The One Lever On The Abortion Rate

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Let’s talk for a moment about contraception.

Contraception has a massive number of positive uses, and is used as a primary method of treating a dozen medical conditions, including as preventive treatment for ovarian and breast cancer. The idea that health insurance providers can elect to stop covering it is a cheap attempt to score political points by denying potentially millions access to readily available medicine that they need.

But decreasing the availability of contraception has another substantial proven effect, and it’s one that directly implicates the culture war the administration is trying to fight.

The World Health Organization comprehensively updated its worldwide abortion statistics most recently in 2016, in a peer-reviewed study published in Lancet. The abortion rate worldwide has continued to decrease over the last 25 years, but the article’s breakdown by geographical region are telling.

Indeed, the conclusions of the article are easily illustrated by the example of Latin America. Not only is Latin America’s abortion rate over double that of North America’s, it has clearly ticked up in the last 25 years, one of the few regions in the world where this is true.

Abortion rates by region
Estimated abortion rates per 1000 women 15–44 years old, by geographic area and time period. Table 1 in the Lancet study.

You might assume that this is because of the liberalization of abortion laws in Latin America as countries develop economically and socially, but the exact opposite is true. South America has some of the most restrictive abortion laws in the world, with such rising world powers as Brazil, Argentina, Mexico, and Chile having functional bans on abortion. (Chile, in particular, has no exceptions for rape, incest, or to save the life of the mother.)

In fact, other than Puerto Rico, only three small countries in Latin America allow access to elective abortions: Guyana, Cuba (with parental notification required), and Uruguay (with parental notification required).

And yet, Latin America’s abortion rate is now the highest in the world, higher as a whole than any subregion of Africa, Asia, or Europe.

Why? The study does break down worldwide numbers on abortion rates and notes that this is actually true worldwide: countries that broadly prohibit abortions or only allow them to save the life of the mother, in the aggregate, have a higher abortion rate than countries that broadly allow abortions.

lawtable
Abortion rate per 1000 women aged 15–44, by grounds under which abortion is legally allowed, 2010–14. Table 4 in the Lancet study.

The study, in the end, concludes that access to affordable contraception is the only factor that has a substantial effect on the abortion rate, INCLUDING restrictive abortion laws. (My reading, at least, of the underlying data indicate that such laws might actually lead to a slight increase in the abortion rate, but it’s probably not sufficiently statistically significant to conclude that.)

In sum, this administration has pulled the only lever that has been demonstrated to increase the abortion rate, and any further restrictions on abortion itself, including the irresponsible 20-week ban winding its way through Congress, are unlikely to actually deliver results in the other direction.

And indeed, if the pro-life movement were serious about minimizing the abortion rate, this reversal on contraceptives should be both alarming to them and a call to action against this administration that claims to be on their side.

I’m not holding my breath.

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