But, over the past few years, as the number of abortions has declined, abortions increasingly have been concentrated in specialty clinics in cities, and pockets of competition have developed. So while women in rural areas must sometimes travel hundreds of miles to the nearest clinic, in cities and suburbs there are price wars and competition over amenities. Doctors have refused to train colleagues, fearing they will only help a potential competitor in a lucrative, often cash-only, business. National statistics compiled by the Alan Guttmacher Institute illustrate the clinics' dilemma. The number of abortions declined by 17.4 percent in just seven years, to a low of 1.328 million in 1997 from a peak of 1.608 million abortions in 1990.
Different groups give different explanations for the drop.
The National Right to Life Committee credits the persuasive power of abortion opponents as well as laws requiring informed consent and parental notification. But Dr. Stanley Henshaw, a senior fellow at the Guttmacher Institute who analyzed abortion data, said the reason is mostly better birth control. While it is true, he said, that more teenagers are keeping their babies, most of those having abortions are in their early 20s and fewer of them are becoming pregnant. Whatever the reason, the falling number of abortions has come at a time when the number of clinics in major cities has not changed. Since 1992, the number of clinics doing 400 or more abortions a year has remained steady at 690.