|Women and their partners are generally forward-thinking and rational in their fertility behavior.
First, studies have shown that while legal restrictions on abortion do reduce the rate at which it occurs, they do not necessarily result in an increase in the birth rate (Trussel et al. 1980; Matthews et al. 1997). Second, the claim that pro-life policies simply lead to an increase in maternal deaths by driving pregnant women to seek unsafe abortions is directly challenged by the empirical record. The lowest maternal mortality rates (MMR) in Europe, for example, occur in Poland, Malta and Ireland—all of which have extremely restrictive policies (Mundial 2010; Hogan et al. 2010). Further, a plethora of systematic analyses examining countries from around the world continuously challenge the idea that legal restrictions on abortion increase MMRs or hospitalizations. This, then, undermines a key assumption in the AGI narrative about illegal abortions. Third, it is important to note that within the academic community the debate is, generally speaking, no longer about whether legal restrictions reduce abortions so much as how they manage to do so. That pro-life policies mitigate abortion is a point that has been repeatedly illustrated by literally dozens of independent, peer-reviewed studies over the course of several decades.
There has, however, been some disagreement about the exact causal mechanism responsible for this relationship. Herein we find the chief problem with the two perspectives introduced at the beginning of this essay. Not only are their key assertions inconsistent with the empirical record, their entire arguments are fundamentally oblivious to recent academic insights on how abortion laws actually operate. Traditionally, scholars have tended to assume that such policies function to minimize abortions by acting on the posterior “…decision of a woman who is pregnant not to have the child” (Medoff 1988, p. 354). In other words, the law was presumed to affect a woman’s behavior only after she had already become pregnant. The AGI and other pro-choice advocates have adopted this outdated presupposition.
Since the mid 1990s, however, the academic understanding has evolved in light of new evidence. A substantial number of independent, peer reviewed studies have consistently shown that legal restrictions on abortion work primarily by reducing the rate at which unplanned pregnancies occur in the first place (Kane and Staiger 1996) and only secondarily by influencing the behaviors of women who are already pregnant (Levine 2004a)! In other words, pro-life policies address both the symptom and the cause! To be more specific, research has shown that women and their partners are generally forward-thinking and rational in their fertility behavior. They do not wait until after a pregnancy has already occurred before deciding whether they should take steps to preempt parenthood. As a result, pro-life policies actually help to reduce the unplanned pregnancy rate by incentivizing couples to take additional precautions prior to a potential pregnancy rather than waiting to obtain an abortion after the pregnancy has already occurred. Conversely, the opposite is also true. When abortion is readily accessible, this very availability reduces the incentive to avoid becoming pregnant by offering a sort of ‘insurance policy,’ should you or your partner happen to do so. For example, studies have persistently shown that more permissive policies are causally connected to an increase in unprotected sex whereas more restrictive policies lead to an increase in contraceptive usage (Levine 2004b; Medoff 2008a, b; Felkey and Lybecker 2011, 2014, 2015). There is also some evidence to indicate that legally restricting abortion leads to a change in the overall amount of sexual activity (Alford 2016).
Of course, many readers are likely to find this logic somewhat counterintuitive or even offensive. Despite this, it has been overwhelmingly supported by the empirical record (Kane and Staiger 1996; Levine et al. 1996; Levine 1999, 2002, 2003, 2004; Levine and Staiger 2004; McNabb 2007; Medoff 2008a, b; Felkey and Lybecker 2011). It also helps to explain the previously puzzling findings of several studies which suggested that abortion laws were able to reduce the number of abortions without an increase in births (Trussel et al. 1980; Matthews et al. 1997) or harming maternal health outcomes (see footnote 3). Furthermore, it is consistent with previous findings that the legalization of abortion is associated with an increase in the spread of sexually transmitted diseases whereas pro-life policies have the opposite impact (Kick and Stratmann 2003; Klick and Neelsen 2012). Studies examining the impact of abortion policies on the number of infants available for adoption have, similarly, supported the hypothesis (Gennetian 1999; Bitler and Zavodny 2002; Medoff 2008b).
In conclusion then, it is important to understand that the primary interaction between pro-life policies and individual fertility decisions happens before a potential pregnancy. Men and women are generally rational, free and forward-thinking when it comes to their sex lives. They consider the risks and potential costs of an unwanted pregnancy before making decisions about whether to engage in sexual activity or to utilize contraception. When those costs are subverted by liberalized abortion laws, this provides a sort of ‘insurance policy,’ which encourages uninhibited sexual activity. When those costs are reinforced by pro-life policies, however, the opposite occurs. Contraceptive usage goes up and unplanned pregnancies go down. As a result, legal limitations on abortion are capable of reducing abortion rates without actually impacting the overall number of births. Where pro-life policies do lead to an increase in births, this change is secondary and relatively modest as compared to the decline in unplanned pregnancy. As a result of this, restrictions on abortion are also able to operate without a concomitant risk of unsafe abortions. After all, you cannot illegally terminate a pregnancy that never occurred. This helps to explain why there does not seem to be any positive relationship between legalized abortion and maternal health outcomes. The arguments introduced at the opening of this essay must, therefore, be dismissed in light of new academic evidence and empirical data. The science simply does not support them. It does, however, indicate that pro-life laws do not merely address abortion as a symptom but that they attack the underlying cause of abortion—unplanned pregnancy—at its source.