By Jorge Balan
The Southampton Press is to be commended for publishing a courageous piece on the diverse viewpoints of the clergy on the morality of abortion [September 1, 2022].
But how much does religious affiliation actually weigh in women’s decision-making on whether to terminate or not an unwanted pregnancy? The fact is that the “official” religious dogmas do not make a big difference for women.
Many politicians want us to believe that their efforts to restrict or entirely ban abortion are based upon religiously based moral principles strongly adhered to by the constituents they represent. They tend to ignore the internal dissent within all religious traditions, the fact that very few American women view abortion in very stark ideological terms, and that more often than not they distrust governmental intrusion in their private decisions.
The political debate often fails to approach the abortion dilemmas as a public health rather than as an ideological issue. Let us review briefly some relevant facts on abortion as we know them through the eyes of experts today.
Abortion in America is a difficult decision made by women of widely diverse backgrounds confronted by unwanted pregnancies. A large majority of them declare some religious affiliation. Studies show that around 25 percent of women in the reproductive age bracket are deciding to perform one or more abortions during their lifetimes independently of their specific affiliation: no big differences are observed today between mainstream Protestants, Catholics, and Jews. Evangelicals show a lower abortion rate than other women, while those with no religious affiliation, whose numbers have tended to increase over time, resort to abortion at a higher rate than other women. Religion, although an influence on beliefs regarding the morality of contraception and abortion, is not the only or even the most important determinant of women’s decision-making when faced with the dilemmas posed by unwanted pregnancies.
Recorded abortion rates increased sharply after the Supreme Court supported it as a constitutional right in 1973. In previous years, illegal abortions had often been performed overseas, sometimes under unsafe conditions, and resulted in deaths or serious health consequences for hundreds, if not thousands, of women each year. Abortion rates, as well as related morbidity and mortality, consistently declined since the early 1990s. The Guttmacher Institute, the most reliable source of survey data in this field, recorded 1.5 million abortions in 1991, but only 930,000 in 2020. Increased access to user-friendly contraception, enhanced and earlier sexual education, and a decline in the family and community stigmas associated with premarital sex are usually accepted as major determinants of a decline in abortions. Birth rates have also declined every year from1989 until 2019.
The vast majority of women undergoing abortions in the U.S. are unmarried and young, facing an abortion for the first time — 57 percent are in their 20s, while 31 percent in their 30s. Teens aged 13 to 19 accounted for 9 percent of those who had abortions, their numbers consistently declining in recent years thanks to increased use of contraception and the so-called morning-after pill. Data for 2020 show that approximately one-half of the total are medical abortions, approved for use until 10 weeks into pregnancy. However, the total number of providers has declined in recent decades. State medical abortion laws increased from 16 in 2000 to 96 by 2018, and only one was repealed. A total of 35 states restricted medical abortion access as of 2018.
Restrictions imposed by many states had limited access to medical abortion (and contraception) before the Supreme Court overturned Roe v. Wade. A 2020 national survey found that women were significantly more likely to perceive difficult access to both surgical and medical abortions in those states (a national average of 30 percent perceived access to be difficult). Restrictive policies in public funding, mandatory counseling and waiting periods, and targeted regulations of abortion providers, were associated with greater perceived difficulty accessing both types of abortion. These restrictions, as expected, have an unequal negative effect according to income, education, ethnicity, and age. Although as indicated above, a majority of women considering an abortion are young and unmarried, they differ markedly in the resources available to them in the face of a hostile environment supported by public action.
The anti-abortion lobby was influential in promoting its policies at the federal and international levels since Roe v. Wade became the law of the land, when they would have been unconstitutional if implemented in the U.S. The Mexico City Policy, first announced by President Ronald Reagan in 1984, prohibited U.S. foreign assistance to any organization that performs or provides counseling on abortion. International organizations affected by this policy are also providers of modern contraception, thus reducing their ability to supply them in developing countries and to prevent unsafe abortions. Unsafe abortion, performed without the assistance of trained professionals and/or in unhealthy environments, has been considered a serious public health risk in the 1967 declaration of the World Health Organization. Unsafe abortions result in about 40,000 women deaths every year and millions more women hospitalized with complications in low-income countries.
The lobby’s major success overseas until very recently was achieved in Ireland. With its support, Ireland voted in 1983 a constitutional amendment banning abortion. In Ireland, divorce had already been constitutionally outlawed, the importation and sale of contraceptives was banned, and the laws against “gross indecency” were still in force. But as Fintan O’Toole recently observed, “If the purpose of abortion bans is to actually reduce the rate at which women terminate pregnancies, the Irish experience show how utterly ineffectual they are.” Prohibition does not diminish the number of pregnancies that women cannot or do not want to bring to term: they look for other options, often abroad, more costly and unsafe. Courts and medical practitioners are forced to work with abstract, always unclear legal frameworks developed in political debates, when faced by women with unwanted pregnancies. In 2018, after decades of attempts to correct the predictable negative effects of the ban, the Irish people finally voted to excise the abortion constitutional amendment of 1983. Will the U.S. learn from the Irish lesson?
Other middle and upper-middle income democratic countries have more recently legislated or implemented severe restrictions to contraception and safe abortion. Hungary, Poland and Brazil are the best recorded examples of anti-abortion policies, often praised in U.S. Conservative political circles. Hungarian Prime Minister Viktor Orban, visiting the U.S. recently, successfully promoted his government pro-family, anti-abortion and anti-immigrant standing. The painful experience of thousands of women in Ireland under the ban, or previously in the Soviet Union under Stalin (1936 to 1954) and in Romania under Nicolae Ceausescu (1966-1989), is seldom, if ever, brought into the picture when policies are debated at the federal or state levels in the U.S.
Lawmakers should learn from past experiences, in the U.S. and elsewhere, and listen more carefully to the voices of women facing difficult decisions and to the best professional advice of the medical profession in the field of reproductive health, before engaging in a new round of detailed regulations of their behavior that are doomed to fail in what they aim as results.
Jorge Balan is a resident of Westhampton.
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