Fewer Women Wanting Them, Not Less “Access,” Is Driving the Decline
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.
State Restrictions aren't driving the decline
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.
Focusing on Supply; Ignoring DemanD
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.
contraception isn't the driver
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 why is abortion dying in america?
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.
How long till no demand for abortion?
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.
If you want to depict a really wicked enemy, you make him a Nazi
The same is true when we think of great evils, of moral conflicts in which many, many lives are lost. If you want to depict a really wicked enemy in some piece of fiction, someone whom everyone knows they should hate, you make him a Nazi, a relic of the past. In the Twentieth Century, Nazism and Communism both offered alternative views of human beings and societies, and justified atrocious crimes against humanity on grounds of an over-arching theory (a master race in the first instance, or a “new man” created by dialectical materialism in the second). These were the only serious social-political contenders against the European Christian view of man and society. Nazism killed about six million Jews, as well as others, and the Communist system under Stalin killed somewhere between 20 and 40 million people, while the Chinese Communist government killed about 65 million of its own people in the last century, and continues, for example, to run concentration camps, and to murder prisoners of conscience for organ transplants today.
These great evils have been nationalist ideologies. What of today, however? Are there Nazis anymore? Is there a comparable, great moral evil, at least in scale?
The rejection of God has opened the door to a “cafeteria” paganism and individualist subjectivism
To look for popular, dehumanizing, nationalist ideologies today, however, is to try to fight the last war. Over the last fifty years, the contender for the minds and hearts of the developed world has not been a replacement political ideology, but secularism (an attempt to “disinfect” society of religion). Not surprisingly, the rejection of God and of a Christian view of humankind in public expression has opened the door to a “cafeteria” paganism and individualist subjectivism. So Supreme Court Justice Kennedy, in the 1992 Planned Parenthood v. Casey decision, wrote infamously that, “at the heart of liberty is the right to define one’s own concept of existence, of meaning, of the universe and of the mystery of human life.” Here is subjectivism in a nutshell.
More individual human beings have been killed in abortion
In casting off the “shackles of religion,” secularism leads not merely to nonsense, but to dehumanization. Where are the victims, comparable to those of Nazism and Communism? It may be a surprise to learn that more individual human beings have been killed in abortion than in any other way, in all of history, and most of that killing has taken place in the last 50 years. (The bulk of that killing has taken place in China and India. Together they are responsible for 24 to 25 million abortions a year.)
Abortion, like genocide and other crimes, has been around a long time. The modern novelty has been technology. Mass killing by the Nazis was made possible by the railroad and road transport, and followed the example of the earlier Armenian genocide. The atom bomb dropped on Japanese cities was a technological marvel. Suction machines were first used to destroy unborn children in utero in Communist Russia in 1922, and spread to the West. Currently in the U.S. there are about a million abortions a year. Entrepreneurial abortionists have been able for decades to perform a series of such suction abortions in rapid succession. Now chemical abortion promises to make the self-induced abortion common, and more difficult to trace.
Note that our “enemy” in the new moral “war” is not a particular religion or ideology. As Orthodox Christians, we celebrate the unique conception of Jesus Christ, “incarnate of the Holy Spirit and the Virgin Mary,” at the Feast of the Annunciation, on March 25. We also celebrate the conception of the Most Holy Theotokos on December 9, and that of St. John the Baptist on September 23. We are predisposed by our faith to see things properly. We could make secular arguments, of course. We could argue that every individual human being began his or her existence in this world at his or her conception. Conception is the only neat point at which life can be said to begin. (Here we have not a potential life, but a new life with potential.) If our imaginations have a hard time recognizing the very early individual life, at the blastocyst stage, say, as a new member of the human family, that is a problem of our imagination, not in reality. (The human being is never just a depersonalized “clump of cells.”) We could mention that the human heart starts beating about sixteen days after conception, about the time when mom is beginning to suspect she’s pregnant. We could say all these things, and we would be right: here is another one of us.
"And who is my neighbor?"
Still, being right is usually not enough to overcome the secularist mindset, in which the defenseless victim is an embarrassment or an inconvenience. “And who is my neighbor?” our interlocutor asks. “I don’t want to think about this silent, little thing in ontological no-man’s-land. I see what I want to see, and my will rules.” This is less a problem of the head than of the heart. It is not surprising that since 1997 the General Social Survey has found that public support for abortion on demand has hovered at around 40 percent. If education about pregnancy and abortion were enough to convince people, that number would have dropped.
We cannot fight the last war – Nazism and Communism as ideologies are dead. We can, however, look at how courageous men (and women) have stood up to evil, and be encouraged to emulate them. During the Nazi occupation of Greece, the Orthodox Archbishop of Athens and All Greece, His Beatitude Damaskinos, signed a letter addressed to the Prime Minister, who was collaborating with the Nazis. The letter was a courageous defense of the Greek Jews who were being rounded up and deported to Poland to be exterminated. When the Germans continued with the deportations, His Beatitude called the Police Chief of Athens, Angelos Evert, to his office and told him, “I have taken up my cross. I spoke to the Lord, and made up my mind to save as many Jewish souls as possible.”
"Our prelates are hung, not shot. Please respect our traditions!"
When S.S. General Jürgen Stroop, police official for Greece, found out about the letter, he threatened to shoot His Beatitude. The Archbishop (with historical oppression by the Turks in mind) told the German officer that “according to the traditions of the Greek Orthodox Church, our prelates are hung and not shot. Please respect our traditions!” His Beatitude would not be stopped. Chief Evert issued false identification cards and Archbishop Damaskinos ordered the churches to issue false baptismal certificates to those threatened with deportation. In Athens and the port city of Piraeus, Christians hid Jews in their homes. The result of their work was the rescue of 66 percent of the Jews of Athens.
The courage of the past often looks simple to us: he saw what was right, and did it. That, however, is what happens when we look back from the present: we air-brush away the complications, the uncertainties, the betrayals, even the doubts. Did no one ask the Archbishop, “What will happen if they don’t shoot you, but take some priests off to Poland to die? What will you do then?” Did others say, “Why are we getting involved in politics? We should just keep our heads down and submit, as Christ did, to the authorities.” “His Kingdom is not of this world. This will all pass.” “Your business is our eternal souls, and the churches and the monasteries, not this trouble.” “Who cares about the Jews? In any case, they can take care of themselves.”
If we had been there, we would have known what to do,
We are tempted to think that it was easy for the heroes of the past to know what was right, and to do it. If we had been there, we would have known what to do, and have done it, just like them. The Lord Jesus implied just this dynamic when He said, “Woe to you, scribes and Pharisees, hypocrites! for you build the tombs of the prophets and adorn the monuments of the righteous, saying, ‘If we had lived in the days of our fathers, we would not have taken part with them in shedding the blood of the prophets.’” In Jesus’ time, the dreadful irony was that those who admired their prophetic predecessors would have been among those who killed them, if they had lived in that day. Our challenge is to see things clearly in our day, to do what we can in the moral war of our day, as the people we admire would have, if they were here now.
“I . . . made up my mind to save as many . . . souls as possible.” We can do the same, in our day. With abortion, we are not only saving the lives of the babies: we are preventing a soul-destroying act by the woman. We are already seeing success in America. Pregnancy help centers are the chief reason that abortion numbers have been declining since 1984. At those centers that have ultrasound machines, they can show the pregnant woman the child in her womb. The sonographer shows the woman the flicker of her baby’s beating heart, or the outline of his or her head, or his or her thumb-sucking. There can be tears. This is often enough, with care and support, for women to change their minds – about 85 percent do so. Truth and love have power, and hearts are opened to life.
Zoe for Life! is one Orthodox organization that is saving as many souls as possible, in Parma, Ohio (near Cleveland), and in Ann Arbor, Michigan. New chapters are starting in Binghamton, New York, and Pittsburgh, Pennsylvania. (Go to https://www.zoeforlife.org for more information on Zoe.) Zoe for Life! is endorsed by the Assembly of Canonical Orthodox Bishops of the United States, and that is good.
We need to translate our good intentions into actions
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.”
Rescue those who are being taken away to death;
 Some claim that the new, genetically unique individual human being is not a person before implantation in the uterus, because he or she is not a yet “person in relation” to his or her mother. (Persons, we are told, must be in relation, as are the Persons of the Trinity.) This claim is specious. By this standard, would we say that St. Mary of Egypt ceased to be a person after years in the desert? Is the seriously mentally and physically handicapped person, incapable of communication, still a person? If it is true that “not one [sparrow] is forgotten before God,” every conceived human being, at whatever stage of life, is known to Him (Luke 12:6). What purpose could this pernicious depersonalization serve? Could it be used to justify the use of abortifacients like the IUD, which prevent implantation, or potential abortifacients, like the morning-after pill, which may stop ovulation, but can prevent implantation of the newly conceived person?
The Pennsylvania Department of Health’s 2018 Abortion Report gives us good news on abortion numbers, and ratios to live births, for Allegheny County, and two other “firsts” for Pittsburgh and Pennsylvania:
In 2018 we also saw the second lowest number of abortions performed in Allegheny County – 6,088.
Let’s start with the last piece of news first: abortions performed in the County were at their second lowest number – 6,088 – eight more than the number in 2016. From the graph below, it seems that we have hit something like a “floor”: to drive abortion numbers lower, we’re going to have to do more. In fact, we are doing more: we are using Google Ads to advertise Women’s Choice Network as well as Choices Pregnancy Services now, and our Facebook ads are now reaching 50,000 or so women each month, and targeting those we think are more likely to be facing unintended pregnancies. (From just January 1 to January 10, we have reached over 62,000 women and had 22 clicks on the “Call Now” button on our Facebook ads, connecting women to the Abortion Pill Rescue Network – advertising works!) We won’t see the result of our recent increased and focused ad work until early 2022, but we expect to make that floor of raw numbers a staircase going downwards.
Abortion ratios show the true picture
In fact, from another perspective, we have already gone below that floor. Abortions decline if pregnancy rates decline, but that doesn’t tell us anything about our success in reaching pregnant women. We want to know if more of the women who are pregnant are choosing life. So we look at the ratios of abortions to live births for residents of Allegheny County. There, the picture is better.
Here we see that abortion ratios are at their lowest ever. From 2010 to 2018, ratios declined 15 percent in the rest of PA. In Allegheny County, they declined 26 percent!
You expect higher abortion ratios in urban settings, but 2018’s number for Pittsburgh residents is actually less than the highest number for the rest of the State (241), which includes all those rural counties. That “floor” seems to have given way here, as the numbers have now fallen two years in a row, a drop of 7.1 percent!
We see the difference between Pittsburgh and the rest of PA in the birth statistics. (Ignore the proximity of the lines in the chart below; they are on two different scales: it’s the shape of the lines that matters.)
From 2010 to 2018, the State’s birth numbers declined 5.3 percent. In the same period, Allegheny County’s numbers were stable, after rising and declining again – a statistically insignificant difference, end to end, of .2 percent.
We’re Doing Something Right in Allegheny County
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.
Abortions to Non-Residents Surpass Those to Residents
Something else that was new in 2018 was the surpassing of abortions to residents of the County by abortions to non-residents.
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.
Speculating about those numbers
Abortion numbers for non-residents dropped from 2010 to 2013, but then bounced up again in 2017 and 2018. The numbers of abortions to women residing in counties neighboring Allegheny have been going down, so it may be that these increased numbers are young women from elsewhere who are studying in colleges from the Pittsburgh area. Why would more of them seek an abortion? Could it be that the defamation campaign against pregnancy medical centers conducted by pro-choice activists may have had an effect? They claimed that the centers are “fake clinics,” not staffed by medical professionals, that the information the centers give out is false, and that they are simply fronts for religious proselytizing. In fact, of course, the centers give out medically accurate information vetted by the centers’ medical directors, have professional staff, including sonographers, that meet all certification requirements, and they are sensitive to the spiritual needs of the women they serve without imposing on them. (For Heartbeat International’s response to the defamation, see PregnancyCenterTruth.com.) Our Facebook advertising to women has recently addressed the “fake clinic” claim obliquely, and we will continue to do so.
The bottom line for Allegheny County: the news is very, very good! Thank God!
What Age Group Is Having the Most Abortions?
Now, what do we learn about abortion and Pennsylvania as a whole? The final “first” mentioned above is the surprising shift in the age cohort having most of the abortions. Before 2018, the largest group was that 20–24 years old; in 2018, the largest group became the 25–29-year-olds.
This shift to older ages is a long-term trend, as we can see in this column chart. (The year 2018 is indicated in the light blue bar on the right of each collection of bars.)
So we see that those under 25 are mostly responsible for the decline in abortion numbers. Concurrent with that, however, there has been a much smaller increase in abortions among those 25–39. (There has been a slight decline as well among those who are 40 and older.)
A Change in Number of Previous Live Births, Too
When people think about abortion, they most often think of a college student: young, and with few responsibilities to others. And this is correct, to a point: many abortion-seekers fit this description. They are surprised to learn, however, that a majority of women who have an abortion have already had one child or more.
Concurrent with the change in the age cohorts, however, the number of women who have had no child, or one child, before having an abortion in Pennsylvania has been declining. At the same time, the number for those with two or more children is stable over time.
It is likely that most women with two or more children already are afraid that they won’t be able to manage financially in the future with a third or more.
First Abortions Declining Faster than “Repeat Abortions”
Just under half of abortions performed in Pennsylvania in 2018 were “repeat” abortions – the woman’s second, third, fourth, or fifth or more.
Both first-time abortion and “repeat” abortion numbers in Pennsylvania have been going down, but the first-time numbers have been going down faster.
This is good news. It means that the abortion business is in terminal decline. If any business has declining repeat business, but even faster declining first-time customers, they have to find ways to capture more of the market. This is exactly what Planned Parenthood is doing: making abortion a bigger part of their business by taking customers away from other abortion businesses. With current trends, however, even Planned Parenthood will run out of customers.
The Trend for Pennsylvania
The number of abortions performed in Pennsylvania in 2018 was not encouraging in itself: the 28,240 total was six more than were performed in 2017. The trend, however, is downward for abortion numbers and ratios for the State as a whole. That trend line is not as sharply downward as we have seen it in Allegheny County, largely because pro-life pregnancy help centers are not advertising as much as they should, especially in the urban areas. The more we can advertise, the faster we will see abortion numbers and ratios of abortions to live births fall.
Please donate today, to help us make those numbers fall faster.
Advertising by Vision for Life is having an increasing impact on the number of contacts made by Allegheny County women considering abortion to pregnancy medical centers in Pittsburgh.
In 2017, 512 abortions were performed, on average, every month in Pittsburgh (Allegheny County). About half were performed on residents. That year we did advertising work that generated, on average, 242 calls or e-mails each month to pregnancy medical center organizations Choices Pregnancy Services and Women's Choice Network. (In earlier e-mails to supporters, I mistakenly over-stated the total number of contacts by about a fourth. It did not affect the trend as a whole, and this mistake has been corrected here.)
Fast forward to this year: from January to November, on average, our advertising work generated 363 contacts (calls, e-mails, texts, or web form submissions) each month. That’s an increase of 50%! As you can see from the chart above, from November 2017 to November 2019, our contact numbers doubled.
Our high point was reached so far in October 2019.
That's Board member Katie Breckenridge on the Hot Metal Bridge.
We don’t know what the relation is between abortion numbers and our contact numbers, and we’ll have to wait till January 2021 to find out what those abortion numbers are, but surely this 50% increase has had a significant impact on them.
In November we had 40 clicks on the "Call Now" button on our Abortion Pill Reversal ad
We have begun advertising to women who have taken the first abortion pill, but not the second. If they act quickly enough, and start the abortion pill reversal protocol, most can save their pregnancies. (So far, the “save rate” is 66%.) Though the other side is doing its best to denigrate abortion pill reversal as unproven, and so forth, the results are in: close to 1,000 healthy babies have been born.
We began advertising Heartbeat International’s Abortion Pill Reversal Network (APRN) with Facebook video ads in November. By the end of the month we had seen 40 clicks on the “Call Now” button to Heartbeat’s 24/7 helpline.
Heartbeat’s counselors connect the women to local physicians who prescribe progesterone pills, which she begins taking. (This replaces the progesterone in the woman’s body that the first abortion pill removed. Progesterone is regularly prescribed when women are at risk of miscarriage.) Women’s Choice Network is part of the APRN.
If we assume that about 500 abortions are performed every month in Pittsburgh currently, and know that about 40% are chemical abortions, we have about 200 chemical abortions a month here. Our 40 clicks would be about 20% of the number of chemical abortions. Of course, some of these calls will have been made just out of curiosity, but many will not.
Why do these numbers matter? Because they represent people just like us. We once were very small in our mothers’ wombs. Like the moms and dads, we have faced pressure from others, and from our own fears and desires, to do wrong. And every one of us matters.
One of our partners helps us see the lay of the land for many of these women and men: “Last week she shared that she thought she might be able to parent. After a sonogram, she was expressing more confidence .... She was just starting to accept that she's pregnant. This week, the father of her baby has started pressuring her more strongly to have an abortion, and she is now feeling confused and very uncertain again. Pray that the life-affirming voices in her life will be heard over his voice, for the preservation of her unborn child!”
We know how important it is for these young women and men, as it is for us, to choose wisely, to avoid a sin like this, to move towards God, and not away from Him. They need to know that they can do what's right, what is pleasing in the sight of God, what they will not regret.
Why do these people matter? Because these are our neighbors, whom we might pass on a downtown street, whom Jesus calls us to love.
We are seeing great success, thank God. But there's much more to be done. Please donate generously today.
The "Plunge-Raiser" -- January 1st, Mon Wharf, 9:30 a.m.
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 firstname.lastname@example.org, 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!
Chris Humphrey, Ph.D.
Will Abortion Numbers Never Stop Falling?
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.
More Reliance on Chemical Abortion
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.
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.
“Buyer’s Remorse,” Regret, and Advertising
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 currently have an ad running on Facebook that does this. (You can see it on Youtube at https://youtu.be/fTwSWh6x58g. Our actress is walking toward the camera, looking downwards, obviously deep in thought. The voice-over: “What was I thinking? I didn’t really want my last abortion, either. (Looks up at camera. Voice-over:) What did it do for me? Really?” Cut to the next scene: she is sitting, looking away, with a friend in the friend’s apartment. Friend: “You know, I’ve heard that you can reverse the abortion pill. . . .” Friend searches on her phone. “Yes: ‘It may not be too late to save your pregnancy.’” Woman (turning to friend, a note of hope in her voice): “Really?” Friend: “Your don't really want this [abortion], do you?” Our actress shakes her head. Cut to Abortion Pill Rescue Network screen. The voice-over: “Don’t wait. Call the Abortion Pill Rescue Network now.” Next screen: "Over 900 healthy babies have been born following abortion pill reversal." Final second-and-a-half: woman bringing her head up, then beaming into the camera lens. The button on the Facebook ad is set to “Call Now,” a clickable link to the Abortion Pill Rescue Network number, 877-558-0333.
If 60 percent of the 6,000 abortions in Allegheny County are chemical, that's 300 a month. From November 1st, when we started running the ad, to November 8 at 11 a.m., Facebook tells that we have had 8 calls on the Abortion Pill Rescue Network hotline. These may curiosity calls, but they may also be part of that 300, that is, women who have immediately regretted their action. Two women saved our ad on Facebook, perhaps to show somebody else. We are not advertising to the 300 alone, of course. Our ad is reaching women who know little about abortion, and hope they never have to know. If they are ever shocked that they became pregnant, they may recall that there were people out there ready to help them deal with their situations in a healthy way.
The key thing is that we advertise the possibility of reversing a chemical abortion. Locally, hundreds of women could be reached with the message, and their babies saved. Nationally, tens of thousands, perhaps hundreds of thousands, could find that admitting their regrets to themselves, and/or acting on their “buyer’s remorse,” could be the start of their way back to wholeness.
The numbers of abortions are falling. They’ll fall faster if we advertise. Your support makes this possible. Now. In Pittsburgh. Please donate today!
What It looks like
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.)
What's Really Happening
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.
Guttmacher is guessing
When the Guttmacher report goes on to say that “it is unlikely that the decline in abortion was due to an increase in unintended births” (emphasis added), we can be suspicious. It’s in their ideological self-interest to think so. How would we know that unintended births haven’t increased? Unintended births are measured by interviews of subjects, and so are not as cut-and-dried as numbers of births, or even as numbers of abortions; how members of groups answer interviewers’ questions may vary from year to year, or decade to decade. (In the “Turnaway Study” of women who had borne their children after being refused an abortion, 38% said in interviews after the births that they had never sought an abortion! Pregnancy and birth can be something like the Twilight Zone!) It’s true, a couple of studies showed unintended births declining in the past, and this might indicate that contraception, especially widespread use of the most effective contraception, is one reason. But then another, longer-term, study showed unintended births going up from 30.6 per 100 live births, to 37.1, an increase of 7%, from 1995 to 2010. All that time, abortion ratios were going down. So Guttmacher is going out on a limb when it says, without further study, that it is unlikely that unintended births did not increase.
Similarly, when they claim that “improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting” are among the “factors that may have contributed to the decline” (emphasis added), they are guessing. It is true that so-called “Long-Acting Reversible Contraception,” or “LARC,” is more effective at preventing pregnancy than the other forms, but the number of women who are using it is not great enough to explain the drop in abortion rates. There was a simultaneous decline in use of the more common forms of contraception, too, so there was probably no net gain in contraception. In any case, as used in real life, common contraceptives (condom, diaphragm, pill) do not reduce unintended pregnancy rates, but in fact increase those rates.
What about "self-managed" abortions?
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.)
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.
Facebook tells me that it has been ten years since I began working on Vision for Life, at that time with new friends Marie Vaina and Jeff Steigerwalt. We became a 501(c)(3) in early 2010, and began fundraising. Just after Christmas in 2010, we launched a six-week television ad campaign, not knowing what the results in Allegheny County would be. We put up ads on buses and bus shelters. Were they having any effect? We wanted to see State abortion statistics, to know if more pregnant women had chosen life, but we had to wait until early 2013 to find out. The PA Abortion Report was released in January that year, and, sure enough, the ratio of abortions to live births for Allegheny County residents – indicating that more women actually chose life – dropped a little (from 31.6 per 100 live births to 30.4 in 2011). But then, these abortion ratio numbers were dropping across the State. In fact, that first year, they dropped even farther elsewhere than in Allegheny County. Was our advertising for Choices Pregnancy Services, Women’s Choice Network, and Pregnancy Resource Center of the South Hills actually having any effect?
Since then, we have seen some exciting developments. We shifted our advertising to the Internet, paying Google for our centers to appear in the search results for women looking online for “abortion” and related terms. We expanded to advertising to young women on Facebook in September 2014. (In 2015 we generated on average 15 calls a month to the centers from our Facebook ads.) The numbers for Allegheny County residents continued to drop, but sharply: from 30.4 per hundred live births in 2011, to 25.3 in 2013. There they hovered for a few years, before dropping again in 2017 to 24.1. That’s the lowest level since 1995 (when the State started recording county numbers), and probably lower even than 1973, the year that Roe v. Wade made abortion-on-demand the law of the land.
Statistically significant drop in abortions
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?
How many lives have been saved?
To answer that, I looked at the abortion ratios for the rest of the State and for Allegheny County from 2010 to 2017. Both went down, but Allegheny County’s ratios went down faster (after 2011). Using the numbers of abortions and births for each year from 2010 on, and the difference between the County’s ratios and the ratios of all the other counties, both applied to the previous year’s ratios and the current year’s birth numbers – yes, it’s complicated – I found that something like 2,100 lives were saved over the seven years, or 300 lives a year. (Again, considering the volatility of abortion ratios, this is very approximate.) Here’s a chart of the estimated results and actuals.
Reducing Demand is winning
on As most people who know me have heard, I am convinced that the best way to reduce demand for abortion everywhere is to advertise centers. Until recently, the general public has understood “pro-life” to mean reducing the supply of abortion, that is, restricting abortion with laws. There are few arguments more ideologically sterile for us, however, than the one over the rights of the child versus the rights of the woman. (It is so much more fruitful, more personal, not to ask, “Do you have the right to do this?” but to ask, “Do you think it’s right?”) While there is no question that, eventually, we will need laws that protect unborn children from abortion, we are having our greatest success right now by helping women in the real world. As demand for abortion falls (and abortion ratios continue to decline nationally from their high point in 1984), there is a snowball effect: more women go to the centers and more women speak highly of those centers; more women choose life rather than abortion, and more of their friends see that, and do likewise; and the defense of abortion (up to birth, for any reason, and so forth) seems ever more extreme, rigid, and inhuman.
Here's our most recent ad on Facebook for Women's Choice Network, one of our partners.
Our fellow pro-lifers are seeing the light: pregnancy help beats changing the laws, for now
David French, a writer for National Review Online, wrote a great article on our prospects after the fall of Roe v. Wade (“In a Post-Roe World, Pro-Lifers Would Still Have a Lot of Work Left to Do”).
French mentions a New York Times report on a “study by researchers from Middlebury College, the Guttmacher Institute, and the Bixby Center for Global Reproductive Health” which “found that in ‘more than half of states, including the entire West Coast and Northeast,' overturning Roe would have no real effect on abortion access" [emphasis added].
French goes on to note something that we at Vision for Life have been saying for a while: abortion ratios have been falling for years, whether the political winds have been favorable or adverse. He asks, “So, what should pro-lifers do with all this information? Mainly it helps us balance our efforts appropriately. We should all be able to agree that keeping the abortion-rate line on the Guttmacher graph moving downward is our fundamental, shared goal. The law can assist in that goal, but the law is not the principal means of achieving it." Bingo!
With abortion pills online, we are going to need more advertising
ePregnancy help is the key to reaching that goal, and advertising amplifies the effect of that help. More and more, pro-life people and organizations are realizing this. Now we have to up our game. We are seeing a shift from surgical abortions to chemical (or “medical”) ones: out of PA’s 30,011 abortions in 2017, 11,496, or 38%, were chemical. While most chemical abortions are still begun at an abortion center, the abortion pills are becoming available online – no need to go to the abortionist – so more and more we are going to have to use online advertising to reach abortion-vulnerable women. Heartbeat International’s “Abortion Pill Rescue Network” is a step in the right direction: women can call a national number and be referred to a local physician. (I am on the Board of Heartbeat.) If a woman has taken the first pill but not the second, she can reverse her abortion with progesterone, which that local doctor can prescribe. The abortion reversal is successful about 65% of the time, and so far over 750 women have borne their children. Advertising the Network widely will save many more lives across America. It will show, too, that women have second thoughts. It will make uncertain women realize that other women are uncertain, too. And that's OK. They can choose what's best for both them and their babies.
It has been a good ten years. As we look ahead, we anticipate reaching even more women, and to seeing those abortion ratios continue downwards. More lives saved, more women grateful. May God, in His mercy, hear our prayer!
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.
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.
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!
No, Educating the General public on abortion hasn't happened -- but abortion Numbers are dropping anywayRead Now
With this article, I am continuing to argue against Michael New that pregnancy help is more likely the driver behind the drop in abortion rates and ratios since the mid-1980s. All the other candidates (increased and more effective contraception, pro-life education and protest, state abortion restrictions, or reduced numbers abortion centers) are not continuous over the period during which abortion ratios dropped (from 36.4 per hundred live births in 1984 to 18.8 in 2015), or have been shown to have no correlation, and/or, in the case of changes to the law, have had an immediate effect, but no provable, ongoing one. (You can read our discussion to date in sequence, beginning with my response in The Federalist online to his National Review article, here, here, here, and here.) Why does this matter? Because we need to know what works, and focus more of our time, energy and resources there. Abortion ratios will continue to go down: we can make them fall faster.
My purpose, then, is not wholly negative; I wish to rain on no one’s parade. However, by seeing things truly, we can be realistic and practical in how we approach saving moms and babies from abortion. The natural temptation is to think that our pro-life efforts, whatever they are, must be effective, because they simply have to be. Otherwise, what would we do? Well, . . . .
We often assume that, if you educate the general public on pregnancy and abortion, fewer women will have abortions. To my knowledge, we have no evidence that this has happened, and we have had 46 years or so to do so. (Advertising pregnancy help centers to the narrower audience of women who may be abortion-vulnerable appears to be effective, however, from our experience in Pittsburgh.) Dr. New admits that we don’t have evidence when he writes that “it is certainly likely that changing attitudes among young people might be playing a role in these large abortion rate declines.”
In his last article, Dr. New argues that “a closer examination of public opinion data indicates there has been a shift in abortion attitudes, especially among young people.” Is this so? I would argue that this shift is feeble in terms of the abortion debate, and is not the result of pro-life education, and that whatever changes can be seen do not account for that continuous, even drop in abortion ratios since the 1980s.
Let’s look at those changes in attitude. Are young people more in favor of things like a ban on abortions after 20 weeks? It may depend on which poll you consult. Dr. New refers to a Quinnipiac poll from 2017, claiming that it “found that 18-to-34-year-olds were more likely than other age demographics to support a ban on abortions after 20 weeks’ gestation.” He is mistaken, however: Quinnipiac reports that the 18-34-year-old cohort is actually less supportive of a ban than the 35-59-year-old cohort, 49 to 54 percent. His colleague Susan Willis found that “the age demographic that showed the largest-percentage decline [in abortion rates from 1990 to 2010] were those aged 15-19, whose abortion rate fell by 71 percent.” This reduction is less remarkable, however, when we realize that pregnancy rates (births, abortions, fetal loss) had fallen 63 percent from 1990 to 2013.
He argues that the most dependable guide to public opinion, in particular the opinion of relatively young people, is the General Social Survey, which has asked the same seven questions about grounds for abortion since 1977 (2012 Final Report: Trends in Public Attitudes towards Abortion, May 2013). Six of the questions were asked for years previously. Here are the subjects of the questions, and the decline in support for abortion from 1977 to 2012 in each case, among those 18–35 years of age: “Please tell me whether or not you think it should be possible for a pregnant woman to obtain a legal abortion if . . .” the woman’s health is seriously endangered (92 to 82 percent); the pregnancy resulted from rape (81 to 76 percent); there was a serious defect in the fetus (86 to 68 percent); the family is too poor to afford another child (55 to 42 percent), when a married woman does not want more children (49 to 41 percent); or when the woman is unmarried and does not want to marry the prospective father (47 to 37 percent)? It is true that, from 2000 on, the 18-35 cohort shows decreasing support for abortion on the various grounds.
The trend is significant, but it signifies disillusionment with abortion, not a growth in pro-life sentiment. Pro-life education makes clear that human life begins at conception; that there is no qualitative change that suddenly makes something – that is not an organ of the woman’s body – into an equally protectable life. It shows that abortion at any stage kills a unique, individual, human being, often enough in gruesome ways. This education would not moderate the views of people in the middle, so that, for example, they think that abortion is acceptable before 20 weeks, but unacceptable afterwards, or that some low level of income could go onto the scale against the life of the child. (People who pride themselves on being “moderate” on abortion should be asked if they are also “moderate” on racism; against slavery, say, but happy with Jim Crow.) It has to be admitted: most people are ignorant about prenatal development and abortion, and not many have given much thought to it, but they think that there should be some restrictions on the practice of abortion. We may be pleased that some people are becoming disillusioned with abortion, but to claim that these changes in the poll results are the effect of pro-life education is grasping at straws.
If pro-life education were seriously affecting public opinion, we would see a decline in the seventh question added to the General Social Survey: whether or not it should be possible for a pregnant woman to obtain a legal abortion “if she wants it for any reason.” We have no reason to think that those who agree are hard-core, pro-abortion absolutists, who could never be persuaded of anything. They are likely as unthinking as the others, and thus open to education, if they were interested. Here there is virtually no change since 1977: about 40 percent consistently say it simply should be up to the woman, as the graph below shows.
A small percentage of respondents to the polls over the years are simply illogical. For 13 years, the levels of support for abortion “if she is not married and does not want to marry the man” fall below the levels of support for abortion “for any reason.” In other words, these respondents said that it should be possible for a woman to have an abortion for any reason, but not if she does not want to marry.
We can see that education is not responsible for the decline in the overall support for abortion with various conditions by the fact that, as the 18–34 cohort of 1977 moves entirely into the 34–59-year-old bracket (from 2000 on), their support for these conditions increases slightly for the period 2002–2012, on average. If you “get” when equally protectable human life begins, when you see the destructiveness of abortion, you don’t unlearn it.
If education were responsible for the decline in support for abortion under various circumstances, then what educational initiatives would have been responsible for this decline? What happened in the 1990s and years following that made the decline fairly continuous? The answers that will spring to most peoples’ minds will not be from large-scale programs of pro-life education, but from politics, and these deserve a separate examination. (Shouldn’t the Gosnell affair have made New York’s permissive, late-term abortion law unlikely?)
If pro-life education is not driving abortion rates and ratios lower, what else might be doing so? I have already mentioned pregnancy help, which is a strong candidate at this point. Another possibility is the increasing number of women who, over the years, came to view their abortions as a mistake. One study found that first-trimester abortion patients expressed the following one week after their abortions: relief (96 percent); happiness (53 percent); regret (33 percent); guilt (55 percent); sadness (61 percent) and anger (28 percent). It is reasonable to suppose that the relief and happiness would fade quickly, while the negative assessments would not. While most women would forget about their abortions, one can imagine that, year over year, the minority of those women who viewed their abortion decisions negatively would have grown in size. (Many help out at pregnancy help centers now.) Here is a possible scenario: a twenty-year-old woman has an abortion in 1975, but bears children five to seven years later. These children reach their twenties in the early 2000s. Somehow they learn about their mother’s abortion and its negative effects. They reject abortion for themselves (in theory, and/or practically). Could first-hand, negative views of abortion, shared in close circles of family and friends, have played a big part in the decline in abortion numbers, and in the decline in support for abortion on various grounds, while leaving support for the ideologically sacrosanct “right to abortion” untouched? I don’t know, but the possibility is intriguing.
Psychologist and philosopher William James made a helpful analysis of decision-making many years ago. Relevant to this topic are his distinctions between decisions that are forced and unforced, and between those that are momentous and those that are trivial. A forced decision is one we can’t avoid making; an unforced one can be put off. A momentous decision is irrevocable and for significant stakes, while a trivial one can be reversed or has little effect one way or the other. Polling on abortion involves unforced and trivial decisions – not that the subject is trivial, but there are no real consequences to telling someone anything on the phone, and you don’t have to answer to begin with. Choosing abortion or life for your child, however, is both a forced and a momentous decision. (Attempts to trivialize the decision often show all the signs of a bad conscience, of the me-thinks-she-doth-protest-too-much variety. “Shout your abortion!” – Really?)
If we think education is important, then we should focus our efforts on those who, we know, are likely to respond, to see how momentous the abortion decision is. So, for example, we know that seriously pro-life people are more likely to go to a church regularly (whether theologically liberal or conservative). Rather than attempt to educate a general public that is disinterested in the issue and finds it distasteful, why not focus educational efforts on the faithful, but ignorant? We rally the troops to go see the movie Unplanned, but perhaps we should also say, “Ask somebody you see in church each week what she thinks about the new abortion law in New York State. If she doesn’t know what you’re talking about, invite her to Unplanned.” Otherwise we may be filling the theaters with the committed, and preaching to the choir, as Nicole Russell suggests. It may be morale-boosting, but it is not educating the general public.
Even better, why not narrow the focus? The person most likely to see the abortion decision as forced and non-trivial is the woman who is pregnant, or may become pregnant soon. Advertising pregnancy help, especially pregnancy medical centers, is not education in itself, but it opens the door to educating the person most involved in abortion, and her husband or partner, or her parents. In Pittsburgh, the annual ratios of abortions to live births dropped 24 percent from 2010 to 2017, after Vision for Life began advertising (versus 17 percent for the rest of Pennsylvania). I would assume that not all of the women who chose life came to one of the centers we advertise. The advertising itself, I think, reaches some women beyond the pro-choice bromides with which they reflexively agree.
Dr. New will be presenting a paper on his research into the effect of the increase in the number of pregnancy help centers on abortion rates, and I look forward to reading it. I hope that it confirms my view of them as the main drivers of the drop in abortion ratios – rates may drop anyway, because fewer people are having sex, but ratios measure how frequently pregnant women resort to abortion. If he finds that the growth in the number of centers, now over 2,750, is not the major cause, or a major cause, of the 48 percent drop in abortion ratios from 1984 to 2015, we will be at a loss to explain it.
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 Can Handle the Facts – And Their Absence
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.
Public Opinion Has Not Shifted in Our Favor
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.”
Can We Change Things without Changing Public Opinion?
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.)
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.
Public Ambivalence Gives Us an In
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.
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.
Is There a Statistician in the House?
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.
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.
Chris Humphrey has been involved in pro-life activity of one kind or another since the late 1970s, when he first looked at the subject of abortion in seminary in Canada. He has an undergraduate degree in English (University of Toronto), and M.A. and Ph.D. degrees in religious studies (McGill). He has had a varied career as a pastor, chaplain in a psychiatric hospital, editor of academic and instructional publications, semi-professional photographer, and home renovator. He is a husband of over 40 years to Edith (a Professor of New Testament), father to three girls, and grandfather to seventeen grandchildren. He lives and works in the Stanton Heights neighborhood of Pittsburgh.