Foiling Fallacies – Women Who Use Abortion As Birth Control

This is my first post in a new series called Foiling Fallacies (FFS for short – which is generally what I mutter when someone uses a fallacy in an internet debate). In the series I will explore the examples that are often brought up to derail internet debates when all hope of making one’s case is gone, the hail Mary passes, the anecdotes that represent such rare possibilities or exceptions to the rule that bringing them up is a logical fallacy (generally a red herring or straw man argument). So join me, as I dispel some myths and feel free to send me suggestions for topics. Consider this series your debate Mythbusters.

For my first post, I would like to take on a subject near and dear to my heart and give you some ammunition the next time you are engaged in a debate about abortion and someone says: “I am generally pro-choice, except for those women who use abortion as birth control.” I have heard this statement come out of the mouths and keyboards of some of the most progressive people I know, as well as the anti-choice extremist crowd. At least both sides can agree on something, right? Not so fast.

Before I bust this myth, let me start from the premise that even if all women who obtain abortion care do so in lieu of using other forms of birth control, I would not care. Abortion is birth control. Expensive, invasive birth control, but birth control, nonetheless. I am 100% pro-choice. No exceptions. If a woman chooses to terminate every unplanned pregnancy she experiences, I support her. Even if she chooses to not use other forms of contraception or abstinence in order to prevent pregnancy. Even if she has lots of unprotected sex. Even if she should “know better” or should “be more responsible.” Terminating an unwanted pregnancy IS responsible. For those of you who think it is not, I ask you this – if you don’t trust a woman to make a decision about whether or not to bring a child into this world, should you trust her to care for that child?

Instead of going down the rabbit hole and allowing the argument to be derailed, how about instead we explore this – how likely is it that a large number of women use abortion as their primary form of birth control? Enough to make this a legitimate part of a debate about a woman’s right to choose? To do this, let me paint a picture, courtesy of the Guttmacher Institute and abortion surveillance reports. About half of all women who obtain an abortion in the United States have had one previously. This statistic seems to really surprise and upset people. Including many people who otherwise consider themselves to be pro-choice. I mean, shouldn’t she have learned her lesson the first time? Upon deeper reflection, though, they should realize that the image in their head of a wanton woman going to the clinic every month for another abortion is just not accurate.

Let’s begin with some stats:

• Roughly one half of all pregnancies in the United States are unintended. Forty percent of these pregnancies end in abortion.
• More than half (51%) of abortion patients reported having used a contraceptive method during the month in which they got pregnant. Of the women who had not used contraceptives, many believed they were at a low risk for pregnancy. In other words women were either trying to prevent pregnancy when they got pregnant, they thought they or their partner was infertile or otherwise felt that they weren’t going to get pregnant. This may indicate that the issue of repeat abortion is more related to a lack of education about pregnancy prevention and access to contraceptives than it is about a woman choosing to use abortion as their primary form of birth control.
• In fact, women having a repeat abortion are more likely than those obtaining their first abortion to have been using a highly effective hormonal method when they got pregnant.
• Forty-two percent of women obtaining abortions have incomes below 100% of the federal poverty level and twenty-seven percent of women obtaining abortions have incomes between 100–199% of the federal poverty level.
• Low income women are less likely to use contraception, and are at higher risk for life disruptions (job loss, homelessness, falling behind on rent or mortgage payments, separation from partner), which may limit their ability to prevent pregnancy. In qualitative research on why women chose abortions, nearly half of women interviewed revealed that disruptive life events had interfered with their contraceptive use. Several mentioned the loss of a job, which led to the loss of health insurance and in turn, access to hormonal contraceptives.
• While 50% of women obtaining abortion care have had a prior abortion, only 8% of those women who have had an abortion have had three or more abortions.
• The occurrence of multiple abortions is strongly associated with age; therefore, multiple abortions may indicate mainly prolonged exposure to the risk of unintended pregnancy. Among abortion patients aged 35 and older, 89% were mothers, and 61% had had a previous abortion as well as a prior birth, but only 4% have only had prior abortions and no births.
• By contrast, 64% of abortion patients younger than 20 had had neither a birth nor an abortion before.
• Women obtaining a second or third abortion are more than twice as likely to be age 30 or older and, even after controlling for age, almost twice as likely to already have had a child.
• Sixty one percent women who have abortions, have also had live births. While it is impossible to know whether or not these prior pregnancies were planned, given that at half of pregnancies in the United States are unintended, it is likely that women obtaining abortions who have also had births have had other unintended pregnancies.
• Heterosexual couples including women of childbearing age who do not use any method of contraception have an 85% chance of experiencing a pregnancy over the course of a year. Considering that most women are fertile for more than 30 years, the likelihood of having more than one or two unintended pregnancies if not using a method of birth control is very high. This means that most women who obtain repeat abortions are NOT likely using abortion as birth control, because this would mean far more than one or two abortions during their child-bearing years.

Will we ever know why women get abortions?

Yes! The Guttmacher Institute has conducted considerable research about why women choose abortion care. The most common responses are having a baby would interfere with work, school or the ability to care for dependents (74%); not being able to afford a child (73%); not wanting to be a single parent or are having problems with their husband or partner (48%) and being done with childbearing (38%) or not being ready for a(nother) child (32%). Perhaps surprising is the fact that no woman responded to this open-ended question with: “I get an abortion whenever I have an unintended pregnancy,” or “I use abortion care in lieu of other forms of birth control.”

Why don’t abortion clinics step in and provide contraceptives and education about how to prevent unintended pregnancies?

Many do, but anti-choice policies designed to limit federally funded family planning providers’ ability to provide abortion care and create fire walls between these services, make improving continuity of care between abortion and contraceptive services easier said than done. Add to this the isolation of abortion as a medical service and stigmatization of patients and providers. While organizations like Planned Parenthood view providing education and contraceptives to abortion patients as an important part of seamless care, many other abortion providers are not set up to provide contraception and the requirements of doing so make it a costly endeavor. Additionally, women don’t tend to want to return to an abortion clinic for ongoing health care – because of distance, stigma or the protestors outside the door. And having to make a separate trip anywhere for another appointment can be a huge barrier for women. Add to that the fact that women often have to travel to access abortion care, they probably aren’t going to want to return that same distance for birth control. While some providers have found ways to offer comprehensive care, they face many barriers in doing so and the very policies designed to end abortion may actually result in a greater demand for that service.

The Bottom Line

The next time someone brings up the mythical “woman who uses abortion as birth control” in a debate about abortion care or a woman’s right to choose, feel free to send them here. If it happens at all, it is so rare it is a red herring in any debate about a woman’s right to choose or related policy. And suggest that they then start supporting greater access to sexuality education and contraception, abortion as a part of comprehensive family planning programs and ending poverty. That is how we can really reduce the need for abortions.

Image credit: Jenny Lee Silver