How many abortions in Michigan? The state can’t say under new law

• For the first time in 45 years, Michigan no longer collects detailed abortion data
• The abortion rights law signed last year repealed a longstanding requirement that providers report information on patients to the state — including whether they are married or have had previous abortions.
• Nearly every state requires some kind of reporting

After more than four decades, Michigan is ending its annual, detailed reporting on tens of thousands of abortions each year, including a patient’s age and marital status, the age of the fetus, the type of procedure and any complications.

The Michigan Department of Health and Human Services will release its 2023 data later this year, but it will be the last such report. 

The change makes Michigan one of just a handful of states that no longer collect such data, according to Guttmacher Institute, an abortion-rights research group that uses state-level data to track trends.

The change comes at a time of increasing concern about personal data collection, especially on cell phones, that could be used to connect patients to reproductive health apps, whether they seek abortion information online and schedule an appointment.

Moreover, the data no longer will be collected in a state that has become a haven for residents from out of state who arrive here for abortions that are banned in their home states.

The data collection was one of the few remaining safeguards for patients, according to abortion opponents, in a procedure that happens about 30,000 a year in Michigan either in clinics or, in the case of medication abortion, in private homes. 

“It's basic quality assurance,” Dr. Catherine Stark told Bridge. 

A long-time ob-gyn, Stark told lawmakers last year that such data provides quality control by, for example, letting the public know about abortion providers with high numbers of surgical complications or “violations of care.” Reporting details of abortion procedures, along with other licensing provisions, established the “protection of the health and safety of women for women undergoing abortion.” 

Stark, who also is medical director for the Auburn Hills-based, anti-abortion Crossroads Care Center, was testifying against the Reproductive Health Act — a law signed late last year and effective this past February. 

Ultimately, the law was passed, reversing a 1978 law that required abortion clinics to report details of their work.

“Some people see that the state has a responsibility to its citizens to protect the health and safety of women, especially undergoing medical and surgical procedures,” she told Bridge this week.

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That law also repealed licensing regulations that set out how clinics were to be operated — such as the size of rooms and the width of hallways. Those regulations ensured, for example, that a stretcher could reach patient rooms in an emergency.

Those requirements, as well as detailed reporting, were “designed to ensure safety and positive outcomes for the patient,” said Genevieve Marnon, legislative director for Right to Life of Michigan.

“The removal of the reporting requirement at the same time health and safety regulations for abortion clinics were removed should be of concern to any woman who walks into an abortion facility,” Marnon said.

But others framed the data as medically unnecessary, burdensome and stigmatizing for those trying to get abortions. “Data collections by health departments can be useful when it's used for public health purposes,” said Rachel Jones, principal research scientist at Guttmacher.

But at other times, she said, “the goal is to monitor and stigmatize health care providers and the people who are getting the abortions.”

“For years, women and their doctors faced burdensome requirements when seeking abortion care that had no basis in medicine and were designed to dissuade women from accessing the care they needed,”  Lynn Sutfin, spokesperson for MDHHS, told Bridge.

The new law removed the reporting “in line with most other medical procedures,” according to Sutfin.

Dr. Sarah Wallett, chief medical operating officer of Planned Parenthood of Michigan, echoed the sentiment, also in an email to Bridge:

“The reporting of private demographic data does not make abortion any safer than it already is, and instead may have a chilling effect for our patients,” she said.

2023 fight, 2024 change

The end to reporting isn’t sudden. In fact, Democrats last year noted that the act repealed what they called “reporting requirements and administrative burdens” that “made the process of affirming everyone’s right to reproductive freedom challenging.”

But for the most part, the fight over the Reproductive Health Act largely focused on the law’s other provisions, including two — later deleted — that would have allowed the state’s Medicaid program to cover abortions and would have ended the 24-hour waiting period.

The new law also notably left intact Michigan’s parental consent law.

But tucked into the language that Gov. Gretchen Whitmer signed in November — and left out of her lengthy press release celebrating the law’s passage — was the repeal of a 1978 section of state law that provided the public with detailed reporting on abortion each year. 

Those details included things like type of procedure (by pill or through surgery), gestational age, how many live births and abortions the patient previously had, race and age and marital status of the patient. Providers had to submit such reports on every case within seven days of the procedure.

Those details were outlined in a 24-page “handbook,” which made clear that individual reports were to be stripped of identifiers and were to be destroyed after five years. It also prohibited copying individual reports.

The change in reporting to the state even surprised provider Shelly Miller, a long-time abortion rights activist and executive director of Scotsdale Women’s Center in Detroit.

It eliminates time-consuming and arguably intrusive questions for patients. Yet, other health systems capture robust data about diseases, conditions and procedural complications as a matter of quality control and health surveillance, she noted.

“As a woman, I get it,” Miller said, of the dropped reporting requirement. “But as a provider, I want our people to be safe and I want our doctors to be safe.’

She and other providers told Bridge they will continue to collect data for internal patient-care purposes, and they will contribute that information to places like Guttmacher, which aggregates data as a way to track trends.

But as states move away from mandatory reporting, it brings into question how solid those trend lines will be.

Voluntary reporting, few details 

The U.S. Centers for Disease Control and Prevention collects data, but it’s dated. The most recent report is based on 2021 data. It’s voluntary, too. Four states — California, Maryland, New Hampshire, and New Jersey — already do not submit data.

Since the 1970s, Guttmacher has provided national data, too. But the group conducted its Abortion Provider Census just once every three years. Like the CDC’s survey, Guttmacher’s efforts also were based on voluntary responses and, to an extent, estimates.

Its most recent survey was conducted in 2021, and just half of the more than nearly 1,700 facilities performing one or more abortions responded. To help fill in gaps, Guttmacher turned to health departments.

Guttmacher switched formats last year in response to the flurry of state law changes after the Supreme Court struck down Roe v. Wade in 2022. Guttmacher now collects data as part of its Monthly Abortion Provision Study, but it, too, is based on voluntary responses.

And Guttmacher doesn’t collect information on complications — a data point that’s crucial to patient safety, abortion advocates noted.

That’s because Guttmacher is focused on abortion trends, rather than clinical nuances, said Guttmacher’s Jones.

In Michigan, providers will undoubtedly keep essential medical records for patient care, Renee Chelian, founder of Northland Family Planning Centers in southeast Michigan, told Bridge.

“We know how many abortions we've done. We know the number of weeks. We keep a log of any complications, just like we always have, just like the health department required when we were licensed,” she said. “But we don't turn it in” to the state. 

Some questions no longer will be asked, such as marital status, said Miller at Scotsdale.

But Miller, Chelian and Wallett — representing Scotsdale, Northland, and Planned Parenthood — will also track data for Guttmacher, representatives told Bridge. Chelian said the Northland data also will be submitted to the National Abortion Federation, which represents some of the nation’s abortion providers.

“Someone’s still collecting the data, bottom line,” said Scotsdale’s Miller.