The Economist thinks it knows how to reduce abortion . . . eh, not so much

Last updated on: December 6, 2016 at 9:00 pm by Jane the Actuary

The Economist thinks it knows how to reduce abortion . . . eh, not so much 2016-12-06T21:00:09-06:00 Jane the Actuary

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“How to Make Abortion Rarer” — that’s the title of an article in this week’s Economist. And — no surprise — their solution if for women everywhere to “see the light” and start using hormonal contraception rather than condoms, and for governments to make these drugs and devices more widely available, and free of charge.

Before they get to that, they claim that legal restrictions on abortion have no effect, based on a Lancet study that claimed to have determined that “abortion is as common in countries where it is illegal or allowed only to save a woman’s life as it is in those where it is provided on demand.” (This study is paywalled; here’s a write up from the BBC and another from the Christian Post; near as I can tell, from memory as well as these articles, it is far too simplistic to say, “abortion restrictions have no effect” because there’s so much else going on with poverty levels, culture, etc., that you can’t simply classify every country in the world into two groups and draw conclusions from it.) They point to one country in particular, South Korea, where abortion is nominally illegal but widely available.

The article then cites various countries in which there is a strong cultural dislike of hormonal contraception. The Greeks, reportedly,

commonly believe that the pill and other hormonal contraceptives cause infertility and cancer. They also distrust intrauterine devices (IUDs), possibly because they have been taught that tampons are unhealthy.

Also,

In South Korea fewer than 5% of women use the pill because they think it is harmful to ingest artificial hormones.

and

In plenty of countries, including Ireland and Russia, more than a third of married couples who use contraceptives rely on condoms. In Japan that share is an astonishing 90%.

despite the fact that condoms have an 18% failure rate. (That is, 20% of users will fall pregnant within a year — this is slightly more pessimistic than the WHO figure of 15%.)

So step one in the Economist plan is to persuade women to overcome their cultural resistance to hormonal contraception.

Step two is to make the contraception free of charge. They write:

A Russian woman who wants an IUD has to pay for the device and for the appointment to have it inserted. Abortions in state hospitals, by contrast, are free. Half of the 16 European countries in the IPPF review provide no reimbursement for contraceptives; none fully covers all methods. Even in some countries with generous social welfare systems, including Germany and Italy, women have to pay for contraceptives, no matter how low their income.

This is despite contraception being cheap for governments to provide. England’s National Health Service (NHS) offers every type of contraceptive free to everyone (better-off people must pay part of the cost for other prescriptions). Its buying power means it can pay less than £10 ($12.50) for a year’s supply of the pill and just £18 for an IUD that prevents pregnancy for five years. England has one of the world’s highest rates of contraceptive use.

But here’s where their argument fails: they include a graphic with abortion rates in selected countries. There are no numbers, so you just have to estimate from the graph’s legend, but the abortion rate for the U.K. looks to be about 16 per 1,000 women of childbearing age. The U.S. is slightly higher on this graph, maybe 17. And Germany, which the Economist reports require women to pay out-of-pocket? Their rate is about 8.

Image: https://commons.wikimedia.org/wiki/File%3APackage_of_Lutera_Birth_Control_Pills.jpg; By ParentingPatch (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

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