You would probably guess that an increase in contraceptive use would decrease the number of abortions, Right? Guess again.
The student campus organization, 1flesh.org, was founded in 2012 by a group of college students who felt compelled to introduce more people to natural methods of family planning through dynamic social media outreach and the tagline “Bring Sexy Back.”
1 Flesh received wild support from various groups, especially conservative Christian youth, pro-lifers, and those wary of the risks involved with hormonal birth control. 1 Flesh was demonized by organizations (i.e. the G@tes foundation) seeking to push widespread availability of abortion and contraception into developing countries. 1 Flesh was also unpopular with the Catholic church, which maintained that the purpose of Natural Family Planning (NFP) was no different from other forms of contraception – the prevention of pregnancy.
A Deeper Look at Contraception and Abortion was written by an author known only as “Marc”, and originally appeared on 1 Flesh on 2012 September 22.
The original 1flesh.org site is now shadow banned by the bandwidth bosses. But the internet lives forever, you know.
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The claim that the widespread promotion of contraception reduces the incidence of abortion is a good one. Its basic logic — that because abortions are the result of unplanned pregnancies, contraception, by reducing unplanned pregnancies, reduces abortions — is reasonable and lucid.
But it’s not true.
An honest look at the data shows that in virtually every country that increased the use of contraception, there was a simultaneous increase in the abortion rate. In England (Rise in contraceptive use: simultaneous rise in abortions), France (Rise in contraceptive use: simultaneous rise in abortions), Australia, (Rise in contraceptive use: simultaneous rise in abortions), Portugal (whose abortion rate only began to rise after 1999, after oral contraceptive methods were made widely available), Canada (whose abortion rate only began to rise after the legalization of oral contraceptives in 1969), Singapore, Cuba, Denmark, the Netherlands, and South Korea — to name a few. That these countries have periodically seen the abortion rate reduced by the use of contraception is good, but it must be taken with a firm grasp of the overall picture: These countries have never seen the abortion rate reduced to its place before the introduction and widespread use of contraception. It is no victory of contraception that it partially reduces a problem it created in the first place.
But before we address why the introduction of contraception to a country is usually simultaneous with a rise in abortion, we need to address the Guttmacher Institute.
The Guttmacher Institute — previously the research arm of Planned Parenthood, now a recipient of their annual donations — is the authoritative source for the claim that contraception is not associated with increased abortion rates. Their study “Relationships Between Contraception and Abortion: A Review of the Evidence” determined that contraception reduces abortion rates, and in countries where it doesn’t, “after fertility levels stabilized… contraceptive use continued to increase and abortion rates fell.” This implies that contraception will eventually reduce the abortion rate in those countries as well.
Here’s the problem. 4 of the 7 countries the The Guttmacher Institute cites to make the claim that contraception reduces overall abortion rates are ex-communist countries: Kazakhstan, Kyrgyz Republic, Uzbekistan, and Bulgaria.
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 a 2002 article published 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.” 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 laudable — can not be used as evidence to make the blanket claim that “contraception 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, a view restricted almost entirely to communist and ex-communist states. The introduction of 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 aided it in achieving its end. (And quite successfully, as most of these countries are now experiencing drastic population decline.) 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.
So, given that the Guttmacher Institute primarily use ex-communist countries as evidence, perhaps it would be wise to change the bold claim that “contraception reduces abortion rates” to “contraception reduces abortion rates primarily in countries who 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”.
The organization Family Health International often cites the fact that “the world’s lowest abortion rates are recorded in Belgium and the Netherlands, where contraception is used extensively, while the highest rates are found in Cuba and Vietnam, where clients have access to a limited range of contraceptive methods”, as evidence for contraception’s abortion-reducing effects. A closer look at Cuba and Vietnam shows the same ignored problem.
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.”
It is suggested 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 actually threefold.
- First, there exists in Cuba that “abortion culture”, a culture that views abortion as amoral — or at the very least morally relative — and thus merely as another means of [birth control].
- Widespread poverty is described as a major driving factor in Cuba’s high abortion rate.
- Finally, there is a greater concern about the side-effects, health risks and the actual use-effectiveness of contraception in Cuba than in other countries, so while contraception is used, it is often used sporadically.
Once again, the “abortion culture” matters, but is ignored in favor of easy answers. (The same article lists Vietnam as a country considered to have an “abortion culture”, similar in its post-communist status to Cuba and the Soviet Union.) We must again replace the confident phrase, “contraception reduces abortion rates”, with something like “contraception reduces abortion rates primarily in countries who already view abortion as an amoral means of family planning, providing these countries have no fear of the health risks and side effects of contraception.” (A fear which will probably persist as long as the Pill continues to increase a woman’s risk of breast cancer, cervical cancer, and HIV infection, and a man’s risk of prostate cancer.)
To recap: Excepting countries with an already ingrained culture of abortion, the introduction of contraception to a country is associated with a simultaneous increase in abortions, an increase which tends to level and experience periodical decreases thanks to the improved use and availability of contraception, but which never decreases back to where it was before contraception was introduced to that country.
Funnily enough, this was seen in Turkey, one of the three countries the Guttmacher Institute cites to support their claims without an “abortion culture”. In the study The Role of Contraceptive Changes in the Decline of Induced Abortion in Turkey — which Guttmacher cites — it is shown that in 1983, when contraception laws were liberalized, abortion ended 12.1% of all pregnancies. As contraceptive used increased, the abortion rate increased, until 1988, when abortion ended 23.6% of pregnancies. Thanks to the improved use and availability of contraception, the rate then began to decrease, until, by 1998, abortion ended 15.7% of all pregnancies. Here the abortion rate dipped, rose, and leveled, and by 2007, abortion ended 17.0% of all pregnancies in Turkey. The Guttmacher Institute see this as evidence of the success of contraception in reducing abortions. We see it as evidence of the success of contraception in increasing abortions.
Obviously, more extensive research is needed, but the bold claim that contraception reduces abortion rates just doesn’t seem to hold up to the light of day. But surely — one might ask — it’s best to promote and use contraception, now that there is this increase? Isn’t some reduction better than none, even if contraception never causes the abortion rate to go down to where it was before contraception was ever popularized?
It’s important to recognize that, while contraception has been a factor in many of the relative decreases in abortion around the world, it is as often a factor in relative increases around the world.
In the 2011 study Trends in the use of contraceptive methods and voluntary interruption of pregnancy in the Spanish population during 1997-2007, surveys of about 2,000 Spanish women aged 15 to 49 were taken every two years from 1997 to 2007. Over this period of time, the number of women using artificial contraceptives increased by about 60%. In the exact same period, Spain’s abortion rate more than doubled, from 5.52 per 1,000 women to 11.49.
Similar results can be found in England. The government implemented their Teenage Pregnancy Strategy in 1995, spending over $454 million promoting the use of contraception. Teenage pregnancies and subsequent abortions continued to increase.
Here in the United States, 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 “reported that they “currently used” contraception during the month of their last menstrual period.”
So we come to the vital question: Why? Why would contraception create a need for abortion?
It’s very simple: According to Guttmacher Institute researcher Stanley K. Henshaw, “contraceptive users appear to have been more motivated to prevent births than were nonusers.” The use of contraception seeks to avoid pregnancy while still performing the act of sex. When contraception fails, and a new life results from that act, there is an immediate difficulty: The couple would have to, by courage and strength, avoid continuing the mentality by which they practiced contraception — that a new child is to be avoided — into the mentality with which they view the actual, living, new child in the womb. I have no doubt it can be done, but not without difficulty, and where there is difficulty, people fail.
This, after all, is the very reason why abortion is legal in the United States. In the Supreme Court case Planned Parenthood vs. Casey, which confirmed the legalization of abortion, it was stated that:
[I]n some critical respects, the abortion decision 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.
The message is clear: Because we have come to use contraception, we have come to need abortion. Luckily for the entire world, and all the babies, medical science has made it possible to effectively practice family planning without the use of contraception. It’s called fertility awareness, and it’s all sort of awesome.
Great post marc! Your last line is confirmed by history: Contraception was legalized in 1970, and thus three years after, to make up for failures in the usage of contraception, they had to legalize abortion.
Lauren Kyfiuk said…
Amazing post Marc!
I (and I expect a good number of my colleagues) have been praying you write about this! Your website is revolutionary. Keep speaking shameless truth beautifully.
On behalf of the countless women and children who will benefit from this post, thank you.
Jeff Miller said…
Plus, add the further complication that some contraceptives are abortion-inducing themselves it seems to make that claim that throwing gasoline on the fire reduces the fire. Of course they would deny that contraceptives can act in this manner in regards to “the pill”, but they don’t have the same case in regards to the IUD and other forms – but instead they move the goal posts to implantation to ignore the connection.
For me, the connection between abortion and contraception is pretty clear. They both have the same purpose essentially: to prevent new life from developing. They also both tend uphold the same good over life: convenience. Most people who are pro-choice will not be able to see this connection. For them, it is useful to point out that abortion is often used as back-up contraception. That is, in case the condom breaks, there’s always the morning after pill or a more invasive form of abortion. Although pro-choice people often like to bring up the scenario that involves a girl who was raped and now has to carry an illegitimate child to term, such situations are quite rare and the one that I described, in which a baby is killed so as to not be an inconvenience, is frighteningly common.
Beth Turner said…
It seems there are three ways to prevent the birth of a child: don’t have sex, have sex with contraception, or have an abortion after achieving pregnancy. When you remove one option, you are bound to get an increase in rates of use of the other two. In “abortion cultures,” abortion will sky-rocket when you remove contraception. But I bet rates of abstinence, including periodic abstinence like NFP, increase too, especially in cultures that resist abortion.
Great article!! Right now the Philippines wants to increase the use of contraception while abortion still remains legal. I fear that it soon will become legal as the new Reproduction Health Bill is passed to allow easier access to contraception for the whole population. I hope our government leaders read this and decide otherwise!
Hi Marc! I have some issues with your post. I won’t address every study or sentence, but I’ll try to get the main points:
I’ll preface this by saying that your entire “An honest look at the data shows that in virtually every country that increased the use of contraception, there was a simultaneous increase in the abortion rate,” paragraph is a correlation, and thus, causation cannot be surmised. See the Guttmacher paper; there are much more confounding factors that can accompany these two phenomena.
For the Guttmacher study “Relationships Between Contraception and Abortion: A Review of the Evidence”, you seem to only address and criticize the data where contraception use rise and abortion rates decline at the same time (in communist countries). However, you ignored similar results in non-communist Turkey, Tunisia and Switzerland. You only gave a passing glance to the countries where contraceptives and abortion rise initially, but then abortion rates fall as contraception continues to increase. The sentence, “This implies that contraception will eventually reduce the abortion rate in those countries as well,” is inaccurate. We have observed this phenomenon in Denmark, United States, Netherlands, Singapore, and Korea.
“It’s important to recognize that, while contraception has been a factor in many of the relative decreases in abortion around the world, it is as often a factor in relative increases around the world.”
- Spanish study just a correlation. Authors even write, “The factors responsible for the increased rate of elective abortion need further investigation.”
- In regards to the English program, “The under 18 conception rate is now 13.3 per cent lower than in 1998. While behind the trajectory needed to achieve the target to halve the teenage pregnancy rate by 2010, conceptions and births are at their lowest level for over 20 years” (https://www.education.gov.uk/publications/eOrderingDownload/00224-2010DOM-EN.pdf)
- U.S.: “…however, their use of contraception might have been inconsistent or incorrect. In 1995, when the most recent NSFG was conducted, approximately 29% of sexually active U.S. women who used only oral contraceptives for birth control reported that they missed a birth-control pill one or more times during the 3 months before their NSFG interview. In addition, approximately 33% of U.S. women who were using only coitus-dependent contraceptive methods** during the 3 months before the interview used these methods inconsistently. At present, not all health insurance plans provide full contraceptive benefits. Therefore, education regarding improved contraceptive use and practices as well as access to and education regarding safe, effective, and affordable contraception and family-planning services might help reduce the incidence of unintended pregnancy and, therefore, might reduce the use of legal induced abortion in the United States.”
“…family planning without the use of contraception.” Contraception, as defined by Google, “The deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse. “Fertility awareness would be still be considered a contraceptive method.
The whole rationale behind this piece seems to be this: Abortion rate increases with contraceptive use (even though abortion rates do decrease over time with increased contraceptive use but let’s ignore that for now), therefore contraceptive use causes increased abortions.
Jude Law Guardian said…
“The message is clear: Because we have come to use contraception, we have come to need abortion.”
WTF???????? HOW does this make ANY sense?? Unless you practice the ridiculous notion of sticking your head in the sand and pretending that people aren’t going to have sex, contraception is the ONLY thing that has a chance of stopping pregnancy without having an abortion. Yeah. Let’s all go back to the 1800’s and turn women back into breeder chattel/baby factories/third-class citizens and put them back in their place so they can spawn tons of babies like so many litters of rats. Sounds like a plan–at least to the Religious Reich.
Apparently, it doesn’t make any sense to you because you didn’t take time to read the whole article or it’s many sources. If you did, you would see that the article, at the VERY LEAST, makes some sense.
The only “ridiculous notion” here, as you say, is the one where you’re pretending and assuming that human beings don’t have any self-control to stop themselves from having sex with the first thing that moves at the end of the bar.
- Philothea on Phire: Melinda Gates, 1flesh.org, and NFP (2012 July 16)
- Couple to Couple League: Interview with 1Flesh.org president (2014 February)
- Σ Frame: Contraception Correlations (2019 November 29)