Does contraception cause or avoid abortion?

[lavendersparkle]

Leaving aside the issue of whether some forms of contraception have post-fertilisation effects, there is a debate about whether contraception makes people more or less likely to have abortions.

I think the arguments go something like this. Anti-contraception pro-lifers* claim that contraception encourages people to be in denial about the connection between sex and pregnancy. This means that people are more likely to have sex in situations where they definitely don't want to get pregnant and if they do get pregnant, they're more likely to view it as a 'mistake' which should be 'corrected' by abortion. This may seem far fetched, but there is evidence from other areas of life that sometimes actions to improve the safety are outweighed by an increase in risk taking. I don't wear a cycle helmet, in part because there is some evidence that they don't improve your overall safety as drivers drive more dangerously around cyclists wearing helmets because they aren't viewed as as vulnerable.

The pro-contraceptive argument is that, even if people are more likely to have an abortion if they get pregnant, the decrease in the number of unplanned pregnancies when people use contraception are so high that they reduce the number of abortions overall.

So, I think this needs to be looked at empirically. I think being a social scientists can help one make more sense of the correlation and causation. One thing said by anti-contraception advocates is that a large proportion of the women who have abortions were using contraception whereas very few were practising NFP, FAM or LAM. I don't think that this correlation results in a causation. Most people who practice NFP are devout Roman Catholics and they'd be pretty unlikely to have an abortion. So in this case, rather than the use of contraception causing abortion it's more that the lack of contraceptive use and the lack of abortion are both caused by the Roman Catholicism.

A pro-contraception argument is that among developed countries with legal abortion, the countries with the lowest abortion rates are the ones where contraception is most easily available and sex education is most comprehensive, such as the Netherlands. A contrasting argument is that abortion rates have risen in England and the US, even as contraceptive availability has increased.

Thinking about this I'm drawn toward a tentative conclusion. I think that ceteris paribus, more access to contraception reduces the number of abortions, because it dramatically reduces the number of unplanned pregnancies. However, I wonder whether the availability of convenient contraception has led to changes in cultural attitudes to sex and children, which in turn makes people more likely to have abortion because they have more sex and are less willing to accept unplanned children.

*This ignores other arguments against contraception just that they cause more abortions.
**This ignores wider reproductive justice issues.

Comments

[neonchameleon.livejournal.com]

However, I wonder whether the availability of convenient contraception has led to changes in cultural attitudes to sex and children, which in turn makes people more likely to have abortion because they have more sex and are less willing to accept unplanned children.

Given the problems e.g. the Victorians had with foundlings, the fact that historical societies have had by our standards an absurd birth rate (either Julian the Apostate or Justinian complained about problems Constantinople had with a falling birth rate - comfortably more than a dozen), the risible effectiveness of abstenance only sex education, and many other factors, I think that the answer is that this simply isn't relevant.

And while I'm at it, I'd be fascinated by a cite for:
One thing said by anti-contraception advocates is that a large proportion of the women who have abortions were using contraception whereas very few were practising NFP, FAM or LAM.

The best evidence I have indicates that a low abortion rate goes hand in hand with use of contraception, and that “The evidence is strong and growing that empowering women with the means to decide for themselves when to become pregnant and how many children to have significantly lowers unintended pregnancy rates and thereby reduces the need for abortion,” whereas "abortion occurs at roughly equal rates in regions where it is broadly legal and in regions where it is highly restricted"

[lavendersparkle.livejournal.com]

The statement about a low proportion of women who used NFP having abortions, referred to women who had access to contraception but chose to use NFP to space births, living in developed countries where abortion is legal. I think the actual statistic was from the US. This seems very likely to me as, I would imagine, the proportion of women using NFP (not just not using articificial contraception) who are also opposed to abortion is very high. Whilst NFP or FAM can be a good option for couples for a variety of reasons, and has a certain following among feminist hippies, it's still pretty much the preserve of devout Roman Catholics and conservative Protestants.

[neonchameleon.livejournal.com]

Once again I'm going to ask for a cite and some actual figures.

And then I'm going to point out that there's a massive sample bias and confirmation bias between the groups using such methods and the general population.

And then I'm going to point out that they are actually forms of modern contraception anyway - and that there is only a small subset of the population for which they are practical.

[lavendersparkle.livejournal.com]

That's what I said in my post. I don't think it's that using NFP or FAM makes you less likely to have an abortion, it's that using NFP and not having an abortion are both caused by adhering to religions which are opposed to abortion and artificial contraception. You could call that sampling bias or just good old "correlation doesn't equal causation".

[lavendersparkle.livejournal.com]

Also, teaching women FAM and providing them with the equipment required, should be regarded as "empowering women with the means to decide for themselves when to become pregnant" as it is a reasonably effective way of avoiding conception.

[neonchameleon.livejournal.com]

Agreed. It is an effective form of contraception for those with the dedication to treat it as such, the will to keep to it, and the luck to have nothing untoward happen that renders it irrelevant.

As such I consider the advocation of it an inherent purity test - only the pure are going to keep to those rules and, far more than other forms of contraception, there is the implication that if someone using it then gets pregnant, that's their own silly fault.

[lavendersparkle.livejournal.com]

It is an effective form of contraception for those with the dedication to treat it as such, the will to keep to it, and the luck to have nothing untoward happen that renders it irrelevant.

You could say pretty much exactly the same thing about progesterone only pills, which require just as much effort and dedication to use correctly. This does not mean that either FAM or POPs, or condoms for that matter, are "purity tests". They both have advantages and disadvantages and are suitable for different people. Catholics are much more likely to use FAM than other methods because it's the only method in line with their churches teaching, but there are other people who use it FAM because it is a good method for them (particularly women who have adverse side effects from hormone based contraception and dislike suing barrier methods).

There is an interesting discussion to be had about why FAM isn't more widely none about and used. There's a lot of disinformation about the method and I think this has a lot to do with our attitudes to female reproductive systems, sexual behaviour and pharmaceutical companies. I can't imagine many of the 'powers that be' wanting to tell teenagers that a woman is only actually physically capable of becoming pregnant about one day a month.

[neonchameleon.livejournal.com]

You could say pretty much exactly the same thing about progesterone only pills, which require just as much effort and dedication to use correctly.

Really? Can you find any people actively pressuring people not to follow the guidance on progesterone pills? (Arguably the Roman Catholic Church...) Because there are depressingly many men who will pressure women not to refuse sex, but will be more than happy for the pill.

[neonchameleon.livejournal.com]

Slight amendment: the advocation of it in preference to other methods. I in no means wish to restrict people from using it if that;s what they want to use.

[naath.livejournal.com]

It is indeed a fairly good method, if done right (which obviously teaching would help with).

I wouldn't do it personally though. I think it requires too much co-operation on the part of men, and I don't trust them.

[lavendersparkle.livejournal.com]

I do take your point, though, that it's very easy to underestimate the amount of sexual activity, abortions and infanticide in earlier periods.

[naath.livejournal.com]

I think the "contraception causes abortions" argument relies on assuming that without contraception people will avoid sex in order to avoid pregnancy and thus avoid abortions or unwanted children. But I don't think that's true; historically women without access to reliable contraception or abortion have killed or abandoned unwanted infants, the existence of unwanted children (presumably resulting from unwanted pregnancies, although also plausibly resulting from the child being 'wrong' in some way, female for instance) isn't a new one.

If we were to accept that the "contraceptive mentality" causes abortions I think I'd expect people using NFP (as a contraceptive method) to get abortions when it fails, and also people practising abstinence to get abortions when it fails (that is, they fail to abstain) because those methods are equally about "I don't want a baby right now". Difficult to study as many people who are using these methods are also very often anti-abortion though.

On the other hand I do think we have a problem with our social views about "who should get pregnant and when". As a society we have the notion that because contraception and abortion exist that women *should* use them to control when they get pregnant, and I think that whilst women who *want* to use them should be able to that women who *don't* (and as a result have large families, or start having children young) shouldn't be socially stigmatised.

[lavendersparkle.livejournal.com]

I always find it difficult to understand why FAM should have to develop a different mentality to other measures to prevent conception. In fact, I really don't think that on an individual level the causation goes from method to mentality at all. I use a very effective form of artificial contraception and I wouldn't have an abortion if I became pregnant whilst using it. I've chatted to women of LJ who use FAM and intend to abort any embryos they accidentally conceive.

I guess, apart from the fact that people who are anti-abortion are more likely to be FAM users, one difference could be the way they are taught. I get the impression that most FAM teachers emphasise that the technique is about making conception more or less likely but that sex can always lead to pregnancy. On the other hand, I definitely get the impression that other forms of contraception are marketed with the message that it will make sex 'safe'. I particularly find this in discussion of young people's sexual health. People seem to assume that any woman experiencing an unplanned pregnancy must have been 'irresponsible' rather than that she might be part of the 1-0.1% contraceptive failure rate.

[loveneverfails.livejournal.com]

I would go with "contraception changes sexual behavior and attitudes, because the likelihood of pregnancy is what changes sex from a short term choice to a long term choice. When sex is a short term choice instead of a long term choice, a long term effect that is unwanted is easily discarded." I still believe that contraception gives more freedom to men than it does to women, and that misogyny in sexual relationships should be considered a root cause of abortion.

[lavendersparkle.livejournal.com]

I still can't quite work out how FAM is different in this respect. If you're charting correctly, there are times of the month when you can have sex and be as unlikely to conceive as if you were using condoms. No form of contraception entirely removes the possibility of pregnancy so it seems to me more like the issue is the attitude of the couple. Do they acknowledge that sex leads to pregnancy or not?

[loveneverfails.livejournal.com]

The inherent procreative possibility of the act itself remains completely unaltered, but it is put into the context where conception is unlikely to occur. It's that you don't change the act or the people participating in the act, because the juncture of sex plus female fertility is the place where conception will occur. Sex remains the same, the partners aren't altering themselves or asking the other to be altered chemically or plumbing wise, but behaviorally they choose to only engage eachother sexually outside of the combination that will lead to children.

I feel like every time I have sex and am not already pregnant, it is a conscious choice to take my life in my hands and offer it to my husband. It is an incarnation of a lifelong choice for him, where love for him is worth accepting whatever (and whoever!) comes along because of that. I should not be pregnant right now, but I am. Like, charting wise this pregnancy doesn't quite make sense, and it's twins. I see that as direct God intervention, but I also have a husband I can trust to not hang me out to dry. We walked into sex knowing that it is the one activity that can lead to pregnancy. Rubbing noses together isn't going to get me pregnant.

From a Catholic perspective, NFP respects the design of the bodies of both spouses and sees that there is a greater meaning built into the body and human sexuality than simple mechanical function. We would argue that altering yourself or your partner, or altering the sexual act itself, creates a fragmented reality. There is no fragmentation when you say "we cannot do justice to what another child would require of us, and until that changes, we will put the highest physical expression of our love for eachother only in the context where pregnancy is unlikely to occur." Nothing gets changed from the original design of how things are supposed to work and what truths they are supposed to convey, but you take advantage of the remaining time that God *also* built into our bodies where conception is extremely unlikely to occur.

I'm rambling because I'm still down with flu, but how contraception, love and commerce are interrelated is an interest of mine. Hope this was vaguely coherent.

[loveneverfails.livejournal.com]

Also, for NFP, the attitude is supposed to be that you are postponing pregnancy (even if that postponement is indefinite to the point where you never conceive) because there is a barrier that makes conception imprudent and incompatible with what God is calling you to do. A child can never be seen as a bad outcome or a "failure" of a method.

Children have to be welcomed and always viewed positively because they are the walking around incarnations of the expressed love between the spouses, and what a wonderful thing that the love you share is so powerful that God uses it to form a whole other person from the basis of your love. Any animosity towards the conception of a child in a marriage is flat out not ok for Catholics. Children may or may not come about in any given marriage, due to any number of factors, but the full and free gift of self (including a willingness for your love to bear fruit) is fundamental to Catholic marriage. An unwillingness to accept children as part of a marriage for us invalidates a marriage.

[cartesiandaemon.livejournal.com]

Hm. Maybe the most effective way of reducing abortions (including infanticide or abandonment) would be to make contracpetion encouraged for people under 25, and forbidden for people over 25. The idea being, young people some of whom who are likely to end up having sex anyway will get contraception, but older people who are more likely to actually abstain if denied effective contraception will be forced to do so.

Of course, you could pick another cut-off than age, but I think either way it's a awfully unacceptable idea.

[alexandralynch.livejournal.com]

If people really wanted to do something about the abortion rate, they'd raise the minimum wage and provide more social support for children and women. Much of the abortion debate is "punish those sluts" not "Every child wanted, loved, and supported", and often ignores the fallout of their positions on the average person and on people of varying social classes.

Abstinence within a marriage can be very emotionally problematic on both sides. For us, given that we were abstaining anyway due to being apart five days out of seven, the pressure to actually be intimate when we were together was pretty strong.

Seven pregnancies, six years. Three children born, one adopted out, three abortions, one first trimester miscarriage. I am neither embarassed, regretful, or ashamed. Being pregnant messed me up worse than having the abortions did.

[traumerin.livejournal.com]

As a side note, it seems like FAM or NFP would not work very well for any Jewish women who follow the niddah laws. Does anyone try this? It seems like the window open for sexual activity would be fairly limited.

[lavendersparkle.livejournal.com]

I think that it would depend upon your cycle. For some women with very short cycles, the laws of niddah actually act like NFP. I think most women ovulate very soon after mikvah night so you'd only have to abstain for another few days and you could do whatever sex acts you allowed which didn't involve semen entering the vagina in those few days. I actually think that you might have more of a problem in that checking your cervical mucus might lead to you inadvertently seeing uterine blood which you wouldn't have otherwise seen, resulting in your being niddah for longer.