abortion rate has gone up. The increase started just before the Dobbs decision. In 2018, the abortion rate began trending back upward for the first time in three decades. Back in March of this year, it seemed that they had declined since Dobbs, but the decline was most notable right after the decision and then started to go back up again. This upward trend appears to have continued.
It’s too early to be confident about the national picture on abortion because the changing legal landscape also means that reporting is a bit of a mess. It is, however, apparent that abortion has gone up in the states where it’s still legal- including 33% in Oregon. Whether this is because of abortion travel from more restrictive states, or a continuation of trends that were already at play before the Dobbs decision is less clear. It’s probably a combination of many things.
We should celebrate that there are places in the country that are protecting preborn lives. There are people alive today who would not be without those protections. Abortion is almost certainly lower than if the Dobbs decision didn’t happen. Yet, because abortions are concentrated in states that do not restrict abortion and because of the other trends I’ve mentioned, and ones we don’t understand yet, the impact seems to be somewhat muted overall. The work is far from over.

What does all of this mean?

The change in the abortion landscape means a few things for us as we consider how best to be a Jesus-centered, life-affirming alternative for pregnancy and women’s health services in our city.
First, it means that the need to reach women actively considering abortion in Oregon is still huge, and it’s growing. It also means that reaching them is more challenging than it used to be. Over a ten-year period, the proportion of women we see actively considering abortion declined by 65%. The changes we’ve been making this year are because we believe those actively considering abortion are who God has called us to serve.
Abortion access in Oregon is a superhighway. We want to be the very first offramp. There is now a much greater urgency to connect with potentially pregnant women as soon as they suspect pregnancy.
In practice, that means we want women facing unexpected pregnancies to be able to talk to a caring, life-affirming medical professional as quickly as possible so they can get the information and support they need to take a step forward.
The urgency to connect with women considering abortion is why we continue to work diligently to make the process seamless and rapid, from searching for something like “pregnancy symptoms” online to talking to one of our advocates and nurses to coming in for an ultrasound. Today, if a woman clicks on one of our ads online, she can immediately chat with an advocate trained to help connect her to our medical team right away.
There are other implications here. Keeping our services free for our patients remains critical. Continuing to offer and expand services valuable to the people we ultimately want to reach is essential. Making sure that we are connecting women to holistic support that brings them greater stability must still happen. And, Jesus must stay central to why and how we do what we do.
That last implication doesn’t come from the numbers. It always has been and always will be true. Jesus is the reason we do this work, and he doesn’t change.