Abortions have declined in states where new laws make it harder to have them, the Associated Press noted in June. But abortion has also waned in states where abortion rights are most protected. What are we to make of such findings?
Pro-life advocates claimed this was evidence of the effectiveness state-level abortion restrictions, while pro-abortion advocates claimed the decline was due to expanded access to effective contraceptives and a drop in unintended pregnancies. Who is right?
In an attempt to answer that question let’s consider the evidence that various types of abortion laws and policies have on the reduction in the rate of abortion.* State-level restrictions and policies that affect abortion rates usually take one of the following seven forms:
Partial-birth abortion bans
Public funding restrictions/bans
Parental involvement laws
Informed consent laws
Increased access to contraceptives
Physician, hospital, and abortion provider requirements
For the sake of brevity, I’ll merely summarize the findings on each type of restriction and provide links to resources that explain the current evidence. Since there are no authorities or evidence that everyone in the debate can consistently agree on, I’ll refer to and cite studies and sources that are generally considered reliable or uncontroversial within the pro-life community.
Here are brief summaries of the effect on abortion rates of various policies:
Gestational limits and partial-birth abortion bans — While there are numerous reasons to support such restrictions, it is difficult to determine whether these forms prevent abortions or merely lead women to have abortions sooner in their pregnancy. The evidence for their effect on overall declines in abortion rates is therefore inconclusive.
Reductions in public funding — The clearest evidence we have on the effect of restriction in public funding is in the case of Medicaid. The pro-abortion Guttmacher Institute reviewed more than a dozen studies that analyzed the effect of state Medicaid funding restrictions on abortion. Approximately one-fourth of women who would have Medicaid-funded abortions instead give birth when this funding is unavailable.
Parental notification and parental consent laws — The findings indicate that when a state enacts a parental involvement law, the abortion rate falls by an average of approximately 13.6 percent. Laws that require parental consent instead of parental notification reduce the minor abortion rate by about 19 percent. Furthermore, laws that mandate the involvement of two parents, instead of just one parent, reduce the in-state minor abortion rate by approximately 31 percent.
Informed consent laws — Although the existing research provides solid empirical evidence that Mississippi’s informed consent law—which requires that women seeking abortions make two separate trips to the abortion provider—has reduced abortion rates, the current research provides little information on the effect of other types of informed consent laws in general or in other states.
Increased access to contraceptives — Use of contraception began increasing in the early 1960s—decades before the decline of abortion that began in the early 1990s. From 1994 to 2008, the rate of unintended pregnancies (a key factor in the rate of abortion) increased for all women at the same time that contraceptive use increased. The connection between contraception and abortion is therefor tenuous at best. Also, lack of access to contraceptives is a negligible factor in abortion rates. According to a Guttmacher Institute study, more than half of women who have abortions used a contraceptive method during the month they became pregnant. Only 12 percent of women who did not use contraception before having an abortion cited having problems, such as an inability to pay for birth-control pills, as the reason for the nonuse. Concerns about contraceptive methods were cited by 32 percent of nonusers and included mainly problems with methods in the past (20 percent) and fear of side effects from methods (13 percent).
Physician, hospital, and abortion provider requirements — Most of these types of requirements are not stringent enough to have an effect on the overall abortion rate within a state. One possible exception is the type of law that was passed in Texas last year that requires strict physical standards for clinics and requires doctors who perform abortions to have admitting privileges at local hospitals. This change forced more than half the state’s 19 abortion clinics to close their doors. It is too early to tell, though, how these types of laws will affect abortion rates in the future.
While we have some ideas what policies work and which do not (parental involvement law reduce abortion, increased contraception use mostly does not), for most types of abortion restrictions it remains unclear what influence the laws are having. Part of the problem is a simple lack of comprehensive empirical data and adequate research in this area. As better data becomes available, we should be able to make better determinations of the effect of such laws.
However, we do know the abortion rate is dropping across the nation—a decrease in abortions of about 12 percent since 2010—and that state level abortion restrictions are correlated with this change. Since 2010 states have adopted 282 new abortion restrictions, including 51 this year alone. But is the abortion rate dropping because states are passing new laws, or are the states able to pass the new laws because the public is becoming more pro-life, and thus there is less overall demand for abortion? Unfortunately, there is simply not enough evidence to determine the level of causation with a sufficient degree of certainty.
Does this mean that we in the pro-life movement are wasting our time in seeking more state level restrictions? Not at all. Even if such laws are not currently affecting the rate of abortion, they serve an important moral purpose, both now and in the future.
The result today is to force some proportion of women to put more thought and effort into their decision to have an abortion. Even if this leads to only a slight change in the number of abortions, the number of children who can be spared makes it worth the effort.
The importance of such laws will also be made clear when Roe v. Wade is overturned. These types of pro-life restrictions lay the essential groundwork for the types of legislation that will be needed when the Supreme Courts puts abortion law back in the hand of state governments. States that have developed the processes and alliances necessary to pass abortion restrictions today will likely have more success implementing similar restrictions in the future.
We should be cautious in making claims about the effects of most state level restrictions that exceed what can be known. We can unintentionally undermine support for the pro-life cause when we make overly broad claims that cannot be supported by evidence. But we should nevertheless remain bold in advancing such legislation. Even if the effect on abortion rates cannot be known with certainty, pro-life laws are an important way for us to seek justice for America’s unborn children.
* Reducing the total number of abortions is obviously more important to the pro-life movement than merely reducing the rate of abortion. But changes in population and demographics, especially at the state level where most abortion laws are implemented, can skew the total numbers of abortions. For this reason the abortion rate provides a better measure by which to gauge the effectiveness or state-level abortion laws.