In the second half of 2019, medical providers in Wyoming performed a total of 31 abortions, according to a recent report from the state Department of Health, indicating that slightly more than 60 such procedures took place last year.

However, during a legislative meeting earlier this month, some skeptical state lawmakers and pro-life advocates questioned if abortions are going uncounted; a pro-choice nonprofit has estimated roughly twice as many procedures took place in Wyoming in past years.

The State of Wyoming has long required doctors to report any abortions they perform. However, up until 2019, “we were not getting the data from providers as far as how many abortions were actually taking place in the state,” state Rep. Scott Clem, R-Gillette, said at a Nov. 5 meeting of the Legislature’s Joint Labor, Health and Social Services Committee.

To change that, Clem sponsored — and the House and Senate passed — a 2019 bill that created penalties for doctors who fail to report the information to the Wyoming Department of Health. It also requires the department to issue an annual public report on in-state abortions.

The first report, issued last summer, covered data from July 1 to Dec. 31, 2019. During those six months, providers reported 26 abortions among Wyoming residents and another five among women from out-of-state. The majority of the women (61%) were undergoing an abortion for the first time, according to the data, while three of the 31 women reported three or more previous abortions.

All of the abortions came in the first 10 weeks of pregnancy and involved “the early medical abortion procedure,” the report says, a category that would include the so-called abortion pill.

But during the Nov. 5 meeting, Rep. Sue Wilson, R-Cheyenne, the co-chair of the committee, expressed doubt about the data contained in the June report. Wilson said she found it “hard to believe” that zero surgical abortions were performed in Wyoming in the second half of 2019.

Deputy State Registrar Guy Beaudoin told the committee any late-term abortions “are potenially being sought out of state,” but noted that was only speculation on his part. Beaudoin added that the data provided to the department is somewhat limited, because certain personal information about the patients remains confidential.

For their part, legislators expressed varying degrees of concern about whether the data being reported to the Department of Health is capturing the full picture.

“In order to ensure that we have good public policy, we need to make sure that we have good data,” said Clem. “[I’m] still a little bit concerned.”

Hanging over the conversation was the discrepancy between the 31 abortions reported to the department — which would indicate 62 abortions over the course of a full year — and past data from the Guttmacher Institute, which has estimated far more annual abortions in Wyoming.

A wide gap in the data

The pro-choice institute surveys a couple thousand facilities and gathers other information to compile annual estimates — and its reports are regarded as perhaps the most comprehensive accounting of abortions in the U.S. Between 2014 and 2017, the Guttmacher Institute logged anywhere between 110 and 140 annual abortions in Wyoming.

The Guttmacher Institute’s estimates of in-state abortions indicate that Wyoming has consistently had the fewest number of in-state abortions in the U.S. by a long ways, both in terms of sheer numbers and on a per capita basis. (A much larger number of Wyoming women seek abortions out of state, with the Centers for Disease Control and Prevention reporting that 493 women did so in 2016.) However, the institute’s figures are still significantly higher than those being reported to the state government.

At the same time the Guttmacher Institute was getting reports of more than 110 annual abortions in Wyoming, the state was only receiving notice of about one per year.

In an abortion surveillance report published last year, the CDC noted that the 2016 figures collected by the Wyoming Department of Health represented less than 5% of those tallied by Guttmacher Institute. That yawning gap was a clear outlier: In the other 49 states and the District of Columbia, health agencies’ abortion counts added up to at least half of the numbers compiled by the Guttmacher’s — and most states’ figures were within 10% of the institute’s count.

‘It is none of their business’

At least part of the discrepancy appears to have been the result of two Jackson area doctors who made an intentional decision to only report abortions to the Guttmacher Institute.

Although reporting the information to the state was required by law, “I do not report to the state because it is none of their business,” abortion provider Dr. Brent Blue told Rewire.News in 2018; Dr. Giovannina Anthony, the state’s other primary abortion provider, told the publication she was doing the same thing.

The Legislature’s passage of House Bill 103, Reporting of Abortions, followed in early 2019, after being pushed by pro-life lawmakers and activists. It gave teeth to the existing requirements, saying that any physician who fails to submit an abortion reporting form to the State Office of Vital Records Services within 110 days may be subject to discipline from the Wyoming Board of Medicine.

With a jump from a single reported abortion per year to 31 in six months, the law appears to have made an impact.

But lawmakers pressed Beaudoin, of vital records services, on whether the state is capturing all of the abortion data.

“I guess I can only comment on the data that we get,” he said, but “the confidence level is that previously we weren’t receiving reports like we are today. So I’m confident that the providers understand the requirements that have been put into law and I’m confident they’re following it, because we are getting those reports to us.”

Beaudoin added that the department had a couple providers — who he did not name — search their records for certain medical codes as a kind of quality assurance.

Rep. Wilson, however, went back to the Guttmacher Institute’s higher numbers and her disbelief about no surgical procedures being performed in Wyoming.

“I guess I don’t have quite your confidence. That doesn’t seem to make sense to me,” Wilson told Beaudoin. “But I guess you only know what you’ve got.”

More data requested

Meanwhile, a couple of members of the public said they want the state to release more information in the annual public reports.

Former Republican state Rep. Marti Halverson of Right to Life Wyoming said her group is seeking data from prior years and wants the Department of Health to go beyond the “cursory and minimal” information presented in the recent report. For instance, Halverson wants to know if any of the patients who received an abortion were minors.

“It is unsatisfactory on many levels; this report raises more questions than it answers,” she said.

Mike Leman, the legislative liaison for the Roman Catholic Diocese of Cheyenne, openly questioned the completeness of the data reported to the state. While he’s long heard that only two providers offer abortions in Wyoming and that most are performed out-of-state, “we wonder where the evidence is,” Leman said.

Noting that doctors have openly admitted to failing to follow Wyoming’s abortion reporting requirements in the past, he wondered if they might also be performing prohibited late-term abortions by exploiting an exception for the mother’s health.

“... if there’s been no correction for noncompliance these last 40-plus years, are we very sure that they’re all in compliance now?” Leman said. “My concern is that most Wyomingites aren’t aware of the possibility that human rights violations could be happening in their very own communities.”

Laramie businessman Greg Hunter, a Democrat who ran for Wyoming’s U.S. House seat in 2018, also made a case for a more complete report.

While containing some information about how each abortion was performed, who underwent the procedures, when and where, “this report really needs some work on the why,” Hunter said. Without knowing the reasons that women are seeking abortions, “we cannot make decisions to prevent or learn to live with these personal decisions,” he said. For example, Hunter wondered if any of those 31 women sought to terminate their pregnancies after being raped, or if any made the decision because of financial hardship.

“When only a partial story is told, and the one that leaves out the why, it gives oxygen to conspiracy theories — and/or we go looking for why the why was left out,” he said.

The committee ultimately took no action, though Rep. Wilson raised the possibility of an individual lawmaker bringing a bill to “clean up” some of the language from the 2019 reporting legislation.

Across the country, the abortion rate has been dropping, according to data from the Guttmacher Institute. In 2017 — the most recent year for which data is available — there were 13.5 abortions per 1,000 women of reproductive age, “the lowest rate recorded since abortion was legalized in 1973,” the institute found.

The data indicates that not quite one in five pregnancies — 18.4% — ended in abortion in 2017, with an estimated total of 862,320 abortions provided in clinical settings.