seyma bayram

Who is getting abortions in Ohio? And where are people getting them?

By Doug Livingston and Seyma Bayram

Published in the Akron Beacon Journal, March 24, 2022 (Click here to view on news site, with data maps and charts intact). This is one story in a 4-part series.

A financially secure 34-year-old married woman, fully employed with a college education and no kids, drove two hours from Columbus to surgically abort a six-week pregnancy. 

A single woman from Youngstown, where no abortion clinics exist, left her 3-year-old child at home and borrowed from her mother for the $650 procedure. 

A 30-year-old Canton woman, seven weeks pregnant, panicked when the first four clinics she called couldn’t see her for weeks.

A 21-year-old single mother from Ashtabula first landed at a crisis pregnancy center, where staff with no medical training tried to pressure her into keeping her pregnancy, before she found an abortion clinic an hour away. 

A 25-year-old Summit County resident “scared for the future” of women’s reproductive rights was thankful she was able to “come and do this now."

"And, hopefully, I won’t have to do it again, but who knows?” she said.

A 23-year-old machinist from Bellefontaine, a small city north of Dayton, tried to go to Columbus, where her boyfriend lives, but the wait time would have put her beyond Ohio's 10-week limit for the abortion pill. 

A 25-year-old woman working in health care in Columbus had to miss work to get a surgical abortion in Cuyahoga Falls.

“I was actually on birth control,” she said. “I’m just not ready. I’m trying to get back to school and … I already have a child.” 

Each of these women had an abortion in late February or early March at the Northeast Ohio Women’s Center in Cuyahoga Falls. They are among 13 women interviewed in February and March by the Beacon Journal while they were at this clinic for an abortion, at another clinic in Shaker Heights or videoconferencing with a doctor in a telemedicine health visit for the abortion pill.

National research suggests at least 1 in 4 women will abort a pregnancy in her lifetime. Women from all walks of life from every county in Ohio get abortions, which have decreased significantly in the state as more and more clinics close under the mounting pressure of restrictive laws.

Most are already mothers. They think about their children, their careers, their futures. Then, they call off work, arrange child care and scrape together $650 or more.

Then they drive hours to abort fetuses that, on average, are no bigger than kidney beans.

Some have tried to get into clinics where they live or as far away as West Virginia, Michigan, Pennsylvania and Indiana. The wait times would have forced them to have surgical abortions instead of medical pill abortions, or no abortion at all if up against Ohio’s 20-week ban.

Despite a slight uptick in 2020, the annual total for the state continues to drop. 

Access declines as clinics close

Only nine clinics perform abortions in Ohio, down from 45 in 1992 and 23 in 2010, according to abortion-rights groups that track the facilities.

And only six of the clinics open today perform surgical abortions, which is the only option for women at least 10 weeks pregnant. The Northeast Ohio Women's Center in Cuyahoga Falls is among them.

State elected officials are fighting in court to close the last clinics in Dayton and Cincinnati, which would drive even more women to Indianapolis (where outpatient abortion is limited to 13 weeks) or Columbus, where patients are reporting untenable wait times at Planned Parenthood. Some could end up traveling even farther north to Summit or Cuyahoga counties. 

The Falls facility on State Road and another location in Shaker Heights are on pace this year to complete 3,850 abortions, more than double the volume in 2019, according to data provided by the clinic. That’s more abortions this year than were performed in all of Franklin County in 2020 when three clinics, including one that's now closed, were in operation.

Planned Parenthood facilities in Youngstown and Mansfield have recently discontinued abortion services. The network’s remaining surgical facilities are understaffed, a spokeswoman said, and abortion is not listed as a telemedicine option at other Planned Parenthood locations.

"Ninety percent of the counties in Ohio don’t have a clinic that performs abortion within 100 miles," said Jordyn Close with Women Have Options - Ohio, the only statewide fundraising effort to help people get to and pay for abortions.

As clinics close, women are getting fewer abortions regardless of age, race, income, residence or education level. The decline in abortions, down 27% from 2010 to 2020, has outpaced the decline in live births, down 7%.

White, less-educated and younger women, particularly in ZIP codes that include public universities and patches of rural Ohio, have seen the largest percentage point declines.

In raw numbers, though, the most dramatic drops have been recorded around Cleveland (with the exception of Garfield Heights where they are up), Toledo, Shaker Heights, Lakewood, Bowling Green, Kent and Athens. In some ZIP codes, there were 100 to 200 fewer abortions in 2020, compared to 2010.

In Summit County, abortions are significantly down among residents of Cuyahoga Falls, Stow, Northfield, Barberton and many of the lowest-income ZIP codes circling downtown Akron, but up in neighborhoods like North Hill, West Akron, East Akron and Northwest Akron. With white women even more underrepresented in the numbers, abortions are more concentrated than ever in low-income and Black communities.

By the numbers: ZIP code data for abortions 

The Beacon Journal analyzed demographic and ZIP code data for abortions, which the Ohio Department of Health has published annually from 2004 to 2020. 

The data reveal that: 

• 2020 was only the second time this century that abortions increased in Ohio. They also went up in 2012. Abortions first dipped below 20,000 in 2014 after a steady decline from about 40,000 annually in the late 1970s and early 1980s.

• 90% of women who received abortions in 2020 were unmarried, up slightly from a decade ago.

• Women 25 and older account for 63% of abortions, up from 47% in 2004.

• From 2004 to 2020, abortions fell 53% for women with no more than a high school education and 26% for college-educated women.

• Black women surpassed white women in the number of abortions for the first time in 2020. White people, who represent 82% of Ohio's population, accounted for 44% of abortions while Black people, who represent about 13% of Ohio, had 48% of abortions in the state.

• None of the 441 abortions after 19 weeks involved a viable fetus in 2020.

• 62% of abortions occurred within nine weeks of gestation, up from 58% in 2010. The FDA relaxed the label on the abortion pill in 2016, forcing Ohio to adopt a more liberal use of the drug designed to terminate early pregnancies.

• Early pregnancy abortions also increased as the state cracked down on surgical abortions, reserved for 10 to 20 weeks of pregnancy, to preserve personal protective equipment during the pandemic.

• The expansion of administering abortion pills via telemedicine, which officials tried to restrict during the pandemic, has also increased access in recent years.

The findings also track national research from the Guttmacher Institute and others who report most patients are now older with children and no history of abortion. 

“The majority, 60%, are already parents,” said Kellie Copeland, executive director of Pro-Choice Ohio. “So when you’re talking about criminalizing people who have abortions, you're talking about parents, you’re talking about putting parents in jail. You're talking about separating parents from their children, you are talking about families, by and large, who are on the lower income scale who are already trying to make ends meet.”

Younger women are also having less sex. Unwanted pregnancies and teen births are down, which each side of the debate attributes to more widely available contraception and sex education. A 2021 study found that people ages 18 to 23 were having less sex because they spent more time on social media.  

Restrictive policies requiring minors to get the consent of a parent or judge have also made it harder for younger people to access abortion.

How safe is abortion for the women? 

In the United States in 2019, 1 in every 4,941 pregnant women died of birth or pregnancy issues, according to the Centers for Disease Control and Prevention. In Ohio, from 2008 to 2017, pregnancy-related deaths jumped from 10.8 to 29.2 mothers per 100,000 births. 

Meanwhile, the CDC found four women in 2017 and 2018 who died after having one of the more than 1.2 million abortions performed nationwide in those two years. 

The data suggest women are 63 times more likely to die of pregnancy than abortion. And Black or Hispanic women die 2.5 to 3.5 times as often as their white counterparts as a result of pregnancy or birth. 

Race and abortion: Sides debate differences 

Neither side of the abortion debate disputes the more precipitous decline of abortion in white women. But they sharply disagree on why. 

Demographics alone aren't enough to settle the debate.

Fertility rates fell 9% for white women and increased 2% for Black women from 2010 to 2020. But that explains only a fraction of 43% decline in abortions for white women compared to only 15% for Black women.

A 2016 study by the Brookings Institution, based on the National Survey of Family Growth, found that “(a) poor woman is more than five times as likely as an affluent woman to have an unintended birth. Since unintended childbearing is associated with higher rates of poverty, less family stability, and worse outcomes for children, these gaps further entrench inequality."

"Closing gaps in unintended childbearing is therefore important for greater equality and opportunity," the study concluded. 

A 2016 National Institutes of Health study found age, relationship status, the age of their mothers when they first conceived, poverty and lack of health insurance contribute to higher rates of unintended pregnancy for Black women. Even among married couples, an earlier NIH study found the share of births that were unintended was higher for Black people (48%) than whites (24%) or Asians (26%).

Higher rates of unwanted pregnancy, whether among Black or low-income women, correlate with higher rates of abortion.

Outspoken critics like Close label abortion restrictions as racist and classist, depriving Black and poor families of their autonomy, denying them a chance to pursue higher-paying jobs, college degrees or the opportunity to generate and pass generational wealth to children when they’re ready to be parents.

One Black woman who got an abortion in Summit County this month said she sees the cycle of poverty and dependence exacerbated by a lack of access to abortion.

“I just feel like the government is just worried about ‘keep having kids, keep having kids’ so we keep relying on them, you know, to be in the system and keep needing food stamps,” said the 25-year-old Black mother from Columbus. “It’s just messed up.” 

She tried to schedule an appointment with Planned Parenthood and others but was forced to drive two hours to the Northeast Ohio Women’s Center in Cuyahoga Falls to get the procedure.

Mike Gonidakis, president of Ohio Right to Life, gives a different explanation of why Black people's share of abortions is more than triple their share of the state population. 

“They targeted African Americans and minorities,” he said of Planned Parenthood and other agencies. “And that's why the numbers are so high.”

Abortions and adoptions

Gonidakis agrees that contraception (on which Ohio Right to Life "holds no position"), sex education and restrictive laws his organization has lobbied for since 1973 have put a dent in the number of abortions.

His side is "winning," he said, by providing parenting classes, diapers and baby formula while discouraging women from seeking abortions at the many faith-based pregnancy crisis centers that outnumber abortion clinics. 

The head of Ohio’s anti-abortion movement also points to a cultural shift in adoption, which he said is cheaper, carries less stigma and is more widely used today. He did not provide data to support the claim.

Statistics on private adoptions are not readily available, but public agency adoptions have declined 25% in recent years, according to the U.S. Department of Health and Human Services. 

Meanwhile, from 2015 to 2019, the number of foster care children waiting to be adopted in Ohio increased from 3,010 to 3,677. The share of children adopted as infants did not increase in that time.