In my last blog post, I showed how Facebook often rejects our ads for pregnancy medical centers, and then, on appeal, reverses its decision. That has been true for Pittsburgh for years, and also for Cleveland, and it used to be true for Philadelphia, but no longer.

July 10, Facebook “restricted” our advertising. At first I was told that it would be resolved in 24 hours. Then it was 48. I was told that the “internal team” was conducting an investigation. At the end of August, I was informed that Facebook needed to establish my identity. Why did it take them more than 6 weeks to get around to asking me for credentials? Why did Facebook – Pittsburgh have no problem with my identity, or Facebook – Cleveland? I had already sent Facebook - Philadelphia photos of my driver’s license (both sides). So I did it again, and started the online identity questionnaire. The questionnaire abruptly stopped and I was informed that I had to get a notarized statement confirming my identity. Uh huh.

I am familiar with bureaucracies, having worked for the Canadian federal government, and having had to deal with large corporations for one reason or another over the years. This delay is what is known in the business as “losing the file.” Facebook itself is not pro-abortion, officially: there are pages for the abortion pill, but there are many pro-life pages. And of course, Facebook in Pittsburgh and in Cleveland happily lets our ads run. (Currently we’re running ads for abortion-pill reversal.) You could say that Facebook is “pro-choice.” It doesn’t seem to be difficult, however, for a Facebook employee, or for several employees together, to curtail pro-life activity unofficially, to “lose the file” and prevent advertising that saves lives.

​In our current environment, where women can get an abortion for any reason up until 24 weeks (Pennsylvania), it is pregnancy help centers that are truly “pro-choice.” Women who come to the centers commonly complain that they have “no choice but abortion.” The centers present women with alternatives: they give factual information on abortion, but they also give women information on adoption and on what is involved in keeping their babies. Plus, of course, they give practical help and moral support if a woman chooses to carry her baby to term. The general public, polls show, loves pregnancy help.

These Facebook employees don’t want women to have alternatives: they don’t care what might be driving women to seek an abortion. They don’t want any solution to the women’s problems but abortion. Why would that be? A personal involvement in abortion, and a guilty conscience expressing itself in hostility? Perhaps. An ideological or anti-religious opposition to pregnancy help, and the Christians who are involved in this ministry? Maybe. An unthinking acceptance of others’ pro-abortion propaganda, and a desire to frustrate those working for “fake clinics”? Who knows?

Google won’t run ads for the Abortion Pill Rescue Network (see Abortion Pill Reversal - Home). Abortion-pill reversal works: over 3,000 women have had their babies with no harm to the children. The reversal protocol is pretty simple: a woman calls the Abortion Pill Reversal number (1-877-558-0333) after she has taken the first abortion pill, but before she has taken the second. She is connected with a physician, who sends a prescription for progesterone to a pharmacy near her. She fills the prescription, and follows the instructions for taking it. She goes as soon as she can to the closest pregnancy medical center, where she gets an ultrasound to establish fetal viability. In an early study, abortion-pill reversal was successful over 64% of the time. 

Progesterone is used commonly to prevent miscarriage. Some people at Heartbeat International, an association of pregnancy help centers, have worn T-shirts that say, “It’s just progesterone.” Ideological hostility would have you believe otherwise.

At a recent meeting of the American Association of Pro-Life Obstetricians-Gynecologists, Joy Stockbauer noted, participants discussed “the utter denial by the American College of Obstetricians and Gynecologists (ACOG) that abortion pill reversal is safe and successful. ACOG is not neutral on abortion pill reversal – it actively fights against informing women about this safe and natural treatment that could allow them to change their minds after beginning a chemical abortion.” Google is quite happy to accept the conclusion of the pro-abortion organization over the mounting evidence in its favor.
​
Half of the abortions in America today involve the abortion pill, and that proportion is likely to increase as it is less expensive than a surgical abortion, and abortion-pill providers can get around state laws to sell them. Ads for abortion-pill reversal are likely more effective than any other kind, as they tell any woman thinking about abortion that she’s not alone, that other women have had doubts, too, that people are ready to help her face her unexpected pregnancy, and that, if she has made the mistake of taking that first pill, she might be able to keep her pregnancy.

When women search for terms like abortion pill, Google won’t show pregnancy medical centers in the search results. Planned Parenthood and its peers don’t really provide options; they have been shown to push women towards abortion, maximizing their anxiety about having a child and minimizing the dangers of the abortion pill. (Those dangers are real, e.g., “Chemical abortion is consistently and progressively associated with more postabortion E[mergency] R[oom] visit morbidity than surgical abortion. There is also a distinct trend of a growing number of women miscoded as receiving treatment for spontaneous abortion in the ER following a chemical abortion,” from a study cited on the Charlotte Lozier Institutes’ page on abortion-pill dangers, Public Health Threat: New York Data Shows Significant Increase in Risky Abortion Method - Charlotte Lozier Institute).

It is becoming challenging to advertise in this environment. It is definitely counter-cultural. It is still possible. While Google is deliberately limiting pregnancy help results in its “organic” search results, it still accepts paid advertising, “Google Ads,” and we are running those in all three cities. Facebook’s censorship of ads seems to be selective, depending on our area. Our friends at Lamar Advertising have been advertising Vision for Life in Pittsburgh, and billboards, especially the electronic kind, may become a bigger part of our work.
​
We’re in the right on this issue, and so any challenge is worth taking on. We will continue to reach out to women, to offer what’s best for them and their babies.

If you read my blog article on the trends in the ages of abortion patients, you’ll know that 63% of abortion patients in the U.S. in 2019 were 25 or older. That wasn’t the case in 1973, when only 35% of abortion patients were over 24. Pregnancy help has reached the younger women and changed the proportions. Yet most pregnancy help centers are still pursuing the scared teenager (now only 9% of abortion patients), or the woman in her early 20s (28% of abortion patients). I think it’s because the women in pregnancy help find it easy to fall into a motherly role with younger women, and younger women are often willing to have a mother-figure help them decide what’s best for them.

Many women say that their pregnancy is “mis-timed”: they’re too young, or they’re not ready financially or relationally to have children. Sometimes older women will say it’s mis-timed, too, if they think that they will have a child or children later. Women will say that a pregnancy is “unwanted,” period, if they don’t want any children. Sixty percent of abortion patients in Pennsylvania have already had at least one child. These are often women who feel they can’t handle any more children, for financial reasons or because of problems in their relationships with their partners. Forty-seven percent of abortion patients in Pennsylvania have had one or more abortions already.

​From what I have seen, our friends in pro-life marketing (in no particular order: Choose Life Marketing, Cornerstone Marketing Strategies, ALIGNN, Stories Marketing, Lilianna Grace Media, among others) are marketing their services to the inexperienced in the 15–24-year-old group, facing their first unexpected pregnancies. Their social media ads are not addressing the 63% of would-be abortion patients who are older, and who may already be mothers, or may have had abortions.

From the start, our Facebook/Instagram ads have been realistic, even gritty, presenting the challenges facing women with an unexpected pregnancy, and the offer of information, help, and hope from the pregnancy medical centers. (I think that’s part of the reason Facebook has rejected the ads at first, and then accepted them. Thirty-two percent of Facebook’s and Instagram’s users are 25–35 years old, their biggest age groups.) In some of our two-minute stories, the woman is already a mother, or her boyfriend is abusive or controlling, or her last abortion didn’t do anything for her, either. Realism may not make friends for us instantly, but some women immediately recognize honesty, and some, I’m persuaded, will look back and see that we told them the truth, while others like Planned Parenthood simply flattered them to seduce them. So with our direct, realistic social media ads, we’ve taken the long view, while telling women where they can get help right away, if they want it.

Our pro-life marketing friends need to start A-B testing with ads aimed at older women. (A-B advertising tests run similar ads with different messaging or creative content, colors, ethnic actors, etc., to discover which are most effective.) As half of abortions are chemical now, they also need to advertise Heartbeat International’s Abortion Pill Rescue Network.

If we can reach older women as successfully as we have the younger ones, we’ll bring down the abortion numbers even faster.

Many conservatives, social and political, claim that Big Tech is hostile to pro-life views. And it's probably true, overall. Google won't let Heartbeat International (an association of over 3,000 pregnancy help centers) run ads for abortion pill reversal (https://reverseabortionpill.com/). And now Facebook has closed down their abortion pill reversal Facebook page.

We are used to rejection at Vision for Life.

We have advertised using still-image ads and video ads since 2014. It is quite common for our video ads these days to be rejected. This month they were rejected, the rejections appealed, and the appeals accepted. Then somebody at Facebook put restrictions on our Philadelphia Choices page (https://www.facebook.com/Philadelphia-Choices-1795645007341892). We almost always win in the end.

I thought you might like to have an idea of how things go when we're appealing our rejections. You might be surprised.

Hi Chris , Thank you for contacting Meta Pro Team. My name is Madhav. Your case ID is 10076855766*****. I can see that you are contacting us with regards to ad approval, Am I correct?
 
Facebook Business Support
 
How are you doing today!
 
Facebook Business Support
 
If you could help us with the ad account Id as well so that we can look into that and assist you with the same.
 
You sent
 
I'm doing well, thank you. Yes, I'm contacting you about rejected ads. In my initial statement, I included the ad set number. It's for Philadephia Choices. I'm going to try to find the ad account ID now.
 
Facebook Business Support
 
Thank you really appreciate that also would like to know the page URL/page ID attached with the Ad so that can see if there is any restriction on the page.
 
You sent
 
https://www.facebook.com/Philadelphia-Choices

Philadelphia Choices
Community
 
Facebook Business Support
 
I have checked your Page status and I can see it has restricted and may I know have submitted the appeal for that.
 
Facebook Business Support
 
No Intend to rush you Chris, are we connected?
 
You sent
The usual pattern with rejections of ads is that you pass on my appeal of the rejection to the internal team. Here is some supporting material that show that the ad treats abortion regret credibly. https://www.abortionchangesyou.com/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161227/ A pro-abortion censor at Facebook has rejected this ad, despite the fact that an earlier appeal of its rejection was accepted.


After Abortion Emotional Healing & Care

You sent
 
This appeal applies to ads for July for AlphaCare and The Hope Pregnancy Center.
 
Facebook Business Support
 
Chris - I completely understand what you are talking about in regards to the ad however the problem now is not with the ad. The problem is with the page for which you are running the ads now, as there are certain restrictions in your page you have to clear and appeal all those restriction so that you can advertise for that page again and run successful ads.
 
You sent
 
What restrictions are these?
 
Facebook Business Support
 
The restriction for the page to advertise again.
 
You sent
 
Again, it appears that this is pro-abortion obstruction by people at Facebook. This is a policy issue for those higher up in Facebook to address: will it treat advertisers fairly, or will it only allow abortion-pill promoters to advertise?
 
You sent
 
My question about the restriction is this: On what grounds is it restricted?
 
You sent
 
What can be done to remove the restriction?
 
Facebook Business Support
 
Please stay connected for 1 to 2 minutes let me see what best can be done, also in the mean while please fill up your page link in the below Page Policy Appeals form https://www.facebook.com/help/contact/2992968173**** This goes directly to the experts.
 
You sent

Thank you.
 
You sent

Done.
 
Facebook Business Support
 
Fantastic! I have tried to expedite the process by putting all the high priority notes in your case so they will directly get back to you through your support inbox or your email address updated on the Facebook, as being an advertiser myself I can relate to your situation.
 
You sent

Thank you for your resourcefulness, it's very much appreciated.
 
Facebook Business Support
 
I have already resolved your problem and I need your support because as a team we can solve this with collective efforts. Your page will be enabled if there is nothing wrong. It will get done in next 24 hours.
 
You sent

Good!
 
You sent
 
Thanks again.
 
Facebook Business Support
 
Thank you really appreciate that! Please be positive. I am feeling very positive, as I have got the team working for you now.
 
Facebook Business Support
 
You are welcome, Chris.
 
You sent
 
Great!
 
Facebook Business Support
 
Anything else, apart from this that needs my attention to?
 
You sent
 
No thanks, nothing I can think of. Have a good day. [I closed the chat at my end.]
 
Facebook Business Support
 
Thank you, That means a lot to me.
 
You are a nice advertiser with us and deserve special attention.
 
Facebook Business Support
 
You too have a wonderful day!
 
Facebook Business Support
 
If this is all, let me quickly sum up the chat as below: To sum up, you contacted us for your restricted ad and page I checked and instructions on the form to fill that I shared with your. Since you have submitted the form, the team shall get back to you with a decision post review and may also ask an ID. Please keep checking for email or notifications sent by them. Although I do not have the authority to directly return the account, I have shared the best and authentic information to help you in the situation. Has my information resolved your issue?
 
Facebook Business Support
 
You may receive a survey shortly and we would like you to help us improve by taking a few seconds to tell us about your experience chatting with us.
 
Facebook Business Support
 
Thanks again, take great care of the nice human being in you.
 
Facebook Business Support
 
Thank you for contacting Meta Pro Team and have a great day!
 
. . .
 
[I responded to the Facebook service survey.] What made handling your issue with Meta Support Pros easy or difficult? Please be as descriptive as possible.
 
You sent
 
He was clearly keen to solve my problem, which I think stems from hostility from some people at Facebook to pro-life pregnancy help. Earlier this month my ads were rejected, though they had run before. The appeal was successful. Restrictions on our Philadelphia Choices page, as far as I can tell, were unwarranted and malicious. I am glad that Facebook has the internal checks and balances to treat us fairly. 

We'll find out tomorrow if Facebook has done the right thing.

​A few years back, the executive director of a local pregnancy help center observed that more clients were not just “abortion-vulnerable,” that is, just thinking about abortion; instead, they were “abortion-determined.” They weren’t calling up with questions about pregnancy and abortion, but asking how much an abortion would cost. They had made up their minds. They were just shopping.
 
Now some of this could be the result of changing mores, new attitudes to sex and relationships, or a changing sense among these young women of how one has to act in “the real world.” A bigger part of the answer, however, is a change in the demographics: more of the women seeking an abortion are older. Let’s take a look at abortion numbers over the long term, to see the trend.

​The most striking change since 1973, perhaps, is how the percentage of young abortion patients has gone down: those under 20 years old (the yellow bars) dropped from 33% then, to 9% in 2019 – a 73% decline. Look at the difference, however, in percentage of patients who were over 24 from 36% to 63% (the blue bars). That’s an increase of 80%.
 
Put this data together with the decline in the rates of abortions per 1,000 women of child-bearing age over the same period, and it is clear: not only are younger women a smaller group of all those having abortions; they are a smaller group of all women their age. The following chart shows the pattern clearly: the trend lines showing the proportion of those women 15–19 and 20–24 who are having abortions go down (the orange and gray lines). The trend lines for abortions among women 25–29 and 30–34 rise slightly (the yellow and blue lines).

​Why are younger women having fewer abortions? The proportion of those using contraceptives has increased somewhat from 2010.[1] Adolescents, however, are also less sexually active than in the past. In 1991, 54% of high school students had had sex; in 2019 that number was 38.4.[2] Many observers have seen a decrease in sexual activity generally, though it is most observable in younger women. A variety of reasons are given to explain it.[3] The result, of course, is fewer pregnancies that lead either to birth or abortion. Is it possible that the morning-after pill (“Plan B”) has played a role here? This is unlikely, as the declining abortion ratios began well before the widespread availability of the morning-after pill, and continued at the same rate after its availability. The relatively sexually and contraceptively inexperienced young woman, if anything, would be less likely to resort to it than her older peer.
 
Women 15–24 gradually became a smaller proportion of all age groups having abortions. They also became a smaller group of all those their age who were pregnant. For those 15–19, those ratios per thousand births dropped over 50% from 1985 to 2007; for those 20–24, they dropped 29%. The decline for those 25–29 was 16%.[4]
 
Could it be that the cohort of women who were open to abortion years ago were just getting older and were still open to abortion, while younger women were less so? Changing practical attitudes to abortion may play a role, but the age trends are lasting much longer than the reproductive years of any given cohort. Something else is happening here.[5]
 
Abortion ratios are the best measurement of factors affecting the pregnancy decision. When the proportion of pregnant women choosing life goes up, one naturally looks for a cause. The most obvious cause of reduced abortion ratios across the country is the increase in pregnancy help centers and the advertising of them. Abortion numbers began falling in the mid-1980s, just as the number of pregnancy help centers began increasing sharply. The abortion numbers have continued to fall steadily to the present, as more centers go up and as advertising for those centers becomes more widespread.
 
Has pregnancy help had an outsized effect upon adolescents and younger women? It is almost certainly so. When they become pregnant, younger women are more likely to be unsure of whether they are. When they have confirmation that they are pregnant, they are more likely to be uncertain of their next step, or of what they really want. They are more likely to be ambivalent about abortion, and find decision-making challenging.
 
This is reflected in the fact that younger women have a lower proportion of early abortions than older women, and a higher proportion of later abortions. We can see this in the gestational ages at which most abortions are performed: 9 weeks or under. In the chart below, showing CDC data from 2019, notice that about 36% of aborting women 15–19 had their abortions at 6 weeks or less. Of those women a little older, 20–24, 41% had abortions within the same period. If you follow the six-weeks-and-under line (blue) to the right, you see that the older a woman was, the more likely it was that she had an abortion early in pregnancy.

The blue line (abortions performed at 6 weeks gestation and under) shows that 15-19-year-olds were a minority of those having abortions at that stage (36%). More of them (38%) waited until 7-9 weeks gestation to abort (the first point on the orange line). The rising blue line shows that the older women were, the more likely it was that they had their abortions earlier in pregnancy.

The declining lines for 7-9 weeks gestation (orange), for 10–13 weeks gestation (gray), and, for 14-15 weeks (yellow) show similarly that the younger women waited longer to have their abortions.
 
So it appears that younger women are more uncertain and ambivalent regarding abortion than those a few years older. It is no surprise that more younger women who have an opportunity to find support, have increasingly turned away from abortion over the years than older women. It is also no surprise that, as abortion numbers have gone down, our success with younger women means that other, older clients seem more “abortion-determined” than ever.
 
Pregnancy help centers are staffed, in many cases, with older women who serve as advisors or mentors for women whose family situations make such mentors invaluable. These older women are effectively surrogate “moms,” taking the right amount of interest in the well-being of their clients, while respecting the freedom of these adult “children” to make their own decisions. These “moms” care, and inasmuch as their clients get to know them, their clients know that they care. It is this, and the information, practical advice, and moral and spiritual support that they provide, that has had the effects we see in my first two charts: younger women, women more ready to accept those falling into a “mom” role, are less likely to abort than those over 24.
 
The result, however, is that the women that pregnancy help centers have to reach are more and more “determined.” That is, they are more experienced, and less impulsive (something that both males and females face, as the brain matures in the twenties[6]). They are surer of themselves, and perhaps more cynical as a result of their experiences. About 60% are moms already, and over 40% have had one abortion or more before.
 
From about 2015 on, ratios of abortions to births for 15–19-year-olds began to climb again. The same was true for those 20–24, though the increase was smaller. Pregnancy help centers cannot ignore this group of pregnant young women, for whom they have done and can do so much, and despite the fact that this group has become smaller. Without ceasing to appeal to those under 25 (aiming at the high schools and colleges, and so forth), pregnancy help centers would do well to reach out to older women, who in many cases face more complicated situations than their younger peers. Despite the challenges, many still respond if they are given the opportunity.
 
 
Chris Humphrey, Ph.D.
Co-Founder, Vision for Life
www.visionforlifepgh.org

[1] “In terms of overall trends in contraceptive use between 2008 and 2014, there was no significant change in the proportion of women who used a method among either all women (60%) or those at risk of unintended pregnancy (90%)” (Megan L.Kavanaugh, Jenna Jerman, “Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014,” in Contraception, Volume 97, Issue 1, January 2018, pp. 14-21, https://www.sciencedirect.com/science/article/pii/S001078241730478X).
​
[2] Kate Julian, “Why Are Young People Having So Little Sex?” The Atlantic, December 2018 (https://www.theatlantic.com/magazine/archive/2018/12/the-sex-recession/573949/); CDC, Youth Risk Behavior Survey: Data Summary and Trends Report, 2009–2019, p. 12 (https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBSDataSummaryTrendsReport2019-508.pdf).

[3] Julian, op. cit.

[4] Calculations were made using “Table 12 (page 1 of 2). Legal abortions and legal abortion ratios, by selected patient characteristics: United States, selected years 1973–2007,” from the 2011 CDC Abortion Surveillance Report (https://www.cdc.gov/nchs/data/hus/2011/012.pdf).

[5] I am indebted to my fellow Heartbeat International Board member Gary Thorne for this observation, and to Jor-El Godsey, President of Heartbeat, for helpful suggestions.

​[6] https://www.nimh.nih.gov/health/publications/the-teen-brain-7-things-to-know
​

The PA Abortion Report for 2020 is not good news overall, but there’s good news for Allegheny County.  The bad news from Philly may be hiding the good effects of advertising, even there.
​
Abortions Down Again for Allegheny County Residents

At first glance, abortion statistics for Pennsylvania in 2020 are reasons for dismay: numbers are up. A close look at Allegheny County, however, shows that the number of abortions for residents actually dropped, while ratios remained the same. How is that possible? Birth numbers dropped, and abortion ratios are – wait for it – the ratios of abortions to births. So both abortions and births decreased proportionately in the County.

Philadelphia’s numbers were more discouraging at first glance. Both resident abortions and abortion ratios were up over the last few years, including 2020. On the surface, one might conclude that Vision for Life’s advertising was having no effect there. However, if one compares Philly not with Allegheny County, but with all the other counties, including neighboring counties, the picture is much brighter. It is quite likely that advertising pregnancy medical centers in Philadelphia County reduced the increase in abortion numbers and ratios of abortions to births.

First, the bad news: Abortion numbers for Pennsylvania residents were both up, for the third time since 2017.

​The ratio of abortions to births measures the proportion of women who choose life. That ratio was up again for PA women in 2020. That is, more PA women who were pregnant chose abortion that year. This was the pattern statewide since 2018.

​The good news, however, is that abortions to Allegheny County residents, after rising slightly in 2019, went down again in 2020, from 3,265 to 3,083.

​How can the numbers of abortions drop from the previous year, yet the abortion ratios remain the same? 2020 was “the year of the fear.” Birth numbers for Allegheny County residents dropped sharply.

​So abortions were down, but so were births, and the ratio of the first to the second remained the same. It is our contention that, without our advertising, abortion numbers and abortion ratios would have been up in Allegheny County, as they were in the rest of PA.
​
Compare the abortion ratios of Allegheny County residents to the residents of all other counties.

The abortion ratios for Allegheny County increased 8.1% from the low point of 2018 to 2020; in the rest of Pennsylvania the ratios from the low point of 2017 to 2020 increased 12.9%. Advertising makes a difference to demographics

What’s Happening in Philadelphia?

Mark Twain quoted British Prime Minister Benjamin Disraeli: “There are three kinds of lies: lies, damned lies, and statistics.” Anyone familiar with the use of statistics (especially in political controversy) can see why this quotation is remembered. Well, we do not want to use statistics to mislead you, so here’s the truth: the numbers for Philadelphia County, where we have been working since 2018, do not look good by comparison with Pittsburgh.

​As you can see, abortion numbers actually rose after we started advertising there. Abortion ratios for Philadelphia County also look disappointing.

​The increase in abortion ratios between 2018 and 2020 for Philadelphia County residents was 2.1%. If we go back to 2017 and compare the ratio of the earlier year with 2020, the increase was 8.5%.
​
Increases in abortion ratios can reflect an increase in the number of abortions, but they can also chiefly reflect, as we saw in Allegheny, a drop in birth numbers. Here are the birth numbers for Philadelphia.

The decline in birth numbers in Philadelphia County for 2017–2020 was not precipitous – 3.1%; this was less than the drop from 2012 to 2013 of 3.9%. The decline of previous years continued, however. From a comparison of abortion numbers and birth numbers over the years, we can conclude that the increase in abortion numbers in Philadelphia County played the larger role in the increase in abortion ratios than the decrease in births.

It appears, then, that our advertising was not having the effect we were looking for. There may be a few of reasons for this. For one, Philadelphia is a bigger “market” than Allegheny County, with 1.6 million people to Allegheny’s 1.2 million. Our ad spending in Philly was not commensurate with this difference in population. For another, the pregnancy medical centers in Philadelphia were not as prepared to handle abortion-determined women as were the centers in Pittsburgh. Finally, the year 2020 was an anomaly: in the midst of Covid fears, the centers in Pittsburgh remained open for business, while those in Philadelphia had restricted services.

Comparing Philadelphia to Other Counties Changes the Picture

Could our advertising have affected abortion numbers, despite the increase? Did it hold abortion numbers down? A comparison of Philadelphia’s numbers with those of the other counties (besides Philadelphia and Allegheny counties) suggests it did.

What do we find when we look outside Allegheny and Philadelphia counties? The number of births fell in these counties, 4.9% from 2017 to 2020, and 3.6% between 2018 to 2020. The drop in births in 2020 is sharp, if not unprecedented, and responsible for a big part of those years’ decreases.

​The really remarkable difference is the increase in abortion numbers and ratios in these other counties in 2020. Here are charts of the abortion numbers, followed by the ratios of abortions to births.

Abortion numbers and ratios increased sharply outside of the counties in which we advertise pregnancy medical centers, Allegheny and Philadelphia counties. From 2017 and 2018, to 2020, abortion ratios for counties other than Allegheny and Philadelphia rose from 135 to 158 per 1,000 births, or 17.0%. How does that compare with the abortion ratios for Philadelphia County?

In the chart below we see how the increases in abortion ratios of women in other counties compares with the increase in Philadelphia County, for the periods 2017 to 2020, and 2018 to 2020. (The low points in abortion ratios in the recent past vary from 2017 to 2018, hence the inclusion of both. The longer period, 2017 to 2020, is more significant, but our advertising in Philadelphia County began in earnest in 2018).

​The difference between the increase in Philadelphia County and its closest county neighbors (geographically, and in terms of abortion ratios) also suggests that advertising reduced the increase in abortion numbers and ratios there. The increase in the abortion ratios in Philadelphia County from 2017 to 2020 was greater than that in Allegheny County, but from 2018 to 2020, while our advertising was running, the increase in Philadelphia was smaller – by 6% (see the chart below).

Summary for 2020

Abortion ratios for Allegheny County residents fell from 2010 to 2013, and stayed relatively low and stable for years. The ratios dipped in 2017 and 2018, but rose to the same generally low level in 2019. Remarkably, those ratios remained stable in “the year of the fear,” 2020, because, though birth numbers fell, so did abortion numbers. Advertising continues to affect the thinking of abortion-vulnerable and abortion-determined women in Pittsburgh. The effects of advertising show up in demographics.

Abortion numbers and ratios for Philadelphia County rose overall in the period 2017 or 2018 to 2020, a gloomy picture indeed. When we compare the County to other Pennsylvania counties (that is, all other counties except Allegheny County), things look much better, however. Both Philadelphia County and Allegheny County saw half the increase in abortion ratios that the other counties had between their low points (either 2017 or 2018) and 2020. To put it another way, other counties in PA had double the increase in abortion ratios, compared to Allegheny and Philadelphia counties, from the latter counties’ low points to “the year of the fear,” 2020.

By comparison with Philadelphia County, from 2018 to 2020 the increase in abortion ratios in counties other than Allegheny County and Philadelphia County was almost 8.5% higher. Comparisons of Philadelphia County with its nearest neighbors reinforce the conclusion that Philadelphia’s increase in abortion numbers and ratios lagged that elsewhere.

No doubt, those who are well-versed in statistical methods could find more elegant ways to establish whether or not the small increase in abortion ratios in Philadelphia County from 2018 to 2020 was statistically significant, and, if significant, how much so. While the above comparisons do not let us quantify the likelihood that our efforts made a difference, they give us good reason to think that our advertising helped cap the increase in abortion numbers and ratios in Philadelphia County over this period. Our advertising, then, acted like a sea anchor, which (Wikipedia tells us) is deployed from a ship in a storm, and “provides hydrodynamic drag, thereby acting as a brake.”

What if Vision for Life had not been advertising in these periods? Would Allegheny County’s abortion numbers have been much higher? Almost certainly. Would Philadelphia’s ratios of abortions to birth have increased much more than they did? We can’t be as confident, but it is quite likely.
 
What Else Do We Learn from the PA Abortion Report That Is Helpful for Our Work?

In order to reach women thinking about abortion, especially with our under-two-minute video ads that run on Facebook, Instagram, and Facebook’s Audience Network, we need to know something about their situations. We learn a lot from sociological studies of abortion patients and their demographics, and also from the pregnancy medical centers, who have first-hand experience with women contemplating abortion. We also learn from the Pennsylvania Annual Abortion Reports, especially about things like race, age, number of previous children, and number of previous abortions. So from the 2020 PA Health Department’s Abortion Report, we learn that a majority of abortion patients are not scared teenagers, but women 25 years and older.

​This trend has been going on for some time.

Each multi-colored column in the chart above shows an age group over nine years (2012 to 2020). Within those columns, the colors apply to the particular years. As you can see above, within the muti-colored columns (Under 15, 1–17, 18–19, and 20–24), from the dark blue column on the left (2012) to the light green column on the right (2020), the trend is a decline in the numbers, except for the 20–24 group, which showed a slight increase in 2020. Among the older cohorts 30–34 and 35–39, the trend is an increase in the numbers of abortions, generally year after year. Among women 40 years old and above, the much smaller abortion numbers declined until 2018, and then rose slightly the next two years. So abortion patients are becoming older.
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They are also more likely to be mothers of another child or of children.

Of the total number of abortions to residents in 2020, mothers of one or more children were the following percentages:
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One previous birth – 26%
Two previous births – 21%
Three previous births – 10%
Four previous births or more – 6%
Mothers with no previous births were only 36% of the total.
 
Abortions to women who had no previous abortion had been in decline for years, until they started to rise in 2018. The same was generally true for women who had one or more previous abortion(s).

​Close to half of all abortions in 2020 were to women had had 1 or more abortion(s) – 47%.

​In summary, we are grateful that abortion numbers fell in Allegheny County in 2020, and that abortion ratios did not increase, as they did elsewhere. We are disappointed to see that we have not brought down abortion numbers and ratios in Philadelphia as we had hoped, but encouraged by the fact that numbers and ratios did not increase at the same rate as they did in the rest of the State, or at the rate of the surrounding counties with significant abortion numbers. We are persuaded that advertising is responsible for keeping abortion ratios down, and have expanded in 2022 to Cleveland, Ohio, whose abortion rate is close to that of Pittsburgh when we began there. Pray that God may bless our work, and that many more moms and babies are saved from abortion.

(This is an adaptation of the talk given by Co-Founder Chris Humphrey at the Fall 2021 Banquet, "They're Here Because You Care.")
 
Most Americans don’t care about abortion.  That may anger us, or sadden us, but, as they say, “It is what it is.”  In Allegheny County, however, thousands of babies are here because donors to Vision for Life care.
 
That care comes at the right time.  Abortion is THE human rights issue of our age. In all of human history, more human beings have been killed before birth than after.  Most of these have been killed in the last 50 years.  In America, however, we are winning on abortion.  Since the mid-1980s, abortion numbers have been falling at a consistent rate.  The ratios of abortions to births are actually lower in the last few years than they were in 1973 – the year of the infamous Roe v. Wade Supreme Court decision.
 
If you are a regular reader of our blog, or have read a few pages on our website, you will know that the biggest driver of this decline has been pregnancy help! Ratios of abortions to births are “inversely related” to pregnancy help centers: as pregnancy help center numbers rise, abortion ratios fall, from the mid-1980s to today.
 
We considered four other possible explanations as the main reason for the decline in abortion ratios: contraception (including abortifacients), restrictive state laws, fewer abortion centers, and public opinion becoming more pro-life because of activism and education.  See the series of six videos, and texts with data, on our website, for why none of these explains the decline.
 
Early on, we realized that trying to change public opinion in general was a mistake: we don’t have the resources.  The question then was, “If pregnancy help is the reason we’re winning, what can we do with what we have, to make the impact of the centers even bigger?”  A Charlotte Lozier Institute study confirmed what we thought: most young women had no knowledge of the centers.  Advertising could change that.  And it does!  Advertising pregnancy help is the most cost-effective thing we can do to reduce abortions in big cities in America now.
 
Our banquet theme was “They’re here because you care!” Who are the “they”? Our pregnancy medical center colleagues could tell you moving stories of individuals.  I want to answer the question, “How many are there?”
 
We estimate that roughly 9,600 fewer abortions were performed in Allegheny County, from 2012 to 2019, because of our advertising.  Incidentally, the abortionists would have lost much more than 4 million dollars.  (This is David versus Goliath, and we get to play the good role.)
 
Recently I looked more closely at the birth numbers in Allegheny County.  The birth numbers seemed a little low, in my analysis, and I realized that I hadn’t taken into consideration miscarriage, or those women, like students, leaving to have their babies at home.  That 9,600 number is still important: a woman who miscarried might be relieved, or grieve, or a bit of both, but she would not have an abortion on her conscience.
 
Here are the birth numbers from 1995 to 2019.

The 2019 PA Abortion Report is out. Abortions to residents of Pennsylvania increased from 28,240 to 28,796, or about 2%. In Allegheny County, there were 386 more abortions performed than the year before, an increase of 6.3%.
 
Vision for Life advertises in Allegheny County on Facebook to residents of the County. (Some of the abortions performed in Allegheny County would be on non-residents – people coming from surrounding counties and nearby states. They would not see our Facebook ads.) We also want to measure the effect of our advertising on all pregnant women considering abortion, so we don’t look at raw numbers so much: pregnancy rates have been going down, and we want to see what proportion of all pregnant women chose life. So we look instead at the ratios of abortions to births for residents of Allegheny County. Abortions to this group were up 8.6%, from 3,007 to 3,265.

When we compare abortions to residents in Allegheny County to those to residents in Philadelphia County, where 40% of Pennsylvania’s abortions are performed, we see that both saw an uptick in abortion ratios.

It is common for people to think that the average abortion patient is a teenager who made a mistake. There are, of course, some teenagers in that category, but most abortions are to adult women. The PA Abortion Report tells us that “more than 87 percent (27,221) of the abortions performed in Pennsylvania in 2019 were to unmarried women. The largest age group having abortions was 25–29, accounting for 9,529 (29.9 percent) of all 2019 abortions.” In fact, the trend over the last many years has been for younger women as a group to have fewer abortions, and older ones to have more.

What may surprise some is the high rate of multiple abortions. More than 1 out of 10 abortions is the woman’s fourth abortion, or more. Is abortion being used as a method of birth control here? Are there psychological problems that lead women to abort repeatedly?