Will federally-mandated contraceptive coverage reduce abortion?

The Institute of Medicine (IOM) Women’s Preventive Services Study Committee recommended that health insurers cover “the full range of Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity” without co-pays or deductibles for patients in a report issued today. The report can be found here. FDA approved contraception includes the IUD, “morning-after” pills, and the abortion-inducing drug Ella. The IOM report is expected to have great weight with federal health officials as they establish the requirements of insurance policies under what has become popularly known as Obamacare.

Supporters of universal funding for contraception argue that the number of abortions will be reduced with greater access to contraception. For example, in a news release regarding the IOM report, Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy stated, “The IOM recommendations underscore what we have known for decades—that access to affordable and effective contraception improves health, shrinks costs to the individual and society, reduces abortion, and helps to promote stronger families.”

Yet the evidence that greater access to contraception reduces abortion is mixed at best. According to a study by researchers at the Guttmacher Institute (historically the research affliate of Planned Parenthood Federation), “Forty-six percent of women seeking abortions had not used a contraceptive method in the month they conceived, mainly because of perceived low risk of pregnancy and concerns about contraception (cited by 33% and 32% of nonusers, respectively). Only 8.1% of all women obtaining abortions had never used contraception. Only 2.1% of all women who had never used contraception did not know where to obtain contraception. Rachel Jones et al, Contraceptive Use Among Women Obtaining Abortions in 2001-2001, at 34 Persp. on Repro. and Sexual Health (Nov. Dec. 2002).

An international study confirmed that abortions rates increased in the United States with increased used of contraception. “In seven countries—Kazakhstan, Kyrgyz Republic, Uzbekistan, Bulgaria, Turkey, Tunisia and Switzerland—abortion incidence declined as prevalence of modern contraceptive use rose. In six others—Cuba, Denmark, Netherlands, the United States, Singapore and the Republic of Korea—levels of abortion and contraceptive use rose simultaneously.” Cicely Marston and John Cleland, Relationships between Contraception and Abortion: A Review of the Evidence, Fam. Plan. Perspec. (Mar. 2003).

In 2006, when the Guttmacher Institute issued a report card ranking the 50 states by how aggressively they promote contraceptives, the embarrassing fact emerged that New York, California and other states receiving the highest grades also had some of the highest abortion rates in the country; some states ranked near the bottom by Guttmacher, such as Kansas and the Dakotas, have the lowest abortion rates. A study of public funding for contraceptive, sterilization, and contraceptive services can be found here.

A well documented fact sheet on the myth of reduced abortions through contraception can be found on the USCCB website.

Teresa Collett

Teresa Stanton Collett is a professor at the University of St. Thomas School of Law in Minneapolis, Minnesota, where she teaches bioethics, property law, and constitutional law. A nationally prominent speaker and scholar, she is active in attempts to rebuild the Culture of Life and protect the institutions of marriage and family. She often represents groups of state legislators, the Catholic Medical Association, and the Christian Medical and Dental Association in appellate case related to medical-legal matters. She represented the governors of Minnesota and North Dakota before the U.S. Supreme Court as amici curiae regarding the effectiveness of those states’ parental involvement laws. She has served as special attorney general for Oklahoma and Kansas related to legislation designed to protect the well-being of minors and unborn children. She is an elected member of the American Law Institute and has testified before committees of the U.S. House of Representatives and U.S. Senate Committee on the Judiciary, Subcommittees on the Constitution, as well as numerous legislative committees in the states.