Abortion: The Case for Choice, Part 3

Part 3 of a 3-Part series on continuous thinking, conflicting rights, bodily autonomy, potential life v. actual life, and how to reduce unwanted pregnancies

In parts 1 and 2 of this 3-part series I argued that (1) the binary-thinking of the pro-life argument that human life and personhood begins at conception is a fallacy because the development of consciousness and personhood is a continuous process, (2) even if we agree that a fetus is a human being what we have then is a conflicting-rights issue between the rights of the mother and the rights of the fetus, so (3) if rights are to be legally protected for one over the other, a stronger case can be made for a woman than a fetus because, (4) an actual human being and rights-bearing person must take precedence over a potential human being and person, (5) the fundamental right of bodily autonomy is one that has historically been expanding to include all adult humans including and especially women, which was hard won because, (6) when left unprotected rights-bearing groups tend to restrict the freedoms of those in non-rights-bearing groups, historically most notably of men over women. In this final part I will seek common ground between pro-life and pro-choice advocates by focusing on how to reduce unwanted pregnancies.

Problem Solving Instead of Issue Moralizing

However one frames the issue of abortion—pro-life, pro-choice, or pro-life personally and pro-choice politically (the opposite of pro-life politically and pro-choice personally is hypocrisy, as it suggests “it’s okay for me but not for thee”)—the more important question in the context of moral progress is identifying the problem to be solved. As I’ve hinted at in this series, the problem is not abortion per se, but unwanted pregnancies that lead people to choose abortion (or, historically, infanticide), or if carried to term orphanages and adoption agencies were options.

What can be done to attenuate unwanted pregnancies? In brief, contraception and education. A comprehensive international study on the relationship between contraception and abortion conducted by Cicely Marston from the London School of Hygiene and Tropical Medicine concluded:

In seven countries—Kazakhstan, Kyrgyz Republic, Uzbekistan, Bulgaria, Turkey, Tunisia and Switzerland—abortion incidence declined as prevalence of modern contraceptive use rose. In six others—Cuba, Denmark, Netherlands, the United States, Singapore and the Republic of Korea—levels of abortion and contraceptive use rose simultaneously. In all six of these countries, however, overall levels of fertility were falling during the period studied. After fertility levels stabilized in several of the countries that had shown simultaneous rises in contraception and abortion, contraceptive use continued to increase and abortion rates fell. The most clear-cut example of this trend is the Republic of Korea.¹

Figure 1 below shows this South Korean data. Abortion rates there took some time to start their decline because for a few years women relied on more traditional but far less effective methods of birth control, such as withdrawal, but when replaced by reliable methods, pregnancy rates tumbled, thereby lowering the demand for abortions.

This data set from South Korea demonstrates that granting women the right to use contraception causes a dramatic decrease in the number of abortions, along with the fertility rate, which has additional benefits for the progress of humanity in creating a sustainable world.²

A similar effect occurred in Turkey when abortion rates dropped by almost half between 1988 and 1998 (from 45 to 24 per 1,000 married women) even though the overall rate of contraceptive use remained stable. A study conducted by Pinar Senlet, a population program advisor at the U.S. Agency for International Development, however, revealed that there was a shift from traditional, pitifully underpowered forms of birth control to more modern and therefore more reliable methods. “Marked reductions in the number of abortions have been achieved in Turkey through improved contraceptive use rather than increased use.” In short, Turkish couples abandoned natural and unreliable birth control methods in favor of condoms and more effective means of contraception.³

Like all social and psychological phenomena, rates of contraceptive use and abortions are multi-variable—many factors are operating at once, which makes inferring direct causal links problematic. When it comes to human behavior, it is almost never as simple as “when X goes up, Y goes down,” and that is certainly the case for contraception and abortion. Different nations and states have different laws and regulations that affect accessibility to both abortions and birth control technologies. Some countries have higher rates of religiosity than others, and this too influences to what extent women or couples use family planning techniques. Socioeconomic forces and poverty rate differences between countries and states also confound conclusions. And so forth.

But as I read the data and analysis, here is my interpretation: when women have limited reproductive rights and no access to contraception, they are more likely to get pregnant and this leads to higher fertility rates in a country and more abortions when the pregnancy is unwanted. When women’s reproductive rights are secure and they have access to safe, effective, and inexpensive birth control, as well as access to safe, legal abortion, they rely on both strategies to gain control over their family size in order to maximize parental investment. So for a period of time after the legalization of abortion and access to contraception, rates of both increase in parallel. But once fertility rates stabilize—once women feel confident in controlling their family size and their ability to raise a child—contraception alone is often all that is needed, so abortion rates decline.

Just Say No?

Why can’t people “just say no” when it comes to sex—that is, use abstinence as a form of birth control, or time their sexual encounters for when it is “safe” during a woman’s natural monthly cycle? They can, of course, and some do, but as the old joke goes that was making the rounds when I was in high school: “What do you call couples who use abstinence, withdrawal, or the rhythm method of birth control? Parents.”

In theory, of course, abstinence is a foolproof method of preventing pregnancies just as starvation is a foolproof method of preventing obesity. But in reality the desire to love physically and to bond socially is fundamental to who we are as human beings; and the sex drive is so powerful, and the pleasures and psychological rewards so great, that recommending abstinence as a form of contraception (and STD prevention) is, in fact, to recommend pregnancy and infection by default. In a 2008 study descriptively titled “Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy,” the University of Washington epidemiologists Pamela Kohler, Lisa Manhart, and William Lafferty found that among never-married American adolescents aged 15-19 years:

Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse, but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse. Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses.

The authors concluded:

Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.⁴

A 2011 PLoS article analyzing “Abstinence-Only Education and Teen Pregnancy Rates” in 48 U.S. states concluded that “increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates,” controlling for socioeconomic status, educational attainment, and ethnic composition.⁵

Most telling, a 2013 paper titled “Like a Virgin (mother): Analysis of Data from a Longitudinal, U.S. Population Representative Sample Survey,” published in the British Medical Journal reported that 45 of the 7,870 American women studied between 1995 and 2009 said they become pregnant without sex. Say what? Are we to believe that biblical-level miracles are afoot in the bedrooms of teenage girls everywhere? This seems unlikely, to say the least. Who were these immaculately conceiving parthenogenetic Marys? They were twice as likely as other pregnant women to have signed a chastity pledge (but apparently not an honesty pledge), and they were significantly more likely to report that their parents had difficulties discussing sex or birth control with them. Although the researchers admitted that “Scientists may still face challenges when collecting self-reported data on sensitive topics,” my point in citing this data is that young women who are pressured through home or church to “just say no” rather than given solid information to avoid pregnancy should sexual intercourse occur, are more likely to both get pregnant and to lie about how it happened.⁶ Here is how Merritt Tierce explained the problem in her 2021 New York Times Magazine cover story on “The Abortion I Didn’t Have”. Attending a Christian college and headed for Yale Divinity, she found herself attracted to a “kind, gentle, handsome, friendly, warm and funny” fellow student that led to a sexual relationships, for which their religion failed to prepare them:

When we had sex, we couldn’t use condoms, because having them around would have been admitting an intent to sin or an expectation of fallibility. For the same reasons, I couldn’t take birth-control pills or use any other form of contraception. To prepare to sin would be worse than to break in a moment of irresistible desire. To acknowledge a pattern of repeatedly breaking, of in fact never failing to break, would have meant acknowledging our powerlessness, admitting we could never act righteously. Our faith trapped us: We needed to believe we could be good more than we needed to protect ourselves. As long as I didn’t take the birth-control pill, I could believe I wouldn’t sin again. His father always pulled out, which works until it doesn’t.

Such programs don’t work because our present selves who commit to not having sex in the future collide our future selves who become weak in the passion of the moment. As with diets, it’s easy to commit to foregoing sweet, rich, and fatty foods when you’re satiated or the next meal is some significant time in the future. Filling out the hotel meal card in the evening for breakfast tomorrow it is easy to check the boxes for oatmeal and fruit, but go down to the buffet and feast your eyes (and nose) on the bacon, sausage, eggs, bagels with cream cheese, and all the rest, self-control weakens. As it is with the basic hunger drive so it is in spades for the equally basic sex drive. Filling out the religious abstinence-only pledge on a Sunday morning is one thing; fulfilling that pledge in a passion-filled Saturday night is another thing entirely. As Augustine of Hippo declared to the almighty, “Lord, make me chaste and celibate—but not yet.” Or as Oscar Wilde admitted, “I can resist everything, except temptation.”

The opposite of an abstinence-only program would be a reverse test of my thesis, and here we could not find a better social experiment than in Romania. When the dictator Nicolae Ceaușescu came to power in 1965 he hatched a scheme for national renewal by severely restricting abortions and the use of contraception in order to increase his country’s population. It worked. When abortion had previously been legalized in Romania, in 1957, 80 percent of pregnancies were aborted, primarily because of the lack of effective contraception. A decade later the fertility rate had fallen from 19.1 to 14.3 per 1,000, so Ceaușescu made abortion a crime unless a woman was over 45, had already delivered (and raised) four children, was suffering dangerous medical complications, or had been raped. The birth rate promptly shot up to 27.4 per 1000 in 1967.

Despite the dictator’s punishments for “childless persons” (monthly fines withheld from wages) or for those with fewer than five children (the imposition of a “celibacy tax”) and rewards for especially fertile mothers with a “distinguished role and noble mission” (state-sponsored childcare, medical care, maternity leave), if (pace Yogi Berra) the people don’t want more babies you can’t stop them. The result was a social catastrophe of epic proportions, as thousands of babies were abandoned and left to the care of a state that was inept, corrupt, and broke. More than 170,000 children were dumped into over 700 dank and stark state-run institutional orphanages, and over 9,000 women died due to complications from black-market (back alley) abortions.

The effects are still felt today as many of those orphaned children are now adults with severely impaired intelligence, social and emotional disorders, and alarmingly high crime rates. The book Romania’s Abandoned Children is a moving account of this tragedy by Charles Nelson, Nathan Fox, and Charles Zeanah that should be read by anyone with pretentions toward social engineering and the restriction of women’s right to choose.⁷

Why Conservatives and Christians Should be Pro-Choice

And while I’m citing statistics, one more is relevant to this discussion: according to the National Institutes of Health, childbirth is 14 times more dangerous than an abortion.⁸ This fact provides a rebuttal to the argument “What if a young woman aborts a baby who would have gone on to become a doctor and find the cure for cancer?” A rejoinder is, “What if a young woman who would have gone on to become a doctor and find the cure for cancer dies in childbirth?”

If conservatives and Christians want to put an end to the termination of fetuses and infants, the best path to take is education, contraception, and the recognition of full female rights—which are simply human rights—including and especially reproductive rights. In the United States alone, studies show that safe, effective, and inexpensive contraception has prevented approximately 20 million pregnancies in 20 years, and given the rate of abortion during that time, this means that nine million fetuses were never aborted because they were never conceived. And note that it’s only seven percent of women who are sexually active, but who do not use birth control, that account for almost 50 percent of all unintended pregnancies and almost 50 percent of all abortions.

Of course, many people are deaf to arguments demonstrating the positive impacts of contraception and education, because their sole concern is the right to life of the unborn fetus which, in their view, trumps the rights of an adult woman, and that leads to a deeper problem in the abortion debate, one identified by the physicist, meteorologist, and applied mathematician Lewis Fry Richardson noted in his documentation of the decline of deadly conflicts:

For indignation is so easy and satisfying a mood that it is apt to prevent one from attending to any facts that oppose it. If the reader should object that I have abandoned ethics for the false doctrine that “to understand all is to forgive all”, I can reply that it is only a temporary suspense of ethical judgment, made because “to condemn much is to understand little.”⁹

It’s time we all put our indignation aside and opt for understanding over condemnation.

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Michael Shermer is the Publisher of Skeptic magazine, a Presidential Fellow at Chapman University, the host of The Michael Shermer Show podcast, and the author of numerous New York Times bestselling books including: Why People Believe Weird Things, The Science of Good and Evil, The Believing Brain, The Moral Arc, Heavens on Earth, and Giving the Devil His Due. His next book is on conspiracy theories and why people believe them.

References

1. Deschner, Amy and Susan A. Cohen. 2003. “Contraceptive Use is Key to Reducing Abortion Worldwide.” Guttmacher Report on Public Policy, October, 6(4), https://bit.ly/3lyvfCQ See also: Marston, Cicely and John Cleland. 2003. “Relationships Between Contraception and Abortion: A Review of the Evidence.” International Family Planning Perspectives, March, 29(1), 6-13.

2. Deschner and Cohen, 2003.

3. Senlet, Pinar, Levent Cagatay, Julide Ergin, and Jill Mathis. 2001. “Bridging the Gap: Integrating Family Planning With Abortion Services in Turkey.” International Family Planning Perspectives, June, 27(2).

4. Kohler, Pamela K., Lisa E. Manhart, and William E. Lafferty. 2008. “Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy.” Journal of Adolescent Health, April, 42(4), 344-351.

5. Stanger-Hall, Kathrin F. and David W. Hall. 2011. “Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S.” PLoS, 6(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3194801/

6. Herring, Amy H., Samantha M. Attard, Penny Gordon-Larsen, William H. Joyner, Carolyn T. Halpern. 2013. “Like a Virgin (mother): Analysis of Data from a Longitudinal, U.S. Population Representative Sample Survey.” British Medical Journal, December 17, http://www.bmj.com/content/347/bmj.f7102

7. Nelson, Charles A., Nathan A. Fox, and Charles H. Zeanah. 2014. Romania’s Abandoned Children: Deprivation, Brain Development, and the Struggle for Recovery. Cambridge, MA: Harvard University Press.

8. http://www.ncbi.nlm.nih.gov/pubmed/22270271

9. Richardson, Lewis Fry. 1960. Statistics of Deadly Quarrels. Pittsburgh: Boxwood Press, p.xxxv.