Pro-life laws prevent abortion primarily by preventing unplanned pregnancy.

Today’s guest post is by Conner Alford.

Women and their partners are generally forward-thinking and rational in their fertility behavior.

Within
our society’s broader debate on abortion, two particular pro-choice arguments
have occupied a great deal of attention among political activists and leaders
alike. The first and stronger of these arguments postulates that legal
restrictions make abortion more dangerous but that they do not make it any less
common. The underlying logic here is that pro-life policies simply replace safe,
legal terminations with an equal number of dangerous, illegal and self-induced
or ‘back-alley’ abortions (AGI 1999, 2009). In other words, if a woman is
pregnant and does not want to be, she will not consider the legality of her
actions or the risks to her own health when deciding whether or not to abort.
Any woman willing to get a safe, legal abortion is also willing to get an
unsafe, illegal one. When the former is harder to obtain, she will trade it in
for the latter. When the latter is no longer necessary because laws have been
liberalized, she will trade it for the former. This is the argument articulated
by the Alan Guttmacher Institute[1] (AGI) and its affiliated researchers
(Tietze 1973; Juarez et al 2005; Sedgh et al 2007b; Singh et al 2010).
The
second argument makes a somewhat contradictory claim. According to this
narrative, pro-life policies do in fact mitigate abortions. However, they only
do so by replacing those abortions with unwanted births. Women trade abortions
for babies. As a result, the story goes, these undesired offspring either wind
up in state custody or eventually wash out to become criminals (Levitt and
Donahue 2001). Either way, the conclusion that we are supposed to draw is that
pro-life policies are generally ill-advised. However, both of these arguments
are deeply inconsistent with the empirical record and based on a fundamental
misconception about the primary way in which abortion laws actually work and
operate.
First,
studies have shown that while legal restrictions on abortion do reduce the rate
at which it occurs, they do not necessarily
result in an increase in the birth rate (Trussel et al. 1980; Matthews et
al. 1997). Second, the claim that pro-life policies simply lead to an increase
in maternal deaths by driving pregnant women to seek unsafe abortions is
directly challenged by the empirical record. The lowest maternal mortality
rates (MMR) in Europe, for example, occur in Poland, Malta and Ireland—all of
which have extremely restrictive policies (Mundial 2010; Hogan et al. 2010).
Further, a plethora of systematic analyses examining countries from around the
world continuously challenge the idea that legal restrictions on abortion
increase MMRs or hospitalizations.[2]  This, then, undermines a key assumption in the
AGI narrative about illegal abortions. Third, it is important to note that
within the academic community the debate is, generally speaking, no longer
about whether legal restrictions
reduce abortions so much as how they
manage to do so. That pro-life policies mitigate abortion is a point that has
been repeatedly illustrated by literally dozens of independent, peer-reviewed
studies over the course of several decades.[3]
There
has, however, been some disagreement about the exact causal mechanism
responsible for this relationship. Herein we find the chief problem with the
two perspectives introduced at the beginning of this essay. Not only are their
key assertions inconsistent with the empirical record, their entire arguments
are fundamentally oblivious to recent academic insights on how abortion laws
actually operate. Traditionally, scholars have tended to assume that such
policies function to minimize abortions by acting on the posterior “…decision
of a woman who is pregnant not to have the child” (Medoff 1988, p. 354). In
other words, the law was presumed to affect a woman’s behavior only after she had already become
pregnant. The AGI and other pro-choice advocates have adopted this outdated
presupposition.
Since
the mid 1990s, however, the academic understanding has evolved in light of new
evidence. A substantial number of independent, peer reviewed studies have
consistently shown that legal restrictions on abortion work primarily by reducing the rate at which
unplanned pregnancies occur in the first place (Kane and Staiger
1996) and only secondarily by
influencing the behaviors of women who are already pregnant (Levine 2004a)! In
other words, pro-life policies address both the symptom and the cause! To be
more specific, research has shown that women and their partners are generally
forward-thinking and rational in their fertility behavior. They do not wait
until after a pregnancy has already occurred before deciding whether they
should take steps to preempt parenthood. As a result, pro-life policies actually
help to reduce the unplanned pregnancy rate by incentivizing couples to take
additional precautions prior to a
potential pregnancy rather than waiting to obtain an abortion after the
pregnancy has already occurred. Conversely, the opposite is also true. When
abortion is readily accessible, this very availability reduces the incentive to
avoid becoming pregnant by offering a sort of ‘insurance policy,’ should you or
your partner happen to do so. For example, studies have persistently shown that
more permissive policies are causally connected to an increase in unprotected
sex whereas more restrictive policies lead to an increase in contraceptive
usage (Levine 2004b; Medoff 2008a, b; Felkey and Lybecker 2011, 2014, 2015).
There is also some evidence to indicate that legally restricting abortion leads
to a change in the overall amount of sexual activity (Alford 2016).
Of
course, many readers are likely to find this logic somewhat counterintuitive or
even offensive. Despite this, it has been overwhelmingly
supported by the empirical record (Kane and Staiger 1996; Levine et al. 1996;
Levine 1999, 2002, 2003, 2004; Levine and Staiger 2004; McNabb 2007; Medoff 2008a,
b; Felkey and Lybecker 2011). It also helps to explain the previously puzzling
findings of several studies which suggested 
that abortion laws were able to reduce the number of abortions without
an increase in births (Trussel et al. 1980; Matthews et al. 1997) or harming
maternal health outcomes (see footnote 3). Furthermore, it is consistent with
previous findings that the legalization of abortion is associated with an
increase in the spread of sexually transmitted diseases whereas pro-life
policies have the opposite impact (Kick and Stratmann 2003; Klick and Neelsen
2012). Studies examining the impact of abortion policies on the number of
infants available for adoption have, similarly, supported the hypothesis (Gennetian
1999; Bitler and Zavodny 2002; Medoff 2008b).
In
conclusion then, it is important to understand that the primary interaction between pro-life policies and individual
fertility decisions happens before a
potential pregnancy. Men and women are generally rational, free and forward-thinking when it comes to their sex lives. They consider the risks and
potential costs of an unwanted pregnancy before making decisions about whether
to engage in sexual activity or to utilize contraception. When those costs are
subverted by liberalized abortion laws, this provides a sort of ‘insurance
policy,’ which encourages uninhibited sexual activity. When those costs are
reinforced by pro-life policies, however, the opposite occurs. Contraceptive
usage goes up and unplanned pregnancies go down. As a result, legal limitations
on abortion are capable of reducing abortion rates without actually impacting
the overall number of births. Where pro-life policies do lead to an increase in
births, this change is secondary and relatively modest as compared to the
decline in unplanned pregnancy. As a result of this, restrictions on abortion are
also able to operate without a concomitant risk of unsafe abortions. After all,
you cannot illegally terminate a pregnancy that never occurred. This helps to
explain why there does not seem to be any positive relationship between
legalized abortion and maternal health outcomes.[4] The arguments introduced
at the opening of this essay must, therefore, be dismissed in light of new
academic evidence and empirical data. The science simply does not support them.
It does, however, indicate that pro-life laws do not merely address abortion as a symptom but that they attack the
underlying cause of abortion—unplanned pregnancy—at its source.
 
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[1] The AGI is a pro-choice lobbying
organization and the semi-official research division of Planned Parenthood. Its
statement of purpose is to promote the liberalization of worldwide abortion
laws.
[2] Similarly, in South and Central
America, Koch et al (2014) finds no relationship between the restrictiveness of
state policies on abortion in Mexico and maternal mortality, while a time
series analysis of Chile failed to show any relationship between historical
changes in abortion policy and either maternal mortality or abortion related
hospitalizations (Koch et al. 2012a). Systematic analyses in Eastern Europe and
studies examining the impact of legalized abortion in Mexico City also
undermine the AGI narrative (Levine and Staiger 2004; Klick and Neelsen 2012; Koch
et al 2012b).
[3] Hansen 1980; Medoff 1988, 2008a,
2008b; Haas-Wilson 1993; Gober 1994; New 2004, 2007, 2011a, b; Guildi 2008;
Koch et al. 2012a, b, 2014…the list goes on. 
[4] 
In fact, some research indicates the opposite: that more liberal
abortion laws may actually lead to an increase in maternal mortality and
morbidity (Alford 2016). Although these findings have yet to be fully explained,
one possibility is that women who obtain abortions are able to become pregnant
again more quickly and/or are more likely to return to former levels of sexual
activity. As a result, this leads to an increase in the overall number of
pregnancies a woman experiences and therefore her overall risk of experiencing
a potentially life threatening complication. This may also help to explain why
countries with more restrictive abortion policies in both Latin America and
Europe tend to have maternal mortality rates that are lower than the regional average
(see above) and why the abortion mortality ratio decrease by almost 96%
subsequent to an abortion ban in Chile (Koch 2013).

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