Increased Contraceptive Use Results in Increased Abortion Rates?
From 1997-2007 Spain increased contraceptive use rates from 50% to 80%. They doubled the abortion rate over the same time period.
(Dueñas, et. al., Contraception, January 2011 - http://www.ncbi.nlm.nih.gov/pubmed/21134508)
What gives? Apparently, people expected their contraceptives to work and planned their lives around that expectation. Apparently, they forgot that small risks taken repeatedly over long periods of time result in very large cumulative risks. A contraceptive method with a 1% failure rate results in a 70% chance of getting pregnant over 10 years. Or maybe they just don't understand the statistics of contraceptive use and most people who do are wedded to a theory of sexual freedom that doesn't allow them to point out such facts?
(Ross, Family Planning Perspectives, Nov/Dec. 1998 - http://www.jstor.org/pss/2135382)
As I see it, what matters most in a country's abortion rate is the attitude toward unplanned pregnancies. Are they welcomed or at least accepted? Are they viewed as unacceptable hindrances to one's goals in life? For too many people, children are an unacceptable hindrance. Yet, they are under the illusion that they can control their fertility, even over long periods of time, (e.g., from college through the establishment of one's career and marriage). No wonder New Yorkers have an abortion rate of 39%.
When it comes right down to it, abortion is just backup birth control half the time. That is to say, half of all abortions happen to women who were using contraceptives in the month they got pregnant. For the vast majority of the other half of abortion cases, it is the only birth control used. Hardly any abortions are due to the "hard cases."
As the Supreme Court noted in Planned Parenthood vs. Casey, "In some critical respects abortion is of the same character as the decision to use contraception." and "for two decades of economic and social developments, people have organized intimate relationships and made choices that define their views of themselves and their places in society, in reliance on the availability of abortion in the event that contraception should fail."
So, when I hear "experts" talk about increasing contraception use rates in the name of decreasing abortion, I gotta wonder if they know what they are talking about. If they don't, why are they the only "experts" one hears about in the MSM? If they do know what they are talking about, why don't they give the full picture. It's just not that simple. As Spain has reminded us once more, depending on the environment, increased contraceptive use can have exactly the opposite effect.
7 comments:
Fascinating post, Douglas, thanks.
Do you know if the Spanish population was also having more sex, or were they just using less reliable methods of contraception? Did the birth rate also decrease proportionately over that time period?
Douglas wrote: "As I see it, what matters most in a country's abortion rate is the attitude toward unplanned pregnancies. Are they welcomed or at least accepted? Are they viewed as unacceptable hindrances to one's goals in life?"
Excellent point. I wonder if socially stressing the ethic of waiting to have a child until you are older and ready has reinforced social and personal opposition to unplanned pregnancies. I don't know how to fix it, but I think you're right that that attitude is key.
Kevin,
Sorry for the delay. I just now noticed your comment. To answer your question as best I know how, I would say there was simply a whole lot more sex going on rather than less reliable contraceptives being used. In going from 50% to 80% contraceptive use, they didn't go from condom use to sterilization, they went from half the country using no contraception to 80% of the country using some form of contraceptive.
Regarding the birth rate, according to wikipedia, the crude birth rate went up 18% from 9.3 to 11.0 births per 1000 people. This is indicative that at least some of the people on contraceptives were keeping their kids, just not nearly as high a percentage as used to before contraceptive use became the dominant paradigm.
http://en.wikipedia.org/wiki/Demographics_of_Spain
Spain is a traditionally Catholic country in which the young are increasingly rejecting Christianity and Church teaching. In regard to societal acceptance of contraception, Spain appears to be undergoing a similar transition to what the US experienced 50 years ago when the Supreme Court struck down some of the last remaining Comstock laws against contraception, and it became not only accepted but promoted as the responsible course of action among society's elite (i.e., the opinion formers for the masses). It may take a while for Spain's abortion rate to catch up to that of the US, and it is very likely it never will. However, they seem to have experienced a sea change in societal perceptions of acceptable reproductive and non-reproductive behavior.
It also appears that there was much pent-up demand and your idea about society promoting being older and ready played into this.
http://www.nytimes.com/2007/07/13/world/europe/13iht-spain.4.6652189.html?_r=1
Mark Regnerus has some interesting thoughts on this. I think he's missing some critical aspects, but he's certainly on to something.
http://www.christianitytoday.com/ct/2009/august/16.22.html
http://www.slate.com/id/2286240/
http://www.christianitytoday.com/ct/2011/february/sexeconomics.html
Stacy Trasancos also blogs about this at http://www.acceptingabundance.com/mathematical-proof-that-birth-control-fails/
She uses the binomial probability calculator at http://faculty.vassar.edu/lowry/ch5apx.html
This is probably the right way to do these calcs. I never have purchased the full article from jstor, so I'm not positive on their calculation method. One of these days I should save my allowance and do so...
Fascinating, Doug, thanks for sharing! I'm not sure I looked through all the links yet, but I just looked through Stacy's article.
Stacy Trasancos wrote: "Thus, birth control does NOT prevent unintended pregnancy, but over time it actually makes it more likely".
Well, not more likely than having the same amount of sex without birth control and expecting not to get pregnant, which is what people usually compare it to. She's right that that comparison is somewhat misleading because the amount of sex likely increases with the use of contraceptions.
So, I think her actual point is focused on "risk compensation" which she brings up in the comments. It does make sense that (because of people's erroneous perception of risk) the incidence of sex can increase with the use of contraceptions to the point where there would actually be _more_ unintended pregnancies than if no contraception were used, but she does not empirically justify that we are past that point, meaning that adding more contraceptives to the mix will increase unintended pregnancies.
I forget; maybe you addressed this before.
"So, I think her actual point is focused on "risk compensation" which she brings up in the comments. It does make sense that (because of people's erroneous perception of risk) the incidence of sex can increase with the use of contraceptions to the point where there would actually be _more_ unintended pregnancies than if no contraception were used, but she does not empirically justify that we are past that point, meaning that adding more contraceptives to the mix will increase unintended pregnancies."
I'm not sure what "empirically justify that we are past that point" refers to, but certainly the study in Spain (first link in the original point) makes clear that there we abortion rate doubled when contraceptive use increased from 50% to 80% of women. Over the same period of time birth rates held fairly steady.
http://www.indexmundi.com/facts/spain/birth-rate
Yep! That'll do for empirical evidence that we're past that point! :) Not only did you address this before, you addressed it in this thread! Ugh. *facepalm*
I'm sorry, I was a bit rushed and just read the link and commented. Her argument needs your evidence (unless I missed that in her article, too).
Oy vey, I'll try to be more thoughtful next time and refresh myself on the context and actually think about what the title of your post means! :)
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