According to a new report released by the Pennsylvania Department of Health, 34,536 abortions were performed in the state in 2012—a 4.8 percent decrease from the number of such procedures performed in the state in 2011.
To anti-choice advocates and lobbyists, this slight decrease means “more women are being empowered to make life-affirming decisions for themselves and their families” and “good news for women.”
But is that what it really means?
Although anti-choicers are working to “end abortion,”
history—evidence of women commonly having abortions goes back much, much farther than American legal battles over it—and global public health data show us it is not possible to stop abortion. Their efforts, therefore, are capable only of reducing access to safe, legal abortion. The most straightforward way to do that is to criminalize the procedure. Studies show, however, that criminalizing abortion doesn’t even reduce its incidence. In fact, abortion rates are higher in countries where the procedure is illegal. The effect is that women in those countries just suffer more preventable medical injuries and death than women living in countries where abortion is legal.
Since abortion is legal in the United States, anti-choice lobbyists and advocates have
employed an incremental approach. This strategy relies on flooding state legislatures with boilerplate bills designed to make it harder for poor and working women in those states to find safe abortion services.
Some of these bills require medically unnecessary, prohibitively expensive facility renovations to force clinics to shut down; mandatory waiting periods that force women who have traveled from out of town (or out of state) to incur hefty travel expenses; prohibitions on insurance covering abortion services; and rigged bureaucratic hurdles like legislation forcing doctors to gain admitting privileges at hospitals even though this is not necessary for health or safety. The legislative strategies are diverse, but designed to work in tandem to restrict poor women’s access to abortion by creating logistical and financial burdens to getting to a clinic and paying for the procedure.
Back to Pennsylvania’s annual abortion statistics report: First, it’s not at all clear that the decrease in abortions in 2012 is statistically significant in context. The number of abortions performed in Pennsylvania peaked in 1980, with 65,777 procedures, and has been generally dropping ever since. In 1990, the number was 52,143. In 2000, it was 35,630, and has hovered in the mid- to upper-30,000s since then.
Hailing the decrease as significant, though, allows anti-choicers to reinforce rhetoric that closing clinics “ends” abortion by tying it to their biggest legislative accomplishment in recent years
In December 2011, against the recommendation of every relevant state medical association, anti-choice
lawmakers in Pennsylvania passed legislation that eventually lead to the closure of at least four clinics. The law required that freestanding abortion clinics adhere to guidelines established for ambulatory surgical facilities (ASF), sites where procedures far more complicated than abortion take place. Those guidelines happen to require expensive architectural renovations. No evidence exists that says requiring clinics adhere to ASF guidelines improves patient safety. Ergo, the distorted view from the anti-choice lobby is that, by forcing clinics to close, they prevented 1,744 women who would have otherwise sought abortions from obtaining them.
The most overlooked factor in this analysis is the most obvious: We don’t know how many of these hypothetical women financially boxed out of obtaining hypothetical abortions successfully prevented pregnancy in the first place.
Abortion is, after all, most often a choice made by women and families dealing with an unplanned pregnancy. Low-income women disproportionately experience those unplanned pregnancies at a rate five times higher than women in the highest income bracket.
While criminalization doesn’t reduce the incidence of abortion,
research shows that access to contraception does. It’s common sense, and also the conclusion of global health research conducted by the World Health Institute, which noted that “the availability of modern contraception can reduce, but never eliminate, the need for abortion.”
A study conducted last year by the Pennsylvania Department of Welfare demonstrated that increasing access to contraception prevents unplanned pregnancies, which subsequently prevents abortion and unplanned births.
In a waiver filed
to showcase the success of a Medicaid demonstration project that provided free contraception to women who traditionally didn’t qualify for Medicaid, state data shows that between 2008 and 2010, the approximately $23.7 million spent on birth control and related services for 64,885 women earning between 100 percent and 185 percent of the federal poverty line prevented 7,061 unwanted pregnancies.
By focusing legislative efforts on limiting access to both abortion and contraception, though, Pennsylvania lawmakers ignore even their own data in favor of anti-choice platitudes: The program that funded this access, SelectPlan for Women, is scheduled to expire to make way for Healthy PA, Gov. Tom Corbett’s proposed Medicaid plan. If it passes as it is, Healthy PA will likely reduce poor women’s access to contraception. Meanwhile, half of all unplanned pregnancies in Pennsylvania end in birth, 37 percent in abortion, and the rest miscarriages.
While the new Medicaid plan will possibly reduce access to contraception, and only 13 freestanding abortion clinics are left in the state, Pennsylvania lawmakers are poised to spend 2014 focused on shutting down clinics: a bill to implement admitting privileges, similar to the one that shut down one-third of Texas’ clinics, has been introduced, and there has been talk of introducing a 20-week abortion ban.
In addition, in 2013 state legislators outlawed private insurers participating in the state’s health-care insurance exchange from covering abortion even when the mother’s health is threatened.
The bottom line is that Pennsylvania lawmakers are clearly devoted to implementing the anti-choice incremental strategy—earning the state the dubious distinction of earning very high marks from Americans United for Life, the anti-choice lobbying
group responsible for some of those boilerplate bills clogging state legislatures. That means that what state lawmakers are not working on are policies that will reduce the number of abortions performed the only way possible: by reducing the number of unplanned pregnancies.
That means more girls and women experiencing unplanned pregnancies. There is no way to formally track the numbers, but given Pennsylvania’s trajectory and the testimony of abortion fund crisis hotlines, there are many women facing an unplanned pregnancy who can not afford an abortion. What happens to them?
A long-term study conducted by the University of California’s Advancing New Standards in Reproductive Health project found that two years after being economically forced into having a child they were not expecting, mothers were three times more likely to be living in poverty than women in similar circumstances who had an abortion.
In Pennsylvania, nearly one in five children live in poverty. And like everywhere else, poverty is linked with poor health.
And yet, despite the public health data, Pennsylvania legislators keep introducing more policies designed to reduce access to both contraception and abortion for low-income and working women in the state. And anti-choice lobbyists and advocates continue to cherry-pick statistics and tie them to a fairytale narrative that, when implemented in real life, results in more unplanned pregnancy, more families in poverty, and more poor health.
Is that what anti-choicers mean by “good news for women and families”?
Correction: A version of this article incorrectly noted that Pennsylvania lawmakers implemented legislation in December 2011 that resulted in at least four clinics shutting down. In fact, the legislation passed at that time. We regret the error.