Will increased access to Plan B reduce unintended pregnancies? The numbers aren’t promising
This weekend on NRO, both Jillian Kay Melchior and Robert VerBruggen have offered commentary about the FDA’s recent decision to allow females age 15 and up to purchase emergency contraception without a prescription. Melchoir argues that will reduce the incidence of abortion, while VerBruggen is a bit more skeptical, saying “we should not expect too much.” I would argue that, worse, from a pro-life perspective, the FDA’s decision will do more harm than good.
In his posting, VerBruggen favorably cites a 2002 Guttmacher Institute study on the contraceptive use of women obtaining abortions, which provides plenty of information to support his argument that abortions are not caused by a lack of access to contraception. For instance, the Guttmacher study finds that, among sexually active women not using contraception, only 12 percent cited either cost or lack of access as reason. This finding even holds among teens: A 2012 Centers for Disease Control study of 5,000 teenage girls who gave birth after unplanned pregnancies found that only a small percentage had difficulty accessing contraception.
Some have argued that increasing the availability of more reliable forms of contraception will reduce the incidence of abortion. A 2012 Centers for Disease Control study cites does show increases in contraception use since 1995, concurrent with increased use of more reliable forms of contraception, such as the birth-control pill and the IUD. However, despite this increase in contraceptive use, the report indicates that the unintended-pregnancy rate actually increased slightly between 1995 and 2008.
Due to risk compensation — which means that those with access to contraception will engage in sexual activity more often — increased use of contraceptives often fails to reduce the unintended-pregnancy rate. There is a also body of research documenting the ineffectiveness of various contraception-access programs. A study of a free-contraception program in Scotland that appeared in the journal Contraception found no decline in abortion rate, while a study of a free-contraception program in San Francisco from the Journal of the American Medical Association found the program produced no decrease in unintended-pregnancy rates.
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The British experience is particularly telling. In 1999 the British government launched its Teenage Pregnancy Strategy program, which was supposed to cut the number of teen pregnancies in half by promoting comprehensive sexual education and birth control. Some £300 million ($454 million) was spent on this initiative. Since then, the British teen-abortion rate has climbed steadily. In fact, in 2009, the Daily Mail reported that teen-pregnancy rates in England are now higher than they were in 1995, and pregnancies among girls under 16 (below the age of sexual consent) are also at the highest level since 1998, the year before the program began.
Pro-lifers are usually not enthusiastic about using contraceptives as a strategy to lower abortion rates, in part because of the empirical issues above, and in part because some of us believe that a sexually liberated culture is never going to support significant restrictions on abortion, regardless of the availability of contraceptives. No contraceptive is 100 percent effective and, when contraceptives fail in a sexualized culture, there will always be significant demand for legal abortion as a “back-up” measure. Further, I’d suggest that we will struggle to enact meaningful legal protections of unborn children until the culture becomes more chaste — and a chaste culture is incompatible with a contraceptive culture. All in all, pro-lifers would do well to remain skeptical of the panaceas proclaimed by contraception advocates.