What if Contraception Could Decimate the Abortion Rate?

A survey of women who terminated pregnancies found 12 percent conceived due to trouble getting birth control. 

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In Ross Douthat's weekend NY Times column, he mediates in the long-running argument  liberals and conservatives have waged over sex, abortion, and contraception. Liberals argue that widespread access to contraception is the surest way to reduce unwanted pregnancies, he writes, whereas conservatives believe "it's more important to promote chastity, monogamy and fidelity than to worry about whether there's a prophylactic in every bedroom drawer or bathroom cabinet."

Both narratives are contradicted by the facts, he argues. For example, socially conservative regions feature higher rates of teenage parenthood and unwed pregnancy than the nation as a whole.

He goes on:

Liberals love to cite these numbers as proof that social conservatism is a flop. But the liberal narrative has glaring problems as well. To begin with, a lack of contraceptive access simply doesn't seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.

Is the takeaway really that lack of contraceptive access isn't a significant factor in unplanned pregnancy? If roughly 1 in 10 unplanned pregnancies is caused by lack of access to birth control, that seems very significant! If I approached Douthat, having devised a way to reduce the American abortion rate by just 5 percent without coercion or significant expense, I suspect he'd be very enthusiastic, and think I accomplished something important. The issue here is that he's unpersuaded these teens would've avoided pregnancy even if they'd been given access to birth control.

As he writes:

...if liberal social policies really led inexorably to fewer unplanned pregnancies and thus fewer abortions, you would expect "blue" regions of the country to have lower teen pregnancy rates and fewer abortions per capita than demographically similar "red" regions. But that isn't what the data show. Instead, abortion rates are frequently higher in more liberal states, where access is often largely unrestricted, than in more conservative states, which are more likely to have parental consent laws, waiting periods, and so on. "Safe, legal and rare" is a nice slogan, but liberal policies don't always seem to deliver the "rare" part.

But the "liberal social policies" he conflates can be teased apart. What if contraceptive access reduces unplanned pregnancies in some jurisdictions, even as women who do get pregnant in those same places have abortions at higher rates due to unrestricted access or the fact that abortion is less stigmatized? As if in anticipation of that very counterargument, he goes on to write:

What's more, another Guttmacher Institute study suggests that liberal states don't necessarily do better than conservative ones at preventing teenagers from getting pregnant in the first place. Instead, the lower teenage birth rates in many blue states are mostly just a consequence of (again) their higher abortion rates. Liberal California, for instance, has a higher teen pregnancy rate than socially conservative Alabama; the Californian teenage birth rate is only lower because the Californian abortion rate is more than twice as high.

But California's higher teenage pregnancy rate is substantially driven by Hispanic immigrants whose religious and cultural background is relatively antagonistic to contraceptives. And if we're citing numbers generated by the Guttmacher Institute, surely the ones that follow are relevant to this subject:

- Publicly funded family planning services help women to avoid pregnancies they do not want and to plan pregnancies they do. In 2008, these services helped women in California avoid 317,900 unintended pregnancies, which would likely have resulted in about 141,300 unintended births and 132,700 abortions.

- Contraceptive services provided at Title X-supported centers in California helped prevent 200,200 unintended pregnancies, which would likely have resulted in about 89,000 unintended births and 83,600 abortions.

If you think that abortion is the killing of an innocent human, surely you should regard a contraceptive policy thought to result in tens of thousands of fewer abortions per year as a significant achievement, unless you think that the policy is causing lots of other abortions to occur. The Guttmacher Institute has published analysis that reaches precisely the opposite conclusion.

And increasing the availability and effectiveness of contraception seems like a more achievable task than reducing abortions by re-establishing bygone norms of chastity, monogamy and fidelity (none of which, by the way, are incompatible with widespread access to effective birth control).

Image credit: Reuters