Megan McArdle: Free Contraceptives Is Not a Method for Reducing Abortion

Free contraceptives might or might not make some kind of difference in the abortion rate but there is no way to know how big a difference or which way.

Megan McArdle has weighed into a debate started with Ross Douthat blasting the idea of free and available birth control reducing the abortion rate. McArdle gives her own evaluation as an economist:

But on this issue – not whether abortion should be legal, but whether the main thing standing between America and fewer abortions is better government birth-control policy – I think Douthat has the better argument.

McArdle argues for Douthat’s position by pointing out the abortion rates in other countries, the rates in various U.S. states, and the problems with the Colorado study in which birth control devices were implanted in women.

When it comes to other countries, we see abortion rates are all over the map despite government healthcare that provides cheap or free birth control.

global abortion rates

The U.S. rate is certainly high compared with, say Germany or the Netherlands. On the other hand, it’s lower than Sweden, and right around that of New Zealand and the UK — countries with comprehensive national health-care services that provide birth control. And who had one of the lowest abortion rates? Ireland, where it was illegal. (Irish women travel abroad to get abortions, but the rate still seems to be quite low by international standards.)

Now, obviously, we could theoretically do something to reduce our abortion rates to more German levels without going so far as to ban it. But this data doesn’t really suggest that “something” is necessarily “provide more affordable reproductive health care services to women,” or indeed, anything else that lends itself to government intervention, such as “better sex ed.” Extremely high abortion rates can coexist with extremely comprehensive health-care systems and liberal social norms.

The same holds true for states in our country.

Liberal blue states with liberal abortion laws and liberal attitudes about birth control seem to have the highest, not the lowest, rates of abortion.  What drives this? I can come up with a number of plausible theories, but I couldn’t tell you which one is right. On the other hand, I think we can reject the hypothesis that liberal attitudes toward sex and birth control are a surefire way to get the abortion rate down.

But the best part of McArdle’s column is her destruction of the Colorado study which the New York Times has claimed was “a startling success.”

In real life, McArdle argues, it was a complete mystery because we have no idea what the results actually were. All we have in the study are young women being given the most failsafe birth control method and then a study of the birth and abortion rates in counties where these devices were implanted.

Basically, what you would want to do with a study like this is randomize it: Divide women into two populations, give half of them increased LARC access [long-acting reversible contraceptives], and track what happened. Failing that, you’d at least want to track what actually happened to the women who got LARCs. The study does neither of these things; instead, after the program had been operating for a while, it took a look at county-level data, either for the whole population of the county, or the population of low-income women in the counties where LARCs became more widely available.

So we have no direct information about what happened to these women. In the meantime, the birth rates and abortion rates dropped in many states, not only in Colorado.

McArdle does the math to figure out how many fewer abortions a year took place: 1,200.

To believe that the CFPI was responsible for all or most of the change, we have to believe that around 15 percent of the women who got LARCs would have gotten pregnant and had abortions in a single year — and that’s before we even try to account for the fact that some substantial number of women who got those 8,400 LARCs would have aged out of the range by 2011, and therefore would presumably not have been counted in the abortion data, so that the remaining women who were would need to have had even higher rates of pregnancy and abortion. Just for reference, the pregnancy rate in the U.S. for teen women aged 15 to 24 was about 6.5 percent, and about 15 percent for women aged 20 to 24. Obviously, not all of those women have abortions.

The only way the study tries to prove that the LARC program was responsible for the lower rate is to compare counties where the program did not operate. But those Colorado counties were far more rural and thus far less populated. There is no reason to think that residents of the country would all behave exactly like their more urban or suburban sisters except for the presence of the implants.

So there is no evidence that a government program of free birth control is likely to reduce the number of abortions.

Of course, if Planned Parenthood is engaged in a campaign to encourage promiscuity then it is encouraging men and women to assume they can have sex month after month, year after year, and not need to deal with a baby. Given the statistical failure rates of birth control, it is virtually guaranteed that such people will become parents, and will want to dispose of the child since they have now accepted as undeniable that they have a right to sexual activity without children.

In other words, pushing birth control is a way that Planned Parenthood makes sure it has future abortion customers.