In case there was any doubt, let’s get one thing clear. If Brett Kavanaugh ends up on the Supreme Court—and, as Katha Pollitt wrote, he won’t get there without a political fight—he will vote to overturn Roe v. Wade and deny women the guarantee of reproductive rights they currently enjoy. That’s not a possibility or even a probability, it’s a fact. Kavanaugh wouldn’t have been on the Federalist Society’s magic list of nominees acceptable to the right if they weren’t absolutely sure of that, something the WaPo’s Jennifer Rubin explained in a column aimed at supposedly pro-choice Sen. Susan Collins (R-ME).
So we know that Republicans want to take away women’s reproductive rights. They say it’s because they want to stop abortions. But here’s the thing: we already know how to do that, and the evidence shows that changing the laws and subjecting women to much greater risk in order to get the abortions they are going to get either way isn’t going to be particularly effective.
First, let’s talk about individual states. Many states have since 2010 passed laws that seek to restrict access to abortion. An Associated Press report compared data from 2010 and 2014 drawn from all 45 states where numbers on abortion are comprehensively collected (California, Maryland, New Jersey, New Hampshire and Wyoming do not compile such data). Which states saw the biggest drop?:
Five of the six states with the biggest declines — Hawaii at 30 percent, New Mexico at 24 percent, Nevada and Rhode Island at 22 percent, Connecticut at 21 percent — have passed no recent laws to restrict abortion clinics or providers.
Know what else those five states have in common? They all accepted the Obamacare expansion of Medicaid, which took effect on January 1, 2014, thus increasing access to contraception after that date. Then-president of Planned Parenthood, Cecile Richards, further explained: “Better access to birth control and sex education are the biggest factors in reducing unintended pregnancies. More restrictive abortion laws do not reduce the need for abortions.”
Another report, this one from the Guttmacher Institute, examined similar data from 2011 to 2014 and likewise “did not find a clear and consistent relationship between state restrictions and changes in state abortion rates.” Here’s state by state data from 2010 to 2014 compiled by the Kaiser Family Foundation.
Overall, the rate of abortion has declined in virtually every state since Obamacare came into effect. That law guaranteed all women access to contraception without a co-pay, except those who work for houses of worship. Thanks to the Hobby Lobby decision, that guarantee has been significantly more restricted for women whose employers object to contraception on religious grounds and, potentially, could be even more restricted by the Trump Administration’s October 2017 executive order expanding employers’ ability to object, which is currently on hold thanks to injunctions issued by two separate judges. On a related note, the national abortion rate has been halved since peaking in 1980-81, and is now lower than the rate that existed before Roe v. Wade was decided in 1973.
More broadly, Mr. Popular Vote Loser and his likeminded minions have sought to make it harder for women to get contraception as part of their broader efforts to restrict women’s reproductive rights. Trump’s proposed changes to Title X funding, in addition to possibly crippling the fight against sexually transmitted diseases (STD)—the occurrence of which has spiked recently—would also have a major impact on access to contraception. Dr. Vivek Murthy, U.S. Surgeon General under President Obama, and Dr. Alice Chen wrote:
First, in an abrupt break from current policy, [the proposed change to Title X] eliminates the emphasis on ensuring women have access to the full range of contraception methods approved by the Food and Drug Administration. Instead, it opens the door to shifting funds to organizations that exclusively provide and educate about abstinence-only and other less effective strategies for family planning.
[snip] Title X has been a driving force behind increasing contraception availability, giving generations of women the freedom to plan their pregnancies as they pursue family, education and career goals. Today, the rate of unintended pregnancy in our country is at a 30-year low. The rate of pregnancy among teens is at an all-time low.
The Trump administration’s proposed rules take a step backward and threaten this progress.
Regarding those non-evidence based, abstinence-only programs, here’s what they actually accomplish:
States that emphasize abstinence-only programs have the highest rates of teen pregnancy and teen birth. And while research also shows that students who go through abstinence-only programs or take virginity pledges appear to have fewer sexual partners and be sexually active for less time, they still have the same rates of STD infection as their non-pledging peers ― possibly because they are less likely to use condoms at first, or get tested for STDs.
The Trump Administration also tried to cancel the Teen Pregnancy Prevention Program, begun under Obama—which was reason enough for Mr. 46% of the Popular Vote to get rid of it. Never mind that it worked, helping to bring the U.S. teen pregnancy rate to a new low, and had bipartisan support, at least before Trump came along. His political appointees—like long time abstinence-only advocate Valerie Huber—pushed through the cancellation over the objections of career staffers at the Department of Health and Human Services. As of now, however, the funding for TPPP grantees continues to flow, but only because of a court ruling stopping Trump from cancelling it. For now.
Why does Donald Trump want to increase the rate of teen pregnancy, and unintended pregnancies overall—increases that will surely lead to more of the abortions he and his fellow right-wing Republicans say they want to prevent? And, to be clear, it’s not about whether abortion is right or wrong, it’s about whether it’s a good idea to promote policies that prevent unintended pregnancies. It’s also about whether Republicans actually care about improving the lives of women and their families.
Looking beyond the U.S., the Guttmacher Institute examined worldwide data and similarly found that restricting abortion rights does not reduce the abortion rate:
- Abortion rates are similar in countries where abortion is highly restricted and where it is broadly legal. The abortion rate is 37 per 1,000 women in countries that prohibit abortion altogether or allow it only to save a woman’s life, and 34 per 1,000 in countries that allow abortion without restriction as to reason—a difference that is not significant.
- High levels of unmet need for contraception and of unintended pregnancy help explain the high levels of abortion in countries with restrictive abortion laws.
The abortion rate is down dramatically across the globe over the past 25 years, but the one place where it has dropped the most is Eastern Europe. Why?
Across all world subregions, Eastern Europe experienced the largest decline in its abortion rate, from 88 per 1,000 in 1990–1994 to 42 per 1,000 in 2010–2014, which corresponded with an increase in access to modern contraceptives following the dissolution of the Soviet Union.
Last, but far from least, although this post has focused on how restricting abortion rights does not appear to reduce the rate of abortion, the Guttmacher report also reminds us of what restricting access to abortion and contraception does to women—a moral outrage to say the least:
- Complications from unsafe abortions are still common in developing regions where abortion remains highly restricted. Estimates for 2012 indicate that 6.9 million women in these regions (excluding Eastern Asia) were treated for complications from unsafe abortions, corresponding to an annual rate of approximately seven women treated per 1,000 women aged 15–44. However, estimates (based on a 14-country sample) suggest that, on average, 40% of women who experience complications never receive treatment.
- According to recent estimates, at least 8% of maternal deaths worldwide are from unsafe abortion; at least 22,800 women die each year from complications of unsafe abortion.
- Almost all abortion-related deaths occur in developing countries, with the highest number occurring in Africa.
I’m sick of hearing about what Republicans believe. Let’s focus on what they actually do, and its impact on Americans. If they really want to reduce the number of abortions, let’s see them take the steps we know will work, and which promote women’s freedom by preventing unwanted pregnancies. Under the Trump Administration thus far, they’ve done the exact opposite. It appears conservatives would rather force women to risk their health, and even their lives, in order to control their own bodies.
Ian Reifowitz is the author of Obama’s America: A Transformative Vision of Our National Identity (Potomac Books).