Let's Reduce the Demand for Abortions

Of all the social issues facing America, probably none provokes more of an emotional response - one way or the other - than the legality of abortion.  It's so heated the two sides don't even agree what to call each other.  This hypersensitivity has made me wary of writing about it extensively to this point.  Moreover, as a dude I feel woefully underqualified to authoritatively discuss something that I"ll never personally have to face.  However, that certainly doesn't stop millions of other men from pontificating about it, and some recent events have now steered me towards the subject.  In short, I agree with former President Clinton that abortion should be "safe, legal, and rare."  I do not support legislative efforts to ban abortion because they violate the basic rights of women and are ultimately ineffectual.  Rather, that wasted energy should be directed to implementing policies and practices that will hopefully reduce the demand for abortion in the future.

Misguided Anti-Abortion Legislation

There has certainly been an effort to overturn Roe v. Wade, the Supreme Court decision that legalized abortion nationally in 1973, in the forty years since.  That ultimate goal is basically impossible, as it would take a Court reversal or constitutional amendment - neither of which is very likely to occur.  The easiest way would be for a committed anti-abortion President to have a committed anti-abortion Senate (for Justice confirmations) and several Court vacancies to fill.  If that didn't happen during Bush's 8 years, it's not likely to happen anytime soon.  And even if it did, it would be reversed as soon as the Court makeup changed again.

And so abortion opponents have turned to crafting laws at the national and state level that chip away at abortion rights either directly or indirectly.  If they can't outlaw abortion outright, they will make it as hard as possible for women to get them, through such tactics as defunding Planned Parenthood or by imposing onerous restrictions on abortion clinics that force them to close (suddenly, conservatives love government regulations!).  Making abortions nearly impossible to obtain in a certain state is extremely biased against poor women - for as long as abortion remains legal somewhere in the US, women of means will be able to get them.  And even if it were illegal nationwide, there would be a way.  Instead such laws end up punishing the women who need Planned Parenthood's services the most (more on this later).

However, the dirty little secret that many abortion foes either don't realize or don't want to admit is that many establishment Republicans don't care about outlawing abortion.  In the 1980s and '90s, they were more than happy to give lip service to the cause in order to win the votes of the large Christian conservative voting bloc.  However, once in government they cared more about tax cuts and deregulation than abortion - "but hey, we'll do a partial-birth abortion ban, lots of people can get behind that.  But otherwise, please, please stop saying stupid stuff about women, rape, and abortion" (remember Todd Akin?).

That trend changed in 2010 when the Tea Party bucked the establishment and seized control of several state governments and the national House of Representatives.  Now, their presence could no longer be ignored - they either could pass what laws they wanted outright, or hold House Speaker John Boehner's job hostage if he didn't throw them some red meat.  And thus we have witnessed a wave of anti-abortion legislation in the past few years, much of it becoming law at the state level.  Let's look at two examples.

Mike Ellis (R-Blowing Gasket)

First, I turn to my former residence of Wisconsin, where I had been genuinely impressed by the openness of its governance and pride in its heritage as a "laboratory of democracy."  That all went south when Tea Party darling Scott Walker was elected Governor and Republicans captured both legislative chambers in 2010.  Suddenly draconian rules restricting peaceful protests at the Capitol and observance of legislative proceedings were put into place (including a dress code, because by God we can't have people in T-shirts in the galleries!).  It was in this environment that a bill requiring women seeking an abortion to have an ultrasound beforehand was introduced.  These laws, implemented in some other states, are supposedly about "giving full information" to a patient, but are really about guilting them into not having an abortion.  They are not medically necessary, and moreover, because most abortions are performed early in pregnancy, an invasive transvaginal ultrasound would be required to get the clear image that the bill requires.  The law rapidly moved through the state legislature, featuring the arrest of some protestors in the galleries and an epic gavel-breaking meltdown by Senate President Mike Ellis as Democratic legislators attempted to prolong debate.  The bill passed both houses, and Walker has indicated his enthusiastic support.  A Democratic amendment that would have prohibited women from being physically forced to have an ultrasound was, unfathomably, defeated.  So, I'm not saying it will happen, but it will soon be technically legal in Wisconsin to physically force a woman to have an invasive medical procedure that she doesn't want or need.  Such is the "freedom" of Tea Party governance.

Not to be outdone, my home state of Kansas now requires abortion providers to tell women about the supposed link between abortion and breast cancer, even though no major studies have ever found any evidence of such a link.  Requiring doctors to lie to patients - now enshrined in Kansas law.

Moving to the national level, this week the GOP-controlled House passed a law outlawing abortions at 20 weeks or later.  Such a law is, of course, unconstitutional, as the Supreme Court has ruled that abortions before 24 weeks cannot be outlawed.  Focused like a laser on creating jobs and improving the economy, that GOP House is, right?  Actually, it's just as pointless as the chamber's 37 attempts to repeal Obamacare.  It won't pass the Senate and President Obama would never sign it.  It's yet another waste of taxpayer money and Congressional time by those "fiscally conservative" Republicans - a purely symbolic act to please the Tea Party base while accomplishing absolutely nothing.

The bill's 20-week cutoff is based on the highly debated notion that fetuses can feel pain at this point in gestation.  Major medical groups such as the American Medical Association and American College of Obstetricians and Gynecologists dispute the idea of fetal pain at 20 weeks.  The only defenses supporters of the bill could mount once again made them look downright silly, such as the bizarre implication, from an OB/GYN Republican Congressman, that male fetuses at 15 weeks masturbate, and since they can feel pleasure, they can also feel pain.  (If you really want to know, turns out there have been a few documented instances of fetuses making "masturbatory motions," but all much later than 15 weeks.)  In reality, 20 weeks is an arbitrary deadline, based on flimsy evidence at best, that really serves to move the goalpost forward towards the end goal of outlawing all abortion.  Fetal pain today, fetal heartbeat tomorrow, conception next Thursday.  And if you think I'm exaggerating, such measures are already moving forward in the states - North Dakota now bans abortions when a heartbeat is detectable.

Here's what gets me - how are these measures being accomplished?  The free market?  Charitable organizations?  Business entrepreneurship?  No!  It's big government!  I'm tired of these conservatives telling us government is not the answer, government takes away our freedom, government can't do anything right.  Any laws aimed at curbing gun violence are pointless and unconstitutional, you might as well ban rocks and hammers, etc. etc.  But when it comes to abortion - a legal practice for 40 years - they can't get enough government.  More restrictions on clinics!  More requirements on patients and doctors!  Screw freedom!  So, I'm only asking conservative abortion opponents to acknowledge what they supposedly believe in their hearts - government can't eliminate the problem.  You can't legislate abortion out of existence, exactly how you can't erase gun homicide.  So let's look at the situation a different way and actually do something productive.

Focus on the Demand, Not the Supply

Conservatives tackle abortion like they do economics - they're supply-siders.  They focus on legally limiting the supply of abortion while in many cases they actively oppose measures that could reduce the demand for them.  Well, if the general failure of such policies as the war on drugs has taught us anything, it's that you can't legislatively eliminate the supply of a good or service that's fairly easily available and in demand.  It'll just move to the black market, which would be a bad situation for everyone involved.

So, instead, let's focus on lowering the demand for abortion.  This should really be an area where both abortion rights supporters and people personally opposed to abortion could work together.  No one thinks abortion is great.  No one wants to see its numbers on the rise.  Imagine what good could be done if everyone could accept the status quo legality of abortion and direct all the money, time, and attention used to constantly fight both sides of the battle to real action to lower abortion rates instead.  Is this a pipe dream?  Most likely - as it is, politicians have way too much to gain from keeping this divisive issue alive.  But one can dream.

I envision a three-pronged approach to reducing abortion rates by lowering demand for them - comprehensive sex education, universal access to birth control, and better support services for poor parents facing an unplanned pregnancy.  I understand these policies might not be popular with a lot of abortion foes, but if you're genuinely interested in doing something substantive about abortion, I urge you to hear me out.

(I'm well aware that my suggestions also include government action.  However, these ideas are proactive measures that people can actively contribute to and work together on, rather than restrictive legislation that limits the rights of women to make decisions about their health.)

Comprehensive sex education is vital to teenagers understanding their reproductive health and the consequences of their sexual actions.  It is very naive to believe that abstinence-only sex ed properly educates youth about their bodies and is actually effective in getting them to put off sex until marriage.  Even 80% of unmarried evangelical Christians self-report as sexually active.  Abstinence programs may shame teens who have sex, which is only going to exacerbate the problem if they find themselves in a tough situation.  Moreover, studies show that many young people - as much as 60% - are grossly misinformed about the effectiveness of contraception.  A 2008 study found that comprehensive sex ed reduced the likelihood of getting pregnant, or getting someone pregnant, by 60%; compared to no statistically significant results for abstinence-only programs.  Three states with the highest teen pregnancy rates do not require any form of sex ed whatsoever.  The statistics speak loudly on this one.  Comprehensive sex education teaches adolescents to be aware of their sexual health, it reduces the likelihood of teen pregnancy, and thus lowers the potential demand for abortions.  It should be mandated nationwide.

Following naturally on sex ed is universal access to effective birth control.  Now, you might be personally opposed to using contraception.  That's fine, and no one is going to force you to use it.  However, opponents have to realize that in 2013 this is a very minority position to have, and that there is no right to restrict access to birth control based on religious or other beliefs.  There are signs that even some elements of the evangelical community are becoming open to responsible birth control use.  And the stats don't lie here either - birth control works.  Teen pregnancies are declining sharply, and increased birth control use is the reason why.  I'm not saying birth control has to be free for everyone (socialism!) but it should be universally and cheaply accessible.  It should be covered in health insurance plans without exception.  Recently some Christian employers have refused to cover birth control on insurance plans due to their religious beliefs.  They have no such right.  They ignore their employees' freedom of religion.  Insurance benefits are a form of compensation, and an employer has no right to tell their employee how to spend such compensation.  A Jewish employer can't tell their workers not to burn their paycheck on bacon.

As it turns out - not evil.

Conservatives love to demonize Planned Parenthood.  In their vision, it's nothing more than an abortion mill.  They constantly seek to defund it and put it out of business, ignoring the majority of services it provides - even to the detriment of many other citizens.  Texas even refused federal Medicaid funding just to kick PP out of Medicaid.  The state's own health department estimates that this defunding will cause 24,000 additional unplanned births in 2014 and 2015, which could cost taxpayers over $200 million in Medicaid and other expenses.  How is that supposed to reduce abortion rates?  How is that "fiscally conservative?"  Planned Parenthood provides essential family planning and sexual health services for low-income women and men. of which abortion is only a small part - 3%.  71% of PP clients are there for preventive measures.  The organization also provides hundreds of thousands of breast exams and millions of STD tests every year.  It is a vital component of public health and deserves to be supported rather than denigrated.

Last, the best sex ed and birth control access in the world still won't prevent all unplanned pregnancies.  So, we need to provide better support services for poor prospective parents facing the dilemma of an unplanned child.  Conservatives who claim to be "pro-life" often seem to ignore this side of the equation - they care deeply about the unborn, but once that child - that they said you must have because abortion is wrong - enters the world, you're on your own.  This gets into the tired "moochers" business that I'm not going to go through yet again, but I think you get the idea.  They want to cut welfare.  They are hesitant to support family and medical leave from work.  They oppose universal preschool.  Just today the House GOP voted to cut food stamp aid from its already meager levels, except for the portion of Tea Partiers who voted against it because it didn't cut enough.  Now, this doesn't all have to be government assistance - think of what all those funds used to fight the abortion battle could do to help these families in need. Instead, it's wasted on endless legal battles and either pointless or unconstitutional legislation.  If parents knew that there would be a safety net for them to support their child, abortion might be a less desirable solution to an unplanned pregnancy.

Abortion will likely remain the single most divisive issue in politics for years to come.  Due to the emotional real-life impact it has on millions of lives, it shouldn't be that way.  If abortion opponents could accept the legality of the practice - which is not going to change - I think there would be great potential for all Americans to work together toward the common goal of making it as safe and rare as possible.