In American pop culture, the face of abortion is often a frightened teenager, nervously choosing to terminate an unexpected pregnancy. The numbers tell a far more complex story in which financial stress can play a pivotal role.
Half of the roughly 1.2 million U.S. women who have abortions each year are 25 or older. Only about 17 percent are teens. About 60 percent have given birth to least one child prior to getting an abortion.
A disproportionately high number are black or Hispanic. And regardless of race, high abortion rates are linked to hard times.
"It doesn't just happen to young people, it doesn't necessarily have to do with irresponsibility," said Miriam Inocencio, president of Planned Parenthood of Rhode Island. "Women face years and years of reproductive life after they've completed their families, and they're at risk of an unintended pregnancy that can create an economic strain."
Activists on both sides of the abortion debate will soon be marking the 35th anniversary of the Supreme Court's Roe v. Wade decision, which established a nationwide right to abortion.
In recent years, the number of abortions has fallen; the 1.2 million tallied for 2005 was down 8 percent from 2000, and the per-capita abortion rate was the lowest since 1974. But overall, since the Roe ruling on Jan. 22, 1973, there have been roughly 50 million abortions in the United States, and more than one-third of adult women are estimated to have had at least one.
Who are these women?
Much of the public debate focuses on teens, as evidenced by the constant wranging over parental notification laws and movies like the current hit "Juno," in which the pregnant heroine heads to an abortion clinic, then decides to have the baby.
In fact, the women come from virtually every demographic sector. But year after year the statistics reveal that black women and economically struggling women — who have above-average rates of unintended pregnancies — are far more likely than others to have abortions. About 13 percent of American women are black, yet new figures from the Centers for Disease Control show they account for 35 percent of the abortions.
Black anti-abortion activists depict this phenomenon in dire terms — "genocide" and "holocaust," for example. But often the women getting the abortions say they act in the interests of children they already have.
"It wasn't a hard decision for me to make, because I knew where I wanted to go in my life — I've never regretted it," said Kimberly Mathias, 28, an African-American single mother from Missouri.
She had an abortion at 19, when she already raising a 2-year-old son.
"It wasn't hard to realize I didn't want another child at that time," Mathias said. "I was trying to take care of the one I had, and going to college and working at the same time."
She was able to graduate, now has an insurance job, and — still a single mother — has a 3-year-old son as well as her first-born, now 11.
By contrast, Alveda King, a niece of Martin Luther King Jr., calls herself a "reformed murderer" for undergoing two abortions when she was young.
Now an outspoken anti-abortion campaigner, King says the best way to reduce abortions among black women is to dissuade more of them from premarital sex.
"We give free sex education, free condoms, free birth control," she complained. "That's almost like permission to have free sex, and the higher the rate of sexual activity, the higher the rate of unintended pregnancy."
Anti-abortion activist Day Gardner of the National Black Pro-Life Union says many blacks are unaware of their community's high abortion rate.
"We don't talk about it," Gardner said. "It's a silent killer among us."
She contends that abortion-rights supporters tempt black women into abortion by suggesting they can't afford to raise the child. But Gardner also acknowledges that some black women make this argument on their own.
"We had the whole civil rights movement — now we're in a place where we're moving further toward equality," Gardner said. "So women think, 'For once, I can see the American dream. I can have the house and the job, but it would postpone it to have another child. I can't afford to take time off."'
Dr. Vanessa Cullins, a black physician who is Planned Parenthood's national vice president for medical affairs, said the allegations of "black genocide" do not help women meet day-to-day challenges.
"These actions take attention away from medically proven ways to reduce unintended pregnancy — comprehensive sex education, affordable birth control, and open and honest conversations about relationships," she said
Looking beyond racial dividing lines, Cullins views the right to abortion as an important component in the ability of all American women to determine the right size for their family.
"Groups that become assimilated in U.S. culture and experience economic opportunities naturally decide to limit family size, because they want to take part in the American dream," she said. "If you're a single mother, achieving the dream is all the harder, so it makes sense to limit family size so you can shower as much support as you can on the children you have."
Georgette Forney, who had an abortion when she was 16 and is now an anti-abortion campaigner leading Anglicans for Life, says she often sees economic pressures triggering abortions, even in middle-class families.
"In one situation, the husband was adamant that they were on track to pay for their two sons' college education, and a third child would throw off his whole calculation," Forney recounted. "So that baby was aborted and that woman was devastated. It was a five-year process to recover."
Forney said she also encountered a single mother who was worried she might lose custody of her daughter in light of a suit by the biological father. The woman then became pregnant, Forney said, and had an abortion in violation of her own beliefs because she feared having a second child would jeopardize prospects for keeping her daughter.
"We've begun to depend on abortions," Forney said. "We feel we have to choose between our unborn child and our born children."
Martha Girard, on the other hand, says she's appalled by the notion that women should lose the right to choose.
A hospital ultrasound technician from Pleasant Prairie, Wis., and a mother of three, Girard had an abortion two years ago, at the age of 44, when she mistakenly thought she was too old to get pregnant.
Having been through three difficult pregnancies previously, and coping with a mentally disabled eldest son, she felt abortion was the prudent choice.
"I knew that this pregnancy would end up badly — I could feel it — and we've already got enough problems with the mentally ill son," Girard said.
"I was very sad and depressed the first week," she added. "But because it's hard on you emotionally and some women regret it, that doesn't mean it's wrong, that someone else should decide for you."
The Journal of Family Issues published a report earlier this month asserting that women often choose abortion because of their wish to be good parents.
That means women who have no children want the conditions to be right when they do, and women who already are mothers want to care responsibly for their existing children, said the lead author, Rachel Jones, a researcher with the Guttmacher Institute.
"These women believed that it was more responsible to terminate a pregnancy than to have a child whose health and welfare could be in question," Jones said.
Even among many abortion opponents, the Guttmacher Institute — which supports abortion rights — is considered the nation's best source of abortion statistics.
Federal statistics do not include California, the most populous state, because its government does not provide data. But Guttmacher researchers surveyed abortion providers there as well as in other states to produce the latest national estimate of 1.2 million abortions in 2005. That's down from a peak of 1.6 million in 1990 but still represents more than 20 percent of all pregnancies.
One of the Guttmacher's top researchers, Stanley Henshaw, said the recent drop may disguise the fact abortion rates remain relatively high for black and Hispanic women. He believes the most effective countermeasure would be wider availability of contraceptives such as intrauterine device, or IUDs, that don't require attention as frequently as condoms or birth-control pills.
Though abortion is commonplace across the country, urban areas have far higher rates than rural areas where access to abortion providers can be difficult.
New York, New Jersey, California, Delaware, Nevada, Maryland and Florida had the highest abortion rates in 2005, according to the new Guttmacher report released this week. Wyoming, Idaho, Kentucky, South Dakota and Mississippi had the lowest rates — the latter two states have just a single abortion clinic in operation.
Susan Hill, founder of the National Women's Health Organization that runs the remaining Mississippi clinic, says the statistics may not fully reflect a subgroup of relatively affluent women who obtain unreported abortions through their private doctors.
"In Mississippi, it's the poor women who don't have access to that who have to run through the maze of protesters screaming and yelling abuse," Hill said. "Wealthier women can be more creative about their alternatives."
According to Guttmacher data, the abortion rate among women living below the federal poverty level is more than four times higher that among women from middle-income and affluent households.
An increasing number of women avoid surgery by using the RU-486 abortion pill or other early medication — these now account for about 13 percent of all abortions.
Of all U.S. women getting abortions, about 54 percent are doing so for the first time, while one-fifth have had at least two previous abortions. Of those over 20, the majority have attended college. Almost a third have been married at some point. About 60 percent have at least one child; one-third have two or more.
"I don't think most people understand that these are women who have families, who are making a very serious decision about their reproductive health," said Nancy Keenan, president of NARAL Pro-Choice America. "The stereotype is that the decision is made lightly. It is not."