​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? ​

A presentation to those attending the fundraising banquet for Vision for Life – Pittsburgh, May 2, 2019

When we were young, my wife and I used to take our kids to a cottage on the French River, in Northern Ontario. The river was about a mile wide where we were, and very deep, and it looked more like a lake. The wind would blow up whitecaps on the river; sometimes from the west or the southwest, and sometimes from the southeast. We would go sailing, and try to bring the sail as close as we could to the water without tipping over. We had no sense that the river had a current. The waves came from every direction. That’s what was happening on the surface.

Let’s look at what’s been happening on the surface with public views of abortion.

This slide shows poll results for what’s called the General Social Survey. It has asked the same seven questions on abortion since 1977. One of those questions is, “Please tell me whether or not you think it should be possible for a pregnant woman to obtain a legal abortion for any reason whatever.” See the line? It goes up, it goes down, but there’s no trend. The wind changes, and people change their minds. Around 40% say that a woman should be able to have an abortion for any reason.

Are these people pro-abortion? No, most of them aren’t. They just think that we, or society, doesn’t have a right to stop a woman from aborting for any reason.

We’ve had 46 years since Roe v. Wade to change the public mind on abortion, and, generally speaking, our education and protests simply haven’t changed minds. Why? Because generally people don’t want to think about abortion, don’t want to talk about it. It is as distasteful for them as talking about going to the bathroom. And they generally prefer just to be troubled about it, but ignorant about it, too.

They don’t know, for example, that our hearts start beating 16 days after conception, about the time a woman is discovering that she’s pregnant. Or that the unique little whorls and ridges on our fingertips appear about 8 1/2 weeks after conception. They’ll sometimes say that abortion is murder, but that it’s up to the woman.

Polls, even on serious subjects, are inherently superficial and trivial, too. Any decision they make answering a pollster is going to be superficial, because there are no consequences for a wrong answer. And they don’t have to decide. They can say, “I don’t know.” Or they can just hang up. We know that the vast majority of voters don’t consider a candidate’s views on abortion to be determinative when they vote. That’s the surface.

You wouldn’t know that the French River had a current, until you went to the narrows, east of our cottage. There, thousands of gallons of water pour every minute between banks about 40 feet across. In the deeps, the whole river is steadily moving, from east to west.
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Now let’s look at what’s happening under the surface with abortion. These are the ratios of abortions to live births, from 1973 to 2015.

Since 1985, those ratios have been going down. That’s the trend. That’s the current. That’s what’s happening down deep. This isn’t just fewer abortions: this is more and more women each year, who know they are pregnant, choosing not to abort. These are the decisions that matter. These women can’t just hang up. Their decision isn’t trivial. They may say, “I don’t know,” but if they’re thinking about abortion, they have to reject it, or they have to pass on it, at some point. And more and more, they are. So we’re winning where it counts.
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Why? Here’s a slide that shows the increase in the number of pregnancy help centers.

That green line actually understates the number of all pregnancy help centers. There are over 2,750, and they are found everywhere. You can see: as that number went up, abortion ratios went down. Each new center helped many women each year.
 
More important, perhaps, each center has made rejecting abortion possible for many more women. The fact that the center is there, says loud and clear, “You still have a choice. Other women like you are having their babies. Your doubts about abortion aren’t crazy. Your friend had her baby. You’re not a fool if you have your baby, too.” Down deep, they know it. And more and more women are doing the right thing, for which we thank God.

I have analyzed all of the possible reasons that abortion ratios have gone down, and none of them except pregnancy help accounts for the long, gradual decline: certainly not contraception; not a decrease in the number of abortion centers; not even restrictive state laws, though they have had a one-time impact in those states where they have been passed; and not changes in public opinion. I don’t think that all of these together are responsible, either. There is one main driver.

American women like pregnancy help. 92% – including “pro-choice” women – say it’s “necessary.” But 54% of women don’t know that there are pregnancy help centers in their communities (2014). When more of them know about them, more of them will pass on abortion.

You’re here because you’re pro-life. You may feel called to make a statement, to tell the world about prenatal development and abortion. There is a place for that, for protest, for education, for some of us. It seems, however, that part of your prophetic message should be, “Hear and hear, but do not understand; see and see, but do not perceive,” because few seem to be understanding or perceiving. Of course, God looks for fidelity, not success.
 
We know that people who are really convinced of the sanctity of life, and act on it, tend to be those who attend church regularly, so try inviting friends from church, who know little about abortion, to a movie like Unplanned. And then, when you have made others aware of the realities of abortion – with them, support pregnancy medical centers here in Pittsburgh.

If you are not compelled to prophetic protest or education, then I recommend that you approach our common task with straightforward realism, and pragmatically. We find out what works, and then we do more of it! If you want to have the biggest, immediate impact on abortion, support advertising for those centers. Why? Here’s a slide that shows what happened in Pittsburgh after we began advertising. The Pittsburgh pregnancy medical centers have been around since the mid-1980s. PA started publishing abortion numbers by county in 1995.

As you can see, the ratio of abortions to live births for Allegheny County residents dropped sharply, even compared to the gradual decline everywhere in PA. A statistician from our parish took a look at the data, and told me that this drop is statistically significant; it’s not a fluke.

I submit that, if we could triple or quadruple the advertising most centers in America do, especially in big cities, in one year we would see the biggest drop in abortion ratios since the CDC began counting. And then it would become even easier, politically, to overturn Roe v. Wade, and start making states protectors of the unborn from conception on.
When we began, 3 out of 4 babies were born; 1was aborted; after a couple of years of advertising, it was 4 out of 5 babies who were born. To reach 5 babies born, out of 6, we need to save 250 more babies in a year. To maintain our current level of advertising, and to reach those 250 more babies, we estimate that we need $40,000. Can you help us?

We don’t need a majority to change their minds on abortion. A small, principled, determined minority, can have profound effects. States with pro-life legislators have passed more than 350 laws restricting abortion since 2010, though the general public remains blasé about the subject. You know the war mini-series, Band of Brothers. The title comes from Shakespeare’s Henry V. King Henry’s roughly 8,500 troops had just won a battle against the French, and were hungry and exhausted. About half of his army had died of disease already, and many of the remainder were sick. The French forces numbered somewhere between 12,000 and 50,000. Henry rallied his troops by reminding them of previous English victories over the French. In Shakespeare’s play, Henry’s cousin wishes that they had more troops. Henry responds with the St. Crispin’s Day speech, one of the most rousing speeches in historical drama, which includes the line, “We few, we happy few, we band of brothers.” (If you haven’t seen the Kenneth Branaugh version of Henry V, you must!) The English won the battle, against seemingly impossible odds. About 6,000 Frenchmen died, but only 400 Englishmen. They won, partly because of technology: their 7 thousands archers used the longbow, which could throw armor-piercing arrows 250 yards, 6 arrows every minute.

Advertising pregnancy help centers, I submit, can be the longbow in the long war against abortion. The ads are like arrows, raining down electronically – our ads showed up over 800,000 times in search results last year, for example, here in Allegheny County. Of course, they do not deal death, but point to life.

 . . . Our fundraising banquet was a great success, but we are still in need of funds to keep those abortion ratios down, and to drive them even lower. Please go to our donation page and give sacrificially to help us save even more moms and babies from abortion!

Michael New of the Charlotte Lozier Institute and I are engaged in a discussion (here and here) on what has brought down abortion ratios from their heights in the early 1980s to 18.8 per hundred live births, a figure lower than that of 1973, the year of Roe v. Wade. ​Pace Michael, I am not “downplaying” the role of education and legislative reform in this: my intention is to kindle interest in what I think is driving down those rates, the proliferation of pregnancy help centers, and to encourage their support. Education and legislative reform have their place, and are no doubt making a contribution where they are found, but I am saying that we have no strong evidence that either are driving this decline. When we advertise pregnancy help, as we have done in Pittsburgh, we see the ratios fall farther – which inclines one to think that the key role of these centers has been overlooked in our focus on changing the laws.

​We need to be honest and realistic in assessing what is happening with abortion numbers. The decline of abortion ratios cited in my first Federalist article is gradual and continuous – the slight peaks and troughs are the “noise” of a steady “signal.” Is there a key factor, or a few key factors, that are continuous in operation from the beginning? In my first article I suggested that we may be seeing an ongoing psycho-social shift in the minds of generations of young, pregnant women regarding pregnancy, childbirth and abortion. This might be a shift which we cannot gauge, but whose effect is that fewer and fewer of them are seeking abortions. One factor in this shift might be personal knowledge of post-abortive women, a knowledge that disinclines a pregnant woman from following the path of someone she knows or hears about. This might have been a factor from the early 1970s on, so it can’t be discounted as not present throughout the period of this decline. Would it have increasing effects on abortion ratios, relative to their decline, however? That seems unlikely, but we simply don’t know. And so it goes with much of our speculation.

​

​Inasmuch as we do know about public opinion, we cannot say the same. Michael New claims that “Gallup data clearly indicates that since the mid-1990s, there has been both a long-term and durable increase in the percentage of Americans who identify as ‘pro-life.’” One of those new converts to the cause, of course, would be the President of Planned Parenthood, Dr. Leana Wen, who recently said that “being pro-choice is . . . being pro-family, . . . being pro-life.” It is somewhat encouraging to know that more people like to think of themselves as pro-life, but most of this can be dismissed as shallow self-regard: see the relatively level lines in the graph of the Gallup poll responses to the question, “Do you think abortions should be legal under any circumstances, legal only under certain circumstances or illegal in all circumstances?" There is simply no real trend here. (This criticism applies to New’s confidence in the educational impact of abortion regulations as well: there’s no evidence of an effect on public opinion. It is true that the laws have a measurable, punctiliar impact on abortion ratios. So in Pennsylvania, the abortion ratio dropped 12.3 percent the year after the Abortion Control Act was finally implemented in 1993. The laws, however, do not explain the continuing drop in abortion ratios, or the fact that abortion ratios had already fallen by over 27 percent from 1981 to 1993.)

What of his claim that the General Social Survey found “long-term gains in pro-life sentiment”? The opposite claim could be made, as one analyst found that “more people” in the 2014 GSS survey “support legal abortion for any reason, no matter why a woman wants it. About 35 percent held that view in the 1970s – but the number has risen to 45 percent in 2014.” What of his claim that young adults were the demographic most sympathetic toward legal abortion until 2000, when they became the most opposed? A close examination of these figures from the General Social Survey show that the change is very slight, and can’t be compared to the 48 percent reduction in abortions per 100 live births (1984–2015). In a Quinnipiac poll of 2017, the 18 to 35 age group was more in favor of abortion as legal in all cases than any other demographic group, by 3 percentage points.

​It is becoming common to observe that we really don’t have a solid grasp of what Americans think about abortion, nor of any trends. Pro-life education is important – how many of us would be pro-life without it? – but not because we can see that it’s changing public opinion as a whole. A local pregnancy medical center director told me that they still commonly hear women say, as they look at their unborn children on the ultrasound screen, “I had no idea.”

​So why does public opinion matter, and why do we want to change it? It may be that we can’t help ourselves: if we were silent, we feel, “the very stones would cry out.” Perhaps we think that, if only the majority of those we know could see the moral horror that is abortion, they would not have abortions, and we could change the laws and “end abortion”? (This is what we really want, but we need to come back to earth here: we won’t “end abortion,” or “abolish abortion” as such, any more than we could end bank robbery, drunk driving, or spousal abuse, simply with laws. Similarly, instead of talking about “a culture of life,” it’s time that we ask, Where have people actually created this “culture”? Perhaps we can contribute to it.)
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What if we can reduce abortion numbers without changing the public mind on abortion? What if we can so reduce abortion numbers – reduce the demand for abortion – that it becomes politically much easier to criminalize the work of abortionists and protect unborn children? (This, we can assume, would have a big impact on abortion numbers, though our success, again, would lack the eschatological completeness of the slogans.) A shift of attention to making pregnancy help better known would be a strategic move, not a denial of the importance of laws.

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​Do the polls give us a clue as to why pregnancy help might be the reason for those dropping ratios? The American Enterprise Institute survey I cited in the earlier article points out that, over the years, “substantial numbers of people tell the pollsters that abortion is an act of murder. They also say that the decision to have an abortion should be a personal choice.” Similarly, people (and not just politicians) will say that they are personally pro-life, but that they can’t impose their morality on others. Ramesh Ponnuru observed somewhere that whoever is perceived as imposing on the other side in the struggle over abortion, loses. We saw this in Pennsylvania with former Governor Tom Corbett, whose proposed bill requiring that a woman be offered the opportunity to see her unborn child on the ultrasound screen before her abortion was widely criticized for imposing on the woman, and withdrawn. We have seen it recently on the other side, as the courts have rejected laws that would have required pregnancy help centers to advertise abortion services as well.

Pregnancy help involves no such imposition: it is assumed that women at all times have a choice, and that many will choose life when they have the right information and support. Americans like pregnancy help. A 2014 national poll commissioned by the Charlotte Lozier Institute found that 92 percent of women (many of whom would be “pro-choice”) said that pregnancy help centers were “very necessary” (70 percent) or “fairly necessary” (22 percent) in their communities. This positive view of pregnancy help was confirmed for us by a young actress who helps us with advertising local pregnancy medical centers in Pittsburgh. S.K. is “pro-choice”: personally “pro-life,” but not willing to judge anyone else, she tells us. Nonetheless, she now knows that these centers are “the way to go” for abortion-vulnerable women.

If we’re looking for that actualized “culture of life” we hear about, we find it in these centers. In 2003, the national pregnancy helpline OptionLine took 35,000 calls from women in need. Like the number of pregnancy help centers themselves over the years, the calls have increased: in 2018, Heartbeat International reports, that number was over 400,000. Over one million visited OptionLine’s website last year.
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Vision for Life – Pittsburgh, the non-profit of which I am the Executive Director, began advertising to abortion-minded women in late 2010. In the next few years, abortion ratios for residents of Allegheny County, Pennsylvania, fell sharply, and stood at roughly the same level before dipping again in 2017, the last year for which we have statistics, to 241 per 1,000 live births. From 2010 to 2017, abortion ratios declined 23.7 percent.

We don’t know for certain that the increase in pregnancy help centers lies behind the drop in abortion ratios, but if advertising local centers can have this kind of effect, it seems likely.

Michael New observes that this is a “rich area for future academic and policy research.” I would welcome the Charlotte Lozier Institute’s work on it. If they were to decline, however, perhaps others, or even a lone sociologist or statistician, would take on the task. I have the data on the increase in the number of centers, but I lack the competence with statistics for a proper assessment.
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We continue to need public education, academic debate, legal engagement, lobbying, and even protest, whether these demonstrably affect abortion numbers or not. If it can be shown, however, that pregnancy help is driving abortion ratios lower, then we should direct greater resources to the increase of the number of these centers, and to making all of the centers better known in their communities through advertising. Statistics and broad trends are dry matters, but with them, and God’s help, we may be able to deliver many more mothers and babies from the scourge of abortion.

(I have offered the following article, a response to an article in National Review by Michael J. New of the Charlotte Lozier Institute, to National Review on January 24.)

Michael New’s January 19th article in National Review Online, “The Best Metrics of Pro-Life Progress,” rightly notes that abortion numbers are falling, which is encouraging for all of us who want to see the end of legal abortion in America. Before we celebrate, however, we should perhaps reconsider the best metric of success. If you measure the rates of abortion for every 1,000 women aged 14 to 44, as he does, the numbers drop significantly ­– more than 50 percent fewer in 2014 than in 1980. The problem with this, however, is that it does not take into account declining fertility in America. Raw birth numbers have been dropping for decades; one would expect abortion rates to fall as well. It’s more helpful, from a pro-life point of view, to know what proportion of all pregnant women choose abortion from year to year (excluding those who miscarry). If the ratios of abortions to live births go down, we know that more women are not seeking abortions, and we can look for possible reasons.

And go down those ratios have. From the peak of 36.4 per 100 live births in 1984 they have fallen steadily to 18.8 in 2015, a drop of 48 percent (CDC data). The decline is profound and continuous. This rules out some explanations from the start. Dr. New rightly dispatches Planned Parenthood’s claim that increased use of contraception, and the right kind of contraception, is largely responsible for fewer unintended pregnancies, and thus for the decline in abortion numbers: rates of unintended pregnancy over the years don’t back it up.  His claim, however, that abortion numbers have fallen because of protective laws or changed hearts and minds needs closer examination. Academic research, he says, “shows that a variety of pro-life laws, including public-funding limits, parental-involvement laws, and properly designed informed-consent laws all reduce the incidence of abortion.” The question is, By how much? When we tally the reduction in abortion ratios that one would expect to see for these measures (which he has documented in his research), we get a total reduction in abortion ratios of 4.7 per 100 live births. The total reduction in abortion ratios from 1984 to 2015 was 17.6, however. (And this comparison assumes that these laws were all passed at some point in all of the CDC’s reporting states, which is not the case.) These laws save lives, and would save more lives if they were passed everywhere, but they are not driving the continuing drop in abortion ratios.

His second reason for the decline, changed hearts and minds, is intriguing, because it must be true in some sense, as women decide whether to abort or carry to term. If there is such a change, however, it is not reflected in public opinion polls. For years now, many have heralded polls ostensibly showing that the younger generation is more pro-life, or that more people consider themselves “pro-life.” Yet researchers from the American Enterprise Institute, who conduct an annual survey of previous polls on abortion, still report that there has been no significant shift in public opinion since the early 1970s. About 20 to 30 percent of the population are pro-choice, the same proportion are pro-life, and about half are in the middle. In May 2016, 29 percent of respondents to a Gallup poll said abortion should be legal in all circumstances, 50 percent said it should be legal in some circumstances, and 19 percent thought it should be illegal in all circumstances. “Substantial numbers of people tell the pollsters that abortion is an act of murder. They also say that the decision to have an abortion should be a personal choice.” (People may want to think of themselves as “pro-life,” but we can believe that there has been a true shift when a majority says that abortionists should go to jail.)

Perhaps, however, women who find themselves pregnant, and didn’t intend to be, are changing how they think of abortion and childbirth. There is ongoing discussion about “intention” among the technocrats who push “family planning” to women at risk of unintended pregnancy. They are challenged by the discovery that not all women plan these things or want to plan them. A woman who is taking some precautions not to become pregnant can actually be happy to find out that she is, especially if she is supported by her partner or those around her. (Those who focus on intention and planning seek to translate a woman’s imagined unhappiness with a future possible pregnancy into a plan for her fertility, that is, to make her over in their own image.) It may be that we are seeing the effects of fairly large-scale, social-psychological changes relating to pregnancy, abortion and childbirth, that we simply cannot discern.

In any case, Dr. New ends his list with “taking care of the material needs of pregnant women.” Here he is really on to something. In fact, the number of new pregnancy help centers has grown continuously while abortion ratios have declined. Heartbeat International, one umbrella organization for such centers, counted 23 new centers opening in 1973; by 2017 over 1,720 new centers had opened. (This is a partial count, as there are currently over 2,750 such centers. Some offer emotional, moral, spiritual, and practical help, some also provide limited obstetrical ultrasounds, and a smaller number are maternity homes.) The biggest one-year increase in centers recorded by Heartbeat was in 1985, the year after abortion ratios reached their peak, according to the CDC.

In a 1992 book, Abortion Rites: A Social History of Abortion in America, Marvin Olasky suggested that abortion rates in the latter half of the 19th Century (almost double ours, incidentally) declined largely because of Christian philanthropy, especially maternity homes. It is quite likely that we are seeing the same thing today with pregnancy help centers.

The key role of the centers has been confirmed here in Pittsburgh, where Vision for Life has been running modest ad campaigns for local centers since late 2010. Abortion ratios from 2000 to 2010 averaged 32.6 per 100 live births in Allegheny County. From 2011 to 2017, the last year for which we have the numbers, the average was 26.2, a 20 percent decrease. (Of course, abortion ratios are falling everywhere. The difference, however, between the two periods for all other Pennsylvania counties was only 7 percent.) The effect of advertising is not surprising: a Charlotte Lozier Institute study in 2014 found that 54 percent of women either did not know if there were centers in their communities, or thought that there weren’t any. When women know about the centers, more of them choose not to abort.

We can’t prove (yet) that pregnancy help is the main thing driving the drop in abortion numbers in the U.S., but it is certainly the chief candidate for study. One thing we can assume: increased advertising for local centers will bring those declining numbers down further.
​
Chris Humphrey, Ph.D.
Executive Director, Vision for Life - Pittsburgh

​Black women had 43% of abortions performed in PA, something that should exercise the hearts and minds of anyone who cares about the black community. As they are about 13% of the population, they are over-represented by two times in the abortion statistics. If black lives matter, then this has to change. Black pastors need to step up, and reassure women that God can and will forgive sexual sin -- the child is His good, natural gift -- and that He gives us sexual boundaries because He loves us.

88% of women who aborted in Pennsylvania in 2017 were unmarried. We know apart from the Report that women who cohabit are most at risk of abortion.

Over 61% of women who aborted had one or more previous live births. In other words, moms with one child or more were more likely than women with no children to have an abortion. It’s very likely that finances and the state of their relationships played a big part in these decisions.
​

​Repeat abortions (a woman’s second, third, fourth or more) accounted for over 47% of the total abortions to residents.

Chris Humphrey
Executive Director

Abortion numbers are falling everywhere across the country, including Pennsylvania. What impact is our pro-life advertising in Allegheny County having on those numbers?

In previous calculations of how many lives have been saved since Vision for Life - Pittsburgh began advertising in 2011, I have used the actual Allegheny County numbers for the year before, instead of the projected ones if there had been no advertising (using the percentage reduction of the rest of the State.)

If I have lost you already, don’t give up.* The bottom line is, I estimate the total number of lives saved from 2011 to 2016 to be over 3,500!

Now, this is a general number, and hardly precise. And, “correlation is not causation.” Still, the gap between the two lines strongly suggests that advertising is making the difference, and reaching the abortion vulnerable.

Birth numbers in the rest of PA declined 2.6% from 2010 to 2016, but increased in Allegheny County by 2.6% (a difference of 5.2%).

Thank God that, through our efforts and those of the pregnancy medical centers, so many more women are choosing life for their babies!

Feel free to share this encouraging news!


* Here’s how I calculated the figures. We have actual, annual abortion numbers for all the counties, including Allegheny. What I needed were the projected numbers of abortions if Allegheny County’s reduction in abortions were the average of all the other counties’. So, for example, in 2012 there were 6,909 abortions, which was 11.6% fewer than 2011’s 7,820. The reduction in abortion numbers for all the other counties, however, was only 1.4%. If we used abortion numbers from the year before we advertised, 2010, as the baseline for all subsequent calculations, the expected number of abortions in 2012 in Allegheny County would have been 7,587 (1.4% fewer than the projected 2011 number, which was 7,697). So the difference between the projected 2012 figure of 7,587, and the actual number, 6,909, was 678. Here’s a chart showing the difference between actual and projected abortion numbers for the years 2011 to 2016.

​Now some of the differences between projected and actual numbers may be due to other factors peculiar to Allegheny County, and some of the difference may be normal statistical variance between any one county and the rest (though it would vary up as well as down over the years). Say we’re out by 500, or even 800, for some reason -- this still leaves us with a very high number.

Chris Humphrey
​Executive Director

Pennsylvania's abortion numbers have been going down for years, and that's encouraging: fewer women doing harm to themselves (at least morally and spiritually) and fewer unborn children killed. The news is even better, however. PA started to record repeat abortions in 2008: the number of previous abortions a woman had when we she went for the current one: none, 1, 2, 3, and 4 or more. The results are below.

Note that first abortion numbers are going down faster than repeat abortion numbers. The reduction of first abortions from 2008 to 2016 was 23%; the reduction for repeat abortions was less than 18%. What does that mean? If it continues, it's the death spiral for the abortion business: as the number of women having their first abortion declines, the pool of those who might have their second, third, fourth, and so on, will get smaller still. If it were any other big business, they would see the handwriting on the wall. Fewer women are trusting that abortion is going to solve their problems, and there's no reason to think the trend will stop.

(Incidentally, it's not contraceptives that is reducing abortion demand; see my previous blog post on the possible explanations.)