U.S. Catholic Bishops - Pro-Life Activities - Fact Sheet: Greater Access to Contraception Does Not Reduce Abortions

Fact Sheet: Greater Access to Contraception Does Not Reduce Abortions

Contraceptive use is already "virtually universal among women of reproductive age."¹

89% of sexually active women of reproductive age "at risk" of becoming pregnant use contraception, and 98% have used it in their lifetime (Alan Guttmacher Institute).²
With typical use, contraceptives often fail to prevent pregnancy.

9% of women using oral contraceptives (OC) will become pregnant within one year,³ as will 15% of women whose partners use condoms.⁴ Forty-eight percent of women with unintended pregnancies⁵ and 54% of women seeking abortions were using contraception in the month they became pregnant.⁶
Studies show that greater access to contraception does not reduce unintended pregnancy and abortion.
- David Paton, author of four major studies in this area, has found "no evidence" that "the provision of family planning reduces either underage conception or abortion rates."⁷
- K. Edgardh found that despite free abortions, free contraceptive counseling, low cost condoms and oral contraceptives, and over-the-counter emergency contraception (EC), Swedish teen abortion rates rose to 22.5 per thousand from 17 per thousand between 1995 and 2001.⁸
- Douglas Kirby concluded: "Most studies that have been conducted during the past 20 years have indicated that improving access to contraception did not significantly increase contraceptive use or decrease teen pregnancy."⁹
- Peter Arcidiacono found that among teens, "increasing access to contraception may actually increase long run pregnancy rates even though short run pregnancy rates fall. On the other hand, policies that decrease access to contraception, and hence sexual activity, are likely to lower pregnancy rates in the long run."¹⁰
Emergency Contraception (EC) does not reduce unintended pregnancy and abortion.

Twenty-three studies published between 1998 and 2006, and analyzed by Raymond, Trussell and Polis, measured the effect of increased access to EC on EC use, unintended pregnancy, and abortion. Not a single study among the 23 found a reduction in unintended pregnancies or abortions following increased access to emergency contraception.¹¹ Here are a few of the studies' findings:
- Sixteen months after 18,000 sexually active women in a health district in Scotland were each given 5 packets of EC, researchers concluded: "No effect on abortion rates was demonstrated with advance provision of EC. The results of this study suggest that wide-spread distribution of advanced supplies of EC through health services may not be an effective way to reduce the incidence of unintended pregnancy in the UK."¹²
- Over 2,000 women in the San Francisco Bay area were randomly assigned to one of three groups. The first were given packets of EC; the second were told how to obtain EC free from pharmacies; the third had to return to the clinic for EC. Over 80% of the women were also using another form of contraception. After only six months, 7-8% of women in each group were pregnant. Conclusion: "We did not observe a difference in pregnancy rates in women with either pharmacy access or advance provision [of EC]; ... Previous studies also failed to show significant differences in pregnancy or abortion rates among women with advance provisions of EC."¹³
- "Another commonly held view for which there is no documented evidence is that improving knowledge about and access to Emergency Contraception will reduce the number of teenage pregnancies. ... Experience of use so far does not give any evidence of effectiveness. Prescribing rates of the morning-after pill have multiplied steadily in Scotland while there has been no observed decline in the rate of teenage pregnancies or abortions."¹⁴
- "Despite the fact that emergency contraceptive pills (ECP) have become easily available across the country during recent years, abortion numbers continue to rise in Sweden, especially in the young age groups (<25)."¹⁵
- The Washington State Pilot Project allowed pharmacies to dispense EC without a prescription from February 1998 to June 1999. Although pregnancy and abortion rates in Washington state dropped (before increasing slightly the following year),¹⁶ between 1996 and 2000, the decline in Washington state (3%) was actually smaller than the decline in the abortion rate nationally (5%).
Studies link increased access to contraceptives to an increase in STDs.
- The Swedish study (cited above) found that between 1995 and 2001, Chlamydia infections rose 50% overall in Sweden and 60% among the young.
- In a 2003 study, David Paton found that between 1999 and 2001, with improved access to family planning clinics in the United Kingdom (teen visits rose over 23%), the number of sexually active teens rose almost 20%, and STD rates rose 15.8%.¹⁷
- "In Scotland there has been a doubling of the rates of Herpes and [Gonorrhea] and a four-fold increase in Chlamydia in the past ten years (1993-2003)," notwithstanding greatly increased access to contraception and a three-fold increase in the use of EC.¹⁸
A decline in teen sexual activity does reduce teen (or unwed) pregnancies and abortions.

One analysis of the decline in non-marital birth and pregnancy rates for teens from 1991 to 1995 found: "The reduction in numbers of 15-19 year olds having intercourse accounts for 67% of the decline in pregnancy rate."¹⁹ As acknowledged by the National Campaign to Reduce Teen Pregnancy, while overall rates of teen sex and teen pregnancy may have declined, it remains true that one in three girls who are sexually active will get pregnant.²⁰
State abortion laws restricting funding and minors' access, and requiring informed consent, help reduce abortion rates.
- A number of researchers have analyzed the impact of state laws requiring parental involvement in abortion on minors' abortion rates. At least seven studies report abortion rates for minors decreased between 13 and 42 per cent.^21,22
  
  The national rate of abortion for minors (age 13 through 17) has declined to 6.5 abortions per 1,000 girls in 1999, from 13.5 abortions per 1,000 girls in 1985. This decline of over 50% contributed substantially to the overall decline of 18.4% in the rate of abortion among all women of reproductive age between 1990 and 1999.
  
  In his most recent study (Feb. 2007), Michael New, Ph.D. analyzes changes in state abortion rates of minors as a result of laws requiring parental involvement in the abortion decision, requiring informed consent, imposing Medicaid funding restrictions, and banning partial-birth abortion. His findings support the conclusion that each category of pro-life legislation reduces minors' abortion rates. Laws that produce the greatest decline in minors' abortions are parental involvement laws which result in a 30.5% decline, and Medicaid funding restrictions which result in a 23% decline.²³
- An earlier study by Dr. New also found a decreased rate of abortion among minors after states enacted (and enforced) a parental involvement law. When such a law was later enjoined or repealed, the abortion rate among minors increased. Finally, with the enforcement or passage of a new parental involvement law, the abortion rate among minors dropped again.²⁴

Notes

Centers for Disease Control and Prevention Advance Data No. 350, Dec. 10, 2004: "Use of Contraception and Use of Family Planning Services in the United States: 1982-2002," available at http://www.cdc.gov/nchs/data/ad/ad350.pdf). All sites last visited February 16, 2007 unless otherwise indicated.
Abortion in Women's Lives, available at http://www.guttmacher.org/pubs/2006/05/04/AiWL.pdf, pp. 6-7.
http://womenshealth.about.com/cs/birthcontrol/a/effectivenessbc.htm.
http://womenshealth.about.com/cs/birthcontrol/a/effectivenessbc.htm.
http://www.guttmacher.org/pubs/2006/05/04/AiWL.pdf, p. 7.
http://www.guttmacher.org/pubs/fb_induced_abortion.html.
David Paton, "The Economics of Family Planning and Underage Conceptions," Journal of Health Economics, 21.2 (March 2002): 207-225; abstract available at http://www.sciencedirect.com/science/article/B6V8K-4537PJR-3/2/7b0ac0ed4b84065fae3119e1663e50bc. This study examined 16 regions of the U.K. over a 14-year period, and also focused on the effect of the Gillick ruling, which from 1984 to 1985 required parental consent for girls under 16 to obtain contraception in England. The ruling did not apply to Scotland. Predictably, a heavy drop in clinic visits occurred among English girls under 16, and many expected to see increased pregnancies and abortions in this group, compared to older girls in England and girls under16 in Scotland. He found no increase in pregnancies or abortions in this group, and no decrease in underage pregnancies or abortions overall from greater access to contraception.
Edgardh, K. et al. Adolescent Sexual Health in Sweden, Sex Trans Inf 78 (2002): 352-6, available at http://sti.bmjjournals.com/cgi/content/full/78/5/352.
Douglas Kirby, "Reflections on Two Decades of Research on Teen Sexual Behavior and Pregnancy," Journal of School Health 69.3 (March 1999).
Peter Arcidiacono et al., "Habit Persistence and Teen Sex: Could Increased Contraception Have Unintended Consequences for Teen Pregnancies?" (Oct. 3, 2005), available at www.econ.duke.edu/~psarcidi/addicted13.pdf.
E. Raymond et al., "Population Effect of Increased Access to Emergency Contraceptive Pills," Obstetrics & Gynecology 109 (2007): 181-8.
A. Glasier et al., "Advanced Provision of Emergency Contraception does not Reduce Abortion Rates," Contraception 69.5 (May 2004): 361-6 (www.cwfa.org/images/content/scotland0905.pdf; visited Feb. 16, 2007).
T. Raine et al., "Direct Access to Emergency Contraception through Pharmacies and Effect on Unintended Pregnancy and STIs," Journal of the American Medical Association 293 (2005): 54-62 (www.dph.sf.ca.us/sfcityclinic/providers/Directaccesscontraception.pdf; visited Feb. 16, 2007).
A. Williams, "The Morning After Pill," Scottish Council of Human Bioethics (Nov. 2005) (www.schb.org.uk, click on "Publications" then "Sexual Health").
T. Tyden et al., "No reduced number of abortions despite easily available emergency contraceptive pills," Lakartidningen 99.47 (2002): 4730-2, 4735 (abstract at www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12523048&dopt=Citation; visited Feb. 16, 2007).
J. Gardner et al., "Increasing Access to Emergency Contraception Through Community Pharmacies: Lessons from Washington State," Family Planning Perspectives 33 (2001): 172-5 (http://www.guttmacher.org/pubs/journals/3317201.html; visited Feb. 16, 2007).
David Paton, "Random Behavior or Rational Choice? Family Planning, Teenage Pregnancy and STIs (Nov.2003), available at www.swan.ac.uk/economics/res2004/program/papers/Paton.pdf.
A. Williams, "The Morning After Pill," Scottish Council on Human Bioethics (Nov. 2005).
JK Mohn et al. "An analysis of the causes of the decline in non-marital birth and pregnancy rates for teens from 1991-1995," Adolescent and Family Health 2003; 339-47; available at www.afhjournal.org.
National Campaign to Reduce Teen Pregnancy, "Science Says: Pregnancy Among Sexually Experienced Teens, 2002," No. 23, April 2006, available at www.teenpregnancy.org/press/pdf/sciencesays23.pdf.
Theodore Joyce et al., "Changes in Abortions and Births and the Texas Parental Notification Law," New England Journal of Medicine, 354: 1031-1038 (March 9, 2006); available at http://content.nejm.org/cgi/content/full/354/10/1031. The authors. found a reduction in abortion rates among minor teens in Texas following enactment of that state's parental notification law. "[A]bortion rates fell by 11 percent among 15-year-olds, ... 20 percent among 16-year-olds, and 16 percent among 17-year-olds, ... relative to the rates among 18-year-olds." Joyce et al. also report: "Results from [five] previous studies have indicated that the abortion rate of minors decreases 13 to 42 percent after enforcement of a parental notification or consent law, if abortions are measured according to state of occurrence."
J. Rogers et al. found: "The pre-enactment to post-enactment change in the Minnesota abortion rate reflected a greater decline for minors (less than or equal to 17 years old) than for 18-19 year-olds (who were not under the law). An increase in abortion rate occurred for women ages 20-44. The law appeared to have had no impact on birth rate in minors. ... These data suggest that parental notification facilitated pregnancy avoidance in 15-17 year-old Minnesota women. Abortion rates declined unexpectedly while birth rates continued to decline in accordance with a long-term trend." "Impact of Minnesota Parental Notification Law on abortion and birth," American Journal of Public Health, Vol. 81, Issue 3, 294-298. See also Michael New, "Analyzing the Effects of State Legislation on the Incidence of Abortion During the 1900s," Heritage Foundation Data Analysis Report #04-01 (2004), available at http://www.heritage.org/Research/Family/CDA04-01.cfm.
M. New, "Analyzing the Effect of State Legislation on the Incidence of Abortion Among Minors," Heritage Foundation Data Analysis Report #07-01 (2007), available at http://www.heritage.org/Research/Family/CDA07-01.cfm.
M. New, "Using Natural Experiments to Analyze the Impact of State Legislation on the Incidence of Abortion," Heritage Center for Data Analysis Report #06-01 (January 23, 2006); available at http://www.heritage.org/Research/Family/cda06-01.cfm.