Jackson Free Press

Michelle Colon, 40, a volunteer "pink-house defender" at the state's only abortion clinic, the Jackson Women's Health Organization, says she can see the effects of the abortion laws in surrounding states at JWHO. Although she believes JWHO is seeing slightly less traffic overall compared to this time last year, the clinic is drawing more patients from surrounding states.

"Sometimes, we get patients from Alabama and Tennessee all day—we are getting some of those people who can't get in (to see abortion doctors) in other states," Colon said.

This is because Alabama now enforces a 48-hour waiting period before women can have abortions, and some clinics in Tennessee have been backed up for three to four weeks, Colon said.

The experiences at JWHO, which is still in the midst of a legal battle with the state of Mississippi over a 2012 admitting-privileges law, mirror a broader trend going on nationwide, where abortion rates have declined in just about every state, Mississippi included, an Associated Press report released June 8 shows. In Mississippi, abortions conducted in the state are down 5.5 percent since 2010.

The U.S. Supreme Court could decide in the coming weeks whether to hear the Mississippi's appeal of two lower court decisions striking down that law. A federal court in Mississippi and an appeals court both ruled that the law, which would close down the only clinic in the state, infringes on women's constitutional right to have an abortion.

Exactly what is driving the decrease has prompted debate on all sides of the abortion question.

Colon said that abortion numbers could be down for multiple reasons, including higher distribution of contraceptives and the lowering of teen-pregnancy rates in states like in Colorado.

"I think a lot of the other reasons the rate is down is because of a lack of money and transportation," Colon said of women needing abortion services.

Data show that in 2010 there were 2,297 abortions performed in Mississippi; by 2013, there were 2,170 abortions performed in the state. In Louisiana, however, abortion numbers are up 11.9 percent. Nationwide, the AP survey showed a decrease in abortions of about 12 percent since 2010.

Diane Derzis, owner of JWHO, said although she was not surprised to see the numbers go down in Mississippi, she thinks the decreasing rate of abortions in the state is negligible. Derzis said the likely reasons for the national decline is two-fold. She said the Targeted Regulation of Abortion Providers, or TRAP laws, that prevent access for women such as Mississippi's ban of abortions after 20 weeks are part of the reason for the decrease. Access to contraception and the "morning after" pill available in pharmacies has also likely helped numbers decrease.

"These laws are designed to make it more difficult for women, and do they do so? Absolutely," Derzis said.

Even with the drop, Derzis doubts the activists who want to see abortion disappear in Mississippi will let up.

"I think these (anti-choice) people will not be happy until they see every clinic closed," she said. "The purpose of these laws is to make it tougher and tougher on women to have an abortion."

Louisiana was one of only two states with increased abortion rates in the past four years, according to the AP report, and Derzis said it is likely that women from Mississippi are a part of those increased Louisiana numbers.

"Women are going to any state that is easier (to) access and if most states pass legislation that does the same thing, then that's when you will have major problems," she said.

Derzis said that some of those women that go to Louisiana are farther along in their pregnancies and go because of the TRAP laws. 9,932 abortions were performed in 2014 in Louisiana.

The recent Mississippi state law that banned abortion after 20 weeks does not affect JWHO. The clinic only performs abortions up to 16 weeks, so if a woman from Mississippi wants an abortion later in her pregnancy she has to go out of state anyway.

"They don't have a choice," Derzis said.

Debate Rages

The AP obtained the most recent abortion numbers from the health departments of all 45 states that compile such data on a comprehensive basis. (States not compiling such data are California, Maryland, New Jersey, New Hampshire and Wyoming.)

With one exception, the data were from either 2013 or 2014, which provides a nationwide gauge of abortion trends during a wave of anti-abortion laws that gathered strength starting in 2011.

Among the groups most active in promoting the restrictive laws is Americans United for Life. Its president, Charmaine Yoest, suggested to AP that the broad decrease in abortions reflected a change in attitudes among pregnant women.

"There's an entire generation of women who saw a sonogram as their first baby picture," she said. "There's an increased awareness of the humanity of the baby before it is born."

But advocates for abortion rights said the figures demonstrate that restrictive laws are not needed to reduce the number of abortions significantly. That can be achieved, they said, by helping more women obtain affordable, effective contraception, including long-lasting options such as IUDs and hormonal implants.

"Better access to birth control and sex education are the biggest factors in reducing unintended pregnancies," Cecile Richards, president of the Planned Parenthood Federation of America, told the Associated Press. "More restrictive abortion laws do not reduce the need for abortions."

Elizabeth Nash, a state-issues expert for the Guttmacher Institute, a research group that supports abortion rights, told the AP that a total of 267 abortion restrictions have been enacted in 31 states since 2011. Among them are measures that ban most abortions after 20 weeks of pregnancy, impose hospital-like physical standards on abortion clinics and require doctors who perform abortions at clinics to have admitting privileges at nearby hospitals.

While lawsuits have blocked some of the new laws, most have taken effect, contributing to closure of about 70 abortion clinics in a dozen states since 2010. States with the most closures, according to state officials and advocacy groups, include Texas with 27, Michigan and Arizona with about 12, and Ohio with at least four. Two clinics closed in Virginia, including one that was the state's busiest. The only states with significant increases in abortions since 2010 are Republican-led Louisiana and Michigan, which have passed laws intended to restrict abortion. Louisiana, where abortions increased 12 percent between 2010 and 2014, was recently honored by Americans United for Life as the No. 1 state in taking steps to reduce access to abortion.

In both Louisiana and in Michigan, where abortions rose by 18.5 percent, the increases were due in part to women coming from other states where new restrictions and clinic closures have sharply limited access. Anti-abortion groups said many Ohio women were going to Michigan and many Texas women to Louisiana.

Regulating the Womb

Lori Carpentier, chief executive of Planned Parenthood Mid and South Michigan, argued that one factor in Michigan's increase was inadequate public funding for family planning.

Genevieve Marnon of Michigan Right to Life said the increase resulted in part from new licensing and inspection regulations that prompted several abortion clinics to close a few years ago. She told AP that some of these clinics had failed to report many of the abortions they performed and that women in those communities were now going to clinics with more scrupulous reporting practices. In all, about a dozen clinics closed; Marnon said 19 remain in operation.

Both sides agree that one factor in Michigan's upsurge in abortions is an influx of women coming from Ohio, where several abortion clinics recently closed. According to Michigan's health department, abortions for nonresidents jumped from 708 in 2013 to 1,318 in 2014.

Northland Family Planning, which operates three abortion clinics in southern Michigan, has been openly soliciting business from women in Ohio and Indiana. Its website notes that one of its clinics is less than 60 miles from Toledo, Ohio.

An influx of women from out-of-state also was cited as a reason for Louisiana's increase. Ben Clapper, executive director of Louisiana Right to Life, told AP that abortions for nonresidents jumped by more than 1,200 between 2010 and 2012, and suggested new restrictions in Mississippi and Texas were a factor.

The AP reported that Ellie Schilling, a lawyer who represents Louisiana abortion clinics, said the state could reduce abortions through expanded sex education and other efforts to reduce teen pregnancies. The rise in abortions "is absolutely not because access has increased," Schilling said. "There were fewer clinics and doctors in 2014 than 2010."

The biggest decrease in abortion, percentage-wise, was in Hawaii, where abortions fell from 3,064 in 2010 to 2,147 in 2014. Laurie Temple Field, government relations director for Planned Parenthood in Hawaii, said more women there were getting access to health insurance and affordable contraception. She also credited the state's policies on sex education in public schools, which includes information to help teens avoid unplanned pregnancies.

Five of the six states with the biggest declines—Hawaii at 30 percent, New Mexico at 24 percent, Nevada and Rhode Island at 22 percent, Connecticut at 21 percent—have passed no recent laws to restrict abortion clinics or providers.

Nancy Northup, who, as CEO of the Center for Reproductive Rights, has overseen some lawsuits against state restrictions on abortion, told AP, "All of this effort is being spent on passing legislation and on litigation, when in fact what those states should do is take a look at the blue states and what they're doing right in decreasing abortions."

Judy Tabar, CEO of Planned Parenthood of Southern New England, said the declines in Connecticut and Rhode Island were due in part to expanded access to long-lasting contraception methods that are now fully covered by health insurers under the federal Affordable Care Act, Medicaid expansion and other initiatives. Nationwide, Planned Parenthood—the largest abortion provider in the U.S.—says its health centers report a 91 percent increase since 2009 in the use of IUDs and contraceptive implants.

The Associated Press contributed to this story.