Factors that increase or decrease
the abortion rate in the U.S.

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Social, medical and other factors that increase or decrease the abortion rate:

Some social, educational, and other factors decrease or increase the abortion rate by altering the numbers of unwanted pregnancies. Other factors affect the abortion rate by making a pregnant woman more or less likely to seek an abortion.

We have a hunch that the vast majority of adults in North America who would like to see the abortion rate reduced, could be far more effective if they focused their effort on changing some of these factors, rather than by attempting to pass state legislation that restricts abortion, demonstrating at abortion clinics, or by defunding abortion providers like Planned Parenthood:

Sex-education:
- Decreases abortion rate: The percentage of students in public schools who receive some form of comprehensive sex-education has been increasing over the past few decades. This involves teaching about sexual activity generally, contraception, and sexually transmitted infections (STI's), Studies have shown that comprehensive sex-ed tends to defer sexual activity among students. This reduces the number of unwanted pregnancies and thus the need for abortions.
- Increases rate: There is a movement towards sex-education that heavily stresses abstinence until marriage. If abstinence is the only message taught, then those students who decide to become sexually active will not receive information from the sex-ed course on how to prevent conception. This may increase the number of unwanted abortions and thus the number of abortions sought by this group. Of course, many students will obtain contraceptive information from other sources of information: family planning clinics, the Internet, movies, TV programs, etc.
Scare tactics:
- Decreases rate:
  - Some pro-life groups have been spreading unfounded rumors that abortions are dangerous, often lead to breast cancer, often cause permanent infertility, etc. In fact, the death rate from legal abortions performed in clinics is much lower than the maternal fatality rate giving birth. That is, it is safer for the woman to have an abortion than it is for her to proceed to a live birth.
  - Some in the pro-life movement teach that a woman's chances of developing breast cancer is increased by abortion. There exists an indirect link between the two: If a woman becomes pregnant and particularly if she gives birth, then her chances of developing breast cancer later in life is significantly reduced. If a woman becomes pregnant and has an abortion, she will not benefit from this effect. Her incidence of breast cancer later in life will be as if she had never become pregnant.
  - The danger that an improper abortion that leads to infertility is very small. According to Kimberley A. Thornton, M.D. a reproductive endocrinologist and infertility specialist at RMA of New York:
    
    "A medical abortion is done by swallowing medication, and should have zero effect on future pregnancies. A surgical abortion can be done a few ways but always involves an instrument being inserted into the cervix. In rare circumstances, abortion can cause damage to the cervix or uterus in the process. "This would be more common with a woman who has had multiple abortions. ... For women who have had multiple abortions, it’s the same risk as a woman who has had multiple pregnancies in general." ₄
    
    If one or more abortions have caused scar tissue that interferes with conception, it can usually be removed surgically.

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Time interval between puberty and marriage:
- Increases rate: In the past in North America, and in some other countries of the world today, the time interval between puberty and marriage was measured in weeks or months. Puberty is now occurring at younger ages. This is one of the factors that is reducing the average age at which a teen engages in sexual intercourse. The latter is now about 17 years-of-age. ₅ Meanwhile, sd Elanor Barkhorn wrote in The Atlantic magazine:
  
  "Americans are getting married later and later. The average age of first marriage in the United States is 27 for women and 29 for men, up from 23 for women and 26 for men in 1990 and 20 and 22 (!) in 1960. ₆"
  
  As a result, the interval between first intercourse and marriage is now on the order of 11 years and probably continuing to increase. During this time, the vast majority of women become sexually active and risk unwanted pregnancy. Thus, they are more liable to seek an abortion.
Financial support for single mothers:
- Increases rate: Welfare payments in the past were increased with the birth of each baby. However, many states now cap payments so that the family's standard of living decreases with each birth. Faced with the choice of a lower standard of living or an abortion, many women will chose the latter.
Increasing cost of abortions:
- Decreases rate: According to the American Civil Liberties Union:
  
  "Since the 1970's, the federal government and most states have severely restricted Medicaid funding for abortion. As a result, low-income women -- who are disproportionately women of color -- often find it difficult or impossible to obtain safe, legal abortions." ₁
Availability of abortion services:
- Decreases rate: By 1999, 86% of all counties in the U.S. had no known abortion provider, and only 12% of obs/gyn residency programs required training in first-trimester abortions. By 2014, the percentage of counties without an abortion clinic has increased to 90%. ₇ This is an often-quoted figure. However, a more accurate measurement is the percentage of women of child-bearing ate (15 to 44 years-of-age) who live in a county without a clinic. This was 39% in 2014.
  
  Many abortion clinics are picketed by pro-life groups, making access more difficult.
- Increases rate: The availability of both emergency contraception and abortifacient medication has made pregnancy prevention and non-surgical abortion more readily available.
Alternatives to risky behaviors:
- Decreases rate: There is a little-studied phenomenon that has recently surfaced among sexually-active youth. Some couples are increasingly engaging in various physical activities that do not involve penile-vagina intercourse -- including massage, cuddling, fondling, oral sex, mutual masturbation, etc.
Emergency contraception:
- Decreases rate: "EC" is available in some locations and at some times during the week. These pills help women who have had unprotected intercourse prevent the start of a pregnancy. ₈ If all fertile women were aware of the medication, if all pharmacies honored physicians' prescriptions for emergency contraception, and if women kept a stock of EC on hand, then the unwanted pregnancy rate would be greatly decreased. Some sources estimate that the abortion rate could be halved with proper education. However, many women are not aware that EC exists. Also, some pharmacies refuse to stock EC.
- Increases rate: Many pro-lifers have a different definition of pregnancy. They believe that it happens at conception. Since EC can sometimes prevent the implantation of a fertilized ovum in the wall of the uterus, some pro-lifers believe that EC is an abortifacient. Thus, with their definition of terms, use of EC increases the abortion rate.

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Webmaster's note to the readers of this essay:

We have probably overlooked some factors that increase or decrease the abortion rate in the U.S. If you can think of any, please email us at [email protected]

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References:

"The right to choose: A fundamental liberty," American Civil Liberties Union, at: http://www.aclu.org/ These are PDF files.
"Kissing cousins get the okay," Associated Press, 2002-APR-3. Published in the Toronto Star, 2002-APR-4, Page A1.
Robin Bennett, article in Journal of Genetic Counseling, published by the National Society of Genetic Counselors.
Amy Marturana, "Does Having An Abortion Affect Your Future Fertility?," Self, at: http://www.self.com/
Kathryn Stamoulis, "Yes Your Teenager Is Having Sex…But It’s Not That Bad," Psychology Today, 2010-JUN-14, at: https://www.psychologytoday.com/
Eleanor Barkhorn, "Getting Married Later Is Great for College-Educated Women," The Atlantic, 2013-MAR, at: https://www.theatlantic.com/
"Data Center," Guttmacher Institute, at: https://data.guttmacher.org/
We are using the medical definition of the time when pregnancies begin. That is when the blastocyst implants itself in the inner wall of the uterus. Most pro-lifers regard pregnancy as starting at conception.