(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?

From the time I (Chris Humphrey) became involved in pro-life work, back in the late 1970's, I have been concerned about making a difference, and not just a statement. We've had 46 years or so since Roe v. Wade to make a difference with our protests and education, and we've had very little success, if we're honest. It's true, we've seen great progress in state regulation of abortion, which frustrates some who want to see abortion banned outright. However, these state regulations have had, at most, a 5% effect on the ratios of abortions to live births.

What is amazing, however, has been the decline in abortion numbers -- rates and ratios to births, too -- since about 1984. There's little question, to my mind, that it's pregnancy help that has accomplished this. (See earlier articles.) The ratios are lower now than they were back in 1973. With first-time customers declining in number faster than "repeat customers," the abortion business is dying. Thank God.

The fact that our advertising has had a demonstrable effect on the abortion ratios in Allegheny County confirms that it is pregnancy help that has driven numbers lower everywhere. The pregnancy medical centers, and the women and men at Choices Pregnancy Services and Women's Choice Network, are the heroes of the story. Without the centers, we would have nothing to advertise. Just tell women not to have abortions? It's done all the time, but there's no reason to think that it changes many minds.

From the beginning of our work with Vision for Life, I have wanted to measure the effect of what we are doing. If we're making a difference, how do we know? Our best resources here are the State Health Department figures: the birth numbers and the abortion numbers.
​

Of course, we measure abortions. But how do we measure the effects of what we are doing in Allegheny County from just after Christmas in 2010 to 2018, the last year for which we have abortion numbers?

If abortion numbers are going down everywhere, it's clear that we can't just point to declining numbers in Allegheny County and say that our work caused that. We have to compare numbers with numbers. Our first concern is that pregnancy numbers are going down everywhere: if fewer women are getting pregnant, then of course abortion numbers will go down if the ratio of abortions to births remains the same. So we want to measure the ratio of abortions to births: if they are lower in Allegheny County after we have done our work, then we know roughly how effective advertising is. The ratios of abortions to live births fell 26% from 2010 to 2018 in Allegheny County, compared to 15% in the rest of PA, and 13% in Philadelphia County (where 40% of PA's abortions are performed).
​

The assumption of predictions of the future (even a "future" in the past, so to speak) based on past performance is that there have been no significant changes that would affect those predictions. We can't "control" for all the things happening around us, especially regarding an issue that is at once very personal, emotional, and controversial, with relational and socio-economic factors beyond our ken. Do women in one period view abortion more as a moral failure, and in another period more as a necessary wrong? Has a disillusionment with abortion affected recourse to it?

So perhaps a better gauge of the effect of advertising is to compare the rates of change in Allegheny County to those in all the other Pennsylvania counties. If there are social and cultural changes that affect abortion numbers generally, it is unreasonable to think that women in Allegheny County would be immune to them. So we can take the percentage change of abortion numbers in the rest of PA, and apply them to the numbers in Allegheny County, beginning with 2010 as the base year. Then we can subtract the actual numbers from these projections to get our number of saved lives. When we do, we find that there were about 9,600 fewer abortions in the 9 years from 2011 to 2019. That's over 1,000 fewer abortions every year. By the end of 2020, there would have been well over 10,000 fewer abortions.

It is striking that the number of lives saved is not that far from the 10,600 that Excel predicted. It is fewer in this prediction, because Excel could not take into consideration that abortion numbers were falling elsewhere in PA. Without advertising, numbers in Allegheny County would have fallen, presumably, about the same as elsewhere. The abortion ratio numbers we have, however, point to the same conclusion: numbers and ratios were falling in Pennsylvania as a whole in 2011-2019, but they fell significantly faster in Allegheny County, and stayed lower overall, because of the advertising.

Another way to measure success is to look at birth numbers. If there are fewer abortions in Allegheny County, you would expect birth numbers to go up, or at least not to fall as fast. In fact, birth numbers rose after we began our work, and settled in 2019 a little bit higher than they were in 2010. If we apply the same technique of projecting past performance on the 2011-2019 period, we see a phenomenal difference between those projections and the actual birth numbers -- an amazing 11,259!

The 5,079 births is lower than the projected 9,600 fewer abortions. Why? Wouldn't one fewer abortion in the County mean one more birth?

No. About half of the 6,000 abortions a year in Allegheny County are to non-residents. So the women who would have had abortions in Allegheny County, but didn't, were not all residents of Allegheny County. Some came from surrounding counties. Many would have been students, and would have gone home or elsewhere to have their children. So this chart is the least helpful in knowing how many unborn children were saved from abortion. Births as a whole, too, are less reliable as an indicator. Yet both birth projections point to the same result: thousands of lives have been saved by advertising pregnancy medical centers in Pittsburgh.

Our calculations for abortion numbers do not take into consideration the proportion of early pregnancies that would end in miscarriage if abortion were declined. There are no sure numbers here, as most early miscarriages do not involve a trip to the doctor. I have heard that between 17% and 32% of pregnancies end in miscarriage. So the number of births would likely have been smaller than our predictions using the abortion numbers.

Miscarriage is a tragedy, felt to varying degrees as such, often depending on the age of the child in utero​ or on the temperament of the woman. It is still important that a woman who miscarried did not have an abortion instead, because she knows that at least she did not participate in the killing of her child.

Pro-choice advocates imply that state abortion restrictions are a main reason that abortion numbers have fallen across the country. Ohio is a good example: Elizabeth Nash of the Guttmacher Institute notes that “Ohio is a testing ground for abortion restrictions.” So in 2019, Ohio passed a law prohibiting abortion once the baby’s heartbeat could be detected, unless it were to save the mother’s life or a major bodily function were threatened. The human heart begins to beat about 16 days after conception, but the heartbeat is usually detectable only sometime between six and eight weeks of gestation. Planned Parenthood and others sued, and the heartbeat law is in legal limbo until the lawsuit is resolved. Other laws are in force, however, including informed consent (the woman has to be told in person what the medical procedure entails, at least 24 hours before the abortion); a 24-hour waiting period; parental consent in the case of minors; and the limiting of public funding to those whose lives are at risk, or who conceived as a result of rape or incest. These and similar restrictions, it is implied, explain why Ohio’s abortion numbers are down from 34,128 in 2005 to 20,425 in 2018, or 40%.

The Guttmacher Institute, formerly the research wing of Planned Parenthood, and its many fellow-travelers tell us that these state laws limit abortion “access,” that is, they make it more difficult for women to get the abortions they want. The chief reason for lack of access, we are to assume, is the decline in the number of clinics near women who need them. On the Institute’s web page for Ohio, it presents its information tellingly under the headings: “Abortion Incidence,” “Where Patients Obtain Abortions,” and “Restrictions on Abortion.” We are to note that, in 2017, 89% of U.S. counties had no abortion clinics, though 38% of America’s reproductive-age women lived there. As a result, women wanting abortions would have to travel to get them.

​One of the articles cited on the Ohio page changes the picture, however. “Abortion Incidence and Service Availability in the United States, 2017,” presents the same implicit argument – fewer abortion centers must mean hardship for women, and thus fewer abortions – but then admits that the number of centers is not a factor in declining abortion rates. “Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates” (emphasis added). So Delaware, for example, had more abortion centers in 2017 than in 2014, but its abortion rate dropped 37% anyway. “States considered to be supportive of abortion rights in 2017 – including large states such as California and New York – accounted for 43% of all U.S. abortions in that year but 55% of the decline [in abortion rates] since 2014.” “Abortion rates declined in all 10 states that had more clinic facilities in 2017 than they did in 2014 . . . . Half of these states had not enacted any abortion restrictions during the study period.” It is to their credit that the authors of the study looked at the evidence and reported this observation, as inconsistent as it is with the mantra of reduced-access-means-fewer-women-get- abortions.

Many on the pro-life side would be inclined to discount the claim that the restrictions aren’t driving the drop: “See, the pro-abortion crowd just wants to discourage pro-life political activity, because it’s working.” Is it? Yes, the laws have their measurable effects on abortion numbers, as political scientist Michael New has shown repeatedly, though altogether these would be less than 5%. Moreover, the effect of a change in the law would be a one-time decrease in abortion numbers. There is no reason to think that, say, the new requirement of a 72-hour waiting period would have an increasing or cumulative effect on the ratios of abortions to live births in following years. As good as all these laws are, from the pro-life perspective, the Guttmacher researchers are right: the restrictive laws are not the primary driver of declining abortion rates and ratios.

The problem with the “lack of access” claim is that the abortion-on-demand crowd are only looking at the supply side of the supply-and-demand relation: those state legislatures, they think, are dominated by men who want to dominate women, and are gradually cutting off the supply. (In reality, those legislatures usually have a share of women legislators, a large portion of whom are pro-life.) Ratios of abortions to live births have been dropping continuously for decades across the country – 49% from 1984 to 2016 – independently of changes to the law or the numbers of clinics. What if the decrease in clinic numbers and abortions reflects a decline in demand for abortion? What if the decline in the number of abortion clinics reflects market forces, and not government intervention? Jonah Goldberg makes a similar point about assumptions with the current coronavirus: to explain the less-than-catastrophic number of new cases and deaths, compared to earlier predictions, people either argue that the government overstated the likely cases and deaths, or that it was government action that “flattened the curve.” He argues for an alternative: when given accurate information in a timely way, people themselves act in a way that has better consequences for everybody.

What could be responsible for dropping demand? Guttmacher and its supporters would say that it is contraception. Fewer women need abortions because of better contraceptives (the long-acting kind), better contraceptive practices, or more widespread use of contraceptives. The evidence, however, doesn’t back this up. If it were so, better contraception would mean that fewer pregnancies would be unexpected or unintended. Researchers, however, found that “changes in contraceptive method choice and use have not decreased the overall proportion of pregnancies that are unintended between 1995 and 2008” (emphasis in the original). In fact, the proportion of these unexpected pregnancies went up 1%, from 48 to 49%. Here, the ratios of abortions to live births are a good measure of demand: while abortion rates (abortions per 1,000 women 15-44) would fall if pregnancy rates fell, the ratios tell us what proportion of pregnant women chose abortion rather than birth. According to the CDC reports, over the same thirteen-year period in the study described above, the ratios of abortions to live births dropped from 31.1 to 23.1 per 100 live births, or 26%. While there are other studies which seem to show a drop in unexpected pregnancies or births, or a certain volatility, so speak, there is no long-term trend in either that parallels the decrease in ratios of abortions to live births. While social-scientific surveys of women’s intentions and the statistics of abortions both have their problems, the latter, at least in terms of establishing a trend, are more trustworthy. Contraceptive use, then, is not driving down the numbers either.

So is there a candidate for the main driver of falling abortion ratios? Drum roll, please . . . . The increase in pregnancy help centers across America, now over 2,750, is the only candidate that lines up in terms of timing and trajectory. The number of centers increased sharply from 1982 to 1986, and continued upward to the present. In his horribly titled Abortion Rites: A Social History of Abortion in America, Marvin Olasky argued that it was mainly pregnancy help (in the form of maternity homes in that day) that reduced the very high abortion rates of the late-19th Century. We are seeing the same thing today.

The pro-choice side knows very well that pregnancy help centers are having an effect on abortion, and some activists have attempted to defame the centers as deceptive, oppressive of women in their religiosity, and unscientific in their information. (In fact, it is the representatives for abortionists who obscure the early development of the child in the womb with terms like “a clump of cells,” or “a blob of tissue.” For an answer to the pro-choice criticisms of the centers, see Heartbeat International’s pregnancycentertruth.com. I am on the Board of Heartbeat.) Abortion is big business, and business is down. The reality is that most women do not want abortions. This is what women who come to pregnancy help centers say themselves. (They come to the centers “abortion-vulnerable” or “abortion-determined,” in the centers’ terminology.) For many, abortion appears to be a necessary evil, to be gotten through numbly, with as little thought and reflection as possible. The centers help them do what they admit they really wanted: to bear their children. Pregnancy medical centers have very high customer-satisfaction ratings. Hundreds of thousands, are deeply grateful for the help they have received at these centers, and their endorsements are simply unanswerable. While technically it may not be true that “no one ever says ‘Thank You’ to an abortionist,” the number would be minuscule by comparison.

If these centers are the main driver for dropping abortion ratios, then advertising the centers should drive ratios even further down. This, in fact, is what we have found in Pittsburgh (Allegheny County). From 2010 to 2018, non-profit Vision for Life advertised two local pregnancy medical center organizations, with five centers and two mobile units between them. Abortion ratios for residents dropped sharply in the first two years, remained relatively stable for several years more, and then dropped again in 2018. The decline overall was 26%. The ratios are the lowest they’ve been since the State began recording them in 1995, and likely the lowest in a half-century. There is no reason to think that ratios would not fall further with more advertising.

​Abortion is dying in America. The abortion industry is consolidating. Abortion is less available in many counties because the demand is just not great enough to sustain a business. In Pennsylvania, the numbers of “repeat” abortions (a woman’s second, third, or more, and about half of all abortions) have been decreasing for years, but first-time abortions have been falling faster. Without more first-time customers, a business is on the way out. The state is probably representative of the country here. The questions then becomes, How low can the U.S. numbers go? How soon will “abortion on demand” become “abortion: no demand”?

(While this article was written for The Word, the Antiochian Orthodox Christian magazine that I edit for Bishop JOHN Abdallah, and will appear in the June issue, readers from other church backgrounds may find it helpful.)

It is a commonplace among military historians that the Allied armies of the First and Second World Wars prepared in each case to fight the last war. The steady advance of troops towards the enemy made sense, before the First World War and the Maxim machine gun put an end to that. Trench warfare made sense, before the mechanized blitzkrieg, or “lightning war,” of the Second World War made lines of trenches useless.​

But it is not enough. Like Archbishop Damaskinos, we need to translate our good intentions into action – time, energy, and money, devoted to saving the vulnerable. If there is no Orthodox organization in your area that is doing this, start one. If none is likely to start, work with other Christians to reach women in your community. Look up your local pregnancy medical centers. Meet their executive directors. Donate to the centers. Volunteer with them. Advertise them. (Vision for Life - Pittsburgh, of which I am the Executive Director, has seen a 26 percent drop in ratios of abortions to live births after we started advertising two local pregnancy medical center organizations. Thousands of babies have been born who would not have been, if we had not run our ads.)

Our hierarchs, too, could lead as did Archbishop Damaskinos, in practical, pro-life pregnancy help, at the very least with funding, and with the very public blessing of the centers. Our parish priests could put the names and phone numbers of the centers in their weekly bulletins, for, as the founders of Zoe were told, unmarried Orthodox women will seek an abortion rather than face embarrassment in their local parishes. A member of the Board of Zoe for Life! - Pittsburgh tells me that a priest’s daughter in another state became pregnant as a teen and was pressured by members of the parish to have an abortion, but she and her family were pro-life and decided to keep the baby. That baby is now grown up, married, and has a successful career.

Clergy and youth workers in every parish need to have the same open heart, the same courage and forthrightness, as had Archbishop Damaskinos when pressured by the Nazis. In terms of sheer numbers, we live in the Age of Abortion. As Orthodox Christians, clergy and lay, we can rise to the challenge and fight the right war. We can do something to “save as many souls as possible.” 

​Some time ago we asked Dr. Albena Ivanova, Associate Professor of Management, Robert Morris University, if she would analyze our data from 2010 to 2016, to see if the change in abortion ratios was statistically significant. She kindly did so, and came to this conclusion: “Controlling for the time effect (year) and contingency factors (all other counties), the results provide evidence that [the advertising work of] Vision for Life has a strong negative correlation to the abortion ratios in Allegheny County; in particular, the average abortion ratio drops by 40 after Vision for Life started (b = - 40.90, p < 0.001).” We now have two more years of data, and they confirm this conclusion: advertising pro-life pregnancy medical centers has a demonstrable “negative correlation” to abortion ratios.

​Who are these non-residents? Some would come from neighboring counties: the total of abortions to those residing in Armstrong, Beaver, Butler, Fayette, Washington, and Westmoreland counties in 2018 was 1,245. The others would be those coming from further afield, and students who are living temporarily in the Pittsburgh area.

​If you haven't given before, here's a simple way to get started. On January 1st, 2020, I will be joining a couple of hundred other people and jumping in the Mon River. While they get out as fast as they can, and hurry away to get warm, I swim back and forth in front of the Mon Wharf for as long as I can handle it. Pledge whatever amount you like for every minute I'm in the Mon. If it's a dollar and I last 15 minutes, you just paid for one of those clicks on our Facebook ad! You can pledge by e-mailing me at christopherhumphrey15@gmail.com, or make a donation on our website (click on the "Donate" tab in the Menu above).
 
This is a great time to be doing pro-life work! We are winning, because people like you care enough to do something. Thank you!