Anchorage Daily News

Abortions rose in Alaska last year while state lawmakers drew attention to the issue with a law requiring an official abortion Web site.

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Alaska's abortion count grew from 1,806 in 2003 to 1,937 last year, an increase of more than 7 percent, according to the state Bureau of Vital Statistics new abortion report. One twist is that more abortions were done with the abortion pill, rather than with surgery, according to the report published last month.

The increase appears real, not just a matter of better reporting, said Phillip Mitchell, chief of vital statistics.

Last year marked the second year in which medical providers were required under state law to report abortions.

"We don't have any theories at this time because we don't have enough years' worth of data," said Dick Mandsager, a pediatrician and head of the state Division of Public Health.

Mandsager is overseeing creation of the state abortion Web site. The Legislature passed a bill last year requiring the Web site as a way to ensure that Alaska women seeking an abortion are fully informed about risks and consequences.

A draft version of the site has been posted for public comment. Officials have said the site should be up in about three months.

Under the new law, once the site is complete, abortion providers must either provide patients with the Web site information or otherwise fully inform women about the nature and risks of abortion. Sponsors of the measure said they hope fewer women will seek abortions once they have more information.

Last year's increase in abortions could be a one-year spike due to natural variation and does not indicate a trend, Mitchell cautioned. For instance, the number of births to Alaska women has climbed the past few years and fluctuated up and down before that.

One obstetrician/gynecologist, Colleen Murphy, said she figures that doctors simply improved their reporting after a year of experience. But Mitchell said he believes the figures are accurate for both years.

"We do have a system in place to monitor the number of abortions, and when we have questions, the providers have always been willing to work with us to get us the information we need," Mitchell said.

So what could account for an increase in abortions?

One change is that Planned Parenthood of Alaska began providing abortions, in Fairbanks starting in March 2003 and in Anchorage a year later. Alaska hasn't had an abortion provider north of Palmer since 1998, said Katherine Davey, director of education and training for Planned Parenthood.

Women who don't have ready access to abortions tend to wait longer, which complicates the procedure, Davey said. Some women may have gone to Washington state before Planned Parenthood opened its clinic in Fairbanks. But it's unknown whether the increase in Alaska is due to that change, she said.

When Alaskans get abortions in another state, they are not reported in the Alaska numbers.

Meanwhile, government funding for family planning services has been cut. Planned Parenthood of Alaska lost $400,000 in state funding in 2003. And one new national government study found an increase in women having sex without birth control even though they don't want to get pregnant, said Rebecca Wind, a New York-based spokeswoman with the Alan Guttmacher Institute, which does sexual health research and analysis.

The new statistics provide a broad view of who is getting abortions in Alaska, how they are paying for them and what type of procedure is used.

Both the total number and rate of abortions went up in 2004. The rate rose from 12.8 abortions per 1,000 Alaska women age 15-44 in 2003 to 13.8 abortions per 1,000 in 2004.

Women under age 30 and especially those age 18 to 24 accounted for almost all of the increase. Abortion numbers dropped for younger teens but rose for those 18 to 19. Ten girls under age 15 received abortions last year; in 2003 there were 12.

Overall, teens age 15 to 19 obtained 21.5 percent of the Alaska abortions last year, higher than the nearly 18 percent found nationally. Murphy, the obstetrician, said teen abortions represent "a parental and public health failure."

Most abortions were done in the first 12 weeks of pregnancy, with fewer than 100 performed after that, in 2004.

Most were performed surgically, but 438 abortions in 2004 were done with the abortion pill mifepristone, formerly known as RU-486. That's up from 335 medical abortions, as they are called, the year before. The U.S. Food and Drug Administration approved the medication for use in the United States in 2000.

There's no evidence the availability of the abortion pill has led women to have an abortion who otherwise wouldn't, Wind said.

Fewer women paid cash for abortions in 2004, and more turned to Medicaid, the government health insurance program for the needy. Even so, nearly 49 percent paid cash last year compared with 34 percent who used Medicaid.

Private insurance paid for 44 abortions both years. Providers didn't always report specific payment information.

The abortion was the first for more than 63 percent of the Alaska women who obtained one in 2004, a higher proportion of first-time abortions than the year before. Eleven women obtaining an abortion in 2004 had had more than four previous abortions, a drop from 15 the year before. More than half the women previously had had babies.

Most women who obtain abortions are single. The number of married women receiving an abortion dropped, from 373 in 2003 to 326 last year. Many of the married women were in their 20s.

Daily News reporter Lisa Demer can be reached at ldemer@adn.com and 257-4390.