Warning! Long post with unpleasant images. The squeamish should beware.
In order to fix something, you have to diagnosis the problem first. For instance, if your computer is not working , because the power is out, replacing hardware will not make a difference. If a child can not study in school, because he is too hungry, providing better textbooks and more teachers will not fill his stomach.
Many people wade into the
abortion rights yes or no debate without understanding the issue. Abortion is not the problem, as some people like to claim. Abortion is one solution to the much broader public health problem of
unplanned pregnancy. Wherever women become pregnant accidentally, there will be elective terminations.
Fact Nearly half of pregnancies among American women are unintended, and four in 10 of these are terminated by abortion. Twenty-two percent of all pregnancies (excluding miscarriages) end in abortion.
http://www.guttmacher.org/pubs/fb_induced_abortion.htmlFiction Rove v. Wade, the US Supreme Court decision guaranteeing a woman the right to an elective abortion has increased the total number of the procedures performed in the country. Here is a site which attempts to make this argument.
http://blackadderiv.wordpress.com/2008/12/01/making-abortion-illegal-reduces-the-abortion-rate/Fact We can not say that total abortion rates in this country increased, because no one was measuring illegal abortions before Roe v. Wade. Instead, those who claim that legalization increases the procedure have to rely upon statistics about the number of
legal abortions done. And yes, more women were able to have a legal, safe pregnancy termination after 1970 than before. (see the Alan Guttmacher link above).
One indirect way to measure the total abortion rates in this country is to look at the number of women who developed medical complications from illegal abortion. When the procedure is performed in someone’s kitchen using non sterile technique, women risk bleeding, infection, sterility and even death. The graph on page 3 of this Alan Guttmacher document
http://www.guttmacher.org/presentations/trends.pdfShows that legalization cut the rate of abortion related medical complications by 90%.
Since “complication” is a cold, scientific word which does not even begin to describe the human cost of back alley abortions, here is the image which represented the potential plight of American women before Roe V. Wade.
This is not a peculiarly American problem. A recent global study found that abortion rates were similar in countries where the procedure was illegal and in countries where it was legal, suggesting that women faced with an unplanned pregnancy largely ignore the law, perhaps because health and economic factors force them to do so.
A comprehensive global study of abortion has concluded that abortion rates are similar in countries where it is legal and those where it is not, suggesting that outlawing the procedure does little to deter women seeking it.
Moreover, the researchers found that abortion was safe in countries where it was legal, but dangerous in countries where it was outlawed and performed clandestinely. Globally, abortion accounts for 13 percent of women’s deaths during pregnancy and childbirth, and there are 31 abortions for every 100 live births, the study said.
http://www.nytimes.com/2007/10/12/world/12abortion.htmlSo, the next time someone tells you that abortion rates went up in the U.S. after Roe v. Wade, say “We do not know the rates. We do know that women suffered 90% fewer health complications after Roe. In other words, making abortion illegal kills women.” Any public health policy decision which reduces the incidence of medical complications (including death) by 90% is a very effective one.
Fiction Because of the risk of contraception failure, the best way to prevent unplanned pregnancies is to tell girls not to have sex.Fact Abstinence only sex education accomplishes nothing, and it is inferior to birth control in reducing the rate of unplanned pregnancy.Congress did a study which showed that children in abstinence only sex education programs had outcomes which were exactly the same as kids given no sex ed.
Authorized by Congress in 1997, the study followed 2000 children from elementary or middle school into high school. The children lived in four communities -- two urban, two rural. All of the children received the family life services available in their community, in addition, slightly more than half of them also received abstinence-only education.
By the end of the study, when the average child was just shy of 17, half of both groups had remained abstinent. The sexually active teenagers had sex the first time at about age 15. Less than a quarter of them, in both groups, reported using a condom every time they had sex. More than a third of both groups had two or more partners.
http://www.washingtonpost.com/wp-dyn/content/article/2007/04/13/AR2007041301003.htmlSo, telling someone not to have sex has no effect whatsoever on the rate of sexual intercourse. That means that we might as well have been throwing close to $200 million a year (the amount the feds spend on abstinence only programs) into the toilet. That money would have bought a lot of condoms.
On the other hand, making contraception more readily available does decrease the rate of unplanned pregnancies. This in turn decreases the abortion rate. From the New York Times link above:
The data also suggested that the best way to reduce abortion rates was not to make abortion illegal but to make contraception more widely available, said Sharon Camp, chief executive of the Guttmacher Institute.
In Eastern Europe, where contraceptive choices have broadened since the fall of Communism, the study found that abortion rates have decreased by 50 percent, although they are still relatively high compared with those in Western Europe. “In the past we didn’t have this kind of data to draw on,” Ms. Camp said. “Contraception is often the missing element” where abortion rates are high, she said.
The Netherlands has the lowest abortion rates in the world at somewhere between 5-7%. The Dutch achieved this by making heroic efforts to disseminate contraception to everyone, including young people. Note that universal health insurance was part of their formula for success.
The introduction of modern contraceptives (mainly the pill and contraceptive sterilization) was stimulated by a strong voluntary family planning movement, fear for overpopulation, a positive role of GPs, and the public health insurance system. A reduction of unwanted pregnancies has been accomplished through successful strategies for the prevention of teenage pregnancy (including sex education, open discussions on sexuality in mass media, educational campaigns and low barrier services) as well as through wide acceptance of sterilization. The Dutch experience with family planning shows the following characteristics: a strong wish to reduce reliance on abortion, ongoing sexual and contraceptive education related to the actual experiences of the target groups, and low barrier family planning services.
http://www.ncbi.nlm.nih.gov/pubmed/7971545Universal health care is important. If poor women are denied preventive health services including birth control, they will have more unplanned pregnancies and give birth to more children whom they can not afford.
"Between 1994 and 2001, the rate of unintended pregnancy increased by 29 percent among U.S. women whose income was below the poverty line, while it decreased 20 percent among women with incomes at least twice the federal poverty level," a Guttmacher press release summarizes.
http://www.salon.com/mwt/broadsheet/2006/05/04/contraception/The Republican Party, which claims that its goal is to eliminate abortion, actually increases the abortion rate in this country by increasing the rate of unplanned pregnancies. They do this by wasting money which could be spent on effective sex education on ineffective abstinence only programs. And they deny necessary contraception services to the women who can least afford to get pregnant. The latter is accomplished in part by stigmatizing various birth control methods such as the IUD, the morning after pill and, in some extreme cases, even regular oral contraceptives as "immoral". Insurers are allowed to opt out of birth control coverage. Pharmacies and hospitals can refuse to provide family planning supplies. Funds for family planning are cut (often on the grounds that the same facilities also provide legal abortions).
The net result of Republican Party policy is to
increase the number of unplanned pregnancies and abortions, while stigmatizing the women who fall victim to their bad public health policies. Poor women are told, in effect,
It is your own fault that you and your children are poor. They are told
If you get an abortion so that you can continue to work and feed your other children, you are an unfit mother. Blaming victims for their own oppression is an invaluable way to decrease the self esteem---and demands---of the nation’s low paid female workers. They become a more compliant labor force, willing to settle for whatever crusts their employer tosses their way.
Fiction Abortion is a moral issue. Policies need to be set by spiritual and moral leaders.Scan any right wing site and you will read that abortion providers are “Satanists” and that women who have elective terminations are “murderers.” Opponents of abortion rights love to quote the Pope. But note that many so called “Right to lifers” ignore the Catholic injunction against violence and the death penalty and war. They also get divorced, even though the Catholic Church forbids this. In addition, they are indifferent to the treatment of children once they are born, endorsing public policies that doom poor children to lives of deprivation. How can they select one moral issue out of many and ignore the rest? They can do this, because their primary focus is not on morality or spirituality. Restricting women’s right to choose is a purely economic/political issue for many.
Fact Abortion is a public health issue. It is a marker of the unplanned pregnancy rate, which is at epidemic levels in this country. When society is not doing enough to help young women avoid getting pregnant, public health policy experts need to step in, the same way that they would intervene when people catch salmonella from their food.
Fiction Spending time and money changing public health policy is not necessary. We can just pass laws against abortion and women will change their behavior and stop getting pregnant. Despite international evidence to the contrary, the anti-choice movement seems to be convinced that the most effective way to cut down on the number of abortions performed is to make it hard or impossible for women to get the procedure. Is there a way to test their hypothesis? Counting the number of abortions in states with restrictive laws will tell us nothing , since these states often create economic conditions that drive providers out of state. A more reliable estimator of the effect of these laws comes from the unwanted pregnancy rate. Since the federal courts allow states a great deal of freedom in restricting the abortion rights of minors, the rate of teenage pregnancy can be used as a marker for the “success” of anti-abortion legislation in cutting down those unplanned pregnancies.
Fact There is no statistically significant relationship between the severity of a state’s anti-abortion laws for minors and the teenage pregnancy rate. Here is a list of abortion regulations by state.
http://www.essortment.com/articles/abortion_laws_100000.htmHere is a site which gives statistics about teenage pregnancy rates by state.
http://www.thenationalcampaign.org/state-data/advanced-search.aspx?state1=alabama&state2=mississippi&state3=texas&18=3&x=35&y=13The most restrictive laws are so called “parental consent”. A girl can not get a legal termination unless a parent says she can. If her parents object (or can not be found or are incompetent) she usually has to go to court. These states include Alabama (Teen Pregnancy Rate or TPR 90), Idaho (TPR 62), Indiana (TPR 73), Kansas (TPR 69), Kentucky (TPR 76), Louisiana(TPR 87 ), Maryland( TPR 91 ), Massachusetts (TPR 60). Michigan (TPR 75 ), Mississippi (Both parents have to give consent TPR 103), Missouri (TPR 74), Ohio (TPR 74 ), Pennsylvania (TPR 60 ), Rhode Island (TPR 67),Tennessee (TPR 89).
Average 77.States with no restrictions include California (TPR 96), Connecticut(TPR 70), , Hawaii (TPR 93), Illinois(TPR 87), Montana (TPR 60 ), Nevada (TPR 113 ), New Hampshire (TPR 47 ), New Jersey (TPR 90 ), New Mexico (TPR 103 ), New York (TPR 91), Oklahoma (TPR 86 ) Oregon (TPR 79), Vermont (TPR 44 ), Washington (TPR 75 .
Average 8177 versus 81. Virtually the same rate. So much for making girl’s jump through hoops.
Fiction Anti-abortion laws may not stop women from getting pregnant, but we can damn well make sure that if she conceives, she will not be able to get an abortion Since a picture is sometimes worth a thousand words, here is a map of the United States with a color code to represent abortion legislation.
http://commons.wikimedia.org/wiki/File:Map_of_US_minor_abortion_laws.svgNote that every state in which a girl must obtain parental consent borders one which does not have this requirement (except Mississippi, but it is only a short drive to Florida). That means that a safe, legal, consent free abortion is available for every young woman in this country if she travels a few hours.
Fact The Republican Party will continue to give lip service to the notion of outlawing abortion, but it will never actually make the procedure impossible for women to obtain in this country. That is because if women ever find themselves unable to get a legal, safe abortion, they will start having the old fashioned back alley kind--and they will start dying, at which point, the tide of public opinion will turn, as it did in the early 1970s.
The bad news is that the GOP will continue to push policies that increase the rate of unintended pregnancies for young and poor women---unless we stop them. The first, most important step is universal access to health care, including contraception
for all women of reproductive age, including minors.