Cynthia Dailard is a senior public policy associate at the Guttmacher Institute in Washington, DC.
South Dakota’s abortion ban, signed into law earlier this week, is a punitive and misguided approach to reducing the number of abortions, but it is not alone. Antiabortion legislators have introduced similar bills in eight other states this year. In 2005 states enacted into law twice as many abortion restrictions as the year before, with biased counseling requirements, onerous waiting periods and harmful mandatory parental consent provisions leading the pack.
While restrictions may make abortions harder to obtain, they do not reduce the underlying demand for abortion. The reason for this is simple: behind almost every one of the 1.3 million annual abortions in this country is an unplanned and unwanted pregnancy. The United States has a comparatively high abortion rate because it has a high unintended pregnancy rate—one of the highest among industrialized nations. States wishing to reduce their abortion rates would do far better to devote the necessary resources to help women obtain contraceptives and use them effectively over time—particularly low-income women who are most likely to experience an unintended pregnancy.
It is therefore somewhat ironic—and also a sad state of affairs—that the state that is leading the charge to outlaw abortions is doing less than most other states to help women avoid unintended pregnancy in the first place. A new report by the Guttmacher Institute, a New York-based reproductive health think tank, found that South Dakota ranked 44th among the states in this regard. The Guttmacher report evaluated the extent to which states (and the District of Columbia) devote public funding to help low-income women access birth control, have laws and policies designed to facilitate contraceptive use and provide subsidized services through family planning clinics to those in need. One potentially surprising finding from the Guttmacher report is that helping women avoid unintended pregnancy is not just a blue state issue. From Alaska to Alabama, California to South Carolina, a number of states spanning the political spectrum and geographical divide are taking creative steps to help women access contraceptives and to use them effectively over time.
Unfortunately, the Guttmacher analysis found that far too many states, like South Dakota, are lagging far behind. This may help explain, in part, why the declines in U.S. abortion rates so apparent during the 1990s have slowed to a crawl in recent years. And recent government data suggest that more women who do not wish to become pregnant are having unprotected sex—putting themselves at risk for more accidental pregnancies and abortions.
One result of all this is that the United States will not come close to reaching its national public health goal, set in 2000, of reducing the proportion of pregnancies that are unintended by 40 percent by 2010. Indeed, significant future reductions in the country’s abortion levels are unlikely to occur absent a bold societal commitment to helping men and women avoid unintended pregnancy. What might we achieve with such a comprehensive and far-reaching effort—one similar to the national campaigns launched against smoking and, more recently, obesity? Between 1965 and 1990, American society underwent a stunning transformation in smoking rates, which declined among American adults by 40 percent. There is no reason to think that, given the political will, comparable progress could not be made on unintended pregnancy. And the payoff would be similarly enormous—if today’s unintended pregnancy rate were 40 percent lower than it is, the annual number of abortions in the United States would be 780,000 instead of 1.3 million.
Unfortunately, the current political state of affairs threatens to stymie any hope of such progress. The Bush administration and like-minded social conservatives ensconced in Congress and many state governments are hostile to the very notion of prevention. Their answer to abortion is to make it illegal. Their answer to unwanted pregnancy—or "out-of-wedlock births," as they define the problem, despite the fact that three in 10 pregnancies occurring in marriage are unintended—is abstinence for all people outside of marriage. At the same time they are forging ahead with an aggressive antiabortion agenda designed to chip away at the foundation of Roe v. Wade , they are engaged in an international campaign to portray condoms and other contraceptives as ineffective in protecting against unwanted pregnancy and disease.
Consider, however, what the U.S. political debate over abortion might look like if its abortion rate were on par with those of other countries with widespread contraceptive use and low unintended pregnancy. One quite plausible scenario is that the considerably lower rate would diffuse the intensity of the abortion debate more effectively than any other approach to date. This, too, would be a social good.
