Aborted babies missing from state-level data

When Bradley Pierce and his fellow lobbyists walked into the offices of Texas legislators last year to lobby for bills to classify abortion as homicide, he said staffers and lawmakers would often respond by telling him abortion is already abolished in their state. After the Dobbs v. Jackson Women’s Health Organization decision in June 2022, abortion facilities shut down in Texas and many other states. Reported abortions dropped by the thousands.

But Pierce, president of the Foundation to Abolish Abortion, and his team would point lawmakers to reports of Texas women requesting abortion pills from online sellers. “And we would say … actually, this is still happening on Texas soil,” Pierce said. “And very quickly they’d be like, ‘Oh wow, I didn’t know this.’” By the end of the session, he said, the Texas legislators and staffers had stopped saying that abortions had ended in the state.

Since Dobbs, researchers and state health departments have predicted that pro-life state laws would lead to increased births. Early data shows that this has happened to some extent, leading to celebration among pro-life advocates. But the increase in births doesn’t cancel out abortion numbers from previous years. Groups like the Foundation to Abolish Abortion largely attribute the mismatch to the booming industry of online abortion pill sellers and the resulting abortions that will never appear in state data.

“I do think that the best evidence we have on the impact of pro-life laws is births,” said Dr. Michael New, senior associate scholar at the Charlotte Lozier Institute. Birth data, he said, tends to remain stable year-by-year, and the government does a good job tracking these numbers. When birth numbers go up, “it’s just an indication that something happened,” said New. “Fluctuations, I think, can be tracked to different policy events.”

The policy events in this case are pro-life protections for unborn babies—and the data show they’ve saved lives. In a November report from the IZA-Institute of Labor Economics, a private economic research institute based in Europe, researchers concluded that births rose by an average of 2.3 percent in states with laws protecting babies from abortion starting at conception. That amounts to roughly 32,000 babies saved per year in these states combined as a result of the pro-life laws—18,594 in Texas alone.

Meanwhile, abortion data in states that have released early 2023 numbers also seem to tell an encouraging story. Texas reported 49 abortions as of September and West Virginia eight as of June. In both states, all fell under the medical exceptions to the states’ abortion laws. So far, Missouri has reported only four in-state abortions, and a spokesperson for the Idaho Department of Health and Welfare told WORLD the state has recorded only five. An Oklahoma State Department of Health spokesperson said their department has so far received no reports of abortions. In North Dakota, the Vital Records unit of the state’s Department of Health and Human Services announced in its 2022 abortion report that it would no longer release annual abortion statistics because of the state’s pro-life law.

But Pierce of the Foundation to Abolish Abortion points out that this birth and abortion data leave thousands of babies “unaccounted for.” Even assuming that mothers did give birth to an additional 18,594 Texas babies in 2023, the state reported nearly triple that number of abortions in 2020. Pierce said other state data tell the same story. “That means there’s still a whole lot of abortions still going on of babies from those states,” he said. “That’s what I think a lot of people miss.”

He and colleagues recently used other reports of Europe-based abortion pill seller Aid Access to estimate the number of self-managed chemical abortions that happen per year even in states with pro-life protections starting at conception. By piecing together data about Aid Access’ abortion pill sales from research letters, studies, and New York Times reports, Pierce and his colleagues projected that states with the strongest pro-life laws have still seen hundreds, if not thousands, of self-managed chemical abortions. They estimated more than 20,000 chemical abortions likely happened in Texas alone in the 12 months after the Dobbs decision.

New, of the Charlotte Lozier Institute, hesitates to rely on the available data about self-managed chemical abortions. “Just because the abortion pill was ordered doesn’t mean the abortion happened,” he said. Pierce said his report accounts for that, relying on reported estimates of the percentage of shipped Aid Access pills that result in completed abortions. But New still said people should take estimates like this “with a bit of a grain of salt” because they depend on women reporting back about whether or not they have actually taken the pills. These reports may or may not be truthful.

Regardless of the accuracy of these numbers, at least some chemical abortions are still happening in pro-life states. Entities like Aid Access say they can send abortion pills to “all 50 states.” Easily searchable abortion pill databases list options of “online clinics” for women in states with protections for unborn babies. Recent posts on Reddit show users recommending Aid Access and other abortion pill providers to women in pro-life states posting pleas for help to abort their babies. On TikTok, abortion advocates post videos about their chemical abortions.

Meanwhile, state health departments are largely failing to track these chemical abortions.

WORLD contacted the health departments in the 14 states that currently protect babies from abortion starting at conception to ask if reporting requirements exist for women who take the abortion pill at home after ordering online from out-of-state. Of the nine that replied, seven confirmed that no such reporting requirement exists, many emphasizing that the burden of reporting abortions rests on the provider. The two other states referenced state code outlining abortion reporting requirements. Both involved requirements for the institution performing the abortion, not the women.

A spokesman for the Idaho Department of Health and Welfare confirmed that the department “would have no way to track abortions” related to chemical abortions coming from out of state. And in Oklahoma, a spokeswoman for the State Department of Health added that, for out-of-state abortion pill sellers, their own states’ laws and not Oklahoma’s would govern their reporting of abortions. The Vital Records data processing manager in North Dakota said he was not aware of the groups that market abortion pills to women in his state.

Tracking these abortions, New said, is a difficulty—and not one with an easy solution. “I just think we need to be savvy,” New said. “The laws do some good, we can celebrate the good they do, but we still need to take care of women who do face unplanned pregnancies in these states because, again, the laws do good, but they’re not magical. They don’t stop every abortion.”

Meanwhile, Pierce said he hopes bringing attention to these missing babies will show lawmakers and others that abortion still hasn’t ended, even in states like Texas, revealing what he believes to be a need for laws that will deter mothers from self-managing their own abortions.

“We’re hoping that it will open a lot of eyes there,” Pierce said. “And help people realize these babies that have been … left behind and I think largely forgotten since Dobbs.”