"So the people shouted, and the trumpets were blown. As soon as the people heard the sound of the trumpet, the people raised a great shout, and the wall fell down flat, so that the people went up...and they took the city."-Joshua 6:1-27

Monday, May 28, 2012

Less is more

How has access to contraception and abortion altered the way people think about sex and pregnancy? And in what ways has the availability of abortion changed the way people think about and use contraception?

The most common methods of contraception are barrier methods such as condoms and diaphragms, hormonal contraceptives such as the pill, the patch, and intrauterine devices (IUDs), as well as spermicides and sterilization. Nearly 40 percent of the most common contraceptives are abortifacients. These include IUDs, the pill, the patch, and emergency contraception. All act to prevent implantation onto the uterine wall of some fertilized eggs, distinct human beings. Contraceptives are widely and cheaply available throughout the United States. The government has subsidized contraceptives for low-income women for more than 50 years, through programs such as Medicaid and Title X...

Among sexually active Americans who do not use contraception, only a small percentage fails to do so because of lack of access to contraceptives. In a 2001 study, the Guttmacher Institute (GI), a public policy organization that analyzes reproductive trends, surveyed 10,000 women who had abortions. Of those who were not using contraception at the time they conceived, 2 percent said they did not know where to obtain contraception, and 8 percent said they could not afford it. 

Despite the pervasiveness of contraception, nearly half of pregnancies among American women are unintended, and four in 10 of those end in abortion, according to GI and the CDC. Part of the problem is contraceptive failure—all methods sometimes fail to prevent pregnancy. 

But a more significant problem is that most sexually active people who use contraception use it inconsistently. According to a GI study, a majority of women (54 percent) who had abortions used a contraceptive method (usually a condom or the pill) during the month they became pregnant. Another GI analysis found that nearly half of women seeking to avoid pregnancy had periods of nonuse of birth control (15 percent) or used their method inconsistently or incorrectly (27 percent). 

Erratic contraceptive use is often rooted in ambivalence about pregnancy. Another GI study found that nearly one in four women who were not trying to become pregnant said they would be very pleased if they found out they were pregnant.

...As Rachel Jones, a GI senior research associate, put it to the New York Times, “[T]he high rate of unwed pregnancy and abortion among poor women is a sign of ambivalence. They are torn between the desire to have a baby and the realization that it would be hard to bring up a child as a single mother.” 

Reproductive decision-making is complicated further by the availability of induced abortion. Statistics suggest that though it is marketed as a method of birth control used only when other measures fail, abortion has become a method of birth control used in place of other measures. 

Few people would admit to using abortion as birth control, but the evidence is in the data. After Roe v. Wade, the US Supreme Court’s 1973 decision legalizing abortion nationally, pregnancies grew by 30 percent even as births decreased by 6 percent. After Roe, which suddenly made abortion much easier to obtain, many Americans began using contraceptives less consistently. 

The results are seen in the number of women who have multiple abortions. Consider that of the more than 1.3 million women who obtained abortions in 2001, about half (650,000 women) had had at least one previous abortion. About a quarter (325,000 women) had obtained at least two previous abortions. And roughly 15 percent (195,000 women) had already obtained at least three abortions. 

Those numbers haven’t changed all that much. Of the 1.21 million abortions performed in 2008, half were performed on women who had already had at least one abortion. These disturbing statistics highlight the moral hazard of abortion. The wide availability of abortion diminishes the expected cost of sexual intercourse, because the pregnancy can be aborted in the event of unwanted conception, thus avoiding many of the costs associated with unwanted pregnancy. 

So, by giving men and women a relatively safe and inexpensive way to eliminate the unintended outcome of risky sexual behavior, liberal abortion laws encourage more and riskier sexual behavior. In other words, the wide availability of abortion discourages people from using contraceptives

...In 1979, Malcolm Potts, former medical director of the International Planned Parenthood Federation, predicted, “as people turn to contraception, there will be a rise, not a fall, in the abortion rate.” 

A couple that uses contraception establishes a “contraceptive mindset,” so that even if a child is conceived that child is unintended and thus unwelcome. The US Supreme Court came close to acknowledging this idea in its 1992 decision upholding the right to abortion. In Planned Parenthood v. Casey, the court stated, “In some critical respects abortion 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.”

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