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.
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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).
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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!

​What is the future of abortion in the U.S.? The good news is that abortion numbers are continuing downwards, and so far they have not leveled out. About half of the abortions in Pennsylvania are “repeat” abortions; these are women who have had at least one abortion before. First-time abortions, however, have been falling faster than repeat abortions, which means that the abortion business is in a death-spiral: fewer first-time abortions means even fewer repeat abortions in the years ahead. There’s still much to be done in Pittsburgh, however: there were 6,140 abortions performed in Allegheny County in 2017, and 3,120 County residents had abortions.

What will abortion look like in the years ahead? It seems that chemical abortion (so-called “medical” abortion) will replace most early abortions (up to 70 days after the last menstrual period). These are already almost 40 percent of abortions in Pennsylvania, and over 60 percent in Pittsburgh. There’s no sign that the proportions won’t increase. In a chemical abortion, a woman goes to the abortion center and is given a pill (mifepristone, RU486), which robs her unborn child of progesterone over the following few days. The removal of progesterone breaks down the connection between the placenta and the uterus, and the child dies. Forty-eight hours after the mifepristone pill, at home, she takes a second pill, misoprostol, which causes her to go into labor and deliver the amniotic sac and the dead child. Even Planned Parenthood admits that the process is painful. Oftentimes the woman is alone when she expels “the products of conception.”

​The next stage, already being promoted by some, is what they call “self-managed” abortion: that is, the woman gets the abortion pill not at the abortion center, but by other means, perhaps by mail through a purchase on the Internet. (We subsidize advertising for Alpha-Omega Centers in Slippery Rock and New Castle, and the Executive Director, Sarah Bowen, has a great website for anyone thinking about an at-home abortion.) How will “self-managed” abortions fit in with changes to the laws? If we look ahead and see the fall of Roe v. Wade, we will then see most of the middle of the country and most of the South pass state laws that largely outlaw abortion, including abortion pills. The Northeast and the West Coast and some others (Illinois, for example) will keep abortion legal, and the fight to protect the unborn legally will become a state-to-state fight.

​Abortion pill suppliers, however, will still be able to mail their product anywhere in the U.S. from other states or from outside the U.S. Even if advertising the pills becomes difficult, and the abortion “supply chain” complicated, it will be very difficult, if not impossible, to restrict the suppliers. Some women will not get abortions in states where the law is changed simply because it’s illegal, but many will. The current Governor of California has signed a bill mandating free access to abortion pills for students of public universities, which will go into effect in 2023. Pro-abortion states like New York will probably subsidize the cost of the pills for their residents, and for anyone else who comes looking for an abortion.

What this means in practice is that reaching pregnant women on the “demand” side of the equation will become even more important. We know that abortion can be hard on women emotionally, psychologically and spiritually: regret is common. (For a summary examination of the effects of abortion on mental health and the controversy about them, see David Reardon’s piece, “The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities.”) This regret is instantaneous with some women who have taken the first pill: there are stories of women trying to force themselves to vomit up the pill, even in the car after leaving the abortion center. This points to the deep ambivalence many women have towards abortion, so that, a week after their abortions in one study, the vast majority could say that they were “happy” and “relieved,” while a third of the women (which must have included women who were “happy”) said that they had “feelings of regret.” That’s one week later.
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What if someone invented a pill that a regretful woman could take, a pill that could reverse the mifepristone? Well, they have. In fact, it is simply progesterone, which doctors currently give women who are at risk of miscarrying. The progesterone reverses the effect of mifepristone, and in about 66 percent of the cases so far, the women deliver their babies, all perfectly healthy. (About 900 children have been born through abortion pill reversal.) Heartbeat International, an international network of pregnancy help, has taken over and expanded a national network of 700 physicians and pregnancy help centers that offer this “abortion pill reversal.” (I am on the Board of Heartbeat.) In November, the four centers of the Women’s Choice Network in Pittsburgh will become part of Heartbeat’s new Abortion Pill Rescue Network. Is abortion-reversal safe? Well, the actuaries of at least one insurance company think so: Women’s Choice Network’s medical insurance premium did not go up after they added their new abortion pill rescue procedure to the policy.

​There is a challenge advertising to women who have had abortions. Many of them, as the psychologists would say, have “unresolved anger issues.” Many are deeply angry with “pro-lifers,” partly because they think of us as self-righteous, judgmental and interfering, but partly because, as the pastoral theologian would say, anger can be one way the unrepentant mind and heart handle a serious sin. Strident pro-life people are a great target, and these public pro-lifers, as they say, “get to live rent-free in the heads” of our wounded neighbors. So any advertising we do has to take the half of abortion patients who have had repeat abortions into consideration, and the fact that some are hostile to what we are doing, while some have lasting regret.

​The Abortion Pill Rescue Network gives us as advertisers a great opportunity. Ads directed to women who have taken the first pill could make the number of abortion pill reversals skyrocket. Not only that, but the ads would influence women seeking surgical abortions, as they reinforce doubts the women may already have. The key theme I have in mind is regret. We all know regrets, big and small, some instantaneous, some delayed. We want to say that we have an idea of what might be going through a woman’s mind as she thinks about a second abortion.

We see political polarization around us all the time, and much of it has to do with the “social issues,” including abortion. If anyone thought that the prosecution of Gosnell, the abortionist and murderer who ran the “House of Horrors” in Philadelphia, would result in a widespread revulsion at late-term abortions and infanticide, he or she was woefully mistaken. Outright infanticide has been accepted effectively by Virginia’s Governor, Ralph Northam, who is also a physician. New York has passed a bill that permits abortion up to birth, and lets doctors deny treatment to a child who survives a late-term abortion. (This is one reason I am not particularly hopeful when one or another abortion atrocity is uncovered: people aren't paying attention. We've had 46 years since Roe v. Wade, and little has changed in the general public perception of abortion. We, however, are paying attention.) 

Away from the public eye, however, we are winning. This can hardly be emphasized enough. Most public pro-life activity is focused on the supply side of the equation: cut abortion access off with laws, and we’ll solve the problem. That has had some success, but it doesn’t account for what we’ve seen with the numbers. It’s on the demand side that we are seeing gain after gain: pregnancy help has driven the numbers lower, year after year. The Alan Guttmacher Institute, at one time Planned Parenthood’s research arm, has just issued its report for 2017, and it confirms that abortion numbers are continuing to fall. Abortion rates (per thousand women 15-44) across the U.S. dropped 7% from 2014’s numbers to 13.5 (an estimated total of 862,320). Most interesting for us is what they say about state abortion laws and numbers of clinics: “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” (“Key Points,” emphasis added).

I think Guttmacher can be trusted here: their researchers may be morally blind on abortion, but they’re dealing with things that can be checked: abortion laws, clinic numbers, and abortion numbers. At the risk of being repetitious – something else beside laws and clinic numbers is driving the drop in abortion ratios: the increase in pregnancy help.​

What of an increase “in the number of individuals relying on self-managed abortions outside of a clinical setting”? This is a new problem, and one we'll consider in a future post. It makes statistical assessments difficult: who reports these, apart from hospitals that report incomplete abortions done elsewhere? And why would we think that they are not the reason for the decline? Again, we look at longer-term trends. In the graph of Pennsylvania’s first and repeat abortions, below, we see that first abortions have been decreasing faster since 2008 (the first year repeat abortions were reported) than repeat abortions, 25% to 20%. (Repeat abortions were 47% of all PA abortions in 2017). This trend, which likely is the same in many other states, pre-dates the appearance of chemical abortion pills (mifepristone, misoprostol) bought over the Internet, and would be unaffected by it. (This same argument could be mounted against the view that Plan B and similar, so-called emergency contraceptives (EC) reduced abortion ratios when they appeared on the scene: the downward trend in abortion ratios long pre-dates EC.)
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What proportion of young women who seek a first abortion would resort to buying pills through the Internet? I submit that it would not be large. The Guttmacher report notes that “one national survey of U.S. adult women, conducted in 2017, found that only 1.4% reported ever having attempted to end a pregnancy on their own.” Women who have a second abortion, or a third or more, however, might come to view abortion pills as just another form of birth control. Yet again, the number of women who are having second, or third, or fourth abortions or more, has been decreasing for at least nine years in Pennsylvania. It is unlikely that “self-managed” abortions played a significant role in the decline in the U.S. abortion rate. The future, however, may be a different story.

As society is becoming politically polarized, so it is becoming polarized in its abortion practices: the number of all pregnant women having abortions in general is falling, but likely fewer U.S. women, and not just Pennsylvania women, are having first abortions. Randall K. O’Bannon of National Right to Life points out something else: “Most of the overall abortion decline happened at high volume abortion clinics performing between a thousand and 4,999 abortions a year. (It should be noted that the country’s nineteen mega-abortion mills – those performing 5,000 abortions or more a year – experienced an increase of about 8,000, or about 428 more abortions per abortion mill)” (Randall K. O’Bannon, “New Numbers from Guttmacher Show Continued Abortion Drop,” NRL News Today, September 18, 2019.) I would bet anything that most of the clients at those mega-abortion mills are having repeat abortions, and that for many abortion has become birth control for them.

The bottom line? Polarization in abortion practices or not, abortion ratios over the long-term continue their constant decrease, as the number of pregnancy help centers is increasing. In Pittsburgh, we’re showing that advertising makes the existing pregnancy medical centers even more effective in saving lives.

Chris Humphrey, Ph.D.
​Executive Director

For most of that time, I had thought that our advertising was behind the drop in abortion ratios, but I was never sure. We now have confirmation that this is not a statistical aberration. Statistician Dr. Albena Ivanova, Associate Professor of Management at Robert Morris University, examined our data earlier this year and concluded as follows: “The results from the regression analysis show that [the work of] Vision for life has a strong negative effect on 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).”
 
Another question I have had in the back of my mind for some time is this: how many moms and babies have been saved from abortion in Allegheny County because of those dropping ratios? I knew that the answer would be very approximate. Pregnancy rates vary. Abortion ratios are volatile: some years they’re up quite a bit, other years they’re down similarly. Still, if we were having an effect, could we measure it in lives? ​