The Contraception/Abortion Connection: Part Two

Scott Alexander’s critique of my attempts to show a potential connection between contraception and abortion is very good. Several of the countries I cite to show abortion rates rising alongside contraceptive use don’t actually establish causation. Some countries do, however, and for these Alexander quotes Guttmacher’s explanation of why increased contraception is often associated with a simultaneous increase in abortion:

The advent of modern contraception is associated with a destabilization of high (or “fatalistic”) fertility preferences. Thus, as contraceptive prevalence rises and fertility starts to fall, an increasing proportion of couples want no more children (or want an appreciable delay before the next child), and exposure to the risk of unintended pregnancy also increases as a result.

Ignoring the baby-scared lingo, Guttmacher are saying that contraception introduces a hitherto un-introduced philosophy, that small family sizes are better than large, or, as Alexander aptly puts it, “lots of sex, few kids.” Thus pregnancy becomes a risk, and thus abortion becomes desirable.

Alexander agrees with this evaluation, which is nice, because it was precisely my evaluation. The introduction of contraception raises abortion rates by creating a contraceptive culture which sees the child as “unintended,” a situation to-be-avoided, thus creating a “need” for abortion in the event that contraception fails, the ability to “terminate” a pregnancy that was previously supposed to “prevented.” This isn’t complex stuff. Even suPPer Guttmacher admit it. But Alexander lends an important distinction to my previous claim. It’s not always the case that increased contraception causes increased abortions. Let me bandwagon on his thesis. The introduction of contraception sometimes causes a simultaneous increase in abortion (by immediately creating a “no-kids” demand) and sometimes contraceptive use rises simultaneously with abortion because they are both rooted in a common philosophical shift in which “people want to have lots of sex but not have kids.”

What Alexander seems to agree with (at least insofar as he didn’t say that I was wrong), is that the introduction of contraception into non-contraceptive cultures, whether on its own or as part of a general philosophical shift, is rarely associated with a decrease in abortion. As we’ve discussed before, the vast majority of countries people point to make this blanket “contraception reduces abortions” argument are ex-Soviet countries, countries that legalized abortion long before most Western countries could even talk about it in public. These countries use abortion as their primary form of family planning, and despite contraceptive’s limiting influence, still have the highest abortion rates in the world. In short, the introduction of contraception into ex-Soviet countries did not create the contraceptive culture Guttmacher refers to because an abortion culture was already there, with all its teeth. That people use these countries to render contraception an across-the-board anti-abortion tool is stupid.

I hardly need to point out that, from the perspective which views abortion as the deliberate destruction of innocent human life, Alexander’s conclusions — if I’ve read them correctly — do not amount to a glorious redemption for our dearly beloved contraception. With a nod and a fist-bump to inevitable outliers, the introduction of contraception is either

1. Causing an increase in abortion,

2. Rising from the same “less-children” root that blooms with the bitter fruit of abortion, or

3. Causing a decrease in the abortion rates of countries that see contraception and abortion as virtually the same thing.

So I’m still not convinced that the introduction of contraception is ever a good idea (much less a pro-life one). But Alexander moves from discussing the introduction of contraception to the increased use of contraception in countries already introduced:

Overall my guess would be that a society that legalizes contraceptives would see an increase in abortion rates (which might or might not be causal depending on that society’s situation), but that in a society like our own, where contraceptives are already legal and the demographic transition is pretty much complete, increasing access to contraceptives is probably going to decrease abortion. And increasing access to extremely effective contraceptives like the implant or RISUG, especially when they replace less effective contraceptives like the condom, are very very probably going to decrease abortion.

And really, I dunno. It’s tough to say. Sometimes increasing contraceptives locally does reduce abortion rates. Other times it doesn’t. Alexander cites a decrease in abortion in the United States between 2008-2009, yes, but no one has adequately shown me that this is the result of our increased contraceptive use and not the growing philosophical victory of the pro-life movement, our record number of state-level pro-life laws, the popularity of scary-ass people like Gosnell, or some combination of the three. Alexander suggests the recent decrease is “due to both fewer unintended pregnancies and less willingness to end unintended pregnancies with abortion,” and again, I’m open to agreement, but I have to ask the following:

Surely, if contraception were to play a role in reducing abortion rates, it would do so by reducing unintended pregnancies? I can’t think of another way. But from what I can find, there’s been no decrease in the rate of unintended pregnancy. The CDC reports (page 17) that in 2006-2010 the total rate of unintended pregnancy was 37.1%. This is up from 2002, when it sat at 34.9%. Or consider this study, which looked at the whole of North America and found its 2008 unintended pregnancy rate unchanged from 1995, sitting comfortably at 48:

If we’re celebrating the recent decline in abortion rates for the years 2008-2009 at the same time we’re seeing a lack of change in the unintended pregnancy rate, should we really be thanking contraception, which could only reduce abortion rates by reducing unintended pregnancies? Maybe I’m missing something obvious.

So maybe contraceptive increases will decrease the abortion rate. Maybe they won’t. I’d agree with Alexander, that our movement towards long-acting contraception will probably lead to reductions in our abortion rate, as there’s far less room for human error, but I’m curious: Does he believe that this would reduce the abortion rate back to its relatively low level before we became a contraceptive culture? Because the goal of those who view abortion as a human rights atrocity cannot be to lower the abortion rate here and there using a method which ultimately perpetuates an overall demand for abortion by separating the act of sex from the family and the child, that demand Guttmacher notes so eloquently.

And this really is the fundamental issue for those facing the complaint that “if you were really pro-life you’d support contraception.” The heresy of consequentialism aside, it seems to me that supporting the use of even the best, most semi-permanently sterilizing devices our friendly pharmaceuticals have to offer would still perpetuate the culture which opposes the child, the culture which has us saying, “Hey, killing the unborn, sounds like a great idea.” Contraception will always create, or aid a demand for abortion. As Guttmacher says:

Demand for abortion falls to zero only in the “perfect contraceptive” population, in which women are protected by absolutely effective contraceptive use at all times, except for the relatively short periods when they want to conceive, are pregnant or are protected by lactational amenorrhea. Because such a state of perfect protection is never actually achieved, a residual demand for abortion always exists…

This is the ideal, always-creepy contraceptive scenario that we’re moving towards with our newfound hope in long-acting contraception. Somehow, I don’t have high hopes for it reducing abortion rates to a level in which we can sleep well at night (lol jk, we’re all sleeping well), because I worry that the greater the promise of “no-kids” a contraceptive device brings, the greater the likelihood of abortion in the event that the device fails. This seems to make sense: A married couple practicing withdrawal will probably be less likely to freak out over a pregnancy than a couple who have sacrificed 3 years of natural cycling with an IUD. This is just speculation though, maybe I’m totally wrong.

The bottom line: Even when increased contraception isn’t directly causing increased abortions, the two come from a similar philosophy, a philosophy they are both representations of, and which they — in turn — promote. Those who understand that abortion destroys a human life should be personally wary of supporting contraception, which has been shown — in one way or the other — to hold hands with abortion.

I look forward to Alexander’s response, and all you readers are wonderful, beautiful, and destined for incredible acts of heroism.

  • RelapsedCatholic

    The problem and flaw I see in this argument is that it assumes that the primary motivating force for abortion is some vague cultural notion of sex being detached from children. The truth is we know that women seek abortion for many different reasons.We know from interviewing women that seek and obtain abortions that 76% of them seek abortion based on economic grounds. The abortion rate steadily decreased under Bill Clinton because the economy improved steadily ande the middle class strengthened. Yet in the intervening 13 years we have seen a steady weakening of the middle class and decreases in social mobility.

    The author also ignores the changes in the economy. Education has become more vital to obtaining a middle class lifestyle, and this usually involves delaying marriage and child bearing until late in the 20′s. Western Europe continually outstrips the US in social mobility and support of working mothers. Their abortion rate is also far less than our own.

    I also fail to see how anyone can describe the 1300 abortion laws passed across this country as a triumph. Closing clinics and cutting off access to healthcare for poor women based on doorway size and parking lot access is not pro-life. Cutting off access to abortion while simultaneously cutting WIC, SNAP and Medicaid is not Pro-life.

    My wife and I used birth control for the first six years of our marriage. It was not about separating sex from children. It was about responsibly bringing children into this world at a time and place that was condusive to being effective and loving parents. We now have a wonderful daughter that we Baptized into the church last week. We plan on having at least one more, and adopting a third if God wills it.

    • Alexandra

      Well of course the individuals all think that *their* reasons are different or unique and justifiable. But the *only* reason why we think murdering a child is an acceptable solution to unwanted pregnancy is because we somehow think that pregnancy is an undesirable, as opposed to completely natural, consequence of sex, and that sex itself is such a good, and indeed such a necessary RIGHT, that it should be pursued at all times, at any cost, even the life of a child. If you aren’t prepared for a child, to the point of killing a child that may come along, then you shouldn’t be having sex at all.

      And to your other point, abortion is NOT healthcare. Period. End of story. Not even for poor people. So yeah, those laws that end up closing up clinics are indeed pro-life in some sense. And abortion clinics at the least should be as regulated as any other clinic, or have you missed the point of the Kermit Gosnell case? And seriously? Making this about Republican/Tea Party politics when this post is obviously not advocating for their entire platform or for any political platform at all?? Talk about a non sequitur and changing the subject so that you don’t have to face the reality of abortion.

      • Bill S

        ” If you aren’t prepared for a child, to the point of killing a child that may come along, then you shouldn’t be having sex at all.”

        That’s not going to happen. I’m personally not against abortion. But if I were, I would be a hypocrite to also be against contraception and leave abstinence and NFP as the only alternatives to conceiving a child. It’s easy to tell someone not to have sex if they don’t want children, but it’s not practical. The practical solution is to make contraception accessible and free.

        • Alexandra

          No, it’s completely practical. We teach people not to steal right? No matter how much they might want an item, and no matter how much that item might make them happy, we expect people to restrain themselves from acquiring an item they can’t afford. Most people understand that if the consequence of obtaining an item is JAIL, they aren’t going to do it, even if they want it. The consequence is not worth the temporary happiness of owning the item. Likewise, if the consequence of pregnancy for you in your current state is so amazingly dire that your ONLY WAY OUT is to kill the child…then you should be restraining from the activity that would make you pregnant in the first place. It’s not a difficult concept.

          And if you think “the practical solution is to make contraception accessible and free” you obviously didn’t read this. Which is really ridiculous. Or do you think that contraception works 100% of the time? Newsflash: It doesn’t.

          • Bill S

            You can’t compare sex to stealing. One is a primal instinct and the other is illegal. You can tell people not to have sex if they can’t deal with the potential consequences, but it is not practical to expect them to listen.

            Contraception is almost 100% effective and is available under health plans. It’s being banned by the Catholic Church is a Pope thing and has no effect on Americans.

          • Alexandra

            If you think that contraception is that effective, you’re ignoring that the CDC itself admits that contraceptive use is nearly universal and yet over 50% of pregnancies are unplanned. Sorry, but you’re ignoring the facts. Contraception has not reduced unwanted pregnancy and due to the risk compensation principle that Marc so ably describes may indeed increase it.

          • Paul McGuire

            Most of these unplanned pregnancies are because people are either not using contraception or weren’t taught about contraception.

            Even if there is a small chance of contraception not working, you will still have many less unplanned pregnancies if people are taught about and use contraception.

            The rates of teen pregnancies are much higher in areas where abstinence is what children are taught and not safe sex. The simple reason being that teens are having sex all around the country but many are using protection.

            “States that prescribe abstinence-only sex education programs in public schools have significantly higher teenage pregnancy and birth rates than states with more comprehensive sex education programs, researchers from the University of Georgia have determined.”
            http://news.uga.edu/releases/article/abstinence-only-education-does-not-lead-to-abstinent-behavior/

          • Alexandra

            Seriously…read this post and the preceding one if you think it’s that simple. I don’t understand you people who comment having completely ignored the text of the article.

          • Paul McGuire

            You can’t really say much about the link between contraception and abortion in the US without breaking it down state by state. Some states still have abstinence only sex education while others don’t. The study I linked to shows a link between abstinence only education and higher teenage pregnancy rates.

            I don’t see how the culture described in the article is going to change or go away if all of a sudden access to both contraception and abortion was reduced. We’ve reached the point in society where all but the most devoted religious individuals consider children a burden to be pushed off until they are ready.

          • Alexandra

            It’s not going to go away “all of a sudden” as if overnight, but it’s certainly NOT going to go away at all as long as we continue to outright encourage such thinking. Change in the laws doesn’t overnight fix culture, but to act as if it makes no difference is willfully blind.

            For example, there was a deeper cultural problem that allowed for and indeed encouraged slavery. Slavery was seen as a solution to a host of problems. Making slavery illegal didn’t overnight cure the underlying cultural disease that had allowed it in the first place. That took another century (or more depending on your opinion of our current race relations) but that shift COULD NOT have happened without the legal change *first.* Now, obviously, some threshold of people had to find the original culture seriously flawed in order to push for the legal change to take place, so obviously some cultural shift is necessary to force legal change, but it need not actually be a change with the majority. If we had waited to fix the culture for the majority before we fixed the law, we would almost certainly still have slavery. This is no different. Fix the laws first. That won’t be the beginning and the end of the work that will need to be done, but it is necessary work.

          • Damien S.

            That was debunked in the post Badcatholic is responding to.

            “The two-thirds of U.S. women at risk of unintended pregnancy who use
            contraception consistently and correctly throughout the course of any
            given year account for only 5% of all unintended pregnancies. The 19% of
            women at risk who use contraception but do so inconsistently account
            for 44% of all unintended pregnancies, while the 16% of women at risk
            who do not use contraception at all for a month or more during the year
            account for 52% of all unintended pregnancies.”

          • Alexandra

            But the ones who aren’t using it, are not doing so because they are unaware of it, don’t know how to use it, or don’t have access to it, so that’s irrelevant.

            The 2010 CDC report states: “Contraceptive use in the United States is virtually universal among women of reproductive age… But that does not mean that contraceptive use in the United States is completely consistent or effective. One-half of all pregnancies in the United States are unintended, and the average probability of an unintended pregnancy in 12 months of contraceptive use in the United States is 12%, unchanged from 1995.”

            The fact that people use contraception erratically or incorrectly just further supports the idea that contraception, no matter how cheap or accessible won’t make up for the fact that people are stupid and monumentally bad at risk assessment.

          • Damien S.

            Except that different forms of contraception are differently prone to error. IUDs and implants have very low failure rates, even among broken couples having drunken breakup sex with their sex.

          • Bill S

            Ok. So we do away with contraception. What is to be gained?

          • Alexandra

            You mean beside a more healthy and realistic view of sex, fertility, and children?

          • Bill S

            It seems to me that you want to deprive people of the joy of sex. Here we have this gift of nature, by far the best gift that natural selection has bestowed upon us and one that can quite easily be enjoyed with a greatly reduced risk of pregnancy through contraception and you just want to confine it to being simply a means to reproduce. That might be what nature intended but nature can be manipulated. The saying “it’s not nice to fool Mother Nature” is just a catchy advertising slogan.

          • Beth Turner

            Some people feel a compulsion (“primal instinct”?) to steal. I believe they are called kleptomaniacs? But it doesn’t make it right, nor does it mean we should just be practical and let them take what they want.

          • Bill S

            By that analogy, are you trying to say that just like we don’t let someone get away with stealing just because they are a kleptomaniac and can’t help themself, we should not let people use contraception just because they enjoy sex but don’t want children?

          • Beth Turner

            I’m saying that making public policy *only* based on what is practical, and not considering the goodness or badness of a behavior first is silly. Like letting kleptomaniacs steal, or permitting perjury just because witnesses are really frightened, or letting children play with fire just because they can’t seem to keep their hands off matches. Behaviors must be evaluated for goodness first; then situational factors considered and policies crafted to accommodate them. I realize that we don’t agree on the goodness/badness of contraception, so that point is still under discussion. But trying to get people who oppose contraception to agree with you, because, as you say, people just can’t control themselves and we should let them fail to control themselves, is silly.

            By the way, I would argue that sex might be a primal instinct…but putting a condom on or a piece of metal inside you is not…perhaps that’s why it’s hard to get people to use these technologies properly…!

          • Bill S

            Are you saying that the “badness” of contraception should be considered in making public policies. If so, then Catholics shouldn’t have any say in making policies that affect the American public.

          • Beth Turner

            Are you saying we shouldn’t even permit anyone to propose that contracepted sex is bad? And suggest policies that accommodate the idea? Because if that’s the case, we should probably just throw the First Amendment out the window.

            Yes, the badness or goodness of contraception is the issue here. If contraception is bad, it’s perfectly acceptable to ask people to avoid sex to prevent pregnancy. If contraception is OK, or people disagree very strenuously about whether it’s good or bad, it’s also perfectly acceptable to ask people to at least pay for it themselves.

          • Bill S

            There is no “goodness” or “badness” to contraception. The “badness” is a Pope thing. No one in this free country need pay it any mind. The Pope does not make the rules in this country.

          • Beth Turner

            Even so, I’d like to suggest that a public policy can both respect your belief that contraception is neutral and mine that it is bad: you can buy it for yourself or your wife or your girlfriend if you want; you can associate with other individuals who choose to to raise money to pay for it for other people who cannot afford it. And I can also be free to do neither of those things, believing it to be bad.

          • Bill S

            I understand how you feel and I assume you did not vote for the President. Obamacare includes coverage for contraceptives. No one is forcing you to use them so this isn’t a First Amendment issue. I don’t really care about employers who don’t want to pay for healthcare that covers contraceptives. Their candidate lost and they have to live with the laws that have been enacted.

      • RelapsedCatholic

        97% of the services that PP offers IS healthcare and reproductive health services, not abortion. They do more to prevent unwanted pregnancies than every piece of abstinence-only education ever created. The laws that have been proposed go beyond the regulations that other clinics face, and are simply designed to close the clinic rather than increase the quality of care. And lastly I agree the the Gosnell case shows we should be overseeing and checking these clinics more closely. I am no fan of abortion, but the strategies of the Pro-Life movement will not end abortion, nor do I even believe will they decrease their number.

        • Alexandra

          Hahahahahahaha. Planned Parenthood helps prevent unwanted pregnancies????? That’s hysterical. It’s as if you think that PP is some benevolent organization, just there to *help the people* instead of a BUSINESS out to do what is best for them. At least 30% of the people who walk into the doors of a PP get an abortion. They pad their numbers so that when Mary Doe walks into a PP in April for the pill, then comes back in May for a STD and pregnancy test, then back in June for an abortion, they count it as offering 4 different and separate services. They offer essentially zero prenatal care and their abortion to adoption referral ratio is disgusting and they don’t do fertility treatments if you’d like to actually you know, plan your parenthood. But let’s just accept that number, 3%, for a moment, and accept that when they’re not killing babies they’re doing some really great stuff. Would you send your parents or grandparents to a nursing home that *only* killed the patients intentionally 3% of the time and the rest of the time did great work? Of course not, because it’s not *only* 3% when the action we’re discussing is murder. And they don’t want ANY oversight, they fight EVERY SINGLE piece of legislation meant for clinics to face inspection. Look at Gosnell’s clinic, locked back doors, halls not wide enough for a gurney, untrained/unlicensed staff. Did you read the Grand Jury report, do you know why that was allowed to continue for nearly 2 decades? Because when pro-choice Gov. Ridge got elected, he didn’t want to “interfere” or “impede access” so he didn’t inspect at all. And EVERY SINGLE TIME that a legislature wants to enforce clinic regs. on abortion mills, Planned Parenthood is there to say this will “impede access” and “interfere” with the “right” of abortion. Do you really think Gosnell was one of a kind? That there are no other disgusting clinics out there that get away with substandard conditions because the state won’t inspect them??

          Finally, your comment that you’re “no fan of abortion” tips your hand. If it’s murder then you have a moral obligation to fight it at every turn. To stand up against that evil and to not allow the government to condone it through permissive laws. If it’s not murder then there’s no reason to worry about it at all, or to be a fan or not a fan of it. It would be as morally neutral as getting your appendix out. That you shy away from being a fan of it, reveals that your conscience knows it’s not that simple. Maybe you should examine why.

          • Damien S.

            But those *are* four different services.

          • Alexandra

            Sure, but when you’re looking at what percentage of their clients get abortions from them…the numbers change dramatically. Most people who walk through the doors of a PP get an abortion, that is the portion of their work that takes the most time, makes the money, and is least duplicated by say a pharmacy or other health center.

          • Bill S

            So, up to 70% go to PP for services other than abortion. What are you complaining about. And of course they are in it for the money. Who isn’t? Even the Church is in it for the money. Who do you think pays for all the luxuries that everyone from the popes to the local clergy enjoy? Don’t compare PP to crackpots like Gosnell.

      • Damien S.

        There’s also that we don’t think abortion is murdering a child.

        http://mindstalk.livejournal.com/337325.html

        • Alexandra

          And you’d be wrong. Not to mention scientifically illiterate.

          • Damien S.

            My link summarizes and links to the actual science.

          • Alexandra

            Easily refuted. Is it okay to kill people in a coma, under heavy anesthesia, or deep sleep? Consciousness is NOT the standard we use to decide whose lives have value and whose do not. The US Code merely defines homicide as the intentional killing of a HUMAN BEING with malice aforethought. The unborn are human beings, they are alive, and abortion intentionally and with malice aforethought robs them of their lives. That is homicide. Plain and simple.

          • Damien S.

            There’s a difference between a person temporarily asleep or comatose and an organism that has never ever had the brain mechanisms for consciousness, or been awake.

            You believe in unscientific notions of a soul. I don’t. Personhood isn’t off or on, it’s something that develops, and most aborted fetuses are aborted long before they have the mechanisms to even start developing personhood.

          • Alexandra

            While I am Catholic and do believe in the soul, those beliefs have nothing to do with my opinions on abortion. And it is patently obvious that the process of birth does not grant consciousness. There is no difference between the child in the womb and the one out of it moments later. Their level of development are exactly the same. And no, there’s no difference. Our lives are not dependent on our cognitive functions at any particular moment.

          • Damien S.

            Actually it seems one big difference is that the born child is ‘awake’ for the first time; the fetus hasn’t had enough blood oxygen to be conscious.

            And as far as not worrying about the 1%, very few abortions occur anywhere near that late. Most are of first term embryos with barely any neural structure. Our lives are definitely dependent on our having sufficient brains; that’s why we have concepts of brain-death, and don’t consider cells in a petri dish to be human beings, despite having a full genome.

          • Alexandra

            Children in the womb before birth can hear and recognize their parents voices and towards the very end of the pregnancy react to light. In the lower gravity environment of the womb, children in utero can even do some things that newborns can’t, like roll over. We don’t “wake up” at birth and it’s ridiculous to even suggest so.

          • Alexandra

            The value of our lives only depend on one thing, and one thing only, are we human beings? If the answer is yes, and the unborn without doubt fall under that rubric, then we have value and to take our lives away because your mere feelings is inherently unjust. Any and all other distinctions are arbitrary and capricious subject to an ever changing set of definitions and whims.

          • Damien S.

            What’s a human being? Are skin cells in culture a human being? The Henrietta Lachs cancer line? Why is a one-cell embryo a human being in your eyes, and not a cancer cell?

          • Alexandra

            It’s very simple. A human being is a member of the species Homo sapiens, something which is easily determined by studying the cells, a complete and self-directed organism. Therefore an adult arm removed from the body is a not a human being but a 2 lb. new born is, the new born as tiny as they are, is a complete and whole self-directed organism. The mother’s body may provide nourishment and an environment, but she does not direct the child’s development any more than the mother with a child outside her womb in providing food and shelter is directing the child’s physical development. A single human skin cell, is a part of a human being, but a skin cell is not a complete self-directed organism, the zygote however, while it is still only one cell is. That one cell contains all the information needed to continue the development all the way to the adults we see walking around. The zygote IS the same as the adult, a different level of development to be sure, but no different than in the sense that when you see your baby pictures, you know you are looking at yourself, at all you were and all you would become all at once.

      • Damien S.

        “If you aren’t prepared for a child, to the point of killing a child that
        may come along, then you shouldn’t be having sex at all.”

        Good think women never get raped or fertilized by their rapists. Oh, wait.

        Or discover during pregnancy that having a child will kill them.

        • Alexandra

          Ah, as usual, making the abortion debate about the 1% of abortions, rather than the 99%.

          • Damien S.

            When the Catholic Church takes an absolutist stance opposed to even life-saving abortions, and claims to be the arbiter of morality, they make it about the 1%. When archbishops opposed abortion for a raped 9 year old girl, whose pregnancy would result in the death of her fetus and herself, they show their moral system as monstrous.

          • Alexandra

            The unborn don’t become less human just because the circumstances of their conception were not the ideal. Abortion does not unrape the woman. As for “life saving” abortions…you’re allowed to treat the mother’s conditions, even inducing early labor or giving her necessary drugs, even if such treatments mean the child has nearly zero chance of survival, in order to treat her condition. What you may NOT do, is purposely kill the child. The killing of a child is NOT treatment for ANY condition. Intent matters. This merely respects the fact that BOTH lives have value. Both lives matter. Neither one more or less than the other.

          • Damien S.

            “Both lives matter” even when both are doomed without abortion?

          • Alexandra

            Consider conjoined twins. It is very often the case that one twin is far stronger than the other. That if they continue to be conjoined both will die. However, separation carries far greater risk for one than the other. Doing the surgery to separate anyway is completely moral as long as every effort is made to save the life of the weaker twin no matter how much of a long shot it would be. What is NOT permissible, and what it is that you are advocating in pushing for abortion in instances when the mother’s life is threatened, is to merely the stab or poison the weak twin FIRST and then do the surgery to separate “unburdened” with even attempting to save them. Like I said, Intent matters.

        • Beth Turner

          For the few women that discover having a child will kill them during pregnancy, it often happens after viability, and early delivery is permissible to save the life of the mother. It is even permissible to deliver early if it can be foreseen that the child will die, provided that early delivery will actually help the mother (and provided that she does not choose to continue with the pregnancy, in spite of the risk).

          What is not permissible is tearing the child limb from limb, or poisoning it, or otherwise making an active assault on the child’s life, at the same time as attempting to relieve the disease which the pregnant woman suffers. Even ectopic pregnancy, which develops far prior to viability, can be ended without attacking the life of the child (that is, poisoning or cutting up the embryo).

          Acting aggressively towards the embryo, fetus, or newborn is not permissible, even if one foresees that certain treatments designed to improve the health of his mother may adversely affect his life.

    • TKDB

      Having basically altruistic motives for separating sex from procreation is nonetheless separating sex from procreation. This isn’t about bare-faced self-centered hedonism, but rather the underlying root mentality of procreation being an optional add-on to sex rather than an integral and natural part of it. Someone using contraception based on reasoning along the lines of “I don’t want my child to grow up having to deal with the financial issues I’m struggling with right now” is certainly more noble than someone who thinks “I don’t want to deal with the hassle of a[nother] kid right now”, but in the end both lines of thinking are products of the very same contraceptive culture Marc is talking about — the idea that one can and should have an active sex life without having to deal with the natural end of that lifestyle.
      Better economic circumstances may certainly make people more disposed to having children, but this phenomenon stems in the first place from the notion that one can and should control when and how often one has children, without sacrificing sex to do so. There are a number of reasons why one may wish to avoid having children without giving up sex, some noble and some selfish, but those aren’t the issue here. The issue is whether the avoidance of procreation should be separated from avoidance of sex in the first place, regardless of motive. The Church says no — the two are intrinsically intertwined, and to separate sex from procreation is to defy God’s will for us and our sexuality. The contraceptive culture says sure, why not? And once a culture has embraced that “why not?”, you’re inevitably going to have people who will resort to abortion to achieve the separation of sex and procreation that they have come to view as the normal and proper way of things.

      • RelapsedCatholic

        Sex has many different purposes and even the RCC recognizes that fact. That is why the Church will marry people that are past child bearing years or who have known fertility issues. Sex is also about bonding, pleasure, and stress relief to name but a few. The problem comes not from separating sex from procreation, but in separating sex from marriage and committment. Moreover w/ a population surging over 7 billion and and environment being pushed to the brink I think seperating sex from procreation to a degree is not only healthy but vital.

        People are not going to stop wanting to have children just because they can have sex without them. Infertile couples and gay couples seek to adopt children all the time. The urge to be a parent and the urge to have sex are related, but clearly seperate.

        • TKDB

          Given the clearly consequentialist bent of your comments about overpopulation, I imagine my attempts to explain the Church’s position (a position founded on natural law ethics) will sound like so much complete nonsense to you (especially since I imagine my attempts would come across rather jumbled and full of holes even to those who thoroughly understand and embrace natural law ethics), but I’ll give it a shot.
          Sex does indeed have purposes in addition to procreation, but the fact that an act serves multiple roles does not necessarily mean that any given one of those roles is not essential to the telos of the act. Furthermore, it’s plainly apparent that the other roles of sex are in fact directly connected to — in fact, from an evolutionary perspective, subservient to — the end of procreation. The bonding effect promotes the formation of stable families and the continued presence of both parents to help raise the children that result from the union. The pleasurable nature of the act is part of the basic reward system that incentivizes us to seek out things that are necessary for our survival — sex is pleasurable not because pleasure is its natural end, but because its natural end is something vital and thus we are hardwired with reasons to seek out the act that leads to that natural end. Same as eating — it’s pleasurable to eat good food, but that doesn’t mean pleasure is a fundamental end of eating that should be separated from its proper telos of providing necessary nourishment. When one mistakenly pursues pleasure in food over its proper telos, the consequences are clearly harmful in a physical manner — obesity and its attendant health detriments, or eating disorders like bulimia. Obviously, there aren’t such clearly visible consequences when it comes to missing the telos of sex, but that doesn’t mean it isn’t still detrimental on a more subtle spiritual level.
          And essentially any other purpose you can think of for sex (such as your third example of stress relief) is simply a variation on the bonding effect or the pleasure incentive.

          As for why the Church blesses marriages between couples who are not expected to be fertile, that’s because the moral nature of an act lies not in how likely it is to fulfill its relevant telos, but rather in whether it’s ordered toward that telos in the first place. A couple past childbearing age or suffering from known fertility issues may be vanishingly unlikely to fulfill the telos of the sexual acts they engage in, but that is a function of a physiological failure in the machinery involved rather than the nature of the sex act itself. The Church’s position is not that every sex act must result in a child, nor even that every sex act must be intended to result in a child — only that every sex act be open to the possibility (however vanishingly slim the condition of our physical bodies may render it) of the creation of a child. It’s a matter of being directed toward the proper end.
          Contrast the use of contraception, which knowingly and deliberately seeks to thwart the telos of the act, and other sexual sins that pursue secondary benefits of the sex act in ways that, even if all parts involved were operating at peak condition, could never fulfill the telos of sex.

          As for your last point…I’m not sure where you’re getting the idea that I and others with concerns about the contraceptive culture are worried about the complete extinction of all desire to have children. I’m sure it wasn’t intentional on your part, but that’s a pretty preposterous strawman.

          • Damien S.

            Sex without reproductive risk is like drinking diet soda.

            The natural world contains lots of non-reproductive sex, too. Especially in bonobos.

          • RelapsedCatholic

            However, evolution amongst social animals is more complex than simple reproduction. The brother of the alpha male stands guard over the pups when the bitch is bringing them from the birthing location. Bees will attack a threat to the hive even when it has no hope of reproducing. The case that male/female coupling is suggestive of natural order is over stated. The only thing we can definitively say is that is an evolutionary hold-over from our ancestor species. Human beings have most often raised children in small social groups, not individual families. So non-reproductive sex acts between people for the purposes of bonding are in fact not opposed to the primary telos of the act, they may in fact be primary to it.

            Simply stated, there is ample scientific evidence to suggest that non reproductive sex is still perfectly in line with the purpose of sex. Sex amongst higher animals simply has more purposes than amongst plants and simpler life forms. Aristotle did not know this, thus Aristotelean arguments about the lessons that nature teaches us are overblown. He was actually a terrible scientist and observer of nature.

      • Damien S.

        This logic is more plausible for most pro-life evangelicals. But the Church opposes abortion even for rape victims, or when the mother’s life is in danger. Those make no sense in terms of the culture or purpose of sexuality.

        • TKDB

          That’s because what makes abortion immoral has nothing to do with sexuality; it’s a matter of the value of a human person. Cultural views of sexuality are pertinent to abortion in that they influence the demand for abortion, but the sexuality has nothing to do with the morality of abortion.

  • Yvain

    Thanks once again for a really thoughtful response. And thanks for pointing me to the unintended pregnancy rate data – I was using teen pregnancies as a proxy, but this is much more interesting.

    So you’re right that unintended pregnancies stay pretty constant. On the other hand, this article claims that change in percent unintended pregnancies that end in abortion only explains two points of the five point decrease in abortion rates. Unless I’m missing something, it is impossible to have a change in the abortion rate that isn’t explained either by the unintended pregnancy rate or the percent unintended pregnancies that end in abortion (unless people are aborting intended pregnancies, which doesn’t make sense). Possibly the difference is that our statistics aren’t from exactly the same years? It looks like yours come from comparing 2006-2010 to 2002, whereas mine come from comparing 2009 to 2008. Any thoughts?

    Second question. Suppose the government were to ban all contraception tomorrow, but not ban abortion. It seems to me that people might have a bit less unprotected sex when not wanting children, but certainly not stop entirely, and this would result in a HUGE spike in the abortion rate and probably turn us into one of those ex-Soviet countries you talk about where abortion *is* the contraception. Do you agree? If so, and you agree that having less contraceptions would lead to more abortions, why wouldn’t the opposite – having more contraception – lead to fewer abortions?

    Third question. What did you think of the claim in my original post that people interviewed at abortion clinics were disproportionately likely not to be on contraception? I thought that was probably my strongest argument and I’d be interested in hearing a response.

    And a final point – I don’t share your intrinsic horror at a world in which everyone has an IUD, and the ethical issues are probably too complicated to get into here, but I do think we can engage on the likely demographic results. You say:

    Somehow, I don’t have high hopes for it reducing abortion rates to a level in which we can sleep well at night (lol jk, we’re all sleeping well), because I worry that the greater the promise of “no-kids” a contraceptive device brings, the greater the likelihood of abortion in the event that the device fails. This seems to make sense: A married couple practicing withdrawal will probably be less likely to freak out over a pregnancy than a couple who have sacrificed 3 years of natural cycling with an IUD.

    I think even if you’re right about the existence of such an effect, the numbers just don’t work out.

    Let’s say that every couple has an IUD…no, actually, let’s go all the way and make it Implanon, the most effective contraceptive known – and that this has the most extreme possible effects – everyone has sex all of the time with no concern for abstinence, and every single time someone has an unintended pregnancy they choose abortion.

    Implanon has a failure rate of 0.05%/year, so in this world, 0.5/1000 women of reproductive age has an unintended pregnancy each year, which she aborts. Compare this to the real world, where the abortion rate per women of reproductive age is 15/1000. We’d effectively be slicing the abortion rate by a factor of 30. That’s moving from a million abortions a year to only about 30,000. If you believe a fetus is a human life, that’s saving 970,000 people per year – pretty tempting for anyone remotely consequentialist.

    • Fnord

      I may be able to square the circle on the higher unintended pregnacy rate/lower abortion rate thing. They have different denominators: the rate of unintended pregnancies AS A FRACTION OF PREGNANCIES rose, whereas the rate of abortions PER WOMAN OF REPRODUCTIVE AGE fell. If you have a drop in number of pregnancies per woman of reproductive age, you could see both results, even in the absence of an increased willingness to carry unwanted pregnancies to term.

      The CDC doesn’t specifically report the rate of abortion as a fraction of pregnancies. But it does track the abortion ratio, which is the ratio between abortions and live births. Assuming that all pregnancies end in either abortion or live birth*, that data suggests a drop in the rate of abortions as a fraction of pregnancies of about 2%. Which is, as the article suggests, smaller than the overall drop in abortion rates. If the fall in abortion rate per reproductive aged woman is greater than the fall in abortion rate as a fraction of pregnancies, there must be fewer pregnancies per woman of reproductive age.

      *Not realistic, given miscarriage, etc. But works out to be fairly close unless the rate of miscarriage etc changes over the time period.

    • brucenyc

      unless people are aborting intended pregnancies, which doesn’t make sense

      Unfortunately, people are aborting intended pregnancies, eg downs syndrome, though it may not change the numbers enough to change the conclusion.

      • Fnord

        The Guttmacher Insitutute and the National Right to Life Coalition both report that only 6-7% of abortions (in the US) are primarily motivated for by health concerns, whether issues of maternal health or fear of fetal defects. And I suspect that pregnancies in that category are (at least) ~1/3 unplanned, just like in the general population, so the rate of abortion of intended pregnancies seems to be quite low.

  • Marta L.

    I wonder if there’s not a flaw in the way you’re analyzing the data here? Specifically, you are comparing cultures with high contraceptive use against other cultures with low contraceptive use, rather than comparing them to what those same cultures would be like if they had low contraceptive use. Granted, we only have data for actual countries and not hypothetical ones, but I still think your approach runs the risk of making unfair comparisons.

    Consider an analogous case. Say some city councilman looks at public schools all over the city, and he notices that on average the greater the proportion of students getting free (government-subsidized) lunches, the lower the test scores tend to be. He concludes that the free lunches are causing the test scores and the best way to raise everyone’s test scores is to take away the free lunches. Of course this would be disastrous because it’s not the lunches themselves that cause the bad test scores. It’s poverty, which tracks pretty well with free lunches. If you want to know how the free lunches impact test scores, you need to find two schools that are alike in all the relevant details except how many kids are eating lunch on the government’s tab and look at how their test scores compare.

    Similarly, if you compare country A (high contraception access, high abortion rate) with country B (low contraception access, low abortion rate) that’s not going to tell you a lot if (say) country A has an average marrying age that’s ten years higher than country B, or if country A’s economy makes it impractical for women to combine paid work and childrearing (meaning that parenthood has a high economic cost) whereas country B’s economy makes it easier to combine the two. You’re comparing apples to oranges. What you need is a country A’ – similar to country A in all the relevant details, except for country A’ has low contraceptive access whereas country A has high contraceptive access. Until you get that, it’s a badly-constructed comparison and probably isn’t going to tell us a whole lot.

    • badcatholic

      You’re right, though I’m not sure what you’re referring to in my post — the ex-Soviet countries?

      I think an easy way to look at the same culture, but with different contraceptive levels, is to look at the same culture before and after the introduction of contraception. Now as Alexander showed, this won’t always mean that contraception caused and increase abortions (they might have increased simultaneously as part and parcel). But it should give a good idea of the effect of a “contraceptive culture” on a country. Guttmacher Institute do this.

      They found that contraception reduced abortions in the ex-Soviet states Kazakhstan, Kyrgyz Republic, Uzbekistan, and Bulgaria, where abortion was already the main form of family planning, and in Turkey (but here they acknowledge that the principle factor reducing abortion rates in Turkey first “a lower propensity to abort accidental pregnancies while using traditional methods” then “a decline in failure rates of traditional methods and finally, a shift in method mix toward modern contraception” and in Tunisia (where abortion was legalized ten years before contraceptive prevalence began the increase that Guttmacher notes) and Switzerland. The majority of the time, contraception reduced an already high abortion rate. This indicates to me that it never introduced a “contraceptive culture” because the culture was already there.

      Guttmacher then notes that in many countries there is a parallel rise in abortion and contraception. They say:

      In societies that have not yet entered the fertility transition, both actual fertility and desired family sizes are high. In such societies, couples are at little (or no) risk of unwanted pregnancies. The advent of modern contraception is associated with a destabilization of high (or “fatalistic”) fertility preferences. Thus, as contraceptive prevalence rises and fertility starts to fall, an increasing proportion of couples want no more children (or want an appreciable delay before the next child), and exposure to the risk of unintended pregnancy also increases as a result.

      Thus a culture, in association with the introduction of contraception, undergoes a philosophical shift towards not wanting children, and thus that culture develops a greater demand for abortion.

      • Damien S.

        “The advent of modern contraception is associated with a destabilization of high (or “fatalistic”) fertility preferences.”

        It’s also associated in practice with falling infant mortality, which would more directly reduce fatalistic fertility preferences, because you could have two kids and count on them probably not dying.

  • Sven2547

    Contraception will always create, or aid a demand for abortion. As Guttmacher says:

    Demand for abortion falls to zero only in the “perfect contraceptive” population, in which women are protected by absolutely effective contraceptive use at all times, except for the relatively short periods when they want to conceive, are pregnant or are protected by lactational amenorrhea. Because such a state of perfect protection is never actually achieved, a residual demand for abortion always exists…

    Nowhere in this paragraph does Guttmacher say contraception creates or aids a demand for abortion. He merely speaks of a hypothetical-but-unrealistic situation where the demand for abortion is zero.

    I will also note that the data on contraceptive use in Spain is conflicted at best. A UN study shows a marked DECREASE in contraceptive usage in Spain during that period of time.

    • badcatholic

      I apologize, my sentence structure was bad and I feel bad. I was referring to the previous Guttmacher quote:

      The advent of modern contraception is associated with a destabilization of high (or “fatalistic”) fertility preferences. Thus, as contraceptive prevalence rises and fertility starts to fall, an increasing proportion of couples want no more children (or want an appreciable delay before the next child), and exposure to the risk of unintended pregnancy also increases as a result.

      As to the two studies, the one you cite is only of married women, not of all Spanish women.

      • Sven2547

        So this means single women are more likely to get abortions. How shocking?
        Speaking of Guttmacher, here is the most telling quote mentioned in Alexander’s critique, which is conspicuously absent in your response:

        The two-thirds of U.S. women at risk of unintended pregnancy who use contraception consistently and correctly throughout the course of any given year account for only 5% of all unintended pregnancies. The 19% of women at risk who use contraception but do so inconsistently account for 44% of all unintended pregnancies, while the 16% of women at risk who do not use contraception at all for a month or more during the year account for 52% of all unintended pregnancies.

        Now unless you’re going to try to suggest there is no correlation between unintended pregnancies and abortions (lol), this really is quite damning.

        • badcatholic

          I’m not saying it’s shocking, I’m just saying what Guttmacher is saying, that the advent of contraception creates (or is part of) a cultural shift that creates a need for abortion, by promoting both the desire and the capacity for sex without children.

          I agree that the Guttmacher quote certainly holds up the benefit of consistent, constant and correct contraceptive use. I’m not denying that contraception does indeed work to reduce unintended pregnancies. But we need to be careful about what the quote is saying in reference to the argument i’m making.

          I and Alexander have both pointed out that the INTRODUCTION of contraception into a culture either causes abortion or comes from the same “more sex, less kids” desire that abortion comes from. Now the vast majority of women in the Guttmacher quote you just mentioned practice contraception. The first two categories are those who practice contraception well and those who do not practice contraception well. The last category is still NOT women who don’t use contraception — they just haven’t used a contraceptive device in a month or more. (Assumedly, this includes women some who don’t at all, but these are very few.)

          So in general, all three of these categories of women are accepting and welcoming to the use of contraception. If it is THIS that I argue is the reason for contraceptions association with the abortion rate, that the use of contraception either promotes a philosophical shift which sees a child as an unintended, to-be-avoided consequence of sex and thereby creates a greater desire for abortion, or it is used as a response to that same philosophical shift.

          Consider this. Say a woman is dating a man, and she uses contraceptive pills perfectly for a year. She has no unintended pregnancies and thus no abortion. She is fit, by Guttmacher, into the first (2/3) category. Then her and her boyfriend break up. She no longer has any need for her contraceptive use, so she stops taking oral contraceptives (to save money/prevent side-effects/just because/whatever). A month later, her and her boyfriend have breakup sex. She gets pregnant. She gets an abortion. Now the next Guttmacher study comes around, and she is placed in the last category “16% of women at risk who do not use contraception at all for a month or more.” Can we, from this, generally say that the promotion, provision and use of contraception reduces abortion rates? Of course not. All we can say is that of those already willing to use contraception, those who are using it better will have less abortions. Which no one is arguing.

          I dunno if that distinction makes sense.

  • Damien S.

    Uh, your Table 2 compares 1995 and 2008, in which time I’d think North America has had basically constant access to birth control. So, no change in unintended pregnancies isn’t that surprising. If you look at the World, or at regions where rising wealth levels would increase contraception access, then you see… falling unintended pregnancy rates.

    And where do you see the lowest rates of unintended pregnancy? In Europe, Oceania (Australia/New Zealand, mostly) and North America. Wealthy and contraception friendly. The highest? Africa and Latin America/Caribbean, the poorest/lowest access continent and a fairly poor and Catholic area.

    I view this as decent evidence that contraception *does* reduce unintended pregnancy.

    ***
    Also, while I was initially seduced by the idea that contraception could raise abortion by introducing the idea of control and unwanted pregnancies, I was quickly skeptical; people had ways and desires of avoiding pregnancy long before. If anything it’s the reduction in infant mortality so that one isn’t playing reproductive Russian roulette, as well as the rising cost of having kids, that drives the desires; contraception just means you can still be having PIV sex.

    • badcatholic

      Right, but what we’re trying to figure out is how contraception could cause abortion rates decline if there was no decline in unintended pregnancy, which is the method by which contraception causes abortion rates to decline.


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