Title: Reducing the Prevalence of Abortion: A Retrospective
Review
Abstract: Research has shown for several decades that restricting
abortion access through legislation does not reduce the prevalence of abortion.
However, utilizing a variety of research techniques an argument can be made
that reduction in abortion rates can be accomplished by improving access to free
or reduced-priced contraceptives, Universal Healthcare, comprehensive sexual
education programs, and a reduction of housing and wage insecurities.
According to the science and data “Restricting a woman’s
access to abortion does not prevent abortion but simply leads to more unsafe
abortions” (Cameron, 2018). Decades of research, both in America and worldwide,
have shown that making abortion illegal does not reduce the number of abortions
that take place instead it merely forces women into obtaining unsafe abortions.
Since 1976 healthcare professionals in America have been aware of this fact.
Researchers from the Center for Disease Control examined national abortion data
from the three years surrounding the rulings (post-Roe V Wade) and estimated
that the number of illegal procedures in the country plummeted from around
130,000 to 17,000 between 1972 and 1974 (Cates & Rochat,1976).
Illegal
abortions lead to high mortality rates from infection and hemorrhage and by
researchers’ standards are avoidable and unnecessary deaths (Haddad, 2009). And
again, abortion-related deaths are more frequent in countries with more
restrictive abortion laws (34 deaths per 100,000 childbirths) than in countries
with less restrictive laws (1 or fewer per 100,000 childbirths) (Haddad, 2009).
There are two main points I would
like to discuss in this article: (1) Data indicates an association between
unsafe abortion and restrictive abortion laws. (2) Preventing unintended
pregnancy by providing better access to health care and contraceptives,
improving sexual education, reducing wage and housing insecurities, and
liberalizing abortion laws to allow services to be provided can reduce the rate
of abortions and thus reduce abortion-related morbidity and mortality.
The
first point is simple and plainly defined and quantified by hundreds of
research projects, thousands of written documents, and decades of scientific
data. It is factual to state, based on the current science and data, that
making abortions illegal does NOT reduce the number of abortions.
The second point is more broad but
just as necessary, which is a multi-step approach to reducing abortions. All of
these are based on scientific data and research.
Firstly, access to free or
reduced-priced contraceptives greatly reduces the prevalence of abortion. In
fact, “The American College of Obstetricians and Gynecologists supports access
to comprehensive contraceptive care and contraceptive methods as an integral
component of women’s health care …” (2015). This means that contraceptives,
such as condoms or pills, should be over the counter, easy to access, and
affordable with accompanying full insurance coverage or cost support. Other
studies have even shown that easier access to contraceptives also reduces teen
pregnancy (Kirby, 2007). To reiterate this point: “Universal access to
contraception benefits society: unintended pregnancies, maternal mortality,
preterm birth, abortions, and obesity would be reduced by increasing access to
affordable contraception” (Rice et al., 2020).
While many countries offer
free or reduced-price oral contraceptives, the United States does not.
Secondly, Universal Healthcare has
been shown to reduce abortion prevalence in several countries. Since the
implementation of the PPACA (Patient Protection and Affordable Care Act) also
known as “Obamacare”, study after study have revealed that access to birth
control reduced abortion rates in America. Obamacare reduced the number of
abortions performed in America because it allowed easier access to more
affordable contraceptives (Abramowitz, 2017). Universal Healthcare would take
what the ACA did and improve on it greatly. A study released by the New England
Journal of Medicine showed that in Massachusetts when healthcare coverage was
expanded) abortion rates dropped (Arons, 2016). To this day, Massachusetts has
one of the nations only near full public state healthcare systems with a health
insurance coverage rate of 97% of their citizens. If the United States were to
implement either a single-payer or public option offering its citizens
Universal Healthcare, abortion rates would decline substantially.
Thirdly, funding and implementing
comprehensive sexual education nationwide would reduce abortion rates. This
remains a controversial issue in America as some feel that abstinence education
is more appropriate, based on a variety of reasons. However, factually
speaking, “increasing emphasis on abstinence education is positively correlated
with teenage pregnancy and birth rates” (Stanger-Hall, & Hall, 2011). Study
after study shows that abstinence education simply does not work, at the state
level it does not reduce teen pregnancy (Carr & Packham, 2017), and on the
local level “abstinence-only education programs were found to cause an increase
in teen birth rates among white and black teens” (Yang & Gaydos, 2010).
Despite these facts, in America, 1 in 4 teens receive abstinence-only sexual
education and it simply is not as effective as comprehensive sex education
(Bright, 2012). However, several studies have found that measures related to
access to, and use of family planning services and contraceptives are related
to lower state-level teen birth rates (Beltz et al., 2015). If the United
States implemented and funded national comprehensive sex education courses in
our public schools, we could substantially reduce abortion rates in teenagers.
Fourthly,
reducing housing and wage insecurities in America would reduce abortion rates.
For decades, researchers have made connections between low-income families,
women, and abortion services. A multitude of these economically-driven research
studies has found several key elements in the relationship between
socioeconomics and abortion. Three different research projects by Coast et al.,
Moore et al., and Rogers et al. found a wide range of economic links between
abortion denial and financial implications for women (2019). According to
Reeves & Venator, “Improving the economic and educational prospects of
poorer women is, therefore, an important part of any strategy to reduce
unintended birth rates” (2015).
It would be difficult to
deny that financial hardship can occur post-childbearing for women and
families. Even more so for women and families in poverty. One large ten-year
study called “The Turn Away Study” looked at 1000 women, some who were allowed
abortion and others who were denied (for a variety of reasons, mostly
legal/limited options in particular states). This study showed that women who
were denied abortion services were FOUR times more likely to suffer future
economic hardships. On the contrary, women who received abortions were SIX
times more likely to achieve 1-year goals for themselves (enroll in school, buy
a house, etc). This same study also showed that women who were able to plan for
children, children also benefited economically versus the women who were denied
abortion services (Miller et al., 2020). The financial burden of being forced
to carry and birth an unwanted pregnancy is severe. Denying abortions causes a
tremendous financial strain on already strained families and burdens further on
an already burdened system.
In
summary, scientific and data-driven information shows us very clearly several
things: abortion bans do NOT work in reducing abortion they INCREASE abortions
and INCREASE mortality rates. To reduce abortions, countries need to invest in
free or reduced-price contraceptives, Universal Healthcare, sexual education,
and housing and wages. Investments in people and infrastructures would
substantially reduce abortions versus simply passing legislation to make
abortions illegal or more difficult to obtain.
In conclusion, the recent supreme
court ruling to overturn Roe V Wade and the subsequent state trigger laws going
into effect will not reduce abortions in America. We will see an increase in
abortions and an increase in mortality from unsafe and illegally performed
abortions. If the United States would like to see a reduction in the number of
abortions performed annually the previously listed and discussed strategies
could substantially reduce the abortion rate.
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