Study Finds That Free Birth Control Leads To Fewer Abortions

One of the most common sense arguments that pro-life people should be pro-birth control is vindicated:

Free birth control led to dramatically lower rates of abortions and teen births, a large study concludes. The findings were eagerly anticipated and come as a bitterly contested Obama administration policy is poised to offer similar coverage.

The project tracked more than 9,000 women in St. Louis, many of them poor or uninsured. They were given their choice of a range of contraceptive methods at no cost – from birth control pills to goof-proof options like the IUD or a matchstick-sized implant.

When price wasn’t an issue, women flocked to the most effective contraceptives – the implanted options, which typically cost hundreds of dollars up-front to insert. These women experienced far fewer unintended pregnancies as a result, reported Dr. Jeffrey Peipert of Washington University in St. Louis in a study published Thursday.

The effect on teen pregnancy was striking: There were 6.3 births per 1,000 teenagers in the study. Compare that to a national rate of 34 births per 1,000 teens in 2010.

There also were substantially lower rates of abortion, when compared with women in the metro area and nationally: 4.4 to 7.5 abortions per 1,000 women in the study, compared with 13.4 to 17 abortions per 1,000 women overall in the St. Louis region, Peipert calculated. That’s lower than the national rate, too, which is almost 20 abortions per 1,000 women.

In fact, if the program were expanded, one abortion could be prevented for every 79 to 137 women given a free contraceptive choice, Peipert’s team reported in the journal Obstetrics & Gynecology.

Let me talk to traditionalist Catholics for a second here. If you really really believe that abortion is murder I cannot imagine how you can oppose widespread access to birth control for the general public. Even if you believe that there is some abstract harm done when humans actively thwart the procreative function of sex, as some violation of one of sex’s inherent functions, are you really so opposed to that abstract evil occurring that you would risk greater numbers of abortions, which you consider to be greater numbers of murders, to happen?

Theoretically, if thwarting our genitals’ procreative functions was such an evil, one worth risking the prospect of what you think are murders rather than ever permit–even passively, then why are you not outraged at celibates, all unmarried adults, married couples using rhythm methods, married couples with sexless marriages, etc.? In fact shouldn’t you be outraged every time a fertile day goes by when those genitals aren’t put to their purpose of trying deliberately to produce a baby?

If no act of sex can be morally permissible–or even politically tolerable–unless it is open to fulfilling that one of sex’s possible good functions then why can a single human day of possessing genitals go by without trying to use them to fulfill that good function? I mean, in your eyes, refusing to put barriers to this function is such an important matter of principle to you that you are willing to risk an increase in what you think are foreseeable murders over it.

Why are you not opposing the barriers to contraception that are abstinence and celibacy this strongly? Why don’t we hear from you traditionalist Catholics injunctions to have sex four times a day every day that one’s partner is not menstruating or pregnant? Why is that not a religious duty worth imposing on the Catholic fold and the nation more generally as the prohibition against birth control is? Why is it only a waste of the genitals’ inherent functionality when birth control is used and not also every time they are capable of having sex but not put to that purpose?

Your Thoughts?

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The Catholic Church Wants Women Pregnant Against Their Wills

“Must (or Can) the Religious Engage in the Secular Sphere ‘Non-Religiously’?”

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About Daniel Fincke

Dr. Daniel Fincke  has his PhD in philosophy from Fordham University and spent 11 years teaching in college classrooms. He wrote his dissertation on Ethics and the philosophy of Friedrich Nietzsche. On Camels With Hammers, the careful philosophy blog he writes for a popular audience, Dan argues for atheism and develops a humanistic ethical theory he calls “Empowerment Ethics”. Dan also teaches affordable, non-matriculated, video-conferencing philosophy classes on ethics, Nietzsche, historical philosophy, and philosophy for atheists that anyone around the world can sign up for. (You can learn more about Dan’s online classes here.) Dan is an APPA  (American Philosophical Practitioners Association) certified philosophical counselor who offers philosophical advice services to help people work through the philosophical aspects of their practical problems or to work out their views on philosophical issues. (You can read examples of Dan’s advice here.) Through his blogging, his online teaching, and his philosophical advice services each, Dan specializes in helping people who have recently left a religious tradition work out their constructive answers to questions of ethics, metaphysics, the meaning of life, etc. as part of their process of radical worldview change.

  • asonge

    Yeah, I really have no idea how Natural Family Planning is acceptable but a condom is not. You’re forming the intent to get around your fertility. In fact, for sperm collection for fertility testing for particularly devout Catholics, they poke a hole in the sperm-collection condom just so that there’s a chance that the procreative act will take place…which sometimes contaminates the sample and increases costs. The lines just seem so arbitrary.

  • Eamon Knight

    My understanding (from a Catholic friend who practices NFP and has seven children, none exactly planned) is that even NFP is bad if done with the Wrong Attitude (I believe the term is “contraceptive mentality”).

  • penn

    I don’t think this argument will get very far with devout Catholics. Catholics consider the pill, plan-b, and IUDs to be abortifacients because it is hypothesized that they can prevent the implantation of a fertilizer egg even though there is no good data to support support this hypothesis. Catholics wouldn’t consider these methods as actually preventing murder, so providing them for free would be increasing murders. So, we’ve already thrown out the most effective forms of birth control, and we’re left with barrier methods and spermicides.

    Additionally, it comes down to responsibility. IF everyone quit having “bad” sex then it wouldn’t be an issue at all (I’ve heard and even made this argument numerous times in my earlier life). The people having the “bad” sex and abortions are responsible for their immoral actions, and if we support those immoral behaviors, then we’re all tacitly responsible. This is really a common problem in policy-making. We often care more a purity, and punishing immoral behaviors than providing effective policy measures to alleviate real societal harms. This is a big issue with the war on drugs. Needle exchange programs work and save lives, but they help drug users. Drug users are doing bad things, so they should go to prison and be punished with other bad people. Does that make it more likely they won’t get off drugs and that they will become hardened criminals? Sure, but we can’t support immorality. Does it cost society more in the long run? Of course, but we must be willing to pay the price for our own self-righteousness.

  • Brad

    This isn’t even new information, is it?

    • Zme

      I think what’s new is the size of the effect…not a statistical squiggle on the researchers graphs but live birth rates cut to a fifth of the average and abortion rates cut 1/4 – 1/2 the average. This is really significant and this research should be considered by heatlh insurers and the DHSS.

  • James Corbett

    This required study? Hmmm, perhaps next we could test to see if a dropped object falls or failure to eat causes death? Women have fewer babies and thus few abortions when they can control conception–shocking! Of course the cultural conservative response will be to test and see if they have more sex so they can prove that available birth control causes sluttery.

  • Lori F – MN

    What this pro-life/anti contraception really expect is that married couples should abstain from sex if the don’t want to have children. Can you imagine being married, having 2 kids, the youngest 16 and NOT having sex for all those years and still being married?! I certainly can’t.

  • Kacy

    Just for fun I’ll argue the Catholic response. (I’m an ex-trad-Catholic, now atheist.)

    Yes, it would be great to avoid abortions, but the CC teaches that one must NEVER commit an intrinsic evil, even if the outcome is good. In addition, we must fight for stricter abortion laws in order to fight abortion. This is a better way to fight against abortion than handing out contraception. Many people who seek abortions do so because their contraceptive method failed, not because they didn’t have access to abortion. NFP, when done correctly has a 99% success rate in preventing pregnancy. (The pro-NFP literature doesn’t bother with user-failure statistics.) The answer is more education on how to properly measure fertility signs with natural family planning and exercising self control.

    Additionally this question is flawed.

    “If no act of sex can be morally permissible–or even politically tolerable–unless it is open to fulfilling that one of sex’s possible good functions then why can a single human day of possessing genitals go by without trying to use them to fulfill that good function?”

    You clearly do not understand Catholic doctrine. The Catholic Church doesn’t teach that a person must always try to procreate. The religious life of a priest, nun, monk, or other celibate is just as high of a calling as those to married life. The CC values continence and chastity. In marriage, the goal is not to make as many children as possible. It’s not the same as Quiver Full teachings. Many saints are actually honored for living in long term celibate (Josephite) marriages.

    The idea behind the CC’s teaching is a matter of simple reproduction. The CC doesn’t allow contraception because it is a perversion of natural law, and the natural law regarding sex. Sex is for uniting the couple AND procreation. Contraception artificially separates the unitive from the procreative aspects of sex. NFP doesn’t do this because the couple works with the body’s natural periods of infertility to avoid pregnancy. This is why naturally infertile couples can still engage in sexual relations. They aren’t artificially thwarting the reproductive process.

    Contraception is a form of stealing because one is withholding their fertility from their spouse. (Seriously, this argument is used in one of my NFP books.) It is saying to your spouse that I will give my whole self to you, but not this part. This is not the sort of mutual, total-giving relationship intended by God, and thus fails to faithfully represent the relationship between Christ and the Church, which all sacramental marriages are supposed to symbolize.

    I could go on, talking about “the language of sex” in JPIIs Theology of the Body, but playing the Catholic apologist is now giving me a stomach ache.

    • Envy Burger

      “I could go on, talking about “the language of sex” in JPIIs Theology of the Body, but playing the Catholic apologist is now giving me a stomach ache.”

      Me, too! :D But you seriously put it all out there – the arguments you see everyday. I especially love “You clearly do not understand Catholic doctrine.” I think I see this every single day. Anytime entire groups of people say the exact same thing, it starts somewhere. I wonder who started with this line :D.

    • Eamon Knight

      Contraception artificially separates the unitive from the procreative aspects of sex. NFP doesn’t do this because the couple works with the body’s natural periods of infertility to avoid pregnancy.

      Do they make any attempt to justify why “natural” should be morally privileged over “artificial”? I mean, it sounds all warm-fuzzy crunchy-granola, but seriously….?

      Contraception is a form of stealing because one is withholding their fertility from their spouse.

      And if my wife doesn’t want my fertility tonight (because we already have as many kids as we want), I suppose I should take that as a rejection of part of me? ‘Cuz that feels like a whole lot less of a rejection than to have her afraid to have sex *at all* because of fear of pregnancy. (And the same applies in reverse, of course). Basically, it seems like an arbitrary, emotional decision to value fertility because it somehow makes the package complete. Granted, relationships and sex run largely on emotion, but that doesn’t justify elevating what *some* people (like my Catholic friend) feel to a universal rule.

    • Kodie

      You clearly do not understand Catholic doctrine.

      I understand they’re not living in the real world. Thanks for the explanation from a perspective, but that’s where it starts and ends for me, lol.

    • Kacy

      “Do they make any attempt to justify why “natural” should be morally privileged over “artificial”? I mean, it sounds all warm-fuzzy crunchy-granola, but seriously….?”

      The problem is they use the word “natural” in two different ways, but collapse the meanings. First, they use natural in the hippie-granola sense. Then, they use “natural” in the Natural Law, Aristotelian sense. Most apologists will go back and forth between these two meanings, with no clear indication of which one they mean at a given time.

      The Aristotelian sense is the argument I made about the unitive and procreative aspects of sex. It fits with Natural Law because we learn through our sensory experiences that sex brings about babies and bonding. Contraception is immoral because it distorts this Natural Law view of sex. Catholics consider homosexuality immoral for the same reason–it’s unnatural in the Natural Law sense.

      Of course, since Natural Law is an Aristotelian concept, it doesn’t take into account any sort of scientific understanding of sex as observed by biologists and studied in lab conditions. The fact that homosexuality is, in fact, quite common in nature is irrelevant. Findings that suggest that humans evolved in polygamous settings (forget marriage) are also irrelevant. It’s just plain silly to declare something “natural” based on an obsolete understanding of science. Keep in mind Aristotle also places nail-biting and bestiality in the same moral categories!!!

      I’ve written more about it here:

      As for “You clearly don’t understand Catholic teaching,” that is the Catholic apologist simply giving up. Instead of engaging the argument, they’ll instead just re articulate Catholic beliefs in different words, quoting different saints, or whatever. They don’t want to bother arguing the consequences of their moral beliefs or the logical conclusions of their doctrines because their doctrinal fantasy is more emotionally satisfying than reality. They do this so often, it’s pathetic. (And I speak as one who has done this in the past and now finds it completely embarrassing.)

    • smrnda

      Is it stealing from your spouse if both parties don’t want a pregnancy to occur? It seems lots of anti-contraception arguments are based on some idea that a mutual decision to use contraception does not occur – that it’s always going against someone’s wishes.

      To me, it’s like saying it’s selfish that you didn’t get your spouse dinner when they didn’t want dinner and neither do you. My basic opinion is that religion wants to be a middle-man between married couples just since too many people can’t avoid getting in other people’s business.

      I also don’t get why natural is so great. I mean, poison ivy is natural. Teeth falling out in your 20s would be natural if it wasn’t for modern dentistry. We thwart nature all the time. Why some ‘naturals’ are important but others are not is beyond me. Is it morally wrong for me to avoid getting wet when it rains?

  • Matt

    If you enroll a bunch of sexually active (“at risk for unintended pregnancy”) 14-45 year old girls & women, give 75% of them IUD’s or implants, and track them for two years…then yeah, you’re going to see a pretty significant drop in abortion rates. I’m not even going to touch the downsides to those contraceptive methods, but that IS one way to reduce the number of abortions.

    There’s also some evidence that the widespread use of contraceptives is associated with increased prevalence of abortion.

    There’s the intuitive side to this as well. If a woman knows that abortion is “safe” and easily accessible as a fallback, she won’t be as motivated to be 100% compliant with pills, condoms, etc. (“It’ll be okay just this once.”).

    If extra-marital sex and pregnancy is heavily stigmatized (as it once was), and if a woman knows that abortion is difficult to “safely” obtain, then there’s a huge disincentive for fornication. [I put the word "safely" in quotes, because the procedure isn't safe for the child at all].

    Government-sponsored contraception is really just treating the symptom…not the root of the problem (namely, a culture that embraces casual sex). Providing contraception to high-risk, sexually-active populations in order to reduce the number of abortions is like providing sterile needles & syringes to high-risk heroin addicts in order to reduce the number of new HIV cases. Both strategies will likely be effective, but in a sense they also “feed the underlying problem” by making fornication/heroin-use safer and more socially-acceptable. It’s a trade-off, really. These strategies achieve results, but fail to address the root of the problem, which is the behavior itself.

    • Kodie

      Not living in the real world.

    • blotonthelandscape

      tldr; what Kodie said.

      1. But the downsides of those contraceptives are the ONE way to argue against their usage, if we’re going to presume that they are otherwise effective for the end goal of reducing unwanted pregnancies and elective abortions. We also need to consider the risks/benefits of celibacy vs the risks/benefits of safe casual sex, not JUST the risks of of safe casual sex. To do otherwise is to focus on a small aspect of the overall picture and blow it out of proportion.

      2. Cherrypicking: and badly at that. This study was on 9,200 St Louis, KN adolescents from poor backgrounds, monitored over an unfortunately unspecified period. Some of the women had already had abortions (I assume, as they were recruited to the study in abortion clinics). You cite in response a study on an unspecified number of Spanish women aged 15-49 monitored over 10 years? Even that study concluded that “more research was needed into the reasons”. So the geographic and demographic factors are incompatible, and the researchers themselves draw no correlation between increases in abortions and contraceptive use, they merely state that both increased over the period. Note, for example, that the overall simultaneous increase gives us no indication over whether the abortions were being given to contraceptive users or non-users, and how repeat-abortions were accounted for, or whether the time trends correlated (i.e. year-on-year increases over the 10 yr period moving synchronously).

      Did you look up abortion laws in Spain? What about prevailing cultural attitudes towards the practice, and towards sex in general?

      3. Intuition is not a reliable guide, particularly in this instance where it could just as easily be intuited that more people preventing conception decreases the aggregate number of pregnancies, and increases the sense of personal responsibility when pregnancies result from carelessness (and as a result reduces the percentage of pregnancies which are aborted).

      4. No, there is no evidence that stigmatizing sex and abortion has a net positive effect on society.

      5. Children aren’t aborted. But there are better places for those semantic games.

      6. The root of the problem is nature. We have a desire to have procreative sex, and simultaneously wish to avoid STIs, plan our pregnancies for the sake of careers and providing for our children when/if we have them, and control our populations and the effects that they have on the planet. The only way to have a measure of both (given the natural state where, sans intervenion, sex frequently results in pregnancy and STI transmission) is contraceptive use and access to abortions. And, as it turns out, it works well. See the above study.

      7. Your comparison to Heroin is a false analogy, for a number of reasons. Sterile needles are not analogous to contraceptives, as they don’t prevent the people from the side-effects of heroin. A more apt analogy is dopamine, which, unless things have changed recently, is exactly what the UK govt gives to heroin addicts, which placates the addiction for heroin with fewer sideffects. Another reason the analogy is poor is that heroin is not analogous to casual sex. Casual sex does not prevent normal functioning in society.

      8. Finally, the behaviour itself is NOT a problem. The symptoms ARE. If we could get the benefits of heroine without the physical, mental, social, economic and fatal side-effects , we would make that option available to people who desired it. We have those options with sex.

    • Baal

      “woman knows that abortion is difficult to “safely” obtain, then there’s a huge disincentive for fornication. [I put the word "safely" in quotes, because the procedure isn't safe for the child at all].”
      Safely shouldn’t be in quotes. The history of amateur abortion in the US is horrific. Even with modern techniques and trained professionals, it’s not lightly undertaken or considered lightly as a “well I could always just get one”. To think otherwise is to believe a lie.

  • Matt

    I stumbled across this article shortly after posting my comment. I think it raises some important issues as well:

    • blotonthelandscape

      Here’s the latest cochrane review on the evidence:
      As of 2010, there was inconsistent evidence from RCT’s over whether contraception and education had a reduced effect on things like abortions (but there was some evidence that they reduced unintended pregnancies). Rather than cite a blatantly pro-life news site, perhaps you should think of starting here.

      Having read through the entire article myself, as someone trained in interpreting and critiquing scientific studies and statistics, I can vouch for the quality of this study. You’re free to not take my word on it, and read it yourself.

      As for what the news site says:
      1. They specifically compared the results of the people they recruited to local, national and demographic averages over a range of measures. At any rate, this was an observational prospective study, not an experimental case-control study. The news site’s suggestion would raise the cost of the study beyond what could be afforded on a reasonable group (we’re talking about the opportunity cost of falling pregnant, which is very high). Maybe the catholic church would like to provide the funding?
      2. In order to qualify they had to explicitly want to avoid future pregnancy. It’s a weakness, but not a big one, and the results here prompt further research using different kinds of study, but are still a strong indicator that free contraception could be a factor in the reduction of unwanted pregnancies and abortions. Note for example that the teenage birth rate was dramatically lower for this group than the national average in spite of a dramatic fall in the national rate. And a fall in repeat abortions of 20% was measured as statistically significant (less than 0.1% chance of getting this result by chance), so even though the actual percentage appears small, it’s still meaningful.
      3. The statistical methods are explicit and sound. There will always be room to nitpick, but this study does what it’s claimed to do. The weighting was done to account for the fact that this group was “at risk”, making the results more applicable to the wider population. It does not invalidate the results, it validates the comparisons being made, and the effect of weighting is carried through into the statitical inference, meaning it is accounted for. I agree that the raw data should be made available, but to the likes of the cochrane library, not a political science professor with an obvious bias.
      4. The data came from the provider of 90% of the abortions in the area.
      5. 9,000 participants is not small.
      6. As for point number 5, more than half of the participants chose IUD’s and implants, so his point here is irrelevant and unsupported by the evidence.
      7. They were explicit as to why they chose the measures they did. They weren’t interested in the effects on STI’s etc, only on unintended pregnancies, for which adolescent births and abortions are suitable proxies, as explained in the article.
      8. Cherry-picking: pick two studies that back up my preconceptions to ignore this one. This study showed the complete opposite effect of the availability of free IUDs on uptake, with the women explictly stating that cost was a barrier. In fact the uptake far exceeded the expectations of the researchers. Give access to free IUD’s and implants, and women WILL use them.
      9. Again, see the Cochrane review. The results from RCT’s are inconsistent from study to study. No, citing particular studies that disagree doesn’t invalidate these results.
      10. The reference to the Daily Mail is, quite frankly, a joke.

      It’s important to realise that every study will have flaws. What those flaws are and whether they were stated and accounted for is what is important. This has been done in this study and as a result it comes out well.

  • Alex

    I just wanted to say: Thank you so much for using the word “fewer” instead of “less”. I am disproportionately happy about that.