Reducing the abortion rate

An essay submitted by "NorthStar,"
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This essay is in response to an earlier essay by Angie Pratt on reducing the abortion rate.

Ms. Pratt should be commended for attempting to forge a workable resolution to the problem of abortion in North American society. Unfortunately, many of her specific proposals are not supported by the available scientific evidence.

Ms. Pratt's emphasis on reducing abortion by aggressively enforcing child support is one of her proposals that can be supported by scientific evidence. Enforcement of child support may reduce the number of abortions by giving women the resources they need to raise children and by encouraging men to take an active role in parenting and in preventing unwanted pregnancies. Statistics from a number of sources have routinely shown that economics is the reason why many women choose abortion. ₁ Statistics also show that a woman is almost six times as likely to abort a pregnancy if she is unmarried, ₂ which suggests that women who have support from the father and from the rest of their families are much less likely to abort. By giving women more economic resources with which to raise children, more women might choose to bring pregnancies to term. Evidence also exists indicating that men are less likely to help create unwanted pregnancies and are more supportive of the women they impregnate if they do not have an economic incentive to shirk their parental responsibilities. Perhaps the best evidence for that assertion comes from an academic study that researched whether child support enforcement policy affects non-marital childbearing. The study found that states employing strict enforcement of child support have up to 20 percent fewer unmarried births than states that are lax about getting unmarried fathers to pay. ₃ The study authors theorized that forcing unmarried fathers to support their children financially might deter them from letting a pregnancy occur, or else motivate them to marry the mother if it did. Many U.S. states have plenty of room for improvement with regard to child support enforcement.

We can also hold fathers responsible for the children they produce by enforcing fornication and adultery statutes against men who abandon their children. Statistics show that at least eighty percent of aborted pregnancies are started by fornication or adultery, so such a strategy might have a significant effect on the abortion rate. Statistics also show that most women obtaining abortions report that the father failed to fully support them in their pregnancies. ₄ Cutting down on rape, incest, prostitution, and domestic violence would also undoubtedly help.

Pratt's suggestion that affordable day care be made available is also likely to help create a culture of life. Perhaps she could provide suggestions for achieving that goal if it is not attained already.

Ms. Pratt's suggestion that all forms of birth control be made freely available by the government to increase its pervasiveness is not as well supported by the evidence. In point of fact, contraception is already pervasive. One study showed that 98.2 percent of all women who have ever engaged in sexual intercourse have used contraception. ₅ The principle reasons why contraception is not preventing more abortions are because people are either carelessly disregarding contraception or because they are using ineffective forms of contraception. Subsidizing all forms of contraception would do little to discourage either practice.

Studies show that many, if not most, women obtaining abortions report that they and their partners used no form of contraception at all. ₆ We need to develop and advocate forms of contraception that are more easily used as well as give people an incentive to use them by placing restrictions on abortion. (More about these points later.)

The problem of people using ineffective forms of contraception is even more significant and can be addressed in several ways. A good example of an ineffective form of contraception is the popular male condom. A study by the Alan Guttmacher Institute found that women relying on male condoms as their method of contraception actually had an elevated chance of obtaining an abortion compared with the population of women at risk of unintended pregnancy as a whole. ₆ That result is not surprising, given that the true failure rate of condoms is 99 percent. That figure may sound high, but it can be supported with reliable data. To derive that figure, I started with the annual typical-use failure rate of condoms given by the Alan Guttmacher Institute- 15 percent. ₇ I then extrapolated that annual failure rate across the thirty years that the typical American woman spends trying to thwart the natural workings of her reproductive system. ₈ See Note A, below. That process may not yield very precise estimates, but it makes more sense than basing failure rates on a single year of use. ₉ The following table gives the failure rates of different forms of contraception derived using the process just described.

Spermicides 99.997%
Withdrawal 99.99%
Periodic abstinence 99.98%
Female condom 99.92%
Diaphragm 99.46%
Male condom 99%
Pill 92%
Patch 92%
3-month injectable 60%
1-month injectable 60%
IUD Copper-T 21%
Female sterilization 14%
Male sterilization 4%
IUD Mirena 3%
Implant 1%

What is very apparent from this table is that the long-acting methods of contraception- implants, IUDs, and sterilization- are far more effective than spermicides, withdrawal, periodic abstinence, condoms, and diaphragms at preventing unintended pregnancies. Not surprisingly, the study by the Alan Guttmacher Institute that I mentioned earlier found that women using long-acting methods were underrepresented among women obtaining abortions. So if we want to reduce the number of unintended pregnancies and abortions, we should encourage the use of implants, IUDs, and sterilization while discouraging the use of spermicides, withdrawal, condoms, and diaphragms. We can do so by selectively subsidizing the long-acting forms of contraception, educating women and men about the advantages of these forms of contraception, restricting abortion, and tort reform. That last proposal needs a little explaining. One of the biggest reasons why implants, IUDs, and sterilization have not gained wider use is because the makers of all three have been subject to opportunistic lawsuits. It's apparently easier to sue a doctor or an implant maker for a failure or an occasional side effect than it is to sue a condom maker when the device proves too unwieldy to use correctly. People living in countries with different legal systems, like Australia, have access to better forms of contraception- like the implant system Implanon. ₁₀

Ms. Pratt's proposals to provide free medical and prenatal care to pregnant women and children and to ensure paid time off from work for pregnancies need additional study. Letting women shirk their parental responsibilities could undermine their incentive to avoid having children they cannot support, ultimately leading to more abortions.

An additional approach that states and provinces can use to suppress the number of abortions is reforming adoption laws to allow birth mothers to choose adoption as freely as they can choose abortion. Currently, pregnant girls and women can unilaterally choose abortion but cannot unilaterally choose adoption. The law in most, if not all, states and provinces allows the birth father to revoke an adoption agreement after the birth. This inequity in policy in favor of abortion and against adoption may lead some women to choose abortion when they otherwise might have chosen adoption. Another way to reform adoption laws is by allowing girls and women to more easily enforce adoption agreements.

Yet another way to reduce abortion is for states to stop paying for abortions. Some states pay for large numbers of abortions. For example, Minnesota pays for about four thousand abortions per year.

My next set of proposals is aimed at reducing the number of abortions done later in pregnancy. States and provinces could start by collecting and reporting more data on second- and third-trimester abortions. In addition, they could conduct studies to determine why women wait until after the first trimester to abort and what can be done to see that abortions occur earlier. Failure to recognize a pregnancy appears to be a common reason why women wait until after the first trimester, so states and provinces might promote pregnancy detection and educate girls and women about how some forms of contraception inhibit regular menstruation (and can therefore hide a pregnancy). ₁₁ They can also help guide women in making decisions about later abortions by conducting studies to determine when fetuses first become sentient or conscious.

As I have alluded to earlier, placing restrictions on abortion can be an effective-perhaps the only- way of addressing some of the causes of abortion. People will have little incentive to refrain from irresponsible sexual intercourse, use effective forms of contraception, choose adoption, or bear children in imperfect conditions if they can shirk the consequences of not doing so. Abortion restrictions would address the selfishness and irresponsibility that are the true root causes of most abortions. Granted, a complete ban on abortion is not politically feasible in most of the United States and Canada. However, studies do show that restrictions on late-term abortions are popular in the United States. For example, an LA Times Poll in 2000 showed that American women favored banning second-trimester abortions by a 72 to 19 percent margin. ₁₂ (Note: Roe v. Wade needs to be overturned for time limits to take effect in the United States.)

So, again, I commend Angie Pratt for her attempt at forging a resolution to the problem of abortion and for presenting some ideas that are likely to work. However, if we really want to reduce the abortion rate, we need to use methods that are backed by scientific research.

References used:

1. For example, http://www.health.state.mn.us/  and http://www.guttmacher.org/
2. http://www.cdc.gov/. The overall report is at http://www.cdc.gov/.
3. http://www.uwnews.org/. Here is the abstract from the study:

   "A simple model of fatherhood and marriage choice implies that stricter child support enforcement will tend to reduce nonmarital childbearing by raising the costs of fatherhood. We investigate this hypothesis with a sample of women from the Panel Study of Income Dynamics, to which we add information on state child support enforcement. We examine childbearing behavior between the ages of 15 and 44 before marriage and during periods of non-marriage following divorce or widowhood. The estimates suggest that women living in states with more effective child support enforcement were less likely to bear children when unmarried. The findings suggest that policies that shift more costs of nonmarital childbearing to men may reduce nonmarital childbearing."

4. http://www.guttmacher.org/
5. http://www.cdc.gov/ **
6. http://www.guttmacher.org/
7. http://www.guttmacher.org/
8. "The typical American woman will spend three decades being sexually active but trying to avoid unintended pregnancy." at: http://www.guttmacher.org/
9. Mathematically, the 99 percent figure can be derived by subtracting the annual typical-use failure rate (15%) from 1, raising the result to the power of thirty, and then subtracting the result from 1.
10. http://www.fpwa.org.au/
11. http://www.guttmacher.org/ and http://www.mariestopes.org.uk/ **
12. http://www.latimesinteractive.com/ Question 35

** These are PDF files. You may require software to read them. Software can be obtained free from: 

Note A:

The appropriate method of computing the failure rate of condoms is to take the probability of avoiding pregnancy during the first year (0.85 according to the Alan Guttmacher Institute), multiply it by the probability of avoiding pregnancy during the second year (again, 0.85 according to the Alan Guttmacher Institute), and continuing for a total of thirty years. That is the chance of avoiding pregnancy is 0.85 raised to the 30th power. This is approximately 0.008.

The failure rate is then 100.0 - 0.008 = 99%.

B.A. Robinson

Originally posted: 2006-APR-06
Latest update: 2008-OCT-15
Author: "NorthStar" at northstar965@fastmail.fm

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