I've been having a discussion on another blog about abortion and reproductive rights. While we disagree on most aspects of these loaded topics, we agreed to try to find consensus. We agreed that reducing the number of abortions was a beneficial goal, and to wit Leila has been gracious enough to present her 3 (really 4) suggestions. My discussion follows. At some later date, I'll present my 2 or 3 suggestions as well. She says:
How can we prevent abortions?
1) Make it illegal. We are a civilized society, and barbarism should not ever be enshrined in law, especially when it targets the most vulnerable and voiceless among us.
2) Teach virtue. Sex is sacred. It has purpose. Sex leads to babies and teens (and adults) must be retaught this. We have bought the lie that only "unprotected sex" leads to babies, which is a whole other post. So, virtue. Chastity. Do not have sex till you can accept the baby that will come with it.
3) Promote intact, two-parent families. The single mothers, the fewer men who take responsibility, the more poverty, the more abortions. Two parent, intact families.
Teach those three things and mean it, and you will have DRASTICALLY reduced the abortion rate.
Oh, and one more thing: Teach science and biology. Make sure we all see lots and lots of ultrasound photos of the unborn, and make sure we all understand that (as you know), science has long ago determined that human life begins when the sperm meets the egg to form a new individual human being.
Yep, that ought to do it! Agreed?
Defining the issues
Like many movements, the abortion rights movement was based on compassion. Women were being injured by illegal abortions, and organizers wanted to make it safe by taking it out of the alleys. I know this is nothing new and I know that the anti-choice community thinks this is misguided compassion. The only reason I bring this up is to point out the positive intention of the pro-choice movement, which is important.
Ok, so chastity, virtue and two-parent families. Yes, yes and yes (most of the time, assuming no spousal abuse.) Nothing in the abortion rights movement prevents the promotion of these beneficial attributes to personal and social hygiene. I think the case has been made, and continues to be made. To live a virtuous life is uncomplicated and affirming regardless of your belief system.
I suppose we can draw a correlation to Roe v Wade as the beginning of the breakdown of these virtues: If not for Roe, many assume we'd have no abortion, or surely less abortion. But is that what the empiric evidence shows? Was Roe the cause of the breakdown of virtue/chastity? Or was it an effect?
Making Abortion Legal
Desperate women used a number of dangerous means to terminate pregnancies. Some sought abortions from back-alley abortionists, with usually humiliating and sometimes deadly results.
Other women tried to induce abortions with homemade means--such as a bleach douche, or inserting sharp instruments into her cervix. This is why the now almost forgotten image of the wire coat hanger became the symbol of the abortion rights movement.
"In Chicago, at Cook Country Hospital, there were about 5,000 women a year coming in with injuries bleeding resulting to illegal abortions, mostly self-induced abortions," Leslie Reagan, the author of When Abortion Was a Crime, said in an interview. "They had an entire ward dedicated to taking care of people in that situation. Those wards pretty much closed up around the country once abortion was legalized."
The goal of the abortion rights movement in the 60's and 70's was to reduce the preventable morbidity associated with abortion. But preventing such morbidity certainly has increased the number of fetuses being aborted, right? We are merely exchanging one pathology for another, no? Well, that's a good question that may not have a clear intuitive answer. Statistics about abortion pre-Roe are difficult to decipher since we cannot know exactly how many abortions were being done surreptitiously, but we can try.
Estimates of the number of illegal abortions in the 1950s and 1960s ranged from 200,000 to 1.2 million per year. One analysis, extrapolating from data from North Carolina, concluded that an estimated 829,000 illegal or self-induced abortions occurred in 1967.
One stark indication of the prevalence of illegal abortion was the death toll. In 1930, abortion was listed as the official cause of death for almost 2,700 women—nearly one-fifth (18%) of maternal deaths recorded in that year. The death toll had declined to just under 1,700 by 1940, and to just over 300 by 1950 (most likely because of the introduction of antibiotics in the 1940s, which permitted more effective treatment of the infections that frequently developed after illegal abortion). By 1965, the number of deaths due to illegal abortion had fallen to just under 200, but illegal abortion still accounted for 17% of all deaths attributed to pregnancy and childbirth that year. And these are just the number that were officially reported; the actual number was likely much higher.
Simple arithmetic: The 829,000 illegal abortions in 1967 before Roe, added to the 2061 legal abortions performed in 1967, would give an abortion ratio (abortions per 1000 live births) of 23.6, compared to an abortion ratio of 23.3 in 1977, four years after Roe. This is in the ballpark of the current rate of abortion, assuming the population growth of the United States. So did Roe cause an increase in abortions? My conclusion, based on this admittedly incomplete data set, is no.
Legalizing abortion has reduced morbidity and mortality in women with unwanted pregnancy, but apparently has not increased the abortion ratio. Cook County Hospital no longer has a ward dedicated to managing complications from abortions gone awry. The abortion ratio peaked at 30 in 1980 and fluctuated in the teens an twenties over the subsequent decades. In the 2000's the ratio has been consistently in the teens; that low rate may be due to incomplete reporting, such as with the increasing use of medical terminations, or better and more available birth control, or social, religious and cultural factors (see below) .
Of course, we can argue that while physical morbidity may have decreased, we have done nothing for the emotional anguish of women aborting fetuses. Even the most strident pro-choice advocate would admit that abortion is not an optimal intervention. Even when done as safely as possible, medical complications can occur. Even when medical complications do not occur, emotional and psychological sequelae, often unquantifiable and unpredictable, may ensue.
At some later date, I can walk through the consequences of making abortion illegal again. Unsurprisingly, mMy conclusion is that most prohibitions probably would not have a material effect on abortion rates, but could increase morbidity in the pregnant woman.
The Chastity Argument
The concept of chastity has been around for a long time and, as Leila says, it has merit. But if that were the universal understanding, if it's such a great idea, then why doesn't everyone remain chaste? Yeah, this usually brings up the argument about Hollywood, television, the media, absent parents, and the loss of faith in God. If only we could correct these horrors, the First Amendment be damned, we'd have a Renaissance of virginal children growing up into monogamous spouses who stay married forever and have sex only for procreation, and the desire for abortion would be eliminated... just like it was in the good ol' days. I doubt that the good ol' days ever existed, at least for any sustained period of time, and it certainly is not what we see today. Or, alternatively, maybe today is as close we get to the good ol' days?
My grandfather would say to me, "Be good, and if you can't be good, be careful; and if you can't be careful, then name it after me." Then he'd smile, draw on his fat cigar and go back to his crossword puzzle. Message received: our actions have consequences, and as much as I loved my grandfather I did not want to change diapers on his namesake.
With such compelling reasons to avoid unwanted pregnancy, the emotional issues of promiscuity, the potential for disease, why hasn't the whole chastity thing caught on? I don't have one answer, but it likely has to do with a combination of our limbic system, or maybe the lack of fear of the negative consequences, or the endemic disbelief that some omniscient supernatural being is judging our bad behaviors. Even my sainted grandfather, who never missed Sunday Mass, did not appeal to the alleged omniscient Father in heaven to affect my behavior. Or, maybe it has caught on and this is about as chaste as our society will ever be.
No discussion of chastity would be complete without discussing abstinence-only education. Studies (1, 2, 3) have disputed the efficacy of such an approach. And while one recent study has indicated a marginal benefit, the study was flawed since it did expose the participants to non-comprehensive information about contraception, and the benefit was short-lived with 1/3 of abstinence-only participants engaging in sexual activity at the 2-year mark. Abstinence-only is a quantum event: either you do it all the time, or it fails.
I'm blogged out for now,and have other things to do, but certainly Leila's desires for the "promoting two-parent households" (however we could do it?) and science education (including comprehensive sex education?) are valid. Those discussions will need to wait for now. Certainly there are ways to decrease the numbers of abortions, and we should continue to look for consensus on effective ways to reduce the numbers of abortion. What do we do right? What do other nations do right? What works and what doesn't?