Abortions up 25 percent after Iowa GOP replaced family planning program

Who could have predicted it, other than anyone familiar with reproductive health care?

Republican lawmakers and Governor Terry Branstad eliminated Iowa's successful Medicaid Family Planning Waiver in 2017 and created a new state program that excluded abortion providers. The move forced Planned Parenthood to close four of its Iowa clinics around the state and dramatically decreased the number of Iowans receiving birth control and other reproductive services.

Preliminary data from the Iowa Department of Public Health indicate that Iowans had 25 percent more abortions in 2019 than in the previous year.

The Des Moines Register's Tony Leys was first to report the new numbers, which followed a decade of "plummeting" abortion totals in Iowa and nationally.

Polly Carver-Kimm of the Iowa Department of Public Health confirmed these "provisional numbers" to Bleeding Heartland on July 13: "Induced abortions for calendar year 2019 = 3,566 (an increase of 717 from calendar year 2018)."

The Des Moines Register article quoted Carver-Kimm as suggesting

the statistical increase might be partly caused by "more awareness of the providers about proper reporting."

But a spokeswoman for Planned Parenthood, the dominant provider of abortion services in Iowa, said it hasn't changed its reporting to the state, and its internal data confirmed it performed more Iowa abortions in 2019 than the year before.

When the Iowa Senate debated the ill-advised plan to defund Planned Parethood in early 2017, Democratic State Senator Janet Petersen warned about this exact scenario. Some Republican lawmakers claimed at the time that excluding Planned Parenthood from Iowa's family planning network would somehow increase access to health care providers, especially in rural Iowa. Petersen countered that the bill would

disqualify many of Iowa’s most qualified health specialists from serving Iowa women in the program.

Providers aren’t magically going to fall out of the sky for this new program.

When you make it harder for Iowans to access family planning services, you increase the number of unintended pregnancies.

Gutting the Iowa Family Planning Network will cause more unintended pregnancies and abortions.

Official figures show 8,207 Iowans were enrolled when the state launched its new family planning program in July 2017. That number had dropped to 5,334 by the following March.

By the end of 2019, only 3,162 Iowans were enrolled, of whom an estimated 1,502 were receiving services including contraception and testing for sexually transmitted infections.

No one should be surprised that abortions increased under those conditions, even though the economy was relatively strong in 2019.

Predictably, Republicans who have sought to defund Planned Parenthood and restrict access to abortion had little to say about the new numbers. Leys reported,

Sen. Mark Costello, an Imogene Republican who helped lead the 2017 debate on the issue, said that if the changes in the family planning program were going to lead to more abortions, he would have expected it to happen before 2019. He declined further comment.

[Governor Kim] Reynolds' office did not respond to requests for comment on the rising abortion rate. [...]

[Iowans for Life executive director Maggie] DeWitte said that if there was an increase in Iowa abortions in 2019, she doubts it was due to the change in the state family planning program. Instead, she contended, it likely would have been due to a 2018 Iowa Supreme Court decision declaring for the first time that the Iowa Constitution protects women’s right to abortion.

The justices' ruling implied that abortion is normal, she said. "They flung open the 'open for business' sign for the abortion industry here in Iowa."

Give me a break. An unintended pregnancy is often a deep personal crisis. People don't go research Iowa Supreme Court opinions before deciding whether they want to terminate.

When the legislature reconvenes next January, lawmakers should acknowledge their mistake, scrap the ineffective Family Planning Program created three years ago, and re-establish the Medicaid Family Planning Waiver. Iowa House Democrats have already drafted a bill to do just that.

Final note: Sioux City was one of the four Iowa communities that lost its Planned Parenthood clinic in 2017. The nonprofit announced on June 1 that it was reopening a facility there "to meet patient need in the region," which includes parts of Nebraska and South Dakota as well as much of northwest Iowa. From the organization's news release:

The Sioux City health center will offer STI testing and family planning services, including birth control, IUD consultation, LARCs, Depo shots, and more. Medication abortion care will also be available. [...]

Lack of sexual health access is having a large impact on Woodbury County. STI rates are skyrocketing in Iowa, and particularly in Woodbury County. STI cases jumped 74 percent in Woodbury county since 2017. Gonorrhea cases increased more than 141 percent.

Top photo taken on March 12, 2018 by Robin Marty. It's part of her photoset of abortion care and clinics images, available via Flickr and published with permission.

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