The explosion in numbers of Pregnancy Help Centers in the mid-1980s across America is likely the biggest factor in the reduction of abortion ratios since the early 1990s.

As you may know, Planned Parenthood is now pushing the argument that their contraceptive work has actually reduced unintended pregnancies in the very short term (2008-2011, and onward), and so has reduced the number of abortions. (They may offer rewards to employees who generate more abortions, but they know what sells in the political sphere.)

(Incident​ally, this is a fundamentally dishonest infographic, as they know that only one-half of unintended pregnancies end in abortion, so the increase in abortions, if the initial claim were true to begin with, would be about 7 to 8% more -- not 15%.)

To make their case, they have to run down what many fine people -- like those at #ChoicesPregnancyServices and #WomensChoiceNetwork -- are doing in the pregnancy help centers. So, one Guttmacher piece says, "Antiabortion activists routinely fail to acknowledge that abortion declines can result from fewer unintended pregnancies, and instead pretend that any decline in the number of abortions is the result of women opting, or being compelled, to give birth rather than have an abortion. These activists often seize on declines in the abortion ratio—the proportion of all pregnancies ending in abortion—to showcase the supposed impact of their efforts."

The problem for Planned Parenthood is that the decline in abortion ratios is long-term, and can't be explained by changes in contraceptive media or rates of contraceptive usage. The conclusion of the most recent annual report on abortion from the CDC does not put much stock in the notion that Long-Acting Reversible Contraceptives -- LARCs -- can be credited with the recent decline in abortion ratios. A big increase in the use of the relatively effective LARCs, if there were one, might make PP's case statistically for the recent past -- but the increase would be short-term, while the decline in abortion ratios precedes it by decades.

While, for example, “between 2002 and 2006–2008, the percentage of women who had ever used emergency contraception rose from 4% to 10% (5.2 million)" and "the percentage who had ever used the contraceptive patch rose from 1% to 10% (5.3 million),” (1) “changes in contraceptive method choice and use have not decreased the overall proportion of pregnancies that are unintended between 1995 and 2008 . . ." (2). If unintended pregnancies remained more or less stable, while the ratios of abortions to live births went down, then more women whose pregnancies were unintended must have been choosing life.

Through it all, the ratios went down. Here's the updated graph showing the long-term and short-term pictures.

These bars represent new centers, not just the total of existing ones. The effect of these centers on their communities likely grew over time, after an initial lag. While changes in contraception may be having some impact on unintended pregnancies in the last few years, and indirectly on abortion ratios, the biggest influence over time, and even now, is likely these centers -- and even on women who wouldn't go to one, but just know that they're there.

The Pennsylvania Department of Health released the 2016 Abortion Report just after New Years, 2018, and it is encouraging in every way for people who are troubled by the enormous numbers of abortions performed in the State. It is somewhat troubling for us as an organization devoted to advertising pregnancy medical centers in Allegheny County and the region, for reasons which I will explore below. In any case, we are learning things that will help us keep driving down the numbers of abortions performed in the County.

First, the good news. Here's a chart that shows that the annual numbers of abortions in PA are falling. We thank God! Further, the ratios of abortions to live births continues to fall. What does this mean? The proportion of pregnancies that are "intended" (or, perhaps, welcomed, would be the better adjective) is relatively stable, we are told. Women who abort come almost entirely from the "unintended" category. If the proportion of women who have unintended pregnancies has not changed significantly over the years, then more women with unintended pregnancies are choosing life.
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There is also the possibility that the use of so-called emergency contraception (ella, Plan B) has reduced unintended pregnancies, and thus, abortions. (There is still some dispute about whether these drugs prevent ovulation or interfere with the implantation of newly conceived human beings.) While we may be unsure about how these drugs work in every instance, we know that fewer women are having later surgical and chemical (so-called "medical") abortions.

What about Pittsburgh and Allegheny County? Here we see that abortion numbers, having dropped from 2008 to 2013, seem to have hit a "floor."​

The same is true if we look at the ratios of abortions to 1,000 live births.

So, if Allegheny County's abortion numbers and ratios don't seem to be going down, what do we do next? Well, we note that the gap is large between the total number of abortions performed in Allegheny County, and the number of abortions performed on residents​.

Some, and perhaps all, of the difference is made up of women coming from surrounding counties. In the following chart we divide these counties into two groups, the "First Tier," which includes the closest, and the "Second Tier," which are those farther afield. (These groups were distinct viewing areas in our original television advertising.) The graph below "stacks" the statistics on top of one another. You can see that the farther you get from Pittsburgh, the fewer the abortions (and the fewer the births).

Do the official statistics from these surrounding counties make up the difference between Allegheny County residents and all of the abortions performed here? No. When we add the total number of abortions performed in Allegheny County to the stacked statistics above, we see this.

The chart might lead us to think that a large number of women are coming from beyond the "Second Tier" counties. This, I think, is unlikely. Another possibility is that these women are coming from colleges in the Pittsburgh area, and are not giving their PA counties as their residences. So, for example, State College has 47,000 students, yet Centre County residents officially had only 139 abortions in 2016. Yet, officially too, only 1,667 abortions were performed in all of PA on women from other countries or states that year. These things just don't add up. (It is possible that the residencies are not being recorded properly for one reason or another, which brings into question the accuracy of all of the residency reports.)

In any case, "the fields are white unto harvest" outside of Allegheny County, too. We have begun advertising work with Alpha-Omega in Slippery Rock and New Castle. There are many schools and colleges in their area, and we look forward to seeing the results. There are other centers outside Pittsburgh, too, that are similarly situated. We look forward to breaking new ground, and, with God's help, reducing abortion numbers and ratios in Southwestern PA in the year ahead.

Chris Humphrey, Executive Director
​Vision for Life - Pittsburgh

We are told that users of Facebook give more attention to video ads than to regular photo ads. We have experimented with some variations on photo ads, boosted from our Facebook pages "Pittsburgh Choices," "Choose Together - Pittsburgh," and "Unexpected," using Facebook's "carousel" ad option, and, as I recall, the results in terms of numbers of click-thru's to websites, was positive. Now we are trying our hand at video.

Personally, as a photographer, I much prefer the still image, but as an advertiser, I see the value in video. It's also a lot of fun getting a team together and going out and shooting. The work afterwards in post-processing takes a lot of time -- more than one expects. Telling a story, however, is an enjoyable, creative challenge. Here's a sample, the version for Women's Choice Network.

You can see the video for Choices Pregnancy Services on Youtube at ​https://youtu.be/QZYqTEcQPdk

We have enough raw footage for another two months, and it takes about a week to prepare one 45-second video. The ads are directed to the friends of abortion-vulnerable women in Allegheny County and parts of Beaver County, reasoning that increasing knowledge of the existence of the centers among the 18-28 demographic increases the likelihood that women will tell their friends that the centers exist, if and when they learn of friends' pregnancies. And of course pregnant women thinking about abortion will see it, too.

The ads went up on Monday, December 4, and have been seen by about 4,900 women. 77 of them have clicked on the links to the center's websites, and 95 have watched at least half the video. This is a pretty response, I think, for the two days the ads have been up. We'll see at the end of the month what the totals are.
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For quite some time we have been told that half or more of those getting abortions were poor women, beneath the Federal Poverty Level. It seems that this is not the case. In the online article, "Sex, Contraception, or Abortion: Explaining Class Gaps in Unintended Childbearing," published by the Center on Children and Families at the Brookings Institution, Richard Reeves and Joanna Venator show that women below the Federal Poverty Level (FPL) who conceive unintentionally tend overall to keep their children. Wealthy women do not, but nor do those who are at 200 to 300% of the FPL. Check out the table below.

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​While there were more of these poor women, the great majority - 78% - carried their children to term. Sadly, 9% aborted. Not surprisingly, those at 400+ of the FPL, the wealthy, conceived less frequently, but, if they conceived, they aborted much more frequently: they were 32% of pregnant women who got an abortion, and only 52% carried to term. (The difference between those who aborted and those who carried to term - 16% - must reflect miscarriages.)

​Who are these women? Here's a chart of the Federal Poverty Guidelines for 2017, which should correspond roughly to the FPL for the original study in 2013. These figures reflect total household income.

It is not poverty, per se, which inclines women to abort, but the complications to life -- work, the rearing of other children -- that another child represents. Likely in many cases, the woman is working. This fits with what many women report when asked about why they are seeking an abortion: they have obligations to others that are made more difficult by the addition of another child. Perhaps the loss of a job seems critical. Oddly, those with less money -- 100 - 200% of the FPL -- carry their children to term 75% of the time. And then those in the bracket above -- 300 - 400% of the FPL -- are more able as a group to handle the challenges, and so 86% carry to term. There's something about this group in the middle, among whom less than half carry to term.

​What does this tell us? For one thing, generally speaking, it is not poverty that leads women to abort. The group that resorts to abortion is not poor. So any sentimentality about grinding poverty is off-base, and any attempt to "solve" the problem of abortion by throwing money at it is not going to help.

We don't know how many from this group are coming to pregnancy help centers. If they are, then staff at these centers have their work cut out for them. The commonest problem may be one of morale. Those in this group will not starve if another child is born, but they may have to make sacrifices that they find overwhelming. Their work and family arrangements may have to change in ways that they find drastic. (We know that about 60% of abortion patients have one child or more already.) They may feel that they will be falling behind financially with another child. Issues of morale are best addressed by the truths of faith: staff at the centers can remind these women that God cares for them, for their families, for their situations. It is true, and it may be crucial.

"Are not five sparrows sold for two pennies? And not one of them is forgotten before God. Why, even the hairs of your head are all numbered. Fear not; you are of more value than many sparrows" (Luke 12:6-7).

​God knows our future, and He has it in His hands. Our material situation may change, but the gift of another child, understood properly, is so much more significant to our lives than any material or social challenge we may face.

Vision for Life - Pittsburgh has been running Facebook ad campaigns for three years now. For most of that period, we were generating, on average, 11 calls a month to pregnancy medical centers -- not bad, when you consider that this was not an audience seeking abortions or pregnancy help.

​The numbers began to drop last Spring, however, and I was looking at possible reasons why. ​The most obvious reason was that every young woman on Facebook had seen the ads -- "Don't choose alone" -- and the campaign was simply tired, faded. I read that videos and combined video/slideshow posts were actually much more successful in reaching and engaging viewers, so we have tried our hand at it. When I say "we," I mean a team of volunteers -- Carley Adams, Cassandra Adams, David Adams, David Bodin, Emily Bonessi, Katie Breckenridge, and myself. We have produced two videos. You can see the first video on YouTube.

Here's a graph showing the response so far: over 7,500 have seen the video, and there were 103 unique "link clicks," that is, 103 viewers "clicked through" to the Women's Choice Network website. That's more than 100 young people (70% women), who now know about a pregnancy medical center organization with offices in Oakland, Wexford, Monroeville and the North Side.

About 40% of clients at pregnancy help centers come by word-of-mouth advertising. Jake Barr of iRapture and I are talking regularly about using Facebook to encourage friends to tell friends about local pregnancy medical centers -- in my case, Choices Pregnancy Services and Women's Choice Network. The hope is that people who like our Facebook pages ("Pittsburgh Choices," "Unexpected"), and people who are like those people, will be willing to say something if a friend says that she's pregnant, and she's thinking about abortion. This is a different audience than the pregnant woman herself, but I think it says all the right things to any woman in this age bracket.

​We know that many women feel coerced or forced into abortion -- that they "have no choice." Ironically, it is Planned Parenthood and other abortion industry members that do their best to narrow choices down to abortion: they make money that way, and, no doubt for some counselors/sales people, it is part of justifying their own abortions, or their complicity in the killing. It is the pregnancy medical centers that truthfully describe all the options: raising a child oneself, placing a child for adoption, or aborting the child. Many women feel that they can't manage their situations with another child; often, it is not a matter of serious hardship, but of morale -- everyone around her is telling her to "get rid of it." A woman can be surprised to find out, for example, that she can continue to go to school and have a baby. "Coercion" can be subtle or unmistakable: the leading cause of death for pregnant women is murder. A woman's psychological state in a time of crisis is also a big factor in the question of coercion.

An article on coerced abortion gives us a sense of what women are going through. "The problem of women feeling pressured into unwanted abortions is . . . acute in light of research into the risk of defective decision making in crisis situations.

"Experts on crisis counseling have found that those who are in a state of crisis are increasingly vulnerable to outside influences and have less trust in their own opinions and abilities to make the right decision. Such 'heightened psychological accessibility'[5]can lead to a situation where parents, counselors, or others in authority can have enormous influence over a woman’s decision. 'A relatively minor force, acting for a relatively short time, can switch the whole balance from one side or to the other—to the side of mental health or to the side of ill health.'[6] Persons in crisis 'are less in touch with reality . . . and more vulnerable to change than they are in non-crisis periods.'[7] They often experience feelings of tiredness, lethargy, hopelessness, inadequacy, confusion, anxiety, and disorganization. Thus, they are more likely to stand back and let other people make their decisions for them, instead of protecting themselves from decisions that may not be in their best interests.

"A person who is upset and trapped in a crisis wants to reestablish stability, and is therefore very susceptible to any influence from others who claim to be able to solve the crisis, especially those who have status or authority.[8] Thus, with a minimal effort on the part of a mental health professional, family member, minister, or male partner, an enormous amount of leverage may be exerted upon a woman who is in a crisis situation.[9] This can be a dangerous situation for a woman who doesn’t really want an abortion but has others around her who push for it.

. . . 

​"What women experience as 'pressure' to abort may involve indirect but significant pressure such as withholding love, approval and personal or practical support from the woman unless she agrees to an abortion. Or it may be overt, as in abuse or an outright threat to abandon or expel the woman from her home if she does not abort her child. In many cases, the pressure is applied intentionally by others. In other cases, the “pressure” is not intended, but simply perceived by the woman. For instance, if her boyfriend exhibits an unenthusiastic response to the news that she is pregnant, she may see this as his way of telling her that he will not help to support her or their child."

​The videos we have made may resonate with a well-to-do, educated audience. This is not the group who are having most of the abortions: abortion patients are more often poor, and disproportionately black. They are more likely to feel explicitly pressured to have an abortion. We will be looking to see if we can't produce materials that appeal to this audience as well.​ It will be a challenge to find the right actors, and the right scripts, and to keep the material upbeat enough that it will encourage women to call the pregnancy medical centers, and get past the Facebook censors (who really just care that people enjoy Facebook). Pray for our success, please.

How should Christians respond to Christian women who get pregnant outside of marriage?

​The question no doubt sounds quaint to those who are not Christian, but it's a live issue for those who are. And it's important for those who care about abortion: Amy Scheuring of Women's Choice Network told me about a 2015 survey by CareNet that found that 70% of those who were having abortions were Christians, and 43% were attending church at least once a month at the time of their abortions.

​There is little question that shame is a big driver of abortion. It is an even bigger motivator among people who go to church. So it seems that the best thing you could do to reduce abortions among Christians would be to tell them that there is no shame in having a baby. This was the common pro-life response to Maddi Runkles, the 18-year-old President of the Student Council and officer in the prestigious Key Club at her Christian high school, Heritage Academy. The student with a 4.0 GPA would be seven months pregnant when she walked across the platform to receive her diploma, and the school wasn't having it. Heritage requires its students to sign a pledge to avoid things like alcohol, tobacco, and illegal drugs, and to abstain from sex. “When Maddi chose to breach that Bible standard, a discipline plan had to be established,” Principal Dave Hobbs said. So Maddi had a two-day suspension and was not permitted to receive her diploma publicly. (The young man involved was not a student, and so faced no public consequences, to my knowledge.)
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“'The school has shown students that it would be easier to choose abortion than to choose life,' said Kristan Hawkins, executive director of Students for Life of America. 'Because she chose to carry her child and courageously made that decision, she’s been punished this entire semester for being pregnant, and that’s just wrong.'"

​Ms. Hawkins is probably right, but we can see it from the school's point of view, too: this was not the story of "the woman taken in adultery" (John 8:1-11), who would have been stoned if her accusers had followed the Law of Moses rigorously. (The trap that His adversaries thought they were setting for Jesus was this: on the one hand, He could be accused of ignoring the Torah, the Jewish Law on adultery, if He didn't agree with her stoning, and, on the other hand, if He agreed, He would be going against the Roman law, as only they had the right to put anyone to death.  Jesus avoids His adversaries' trap entirely by throwing the question back at them: "Let him who is without sin, cast the first stone.") So where does this leave us? We are all sinners, it is true, but the school wasn't going to stone Maddi, and it had to maintain discipline. If it ignored its own rules, everyone would see that the administration wasn't serious about abstinence as the goal.

​Pre-marital sex is a common phenomenon, in permissive and in rigorous times. In Abortion Rites: A Social History of Abortion in America, Marvin Olasky estimates that about 30% of American colonial marriages were "shot-gun," that is, the young woman was pregnant and the bride's family forced the issue.) We must recognize the realities here: the God-given drive for sex is a good thing, but it can find its full expression only properly in marriage. Many of us will fail, but that is no reason to abandon the goal, for those who have "fallen" and those who have not. If discipline is necessary, it is still true that none of us is without sin: shame attaches to public things, but the most offensive things to God may be hidden in our hearts. There is no ground for us to pass judgment on others. And women today who don't succumb to shame and abort their babies are oftentimes the courageous and honorable ones.

​We (Christians, churches) need to say loud and clear that a baby is no reason for shame. We can and should control our sexual behavior; that's the goal. If the discipline of those who fail is necessary for the sake of other young women and men, then let it be as discreet as possible, and only as obvious as necessary. (Remember Joseph, who, when he learned that Mary was pregnant, "not willing to make her a public example, resolved to put her away privately.") We Christians need to say publicly that, if any of us fails to be chaste, he or she can repent; there is forgiveness, and we can start again.

The mock-ups for ads here make similar points, as simply as we can in a few words, without sacrificing our Christian sexual ethic, our humility as sinners too, or our deep desire that women love the children they carry, no matter the situations in which they are conceived.

You may not know, but the shock troops from Planned Parenthood and their (paid) supporters have been out in force in Pittsburgh recently. Amy Scheuring, Executive Director of Women’s Choice Network, sums up what happened:

​“On Monday [July 17], two young actors from the New York City area posed as a nervous client couple seeking a pregnancy test at our Monroeville location. These fake clients gave a convincing performance (complete with tears and hugs!) and our team lovingly served them according to our normal medical policies and procedures. But their visit was a “reconnaissance mission” fueled by an agenda to discredit our work. Grabbing literature on the way out the door, this young man and women were part of an orchestrated ambush that would unfold over the next 24 hours.

​“On Tuesday afternoon our North Side Center staff observed a group of protesters blocking our entrance and storefront. The group was led by Lizz Winstead, a nationally known comedienne and activist. A camera crew and observer were filming the event. About 10 people dressed in medical scrubs chanted slogans included 'God hates fake clinics' and 'CPCs hurt women.' Our first response was to email our prayer partners to pray for us. Then the police were notified and the officers cleared the entrance so that our scheduled clients could enter. Early in the protest, the fake client couple was called upon to recount their experience. That’s when we realized the full impact of this smear campaign. The false accusations that followed were almost too numerous to count.”

Some time ago I remember reading about a study of women who had been refused abortions, and had gone on to bear their children. It was fascinating. A significant proportion did not even remember seeking an abortion. You would think that, if they had been frustrated in their search for an abortion, they would have been angry about it, and remember; most of us do remember the situations where we didn't get what we want, and it was serious. Yet they had forgotten entirely. They were happy with their babies, and that's all there was to it.

Amy Scheuring, of Women's Choice Network, observed that one client completely mis-remembered how things had gone when she came to them. There had been a high level of drama -- raised voices and lots of tension -- as this young woman wrestled with the decision whether to have an abortion or a baby. When this girl recounted the story later, however, it was as though abortion had never really been an option. What?!

Recently, we ran a Facebook ad for Choices Pregnancy Services of Coraopolis (just outside the City of Pittsburgh) on Choices' Facebook page. It invited women who had been clients of Choices to write stories about how they came to Choices, what they were facing in their lives, how they were treated, and how they decided to have their babies. 

The ad had the obvious audience, but it had other ones, too: women who were thinking about having an abortion, and people who didn't know what they thought about pregnancy help centers, or thought that pregnancy help centers treat women badly. Pregnancy help centers do a lot of good, but it's not widely recognized.

So, as advertising, I don't think it was a complete loss when we got no responses. Yep: zero. Perhaps no woman who used Choices services saw the ad: 7,100 is not a lot of women in an area like ours. Or, perhaps the few women who had their babies because of Choices and saw the ad had forgotten entirely the role that Choices played in their lives. That would be no surprise.

"Dissociation" is the psychological process by which a person puts distance between himself and something unpleasant that he has experienced. We see it with sexual abuse victims, who may have an "out-of-body" experience while the abuse is taking place, and cannot remember the abuse itself afterwards. There is something deeply unnatural about abortion, and it is no surprise that some women "put it out of their minds" afterwards. There is often a hardening of their hearts afterwards, however. They can't look at babies without irritation, they are more remote from those close to them, and so forth.

Many of the fiercest pro-choice people appear to care too much. They don't seem to be defending an abstract right, but what they have done themselves; if they let up in their cool anger about "pro-lifers" for a second, the facade might collapse. Some women can't hide from the past, and they are broken up by what they have done. Thank God that there are ministries where they can, and often do, find forgiveness and healing! (Broken Vessels and Rachel's Vineyard are two in our area.)

So our advertising was an experiment which failed overall. Still we have learned something. It has confirmed something more general that I have thought for a while: no one likes to think about abortion.