The pro-life movement has been forced into an all-or-nothing mindset. They’ve convinced themselves that abortion is murder and that it must be eliminated, and yet in no foreseeable future will there be zero abortions.

Nevertheless, this is their unreachable goal. This dogged attachment to a no-win project, at the expense of better approaches, puts the blame for most U.S. abortions on them.

Let’s consider another route, a win-win route, to substantially fewer abortions. With this approach, we will try to reduce abortions, not pretend that we can eliminate them. We won’t try to make them illegal (which has never worked) but make them unnecessary. The focus will be on the actual problem (unwanted pregnancies) rather than the symptom (abortions). If we deal with the problem, the symptom takes care of itself, and pro-lifers will discover that pro-choice advocates share the very same problem. The evidence shows that to reduce unwanted pregnancies, we need to provide comprehensive sex education and convenient, subsidized access to contraception.

Do I hear grumbling? Do I hear puritanical Christians muttering that they won’t put up with public schools teaching 12-year-olds how condoms work or pharmacies providing easy access to contraceptives? Then let’s double check: are we dealing with a Holocaust or not? Is abortion murder or not?

I’ve read many articles from Christians claiming this very thing. Assuming that they’re being honest and millions of conservative Christians really do think this way, let’s take them at their word and proceed.

(This post is about twice as long as usual, but with the U.S. election coming up in days, and abortion being the biggest single issue driving Trump voters, I wanted to have a complete argument for a logical approach to abortion in one article. And pro-life voters, if you want to reduce abortions, you need to rethink what you look for in your candidates.)

Harm reduction and consistency

Let’s consider abortion from a harm reduction standpoint. A harm reduction policy tries to minimize the harm caused by a human behavior.

The best-known such policy is probably needle exchange programs that allow intravenous drug users to exchange used needles for clean ones. While it’d be great to eliminate the drug addiction, experience has shown that that’s very hard to do. Instead, many jurisdictions focus on minimizing the social harm such as the incidence of HIV, hepatitis, and other diseases that can be transmitted by dirty needles. This policy also puts addicts in frequent contact with organizations that can help when they’re ready to quit.

Cast the net more broadly, and medical treatment for accidents can be thought of as harm reduction. No one wags their finger at an accident victim and says, “You knew that car crashes can happen, and yet you drove in a car anyway, didn’t you?” We treat the guy who shot himself by accident. We treat the smoker who gets lung cancer. We treat the person with a poor diet who gets type 2 diabetes. The medical staff does their best, and society (directly or indirectly) pays the bill.

Consider harm reduction even more broadly. We don’t want anyone getting married casually, but we provide divorce as a mechanism for getting out if necessary. The legal option of bankruptcy causes less harm than debtor’s prison. A tough love approach, like long prison terms for drug offenses, often doesn’t minimize societal harm, and a soft landing can be a smart compromise.

If the medical system treats the victim of a car accident (heck, if the medical system treats the person who has a sexually-transmitted disease), by the same logic it should treat the woman who’s pregnant by accident.

A new plan, part 1: sex education

The first part of a workable plan to reduce unwanted pregnancy is comprehensive sex education in school. Of course, the first category of people trying to squirm away from this will be conservative Christians, but remember that the motivation for this approach was to find a way to substantially reduce abortions to satisfy those conservative Christians. This is for you, so grit your teeth and let’s proceed.

Schools must teach children early, before they are likely to become sexually active. The curriculum must come from U.S. and international programs proven to work (unlike abstinence-only programs, which have been proven to fail). There’s clearly room for improvement, since the U.S. ranked worst in a National Institutes of Health survey of 21 countries: Switzerland had 8 pregnancies per thousand women aged 15 to 19, while the U.S. had seven times as many.

Effective programs can provide dramatic success. Wyoming had its birth rate among 15–19 year-old women drop by 40 percent in six years, and this was credited to improved sex education.

And ineffective programs can worsen the problem. A survey of Americans between the ages of 18 and 29 found that “60 percent of young adults are misinformed about birth control’s effectiveness,” and blamed that misinformation on abstinence education, which often tries to downplay the effectiveness of contraception. In another survey 44 percent of young women agreed that “It doesn’t matter whether you use birth control or not; when it is your time to get pregnant it will happen.” Only 31 states require sex ed, and only half of those mandate that it must be accurate.

We teach teens how to do things safely: don’t read your phone while driving, don’t get into a car with a driver who’s drunk, and so on. They’re going to get a sexually mature body whether we like it or not, and 95 percent will have premarital sex. We must teach them how to use that body wisely.

Let’s end this section with a palate cleanser:

Life in Lubbock, Texas, taught me two things: One is that God loves you and you’re going to burn in Hell. The other is that sex is the most awful, filthy thing on Earth and you should save it for someone you love. (Butch Hancock)

Part 2: convenient contraception

The next component in workable policies to minimize unwanted pregnancy is easy access to safe contraception. Long-acting reversible contraceptives (LARCs) like intrauterine devices or subcutaneous implants are twenty times more effective at preventing pregnancy than the birth control pill. They make no demands on the user, like remembering to take a daily pill or to bring a condom.

That difference between perfect use and typical use (the success rate in a laboratory setting vs. in the real world) is important because about 40 percent of unplanned pregnancies in the U.S. are due to careless usage.

Several programs show the value in LARCs. Delaware reduced its abortion rate 37 percent in three years. A similar program in Colorado reduced abortions by 34 percent in two years.

Those are improvements due to improved contraception technology. What about cost as an obstacle? One study found that free birth control cut abortion rates by about two-thirds.

Part 3: no nuisance regulations

Conservative states seem to compete with each other to find ever more innovative nuisance regulations that don’t reduce the number of unwanted pregnancies or improve the health of the woman. These include pharmacists deciding which prescriptions they will fill, mandatory waiting periods, false or incomplete information about abortion, mandatory counseling, required reading materials, unnecessary sonograms, required listening to the fetal heartbeat, and so on. These must go. The time from the discovery of an unwanted pregnancy to abortion (if that’s the woman’s choice) should be minimized. That’s not to suggest it should be rushed but that, if it is to happen, it should happen as quickly as possible.

And that’s it: comprehensive sex ed in schools, convenient subsidized contraception, and no nuisance obstacles to abortion. Make these sensible changes, and the abortion rate will be cut in half. One influential thought piece—where I was first introduced to this program—suggests that the rate could be cut by ninety percent. That argument adds some additional features like helping parents become more comfortable discussing sex with their children, improving access to reproductive health services in marginalized communities, seeing family planning as not only a private matter but one that belongs in the conversation with one’s doctor, and researching birth control for men.

Costs?

Some may be wondering who’s going to pay for all this. Given the high cost of more citizens—it costs about a quarter of a million dollars to raise a child to age 17 in the U.S.—it’s not surprising that these programs generate more savings than they cost. One study concluded that “Teen childbearing cost taxpayers $9.1 billion in 2004.” The Colorado program (above) found that every dollar invested in the program brought a six-dollar savings in the Medicaid program. A policy simulation from the Brookings Institution predicted similar savings.

Some Christians might say that taxpayer funding of contraception and sex ed offends them. Yeah, well, that’s life. I don’t like paying for abstinence-only education programs or government programs that promote religion, and I doubt you protested then. Even if you don’t have school-age kids, you pay for public school. We need to follow the evidence and work together for the common good.

Let’s look at the social cost of the pro-life movement from a different angle. What happens when a child is brought into the world unwanted and unloved? Or when the mother doesn’t have enough for another child or the environment is dangerous?

An article from 2001 tried to quantify that. It concluded that the dramatic drop in violent crime in the early 1990s was due in large part to the legalization of abortion nationwide by the landmark Roe v. Wade decision.

We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly eighteen years after abortion legalization. The five states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater crime reductions in the 1990s. In high abortion states, only arrests of those born after abortion legalization fall relative to low abortion states. Legalized abortion appears to account for as much as 50 percent of the recent drop in crime.

In short, many of the 18-year-old men who would have caused violent crime in the early 1990s didn’t exist because they had been prevented 18 years earlier.

(This argument might sound like that from the book Freakonomics (2005). In fact, Steven Levitt was the coauthor of both the article and the book.)

The impact of abortion on the crime rate is often overlooked, but the pro-life movement must answer for the increased crime due to unwanted children.

Revisit the problems within the pro-life movement

In the last post, 6 Flaws in the Pro-Life Position (that Pro-Lifers Must Stop Ignoring), I explored six problems with the pro-life position. I promised in response a new, more effective approach (sex ed, convenient contraception, and no nuisance obstacles). Let’s revisit those six problems. I think they’ve been resolved.

• Problem 1: Abstinence doesn’t work as birth control. Encouraging abstinence can be part of sex education, and it does work for a minority of teens. But abstinence-only education is a failure.
• Problem 2: You focus on the symptom, not the problem. We’re now focusing on the problem: unwanted pregnancies.
• Problem 3: You’re working against pro-choice community. By focusing on unwanted pregnancies, what both groups see as the problem, the two groups can work together.
• Problem 4: Children will become sexually mature, whether you like it or not. Sex ed will be made appropriate for the age of the children. Children will be taught what they need to know before it becomes necessary.
• Problem 5: Making abortion illegal doesn’t prevent abortions. The goal is reducing unwanted pregnancies. Abortion is still available, but the better we are at reducing unwanted pregnancies, the less the demand for abortions.
• Problem 6: Obstacles erected for abortion clinics won’t work against medication abortions. We’re reducing abortions by focusing on the problem, unwanted pregnancies. Nuisance regulations aren’t helpful.

Is this a bridge too far?

I feel the need to check in again with Christians who are squeamish about this route. Perhaps they’re afraid that it might encourage teen sex. To them I say: I thought you said that the state of abortion in the U.S. is a Holocaust. I thought you said that abortion equals murder.

If not, then don’t create a pro-life litmus test for politicians. And if it is, then it may be true that teens will have sex more. You can even consider this a harm if you want (though keep in mind that pregnancy and STD rates will be much less than they are now). But who cares if this approach dramatically reduces abortions? If abortion really is murder, then I can’t imagine what could be worse. You’d really push back against a workable approach because it offended your prudery?

For Chicken Little politicians, it’s all about the power

Remember the folk tale Chicken Little (or Henny Penny)? An acorn fell on his head, and he ran around warning everyone that the sky was falling. We see something similar in the U.S. today. Christian and political leaders run around, telling Christians that the sky is falling because of abortion. (I’ll refer to both Christian leaders and political leaders as “politicians” since, in this context, their motivation is power.)

The pro-life movement is a political movement, not a moral movement. The problem was manufactured, and many Christian denominations just a few decades ago were in favor of the Roe decision that legalized abortion. A summary of a 1978 Christian analysis of abortion shows a surprisingly pro-choice attitude, supported by these churches: American Baptist Convention, American Lutheran Church, Disciples of Christ, Church of the Brethren, Episcopal Church, Lutheran Church in America, United Methodist Church, and United Presbyterian Church.

Today, abortion to conservative politicians is a problem to be nurtured, not to be solved. They’re the only ones who can solve the problem, you see. But if it were solved, it wouldn’t be a vote getter. What else explains conservative politicians pursuing a policy that is so ineffective? (For more on this critique, see my previous post, which listed the fundamental flaws in the pro-life position.) These politicians want pro-life and pro-choice advocates divided. Strife means votes!

The conservative voter is the mule pulling the cart, motivated by the carrot on a stick of Roe overturned. And who’s back there sitting easy in the cart holding out the carrot? It’s conservative politicians who know what motivates the mule. If you want to make some serious progress on abortion rates, find politicians that embrace a practical policy like the one in this post and join forces with pro-choice advocates. Working together, you’d be unbeatable.

For years, conservative Christians have been taught that “Are you pro-life?” has the same answer as “Do you love Jesus?” Whether Jesus cared much about abortions is a question for another post, but if you want to make a dent in abortions, refocus your activism on measures shown to minimize unwanted pregnancies.

We have an election coming up. If abortion is a big deal to you, forget overturning Roe. Vote instead for those candidates who are most likely to push for tested policies that discourage unwanted pregnancies. That’s how you will minimize abortions.

Pro-life advocates, we can’t do this without you.

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Image from Spenser (free-use license)
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