BY MARC BARNES
The claim that the widespread promotion of contraception is pro-life is by no means a bad one. Mary Krane Derr, in her well-researched contribution to the Life Matters Journal entitled "Family Planning Freedom is Pro-Life," argues precisely this. The underlying idea -- that because abortions are the result of unplanned pregnancies, contraception, by reducing unplanned pregnancies, reduces abortions -- is reasonable, understandable, and lucid. And although I wish I didn't, I disagree. The statistics and anecdotes cited by Derr in defense of her argument do not present an accurate picture of the relationship between contraception and abortion.
Derr claims that birth control prevents 112.3 million abortions a year. This is, in one sense, true. If conception is prevented by contraception, then there is no child to abort.
But in order for this to matter, or to be some sort of check-mark on the side of contraception, contraception cannot have created a need for abortion in the first place. If contraception does create that need for abortion, and by its introduction into society increase abortion rates, then it is no victory that it partially reduces the problem it created.
An honest look at the data shows this to be the case. In virtually every country that accepted the widespread use of contraception -- usually by the late 1960s and the 1970s -- there was a simultaneous increase in the abortion rate over the same time. In England (FPA, 2007; Rogers, 2012), Australia (Caldwell and Ware, 1973; Johnston, 2012), Canada (Women's Health Surveillance Report; Johnston, 2012), Singapore, Cuba, Denmark, the Netherlands, and South Korea, to name a few (Marston and Cleland, 2003).
That these countries have periodically seen the abortion rate reduced by the use of contraception is good, but it must be considered in the overall context. These countries have never seen the abortion rate reduced to its place before the introduction and widespread use of contraception. Again, it is no victory of contraception if it partially reduces a problem that it created in the first place.
Photo courtesy of braints the head on flickr; some rights reserved.
Derr does not mention these countries. She mentions the few countries that saw a decrease in their abortion rates simultaneous with the increased use of contraception. But even if we were to ignore the previously mentioned countries that saw an increase in abortion rates simultaneous with increases in contraception, there would still be precious little evidence to support the blanket claim that contraception lowers abortion rates.
Most of the countries that saw a decrease in abortion rates simultaneous with the introduction of contraception were communist countries. In fact, 4 of the 7 countries The Guttmacher Institute cites to make the claim that contraception reduces overall abortion rates (a claim restated by Family Health International, who Derr cites) are ex-communist countries: Kazakhstan, Kyrgyz Republic, Uzbekistan, and Bulgaria.
This is precisely the problem that Derr does not take into account. 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 the article "Is 'abortion culture' fading in the former Soviet Union? Views about abortion and contraception in Kazakhstan," published in 2002 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" (Agadjanian, 2002). 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 excellent -- can not be used as evidence to make the blanket claim, as Derr does, that "family planning measurably 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. 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 aids it in achieving its end (and quite successfully, as most of these countries are now experiencing drastic population decline [Jackson, 2011]). 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.
Perhaps it would be wise to change the bold claim that "family planning measurably reduces abortion rates" to "family planning measurably reduces abortion rates in countries that 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. 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."
Derr suggests 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 threefold. First, there exists in Cuba an "abortion culture," a culture that views abortion as amoral -- or at the very least morally relative -- and thus merely as another means of contraception. Secondly, poverty is described as a major contributor to the Cuban abortion rate. Finally, there is a greater concern about the side-effects, health risks and the actual use-effectiveness of contraception, so while contraception is used, it is often used sporadically.
We must add to our previous rewrite: "Family planning measurably reduces abortion rates in countries who already view abortion as an amoral means of family planning, providing those countries have no fear of the health risks and side effects of contraception."
While I can find no specific studies pertaining to the abortion culture in Vietnam -- a country whose high abortion rate is claimed by Derr to result from a lack of family planning freedom -- the same article does list it as a country considered to have an "abortion culture" similar in its post-communist status to Cuba and the Soviet Union (Belanger and Flynn, 2009).
My point is simply that claiming these countries as evidence of the pro-life, abortion-reducing nature of contraception is a weak argument.
Outside of the narrow parameters set by Derr, contraception does create a need for abortion. 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 "report[ing] that they 'currently used' contraception during the month of their last menstrual period." More importantly, according to Guttmacher Institute researcher Stanley K. Henshaw, "contraceptive users appear to have been more motivated to prevent births than were nonusers."
Contraception, as far as I can tell, is not pro-life.
"Contraception: patterns of use factsheet" FPA. Fpa.org. November 2007. Web. September 2012
Rogers, Simon. "Abortion statistics for England and Wales: see the latest breakdown" The Guardian. Guardian.co.uk. 29 May 2012. Web. September 2012
Caldwell, J.C. and Ware, H. "The evolution of family planning in Australia". Population Studies: A Journal of Demography. Tandfonline.com. 1973. Web. Sept 2012.
Johnston, Robert. "Historical abortion statistics, Australia". Johnston's Archive. 11 March 2012. Web. September 2012.
"Women's Health Surveillance Report" Public Health Agency of Canada. phac-aspc.gc.ca. n.d. Web. September 2012
Johnston, Robert. "Historical abortion statistics, Canada". Johnston's Archive. 11 March 2012. Web. September 2012.
Marston, Cicely and Cleland, John. "Relationships Between Contraception and Abortion: A Review of the Evidence" International Family Planning Perspectives. Guttmacher.org. March 2003. Web. September 2012
Agadjanian, Victor. "Is 'abortion culture' fading in the former Soviet Union? Views about abortion and contraception in Kazakhstan." Studies in Family Planning. Highbeam Business. September 1, 2002. Web. September 2012.
Jackson, Joe. "Nobody Home: The Countries Where Population Is on the Decline" Time Specials. Time.com. Oct. 26, 2011 Web. September 2012.
Belanger, D. and Flynn, A. “The persistence of induced abortion in Cuba: exploring the notion of an "abortion culture" Studies in Family Planning. PubMed.gov. March 2009. Web. September 2012.