Correlation between abortion rates and illegality

Christina here…

Lookit: somebody recently released an observational study on abortion rates, which the media reported with headlines such as, “Abortion Rates Are Higher In Countries Where Procedure Is Illegal, Study Finds.”

I love it when researchers release new studies!

… but I hate it when secondary sources like the one above don’t bother to link to the actual study, forcing people like me to hunt around the ‘tubes for it. Citation needed, Lazy BoLazyface.

Here it is. You can even download this particular study free if you register with the Lancet. I couldn’t imagine any negative repercussions to joining the Lancet (Excepting if they publish another fraudulent study leading millions of people to the absurd conclusion that vaccines cause autism…) so I joined, just for you, so that we may science together.

In the study, researchers looked at worldwide incidence of abortion between 1995-2008, finding rates of abortion of 35(in 1995), 29 (in 2003) and 28 (in 2008) per 1000 women aged 15-44 years. Between 1995-2003, the rates of abortion declined around 2.4% each year, but the decline has leveled off to almost nil between 2003-2008.

Despite this decline in abortion rates, the rates of unsafe abortions are on the rise, moving from 44% of abortions being unsafe to 49%. Researchers also found that abortion rates are lower in regions with more liberal abortion laws.

Let’s talk definitions:

When the WHO describes an abortion as “unsafe”, they mean:

a procedure for termination of an unintended pregnancy done either by people lacking the necessary skills or in an environment that does not conform to minimum medical standards, or both.

“Safe”, abortions are defined as:

those that meet legal requirements in countries with liberal laws, or where the laws are liberally interpreted such that safe abortions are generally available.

And here’s what they mean by “liberal laws”:

Countries with liberal laws were defined as those where abortion is legal on request or on socioeconomic grounds, either with or without gestational limits; and countries whose laws allow for abortion to preserve the physical or mental health of the woman, if these laws were liberally interpreted, as of 2008.

They don’t spell out the definition of “non-liberal” abortion laws, so I can only presume those laws to be laws in which abortion is not legal upon request, or countries which do not allow abortion for mental of physical health preservation.

By these definitions, the North America is mostly liberal. Abortion is legal upon request with gestational limits. Our rate of abortion is 19 per 1,000 women.  Compare that to Africa, whose laws are highly restrictive (abortion is mostly illegal) abortion rate is 29 per 1,000 women.

There is another frightening statistic about Africa: 49% of all abortions in the world are unsafe. 97% of those in Africa are unsafe. Comparatively, less than .5% of abortions are unsafe in North America.

What this means is that in Africa, where abortion is largely illegal, more women are having abortions, and almost all of those abortions are unsafe.

The researchers conclude:

We found that the proportion of women living under liberal abortion laws is inversely associated with the abortion rate in the subregions of the world. Other studies have found that abortion incidence is inversely associated with the level of contraceptive use, especially where fertility rates are holding steady, and there is a positive correlation between unmet need for contraception and abortion levels. The unmet need for modern contraception is lower in subregions dominated by liberal abortion laws than in those dominated by restrictive laws, and this might help explain the observed inverse association between liberal laws and abortion incidence.

In other words, women get fewer abortions in countries in which abortions are easier to obtain and legal. Women also get fewer abortions in countries that favor contraception use. Women get more abortions in countries that use fewer contraception methods.

 

Photo: A sign reading, "Keep abortion safe and legal!"

Let’s have a conversation, pro-lifers. Pay attention. I’m about to science you.

If you’d like to see the abortion rate fall, then you are not wise to think that increasing restrictions will cause abortion rates to fall, because we do not see such an association. We see the opposite.

Criminalizing abortion or restricting a woman’s right to a legal abortion does not stop her from having an abortion. Arm yourselves with that information, pro-lifers.  If you’re a pro-lifer and a “small government” conservative, this information should be doubly important. Restrictive laws do not correlate with preventing women from obtaining abortions. You therefore have no reason to lobby for those restrictions in the name of reducing abortions, leaving your pro-choice foes a wide berth with which to speculate your motives.

I know, one’s knee-jerk reaction to “I want activity X to stop” is to make activity X illegal. If activity X is illegal, we reason, people will be less likely to engage in that activity for fear of the repercussions. We raise our children and our dogs this way, teaching them to avoid punishment by avoiding activity X if activity X causes punishment.

However, abortion (and other activities deemed wrong by others) is more complicated than this. The criminalization of abortion does not reduce the number of abortions. Evidence has shown this repeatedly. Yet you can’t shake the idea that if you just spank those naughty aborting women, they will learn their lesson.

We won’t, not because women are belligerent children, not because we are selfish, not because we lack moral character. It’s because your position is wrong.

However even if your position weren’t wrong, you’re doing it wrong by ignoring evidence.

If you care about maternal health, especially if you’re a pro-lifer who wrings your hands over (supposed) increase in rates of cancer,  depression  or other morbidities associated with abortion, you should note that liberalization of abortions laws decreases mortality.

Finally:

We found that abortions continue to occur in measurable numbers in all regions of the world, regardless of the status of abortion laws. Unintended pregnancies occur in all societies, and some women who are determined to avoid an unplanned birth will resort to unsafe abortions if safe abortion is not readily available, some will suffer complications as a result, and some will die. Measures to reduce the incidence of unintended pregnancy and unsafe abortion—including improving access to family planning services and the effectiveness of contraceptive use, and ensuring access to safe abortion services and post-abortion care—are crucial steps toward achieving the [UN Millennium Development Goal].

So, pro-lifers. Shall we follow where the evidence leads or continue to lobby for abortion laws based on your hunches and emotions?

P.S. I hope you noticed my meticulous avoidance of confusing correlation with causation.

Reference:

Sedgh G, Singh S, Shah IH, Åhman E, Henshaw SK, Bankole A. Induced abortion: incidence and trends worldwide from 1995 to 2008. The Lancet 2012(11)61786-8

Learn more about Christina and follow her @Ziztur.

About christinastephens
  • jimmy60

    I’m sure many of you have seen this video but it’s very appropriate to this article. It seems many of the pro-lifers haven’t really thought this through.

    (Hope I did the tag thing right :-)

    • jimmy60

      Well not quite but close enough.

    • alexandra14c

      Thanks for that! That was fantastic. I guess there is a difference between murdering a child and having an abortion. These people probably didn’t even realize that deep down they do see a difference between the two.

  • http://www.cstdbill.com Bill

    Maybe I missed it in your article. Could it be that, in more liberay societies generally, abortions are less prevalent because they’re less often desired? (I’m guessing that the U.S. has fewer unwanted pregnancies than, say, Africa because of greater knowledge of how to avoid them.)

    Does that make sense?

    • http://www.cstdbill.com Bill

      Oops…liberayliberal

    • Pteryxx

      Bill: is this what you missed?

      Other studies have found that abortion incidence is inversely associated with the level of contraceptive use, especially where fertility rates are holding steady, and there is a positive correlation between unmet need for contraception and abortion levels.

      • Mark

        What is missing here is a consideration for factors that contribute to demand for abortion, particularly poverty and rape. Critical thinking might lead us to see that these rates are higher in Africa than the United States.

  • Pteryxx

    SCIENCE FOR GREAT JUSTICE

  • http://war-on-error.xanga.com/ Ben

    But evidence and consequentialism makes virtue ethics baby Jesus cry.

  • ohioobserver

    This adds support to a feeling I have had since 1973, that the right’s objection to abortion had little or nothing to do with the welfare of the unborn. More, it has to do with the idea that a woman who makes her own decisions abut sex should be punished, but since they can’t really get unregulated sex made illegal, they are willing to impose unwanted pregnancy as a punishment. They don’t give a damn about fetuses. It’s women fucking when and who they want they really fear.

  • ohioobserver

    Oh, and to add to my first comment:

    I know this is conjecture. The more evidnce I see, however, the more it seems to be confirmed. If there’s anyone out there with real evidence that this is not true, let’s se it.

  • F

    ohioobserver

    Nope, a lot of people have made the same observation: It’s about controlling women.

    Unless the pro-life folks want to have a look at the evidence and prove all of us wrong on that count.

  • Tsu Dho Nimh

    Notably, those countries that have laws against abortions often have laws against contraception too.

  • Pteryxx

    @ohioobserver: Someone made this chart of inconsistencies in pro-life stated positions if they actually believed abortion was murder.

    Pro Life Belief Chart: Image link

  • Julie

    I am as absolutely pro-choice as Christina, but she screwed up royally in this post. Comparing a country (the US) to a continent (Africa) consistently throughout this post just makes pro-choice people look stupid.

    Africa is made up of more than one billion people and at least 47 countries. Comparing abortion rates in Africa with those of the US is like comparing abortion rates in Tulsa with those of England (I just picked those places out of thin air – I have no idea of populations).

    This entire post fell down as soon as the US was compared to Africa and I stopped reading. I’m sure I wasn’t the only one.

    Americans are seen by most of the world as being ignorant about anything outside their own country – posts like this don’t help.

    • Kareth

      Scientifically speaking there is nothing wrong with her comparison of America to Africa, because she compared abortion rates, as a percentage of population, not total numbers of abortions performed.

      In statistics that is how you compare two, or more, groups of differing sizes. The same would work comparing Tulsa to the national average for America, or Tulsa to England, or Tusla to Asia if you wanted to push it to an extreme. That is how analytical mathematics works. If it didn’t then there would be no way to compare common elements of two different populations, or to compare a subset of a population to the population as a whole.

      It doesn’t cause the post to “fall down,” as you put it, rather it strengthens the point by applying good math to good science.

    • http://www.facebook.com/ziztur Christina

      I am as absolutely pro-choice as Christina, but she screwed up royally in this post. Comparing a country (the US) to a continent (Africa) consistently throughout this post just makes pro-choice people look stupid.

      I can understand your concerns.

      I don’t really know if I’d say I compared country to continent “consistently throughout this post”. I did it in one place. Perhaps you think I did so consistently because, as you said, you stopped reading?

      I meant to write North America, so I fixed my royal screw up.

      Thanks for your feedback! =D

  • Robert

    “If you’d like to see the abortion rate fall, then you are not wise to think that increasing restrictions will cause abortion rates to fall, because we do not see such an association. We see the opposite.”

    Watch out, you’re making a correlation = causation fallacy here. There is no evidence that legalizing abortion will cause rates to drop. In the case of Africa I suspect that poverty causes both a lack in adequately trained medical personel and lack of (education about) contraceptives. Hence the rates of both unsafe and safe abortions will be higher.

    • http://www.facebook.com/ziztur Christina

      No I didn’t. I said we see an association. Not a correlation. I didn’t say that legalizing abortion will cause rates to drop.

    • Robert B.

      It’s important to remember that correlation is different from causation, but the two are not unrelated. Correlation is a necessary but not sufficient condition for causation. This correlation cannot prove that legalizing abortion lowers abortion rates. It can and does prove that criminalizing abortion does not lower abortion rates. It proves that, if there is any causal connection between abortion laws and abortion rates, it is not what anti-abortion activists seem to assume. Apparently, either criminalizing abortion increases abortion rates, or high abortion rates lead to abortion being criminalized, or there is no important direct causal link between the two.

  • http://sciencenotes.wordpress.com/ Markita Lynda—-Happy New Year, everyone!

    Abortion being illegal also correlates with contraception being illegal or hard to get, especially in Roman Catholic countries. More unwanted fertility equals more abortion.

    People do not mourn a miscarriage the way they do a child; deep down, they know it’s not the same. It’s only religious logic-chopping and an unhealthy obsession with other people’s sex lives that keeps abortion on their front burner.

  • http://florilegia.wordpress.com Ibis3, denizen of a spiteful ghetto

    By these definitions, the North America is mostly liberal. Abortion is legal upon request with gestational limits. Our rate of abortion is 19 per 1,000 women.

    I’m not sure if this is more messed up after correcting to compare continent with continent, but you (or the WHO?) really cannot lump in the US with Canada (or with Mexico, I would think, where it is completely illegal in many states). Canada has no gestational limits. We have no laws concerning abortion at all. We have a Supreme Court ruling which linked access to abortion to our constitutional right to “security of person”. We have a Health Care Act which mandates that we be provided with funded, comparable access to medical procedures no matter what province we live in. We have national and provincial colleges of physicians and nurses that outline ethical standards that doctors and nurses must follow. There is no political will try to change the status quo, even from the Conservative Party which is currently in power.

    Our main obstacle concerns access not legality. We don’t have enough providers, especially in sparsely populated areas (e.g. up north), and in PEI. As well, there is a strong correlation between use of contraception/abortion and socio-economic status. Aboriginal girls and women are particularly vulnerable.

    Also, there is a bloc of anti-choice MPs (which cuts across party lines) who press the government to adopt policies that don’t directly restrict abortion for Canadian women. Like defunding Planned Parenthood International and directing foreign aid dollars to anti-choice agencies.

  • http://florilegia.wordpress.com Ibis3, denizen of a spiteful ghetto

    I’m not sure if this is more messed up after correcting to compare continent with continent, but you (or the WHO?) really cannot lump in the US with Canada (or with Mexico, I would think, where it is completely illegal in many states).

    Since I was concerned, I went and looked it up myself. :)

    It wasn’t you (sorry Christina) or the WHO, but the researchers who used US statistics as a shorthand for Northern America (Mexico was grouped with Latin America, I believe). Since they were using a fairly broad categorisation (liberal vs. restrictive laws), it’s not needful to draw further distinctions in this case, though I would expect Canadian stats to mirror those of Northern Europe more closely than those of the US (unfortunately, stats for Canada were not included–possibly because Statistics Canada has no stats after 2005–more Harperite interference?).

    • Julie

      I think that Ibis3 has made the point I was trying to make in my earlier comment. It is silly to compare abortion rates from one country to another (or one continent to a country/continent) to try to make a point about legalising or keeping abortion legal. There is really no study that will convince anyone who is anti-choice. I’m sure that 95%+ of the people who read JT’s blog are already in agreement with you that abortion should be legal. I am also fairly sure that they believe it should be as rare as possible.

      The only way to reduce abortion is to make contraception easily available and teach young adults how to use that contraception. It drives me absolutely nuts that a so-called “first world” country has people who will do their utmost to stop that education and they are considered intelligent enough to run for president!

      I do wonder if it wouldn’t be better for everyone who is pro-choice in the US to stop campaigning for abortion rights and put their energy into contraceptive rights. Abortion is such a hot button, but contraception might be less contraversial.

      As I’m typing this I realise that you can’t let abortion rights go because Roe -v- Wade seems to be at such risk all the time, but I do really feel that you might be better off spending more time fighting for contraceptive rights than the abortion rights that already exist. Here in the UK contraception is free for everyone. If I want the pill then I can get it for free (well, actually *I* probably can’t because I’m 45 years old and they don’t like giving it to people my age – but when I wanted it from the age of 17 to about 35 I got it for free). If I need condoms I can get an appointment with my doctors’ surgery and ask for condoms and the doctor will just give me a handful (of condoms) for free. I’m also fairly sure that anyone can walk into a doctor’s surgery and just ask for condoms and they will be given some. If I think an IUD will be best then it’s free. And my DH’s vasectomy was free (well, not really free – I know we get taxed for the “free” NHS).

      Universal healthcare including contraception is what reduces abortion. Fight for that. (and I’m also posting drunk again so please feel free to tell me that I’m talking out of my arse.)

      • Julie

        Sorry, didn’t know it would be *that* long of a comment.

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  • Pablo

    I am not sure that I see the logic in the argument. It is said that ” Women get more abortions in countries that use fewer contraception methods.” which is precisely why it is not possible to use the correlation (or lack thereof) between abortion rates and legalization, without correction for access to contraception, to say that there is (or not) a relationship between the two.
    But then it is claimed that “If you’d like to see the abortion rate fall, then you are not wise to think that increasing restrictions will cause abortion rates to fall, because we do not see such an association. We see the opposite.”

    • Nate Frein

      That’s not the argument. That’s oversimplified.

      First, most countries with excessive restrictions on abortion also have excessive restrictions on contraception.

      Second, the fact that abortion rates in countries with excessive restrictions on abortions are similar, if not higher, than countries with less restrictions on abortions means that the women getting abortions are probably going to get them whether it is legal or not.

      Now, this is important. Illegal abortions are by definition not regulated or under any kind of oversight. Hence, it should come to no surprise that the mortality involved in illegal abortions is higher than legal abortions. Case in point: Kermit Gosnell.

      Now lets address your final statement:

      But then it is claimed that “If you’d like to see the abortion rate fall, then you are not wise to think that increasing restrictions will cause abortion rates to fall, because we do not see such an association. We see the opposite.”

      That’s a misstatement. It would be more accurate to say that “the overall efforts to reduce the timeframe in which abortions can be performed, reduce access to abortions, place barriers to abortions, in addition to reducing access to contraception will only serve to increase the suffering of women without having any appreciable impact on abortion rates.

      • Pablo

        Nate,
        I agree completely with the first point. That is why I think the effects of both things are confounded and are not easy to separate in their effects.
        Regarding the second point, I think that is precisely (part of) the question: are women getting abortions anyway? Obviously they are getting some abortions, I wonder if the total number of abortions is not restricted, meaning that all women who want to get an abortion will get it anyway although it is illegal. That I don’t think can be argued from the presented data.
        Regarding your comment on my final statement, I think the key part that you add (but I don’t find in the original article, may be I missed it?) is “…in addition to reducing access to contraception…”. If you add that part, I agree that the data suggests we will only see more abortions and done in worse conditions.

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