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”?
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.