Reducing the Prevalence of Abortion: A Retrospective Review

 

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.

 

References

 

Access to contraception. ACOG. (2015). Retrieved https://www.acog.org/clinical/clinicalguidance/committee-opinion/articles/2015/01/access-to-contraception

Abramowitz, J. (2017). Access to birth control through ACA drives down abortion rate. Institute for Healthcare Policy & Innovation. Retrieved 2022, from https://ihpi.umich.edu/news/access-birth-control-through-aca-drives-down-abortion-rate

Arons, J. S. (2016). A universal win. Center for American Progress. Retrieved https://www.americanprogress.org/article/a-universal-win/

Beltz, M. A., Sacks, V. H., Moore, K. A., & Terzian, M. (2015). State policy and teen childbearing: a review of research studies. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 56(2), 130–138. https://doi.org/10.1016/j.jadohealth.2014.11.001

Bright, M. (2012). Study finds that comprehensive sex education reduces teen pregnancy. American Civil Liberties Union. Retrieved 3AD, from https://www.aclu.org/blog/reproductive-freedom/study-finds-comprehensive-sex-education-reduces-teen-pregnancy

Cameron S. Recent advances in improving the effectiveness and reducing the complications of abortion. F1000Res. 2018 Dec 2;7:F1000 Faculty Rev-1881. doi: 10.12688/f1000research.15441.1. PMID: 30631424; PMCID: PMC6281004.

Carr, J. B., & Packham, A. (2017). The Effects of State-Mandated Abstinence-Based Sex Education on Teen Health Outcomes. Health economics, 26(4), 403–420. https://doi.org/10.1002/hec.3315

Cates, W., & Rochat, R. (1976). Illegal Abortions in the United States: 1972-1974. Family Planning Perspectives, 8(2), 86–92. https://doi.org/10.2307/2133995

Coast, E., Lattof, S. R., van der Meulen Rodgers, Y., & Moore, B. (2019). Economics of abortion: a scoping review protocol. BMJ open, 9(7), e029939. https://doi.org/10.1136/bmjopen-2019-029939

Haddad LB, Nour NM. Unsafe abortion: unnecessary maternal mortality. Rev Obstet Gynecol. 2009 Spring;2(2):122-6. PMID: 19609407; PMCID: PMC2709326.

Kirby D. Emerging answers 2007: new research findings on programs to reduce teen pregnancy . Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy; 2007. Available at:https://thenationalcampaign.org/sites/default/files/resource-primary-download/EA2007_full_0.pdf.

Miller S, Wherry LR, Foster DG. The economic consequences of being denied an abortion. January 2020. Working Paper 26662, National Bureau of Economic Research.

Moore, B., van der Meulen Rodgers, Y., Coast, E., Lattof, S. R., & Poss, C. (2021). History and scientific background on the economics of abortion. PloS one, 16(9), e0257360. https://doi.org/10.1371/journal.pone.0257360

Reeves, R., Venator, J. Sex, contraception, or abortion? Explaining class gaps in unintended childbearing. Center on Children and Families at BROOKINGS. 2015. Retrieved https://docplayer.net/11861302-Sex-contraception-or-abortion-explaining-class-gaps-in-unintended-childbearing.html

Rice, Espey, Fenner, Gregory, Askins, C. Lockwood. Universal access to contraception: women, families, and communities’ benefit. American Journal of Obstetrics and Gynecology. Volume 222, Issue 2, 2020. Pages 150. https://doi.org/10.1016/j.ajog.2019.09.014.

Rodgers, Y., Coast, E., Lattof, S. R., Poss, C., & Moore, B. (2021). The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes. PloS one, 16(5), e0250692. https://doi.org/10.1371/journal.pone.0250692

Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the U.S. PloS one, 6(10), e24658. https://doi.org/10.1371/journal.pone.0024658 

Yang, Z., & Gaydos, L. M. (2010). Reasons for and challenges of recent increases in teen birth rates: a study of family planning service policies and demographic changes at the state level. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 46(6), 517–524. https://doi.org/10.1016/j.jadohealth.2010.03.021