CHARLESTON, W.Va. -- Four decades after the landmark Supreme Court case that legalized abortion throughout the United States, the number of abortions performed on West Virginia women is fewer than half of what it was in the late 1970s, the most recent statistics available show.

The number of women in the state terminating pregnancies by abortion has declined steadily from 6,170 in 1978 to 2,169 in 2009, according to the Guttmacher Institute, a research agency that conducts a periodic census of known abortion providers, and the U.S. Centers for Disease Control and Prevention.

Tuesday marks the 40th anniversary of the 1973 Roe v. Wade court decision, which struck down a Texas law that made abortion a crime except when a woman's life is in danger.

West Virginia's abortion rates have fallen in step with the nation's rates, though the national rates have historically been higher than those of the state.

National abortion rates peaked soon after legalization, were constant during the 1980s and have declined since then, according to a Guttmacher Institute report.

In 2008, the West Virginia abortion rate was 6.6 per 1,000 women of reproductive age, compared to 19.6 per 1,000 women in the United States, Guttmacher reports.

While there may be many factors in the decline, no scientific research confirms a single reason, Dr. Michael Vernon, chairman of the Department of Obstetrics and Gynecology at West Virginia University, said in an email to the Gazette.

One short-term factor could be the recent economic turmoil in the country, Vernon said. He said such downturns have been shown to correlate with a significant drop in conception and birth rates.

"With this significant reduction in the national conception rate, it would seem logical that the need for abortions would also decline," Vernon said. "So, indirectly the decrease in abortion rate may be related to the economy.

"Another suggestion for the reduction in abortions has been an increase in the availability of contraceptives, but I am not familiar with any research in [West Virginia] showing a correlation between availability of contraceptives and the decline in abortions," he said.

Margaret Chapman Pomponio, executive director of reproductive rights organization WV Free, said there are several reasons the state's abortion rates -- one of the lowest in the country -- have lagged behind national rates.

"[It's] one of the lowest in the country and I think there are a variety of reasons for that," Pomponio said. "We have a shortage of providers, and transportation is a challenge."

Vernon said anti-abortion advocates have been successful in decreasing the number of medical sites that offer abortions in the state. Some women travel out of state for an abortion as a result, he said.

West Virginia's only two abortion clinics are both in Charleston. For women in rural counties, getting to such a clinic can be a challenge, Pomponio said.

Advances to the state's sex education and public family planning policies have also played a role in decreasing the state's abortion rate, Pomponio said.

The state Department of Health and Human Resources, through the office of Maternal, Child and Family Health, offers free contraceptive methods, pregnancy tests and health education in addition to medical services through county health and other clinics.

Pomponio called the state's family planning program one of the best in the country.

"It really shows we as a state value access to affordable birth control," she said.

In 2006, the state's 148 publicly funded family planning centers gave contraceptive care to 53,700 women, including 14,000 teenagers, according to Guttmacher.

In 2008, those services helped women in West Virginia avoid 11,900 unintended pregnancies, which would likely have resulted in 5,300 unintended births and 5,000 abortions. Guttmacher estimates that public family planning services saved the state and federal governments more than $55 million in 2008.

The more the state can educate women and young people about family planning and sexual health, the fewer unintended pregnancies there will be and the greater chances for life opportunities there will be for women, Pomponio said.

"When women decide when and how they have children, the chances for economic security and educations are much greater," Pomponio said. "And we're so lucky in the 21st century to live in a time where if we have access to reproductive health care, women can decide if and when and how they want to have children."

Pomponio also credits the end of abstinence-only sex education with decreasing teenage pregnancy and abortion.

West Virginia state policy mandates that sex education covers sexually transmitted infection, abstinence, contraception, STI and HIV, according to the Guttmacher Institute.

Community development is a missing piece when it comes to reducing teenage pregnancies, Pomponio said.

"We've noticed in some areas where teenage pregnancy is high, there is very little for kids to do," she said. "High poverty rates, few jobs. We really need to just -- on a basic level, make more available to youth."

Young people should be given a broad view of their lives so they know they have choices and they can put their reproductive lives in perspective, she said.

"Let's face it, your reproductive life is your life," Pomponio said. "It's intrinsically tied to what you're able to achieve."

More could be done in the way of planned parenting and sex education, though, Vernon said.

"Every year there are approximately 6 million pregnancies in the United States and unfortunately 3 million of these pregnancies are unwanted pregnancies and of these unwanted pregnancies, one million are aborted every year," he said. "We need to expend more energy on decreasing the number of unwanted pregnancies through sex education and planned parenting."

Although abortion remains legal, increasing restrictions have played a role in decreasing the rate for the procedure, advocates say.

In 2011, states enacted a record-breaking 92 restrictions on abortion. Another 43 were enacted in 19 states last year, according to Guttmacher.

In West Virginia, women must undergo mandated counseling and wait 24 hours before having an abortion. Additionally, one parent must be notified in the case of a minor getting an abortion.

These and other restrictions are cause for concern, Barbara Ferarro, a former nun who, along with Pat Hussey, founded Charleston's social services hub Covenant House.

Ferraro and Hussey will speak at WV Free's annual gala Tuesday from 6:30 to 9 p.m. at the Culture Center. (A limited number of tickets will be available at the door for $50. Those interested in attended are encouraged to call ahead to 304-342-9188.)

The two have been outspoken supporters of the pro-choice movement and critics of the Catholic Church's opposition of abortion, and Ferraro points to the church's influence as another factor for the decline of abortions.

In the United States, there are more than 600 Catholic hospitals, she said, with one in every six hospital beds in a Catholic hospital. Such hospitals enforce ethical and religious directives that basically ban abortion, as well as sterilization, fertility services and providing contraceptives, she said.

Ferraro said she's concerned that if restrictions continue, more women will die from unsafe abortions, just as they did before they were legal.

According to Planned Parenthood, in 1965, illegal and unsafe abortions accounted for 17 percent of maternal deaths. Today, the group said, less than 0.3 percent of women who undergo a legal abortion have a serious complication, though the chance of death increases with the length of pregnancy.

Vernon said the decline in maternal deaths because of abortion is Roe v. Wade's effect on women's health.

"The passage of Roe v. Wade has led to an increase in the total number of professional, medical abortions in the United States and it has led to a precipitous reduction in the number of maternal deaths from non-professional, non-medical abortions," Vernon said.

Pomponio recognizes that people have strong feelings about pregnancy and childbirth, and the Roe decision said that women get to make that decision for themselves.

As the era before the decision recedes, it may be difficult for people to remember that before legalized abortion, women were dying from illegal procedures, she said.

"We must preserve Roe and prevent efforts to chip away at it," Pomponio said. "The more restrictions there are the less access [there is]. I think we need to respect individual beliefs and decision making."

When it comes to abortion and its restrictions, the question comes down to trust of women, Pomponio said.

"The underlined value in these decisions when we talk about reproductive health is 'Do we trust women and health-care providers?'" she said. "Forty years after Roe, the answer must be yes."

As far as the public's perception on abortion, Vernon said the issue is still very much a divisive one.

"In the past 10 years I have noticed an increase in the number of people that are either strongly opposed to abortion or are strongly supportive of being pro-choice," he said "Very few people are indifferent about this issue."

Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.