In President Obama’s first term, there was a brief shining moment when people with various views on abortion’s legality thought they might agree on some ways to reduce abortions.
That effort quickly broke down, and each side proceeded to enact part of its agenda separately as amendments to the health care reform act. It’s important to understand why, and to see what more can be done.
A key discussion was among those invited to advise the new administration’s faith-based office. But pro-life participants soon found what they saw as a bait-and-switch. Pro-choice participants, joined by White House staff, were not willing to speak of “reducing abortions.” Instead they wanted to “reduce the need for abortion” — that is, reduce unintended pregnancies, chiefly through expanded contraceptive programs. Catholic representatives could not in conscience endorse the changed goal, as their moral teaching neither approves contraceptives nor sees an existing “need” for abortions.
Less well known is the fact that contraceptive programs often fail miserably at reducing unintended pregnancies or abortions — and can be associated with increased rates of sexually transmitted diseases, including AIDS. In a major meta-analysis by proponents of “emergency contraceptives,” out of 23 studies of programs to enhance access to those drugs, not one could show a reduction in unintended pregnancies or abortions.
An alleged exception to the rule is a recent “Contraceptive Choice” study in St. Louis. The organizers abandoned all pretense of “nondirective” counseling, offering over 9,000 women free contraceptives while specially promoting long-acting methods like hormonal implants and IUDs. They persuaded most of the women to accept these more aggressive methods, which make a woman sterile for years and cannot be removed without a doctor’s help, and periodically followed up to make sure they stayed with the program. They showed significant reductions in pregnancies and abortions, proving only that sterilized women don’t get pregnant. It’s been harder to find data on adverse effects or rates of STDs.
But assuming we don’t want to focus on compromising the autonomy and dignity of women to achieve a sterile population, what approaches with wide popular support could reduce abortion, even as it remains legal under the Supreme Court’s decisions?
1. Fight poverty. Poverty and the hopelessness it can bring into people’s lives is a major factor in the abortion rate. In one study by the Guttmacher Institute, women on Medicaid had twice the abortion rate of other women, even in states that fund childbirth but not abortions.
2. End publicly-funded abortions. That Guttmacher study showed that if the state funds abortions in its Medicaid program, low-income women’s abortion rate doubles to be four times that of others.
3. Pass laws regulating the abortion industry. Research by Michael New and others has shown that even very modest laws — Informed consent, waiting periods, parental involvement for minors, etc. – afford more time to think over an abortion decision and lead to significant reductions.
4. Uphold strong marriages. Unmarried American women may have four times the abortion rate of those who are married. This factor can combine with poverty in a vicious circle – the disruptions in life caused by poverty can make stable relationships harder to maintain, and unmarried or divorced women lack the personal support system that can help keep them from poverty and a desperate resort to abortion.
5. Promote “sexual risk avoidance” for the young. This is an objective public health term for avoiding sexual involvement, as opposed to the “sexual risk reduction” approach of taking premature sexual activity for granted and then trying to reduce the damage. Recent declines in the abortion rate have occurred disproportionately among teens and young adults, and seem due largely to more young people delaying initiation of sexual activity. Teens are not known for being more reliable in contraceptive use than their elders.
This is an ambitious agenda but most Americans can be shown to support each aspect of it. Those most unlikely to support it are the representatives of “abortion rights” groups, who now speak of abortion being ”safe and legal” (not “safe, legal and rare”) and are even abandoning talk of “choice” in favor of pushing for maximum “access” to abortion. In other words, they don’t want to reduce abortions. But most of us still do.