By Emily Hoofnagle, Columnist
Two months ago, a Texas law and the Supreme Court’s refusal to rule on its constitutionality before September 1 curtailed the abortion rights of millions of Texas residents. The Supreme Court will hear challenges to the Texas Heartbeat Act and Mississippi’s Gestational Age Act within the next couple of months, leaving the fate of Roe v. Wade hanging by a thread.
The worst-case scenario for those requiring abortion services may become a reality next year. The precariousness of reproductive rights makes it all the more necessary for serious discussion of the abortion issue. One debate on this topic concerns what policies can actually reduce the abortion rate. In analyzing states that have passed abortion laws and countries that have outlawed abortion in the past decade, the evidence suggests that restrictions are not effective in curbing abortion rates and may only succeed in harming an individual’s health. Meanwhile, the best policy to reduce abortion rates is ensuring the widespread availability of contraceptives.
Theoretically, governments pass new policies to address current public problems. However, the U.S. abortion rate is at its lowest level since the Roe decision. The Guttmacher Institute, a non-profit that helps adolescents access abortion services, found that new abortion restrictions do not appear to drive the decline in abortions, as 57% of the decrease happened in 18 states that have not passed new restrictions. In four states that enacted restrictions, the abortion rate increased. Among the six states with only one abortion clinic left, most have experienced slight declines in the abortion rate that mirrors declines in the rest of the U.S. The outcomes of abortion laws are hard to determine due to multiple factors, but they appear to inflict a slight decrease in abortion rates at most.
Globally, abortion rates are estimated to be similar in countries with restricted abortion access and countries where abortion is legal. In countries that restrict abortion, the abortion rate has increased to 50% of unintended pregnancies, whereas abortion and unintended pregnancy rates in “pro-choice” countries have declined. For example, Switzerland, a country with legalized abortion, simultaneously has the lowest abortion rate in the world. According to research that has examined national abortion rates by how much a country restricts abortion, the rates in countries where abortion is “broadly legal” or “prohibited altogether” are about the same, at 40 abortions per 1,000 pregnancies.
There are health and financial setbacks for individuals unable to get abortions. In the Turnaway Study — which compared the outcomes of women who received abortions and those who were denied abortion care — women who had to carry their pregnancies to full term suffered a temporary decline in mental health, “a 78% spike in debt, and an 81% increase in bankruptcy, evictions, and tax liens.” Additionally, women denied abortions were four times more likely to be impoverished and three times more likely to be unemployed. On the other hand, women who received abortions experienced no mental health regression, debunking the myth that women generally regret abortions. They felt stronger maternal bonds to the children they chose to have compared to women denied the right to an abortion.
Making abortions illegal does not lower the abortions rate much, if at all, but it does make abortions unsafe. Complications from unsafe abortions make up between 4.7% and 13.2% of maternal deaths worldwide. Abortions injuries include hemorrhages, infections, uterine perforations (damage to the uterus), and internal organ damage.
So, what actually reduces the abortion rate? The evidence remains strong that easy access to birth control reduces unwanted pregnancies and abortion substantially. A recent Washington University in St. Louis study found that offering free birth control lowered unplanned pregnancy and abortion rates between 62% and 78%. In addition, the Guttmacher Institute found that a spike in the use of long-acting reversible contraceptives (LARCs), including a tripling of IUD use from 2007-2012, could best explain the drop in unplanned pregnancies between 2008-2011. Since LARCs are implants that can last up to 12 years, people do not have to remember to use this birth control method every time they need it. This recent evidence matches the conclusions of research on the drop in teen pregnancies in the early 2000s: 86% of the decline was due to increased contraceptive use among adolescents.
Based on the scientific evidence, anti-abortion activists should focus their efforts on improving access to contraceptives, not on restricting abortion access, if they wish to be successful in their ultimate goal of reducing incidences of abortion.