Sunday, June 14, 2015

The Abortion Debate

The Abortion Debate
by Angela Smith, HEAL Coordinator, and featuring Kelsey Hazzard and Peggy Loonan


On June 6th, 2015, The HEAL Report hosted a debate on abortion between Kelsey Hazzard, President of Secular Pro Life and Peggy Loonan, Founder and Executive Director of Life and Liberty for Women.  That debate is available online at https://youtu.be/4VzWUfkOw1w.

HEAL takes no official position on abortion.  But, we would like to take this opportunity to pose questions and provide answers regarding abortion facts.

Below are the questions we've asked and the answers we've found. 

1.  How many abortions occur in the US each year?

Kelsey Hazzard, President of Secular Pro Life Comments: (http://www.secularprolife.org/)

"A couple of points. First, with respect to abortion statistics, you may want to mention the most recent numbers from the Associated Press, reporting a dramatic decrease in American abortions in just the last couple of years. That data was not available at the time we recorded the episode. See http://www.nytimes.com/aponline/2015/06/07/us/ap-us-abortion-decline.html?_r=1"  

Peggy Loonan, Founder and Executive Director of Life and Liberty for Women Comments: (http://www.lifeandlibertyforwomen.org/)

"It shows that restriction of access to abortion leads many women to seek abortions in other states. It shows that desperate determined women will always find a way. It also talks about how the reduction in teen pregnancy has affected these numbers. I found Charmaine Yoest’s (Americans United for Life)suggestion that such a broad decrease in abortions nationwide and in states with the least restrictions was a function of forcing women to view sonograms, unrealistic and not grounded in fact. I think the article draws a stark line between the reality of why the numbers are what they are and the pie in the sky version anti-abortion groups claim." 

(Returning now to follow up analysis prepared by Angela Smith, HEAL Coordinator)

The data varies, but, seems to remain between 1 and 1.5 million legal abortions annually.  The most recent available data is for 2011, but, does not include data on some States.  The 2011 data shows 730,322 legally induced abortions with 0.9% occurring at or after 21 weeks of gestation and 91.4% of abortions occurring at or before 13 weeks gestation.  Source: http://www.cdc.gov/reproductivehealth/data_stats/Abortion.htm.

In 1979, data shows 1,251,921 legal abortions and that data includes all 50 States.  In 1979, over 90% of abortions were performed at less than 13 weeks gestation with 0.9% occurring at or after 21 weeks of gestation.  Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001243.htm  

In 1990, all 50 States participated in CDC reporting as well as Washington, DC.  In 1990, data shows 1,429,577 legal abortions occurred.  And, 87% of abortions were performed before 13 weeks of gestation with 1% of abortions occurring at or after 21 weeks of gestation.  Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/00031585.htm

In 1999, the statistics are significantly lower because Alaska, California, Oklahoma, and New Hampshire did not report and the CDC did not choose to estimate based on historical information for those states.  The CDC shows of the States reporting that 861,789 abortions reportedly occurred throughout the US.  And, that 87% of abortions were performed before 13 weeks of gestation with 1.5% of abortions occurring at or after 21 weeks of gestation.  Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5109a1.htm

In 2005, all States participated in CDC reporting except California, Louisiana, and New Hampshire.  Of the States reporting, the collective total of reported legal abortions for participating States was 820,151.  And, 87% of abortions were performed before 12 weeks of gestation with 1.3% of abortions occurring at or after 21 weeks of gestation.  Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5713a1.htm?s_cid=ss5713a1_e

Based on the above information, it would appear the abortion statistics remain pretty much the same in regards to when the majority of abortions are performed with the vast majority being performed before 20 weeks of gestation. 

2.  What are the abortion laws in each State in the US?

Most US States ban abortion unless medically necessary to save the life of the mother at 20 weeks and/or viability.  Alaska, Colorado, Washington DC, New Hampshire, Oregon, and Vermont have little to no restrictions on abortion access.  Source: http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

Peggy Loonan, Founder and Executive Director of Life and Liberty for Women Comments: (http://www.lifeandlibertyforwomen.org/)

"Here are some links I found regarding 20-week bans which are indisputably unconstitutional on their face because they aren’t in keeping with the central holding of Roe regarding viability as the balancing of a woman’s right to choose and when the state will have an overriding interest in protecting potential life. Those 20-week bans that have been challenged have been struck down as blatantly unconstitutional by appellate courts. Anti-abortion groups hope this challenge to the central holding of Roe will establish a new benchmark via their claims of fetal pain. Anti-abortion groups and legislators think this could be the challenge that could overturn Roe or change the benchmark making it virtually moveable at the will of anti-abortion legislators until it reaches fertilization and abortion is once again criminalized. However, subsequent rulings including the 1992 Planned Parenthood v Casey reaffirmed the central holding of Roe; viability as the balancing of right to life. The Court has never swayed from viability as the benchmark. As I said in the debate, viability is –at the outset 24 weeks. Roe left the viability question to those best suited to know it – doctors. In the 1989 decision Webster v Reproductive Health Services the court said, “the legislature could not give one element such as gestational age, dispositive weight.” That’s exactly what the 20-week bans do. 





http://www.guttmacher.org/statecenter/spibs/spib_PLTA.pdf

The link below is the story of a woman adversely affected by the Texas unconstitutional 20-week ban. It places an “undue” burden on women in addition to being unconstitutional on its face.


(Returning now to follow up analysis prepared by Angela Smith, HEAL Coordinator)

Available reports show that in Colorado, where abortion is least restricted, the number of abortions has decreased significantly.  1.4% of abortions occurring in the US occurred in Colorado.  I was unable to locate gestation statistics regarding Colorado abortions.  Source: https://www.guttmacher.org/pubs/sfaa/colorado.html

Available reports show that in Vermont, where abortions are least restricted, the number of abortions has decreased significantly.  Vermont represents 0.1% of abortions occurring in the US.  In Vermont, a total of 1734 abortions were performed in 2004 with 1722 occurring before the 17th week of gestation and 12 occurring between the 17th and 27th week of gestation.  Source: http://healthvermont.gov/research/stats/2004/e0506.htm#e5

The States where abortion is most restricted include Alabama, Arkansas, Indiana, Texas and West Virginia.  Those States with a couple of others ban elective abortions at 20 weeks.  Source: http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

Available reports show that in Alabama, where abortion is most restricted, the number of abortions has decreased significantly.  Alabama represents .9% of abortions occurring in the US.  This is a greater percentage than abortions occurring in Vermont which has less restrictions.  In 2012, Alabama reported 7,970 "induced pregnancy terminations" (abortions).  Sources: https://www.guttmacher.org/pubs/sfaa/alabama.html and http://media.al.com/wire/other/vital%20stats.pdf

In Vermont, there are roughly 626,000 people and there are approximately 4,800,000 people in Alabama.  In Vermont, roughly 0.27% of the population had an abortion in 2004.  In Alabama, roughly .17% of the population had a legal abortion in 2012.

Available reports show that in Texas, where abortion is most restricted, the number of abortions has decreased significantly.  Texas represents 6.9% of abortions occurring in the US.  This is a greater percentage than abortions occurring in Vermont which has less restrictions.  In 2012, Texas reported a total of 68,298 abortions with 380 occurring after 20 weeks of gestation.  Due to Texas law, the abortions after 20 weeks of gestation were medically necessary to save the life of the mother.  And, that means .56% of all abortions occurring in Texas in 2012 were medically necessary to save the life of the mother.  In Texas, in 2005, there were a total of 77,374 legal abortions performed with 450 occurring after 20 weeks gestation.  And that means at least 0.58% of all abortions occurring in Texas in 2005 were medically necessary to save the life of the mother.  One might conclude based on this information that at least 0.57% of all abortions are medically necessary to save the life of the mother.  There are approximately 26 million people in Texas and that means in 2012 and that means approximately 0.26% of the population had an abortion that year.  And, that means there is little to no difference in regards to the use of abortion regardless of State law restrictions when you compare the 0.27% in Vermont to the 0.26% in Texas opting for or requiring an abortion.  Sources: http://www.dshs.state.tx.us/chs/vstat/vs12/t36.shtm, http://quickfacts.census.gov/qfd/states/50000.html, http://quickfacts.census.gov/qfd/states/48000.html and http://www.dshs.state.tx.us/chs/vstat/vs05/t36.shtm.

3.  Does criminalizing abortion result in fewer abortions and/or deaths?

Kelsey Hazzard, President of Secular Pro Life, reports that in Chile, criminalizing abortion has resulted in fewer abortions and a decreased maternal mortality rate overall.  Hazzard's sources for this position include http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0036613 and http://www.mercatornet.com/articles/view/a_ground_breaking_abortion_study_from_chile. 

In March of 2015, Chilean officials consider eliminating and/or revising the ban on abortion to permit abortion in certain circumstances.  Source: http://www.reuters.com/article/2015/03/17/us-chile-women-abortion-idUSKBN0MD2BP20150317

The abortion ban in Chile was signed into law by the dictator Augusto Pinochet.  Pinochet was a violent and corrupt leader who murdered his predecessor and seized control of Chile by force.  While information varies depending on source, Pinochet's regime is reportedly responsible for thousands of deaths and tens of thousands of human rights violations including unjust detainment and torture.  Given Pinochet's reputation for corruption and murder, it would be difficult to believe his abortion ban was anything more than a political stunt intended to pacify church leaders while he terrorized the nation.  Sources: http://www.reuters.com/article/2015/03/17/us-chile-women-abortion-idUSKBN0MD2BP20150317, and https://cyber.law.harvard.edu/evidence99/pinochet/HistoryGeneralArticle.htm  

Regardless, if we ignore the person and regime in Chile and focus solely on the facts, what do we find?  According to a 2014 report on Chile, between 13,000 and 18,000 illegal abortions are performed each year in Chile.  Chile has a population of approximately 17.6 million people.  If we use an average of 15,000 abortions given the above estimates, this means that Chile, with a total abortion ban, still has .085% of the population reporting an illegal abortion.  This is percentage-wise, about half the abortions reportedly occurring in Alabama.  But, given the lack of reporting and the fear of punishment if one does report under existing Chile laws, the statistic may itself be flawed.  Sources: http://www.eurekalert.org/pub_releases/2014-11/mi-tca110614.php and http://worldpopulationreview.com/countries/chile-population/ 

"In Chile, it is estimated occur 13,000 to 18,000 illegal abortions each year, representing a death risk of 1 in 4 million women of fertile age and leading to about 16% of hospital discharges due to any type of abortion. It is thought that most illegal abortions are provoked through the self-administration of misoprostol. However, several authors agree that the Chilean progress in this matter is likely to be explained by the success of maternal health policy interventions, the access to modern methods of family planning, the increase in women's educational level and, more recently, to the emergence of support programs for vulnerable women with unplanned pregnancies at risk of abortion."  Source:  http://www.eurekalert.org/pub_releases/2014-11/mi-tca110614.php

Other reports state the following: "Chile has the highest abortion rate in Latin America, with some 40,000 illegal procedures carried out annually, according to a new report. The findings were presented Monday by AnĂ­bal Faundez, a physician and coordinator of the sexual and reproductive rights committee of the International Federation of Gynecologists and Obstetricians."  Source: http://laht.com/article.asp?CategoryId=10717&ArticleId=148871

Now, if we average the rate to 25,000 based on the different rates provided above, the total percentage of people in Chile having illegal abortions becomes 0.142% and if at the higher rate recently reported above we see 0.227% having unsafe abortions.  And, that is more than Alabama and less than Vermont by a small margin. 

Turning our attention now to The Netherlands where abortion is legal.  The Netherlands have a maternal mortality rate of 6 per 100,000 and Chile has a maternal mortality rate of 25 per 100,000.  In The Netherlands, abortion is banned 24 weeks after conception, even for medical reasons.  Approximately 28,000 abortions are performed in The Netherlands each year.  There are approximately 16.87 million people in The Netherlands.  And, that means approximately 0.16% of the population has an abortion annually.  That is a lower abortion rate than in the most restrictive US States.  Sources: http://www.un.org/en/development/desa/population/publications/pdf/policy/WorldAbortionPolicies2013/WorldAbortionPolicies2013_WallChart.xls,  http://southholland.angloinfo.com/information/healthcare/pregnancy-birth/termination-abortion/, http://www.cbs.nl/en-GB/menu/themas/bevolking/publicaties/artikelen/archief/2011/2011-3322-wm.htm, and https://www.cia.gov/library/publications/the-world-factbook/geos/nl.html

"This article gives a review of the main factors that are related to the low abortion rate in the Netherlands. Attention is paid to figures on abortion and the use of contraceptive methods since the beginning of the 1960s up to the end of the 1980s. The strong acceptance of family planning was influenced by changing values regarding sexuality and the family, the transition from an agricultural to a modern industrial society, rapid economic growth, declining influence of the churches on daily life, introduction of modern mass media and the increased general educational level. The introduction of modern contraceptives (mainly the pill and contraceptive sterilization) was stimulated by a strong voluntary family planning movement, fear for overpopulation, a positive role of GPs, and the public health insurance system. A reduction of unwanted pregnancies has been accomplished through successful strategies for the prevention of teenage pregnancy (including sex education, open discussions on sexuality in mass media, educational campaigns and low barrier services) as well as through wide acceptance of sterilization. The Dutch experience with family planning shows the following characteristics: a strong wish to reduce reliance on abortion, ongoing sexual and contraceptive education related to the actual experiences of the target groups, and low barrier family planning services."  Source: http://www.ncbi.nlm.nih.gov/pubmed/7971545

Based on a modicum of research on this issue, it would appear that the answer is clearly No.  No, criminalizing abortion does not result in less abortions and less death.  This would suggest that the goal of pro life organizers should be to prioritize access to birth control, socialized/public health insurance, extensive sex education, and readily available family planning services in order to reduce the number of abortions occurring annually.

And, to reduce the overall demand for abortion services, addressing economic inequality and other socio-economic factors may be the best bet for reducing and hopefully eliminating the demand going forward.

In addition, the US has the highest infant murder rates in the world at 8 infants per 100,000.  The number of pre-school aged children murdered at a rate of 2.5 per 100,000 and the number of school aged children murdered at a rate of 1.5 per 100.000.  Economic distress and unemployment were the primary reasons parents gave for killing their children.  And, in the US, the unemployment rate in 2015 is 10.8%.  In 2012, the unemployment rate in the US was 14.4% and in 2005 the unemployment rate was 8.6%.  Comparing the unemployment rate with the abortion rates in Texas during those years, you can see that when unemployment was down in 2005, abortion demand dropped by approximately 9,000.  In 2012, when the rate of unemployment increased, so did the demand for abortion.  The demand for abortion is tied to economic instability.  Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174580/  and http://portalseven.com/employment/unemployment_rate_u6.jsp

Again, this would suggest pro life organizers should focus efforts on economic inequality issues, expanding access to birth control, public health insurance, comprehensive sex education, and greater access to family planning services for all.  As Kelsey Hazzard said, abortion is a symptom of greater issues.  And, that is quite clear.  This would suggest that abortion is not at the heart of the abortion debate, but, the other issues mentioned above are at the core and should be the priority of all who wish to reduce and even someday eliminate the demand for abortion services.  Criminalizing abortion does not address the core issues and only puts women's lives at risk due to illegal and unsafe abortion.

Kelsey Hazzard, President of Secular Pro Life Comments: (http://www.secularprolife.org/)

Chile, in addition to creating legal protection for life before birth, concurrently invested in girls' education and other vital anti-poverty measures. It doesn't have to be either-or.