The claim that the widespread promotion of contraception reduces the incidence of abortion is a good one. Its basic logic — that because abortions are the result of unplanned pregnancies, contraception, by reducing unplanned pregnancies, reduces abortions — is reasonable and lucid.
But it’s not true.
An honest look at the data shows that in virtually every country that increased the use of contraception, there was a simultaneous increase in the abortion rate. In England (Rise in contraceptive use: simultaneous rise in abortions), France (Rise in contraceptive use: simultaneous rise in abortions), Australia, (Rise in contraceptive use: simultaneous rise in abortions), Portugal (Whose abortion rate only began to rise after 1999, after oral contraceptive methods were made widely available), Canada (Whose abortion rate only began to rise after the legalization of oral contraceptives in 1969), Singapore, Cuba, Denmark, the Netherlands, and South Korea – to name a few.That these countries have periodically seen the abortion rate reduced by the use of contraception is good, but it must be taken with a firm grasp of the overall picture: These countries have never seen the abortion rate reduced to its place before the introduction and widespread use of contraception. It is no victory of contraception that it partially reduces a problem it created in the first place.
But before we address why the introduction of contraception to a country is usually simultaneous with a rise in abortion, we need to address the Guttmacher Institute.
The Guttmacher Institute — previously the research arm of Planned Parenthood, now a recipient of their annual donations — is the authoritative source for the claim that contraception is not associated with increased abortion rates. Their study “Relationships Between Contraception and Abortion: A Review of the Evidence” determined that contraception reduces abortion rates, and in countries where it doesn’t, “after fertility levels stabilized…contraceptive use continued to increase and abortion rates fell.” This implies that contraception will eventually reduce the abortion rate in those countries as well.
Here’s the problem. 4 of the 7 countries the The Guttmacher Institute cites to make the claim that contraception reduces overall abortion rates are ex-communist countries: Kazakhstan, Kyrgyz Republic, Uzbekistan, and Bulgaria.
At the time contraception became widely used, the abortion culture in these countries was radically different from the abortion culture of the rest of the world. In a 2002 article published in Studies in Family Planning, the point is made that in the Soviet Union “soon after it was re-legalized in 1955, abortion became the main form of birth control, available on request and free of charge (Popov 1991; Remennick 1991). Little ideological or moral opposition to abortion existed.” This cannot be said of the vast majority of countries.
The fact that the introduction of contraception lowered the abortion rate in these countries — while laudable — can not be used as evidence to make the blanket claim that “contraception reduces abortion rates.” Rather, it seems that the introduction of contraception helped to reduce abortion rates in certain countries in which abortion was already regarded as a moral form of contraception, a view restricted almost entirely to communist and ex-communist states. The introduction of contraception, by reducing the overall number of conceptions, created a society in which there were far fewer children to abort. It did not do away with abortion, it simply aided it in achieving its end. (And quite successfully, as most of these countries are now experiencing drastic population decline.) Thus, despite initial reductions, these communist and ex-communist countries still have some of the highest abortion rates in the world. Contraception has not made abortion any less of a cultural need.
So, given that the Guttmacher Institute primarily use ex-communist countries as evidence, perhaps it would be wise to change the bold claim that “contraception reduces abortion rates” to “contraception reduces abortion rates primarily in countries who already view abortion as a moral or amoral means of family planning.” But even this (considerably less hopeful) statement isn’t precisely true.
It is not always the case that contraception lowers the abortion rate, even in countries with an “abortion culture”.
The organization Family Health International often cites the fact that “the world’s lowest abortion rates are recorded in Belgium and the Netherlands, where contraception is used extensively, while the highest rates are found in Cuba and Vietnam, where clients have access to a limited range of contraceptive methods”, as evidence for contraception’s abortion-reducing effects. A closer look at Cuba and Vietnam shows the same ignored problem.
In the article “The Persistence of Induced Abortion in Cuba: Exploring the Notion of an “Abortion Culture”” published in Studies in Family Planning, it was shown that in Cuba, like in other communist or ex-communist societies, “abortion is seen as a reasonable fertility-control option by itself, not just in cases of contraceptive failure or unprotected sexual intercourse that results in pregnancy.”
It is suggested that the reason for Cuba’s high abortion rate is that Cuba does not have enough access to contraception. If there is truth to this, it is not the whole truth. Cuba has greater access to contraception than many countries with lower abortion rates, with approximately 73% of sexually active women “currently using” contraception. The issue is actually threefold. First, there exists in Cuba that “abortion culture”, a culture that views abortion as amoral — or at the very least morally relative — and thus merely as another means of contraception. Widespread poverty is described as a major driving factor in Cuba’s high abortion rate. Finally, there is a greater concern about the side-effects, health risks and the actual use-effectiveness of contraception in Cuba than in other countries, so while contraception is used, it is often used sporadically.
Once again, the “abortion culture” matters, but is ignored in favor of easy answers. (The same article lists Vietnam as a country considered to have an “abortion culture”, similar in its post-communist status to Cuba and the Soviet Union.) We must again replace the confident phrase, “contraception reduces abortion rates”, with something like “contraception reduces abortion rates primarily in countries who already view abortion as an amoral means of family planning, providing these countries have no fear of the health risks and side effects of contraception.” (A fear which will probably persist as long as the Pill continues to increase a woman’s risk of breast cancer, cervical cancer, and HIV infection, and a man’s risk of prostate cancer.)
To recap: Excepting countries with an already ingrained culture of abortion, the introduction of contraception to a country is associated with a simultaneous increase in abortions, an increase which tends to level and experience periodical decreases thanks to the improved use and availability of contraception, but which never decreases back to where it was before contraception was introduced to that country.
Funnily enough, this was seen in Turkey, one of the three countries the Guttmacher Institute cites to support their claims without an “abortion culture”. In the study The Role of Contraceptive Changes in the Decline of Induced Abortion in Turkey – which Guttmacher cites – it is shown that in 1983, when contraception laws were liberalized, abortion ended 12.1% of all pregnancies. As contraceptive used increased, the abortion rate increased, until 1988, when abortion ended 23.6% of pregnancies. Thanks to the improved use and availability of contraception, the rate then began to decrease, until, by 1998, abortion ended 15.7% of all pregnancies. Here the abortion rate dipped, rose, and leveled, and by 2007, abortion ended 17.0% of all pregnancies in Turkey. The Guttmacher Institute see this as evidence of the success of contraception in reducing abortions. We see it as evidence of the success of contraception in increasing abortions.
Obviously, more extensive research is needed, but the bold claim that contraception reduces abortion rates just doesn’t seem to hold up to the light of day. But surely — one might ask — it’s best to promote and use contraception, now that there is this increase? Isn’t some reduction better than none, even if contraception never causes the abortion rate to go down to where it was before contraception was ever popularized?
It’s important to recognize that, while contraception has been a factor in many of the relative decreases in abortion around the world, it is as often a factor in relative increases around the world.
In the 2011 study Trends in the use of contraceptive methods and voluntary interruption of pregnancy in the Spanish population during 1997-2007, surveys of about 2,000 Spanish women aged 15 to 49 were taken every two years from 1997 to 2007. Over this period of time, the number of women using artificial contraceptives increased by about 60%. In the exact same period, Spain’s abortion rate more than doubled, from 5.52 per 1,000 women to 11.49.
Similar results can be found in England. The government implemented their Teenage Pregnancy Strategy in 1995, spending over $454 million promoting the use of contraception. Teenage pregnancies and subsequent abortions continued to increase.
Here in the United States, according to The National Center for Chronic Disease Prevention and Health Promotion, the majority of women undergoing abortion were using some form of contraception when they conceived, with 55-60% of women who undergo abortion “reported that they “currently used” contraception during the month of their last menstrual period.”
So we come to the vital question: Why? Why would contraception create a need for abortion?
It’s very simple: According to Guttmacher Institute researcher Stanley K. Henshaw, “contraceptive users appear to have been more motivated to prevent births than were nonusers.” The use of contraception seeks to avoid pregnancy while still performing the act of sex. When contraception fails, and a new life results from that act, there is an immediate difficulty: The couple would have to, by courage and strength, avoid continuing the mentality by which they practiced contraception — that a new child is to be avoided — into the mentality with which they view the actual, living, new child in the womb. I have no doubt it can be done, but not without difficulty, and where there is difficulty, people fail.
This, after all, is the very reason why abortion is legal in the United States. In the Supreme Court case Planned Parenthood vs. Casey, which confirmed the legalization of abortion, it was stated that:
- [I]n some critical respects, the abortion decision is of the same character as the decision to use contraception[...]For two decades of economic and social developments, [people] have organized intimate relationships and made choices that define their views of themselves and their places in society, in reliance on the availability of abortion in the event that contraception should fail.
The message is clear: Because we have come to use contraception, we have come to need abortion. Luckily for the entire world, and all the babies, medical science has made it possible to effectively practice family planning without the use of contraception. It’s called fertility awareness, and it’s all sort of awesome.