Restricting Abortion as a Birth Control Method

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Repeat abortions are a signal to healthcare professionals and policy makers that these women need enhanced support and education. Modifications in women’s behaviors will likely prevent health issues as a result of an abortion. Policies around repeat abortions will lower public and private healthcare expenditures.

The current prevalence of abortions hovers around 1.1MM according to the CDC, which does not account for all states. Repeat abortions now account for 48% of abortions. After Roe v. Wade, these repeat abortions doubled. These steadily increased to nearly half of all abortions today. Policy increased the number of repeat abortions.

Pregnant again?!

Policy could also reduce these numbers. Few states impose policies to restrict repeat abortions such as parental notifications for minors. According to Congress, federal Medicaid barred reimbursing abortions. However, seventeen states use public funds to pay for abortion programs, and roughly 20% of women surveyed confirmed using Medicaid to pay for their abortions.

Most importantly, who are these women that physically and mentally subject themselves to multiple abortions? Statistics share that repeat abortion victims are less educated and poor, in their early 20’s. Those with one or more children account for 61% of abortions. Most surprising is that 46% of women did not use contraception when they became pregnant.

These women need family planning education, support and resources. Organizations such as PlannedParenthood, CareNet Pregnancy Center of SE CT and ABC Women’s Center support and educate on the psychological and physical health issues involved with abortion. Community outreach also impacts the rate of repeat abortions with groups like 40 Days for Life. These programs, regardless of whether they support abortions or not, should not support repeat abortions.

This is not a question of being pro-choice or pro-life. Policies to deter repeat abortions must be mandatory for every state ie prevention with long-term birth control ie an implantable rod lasting 3 years. Advocate change with your local Senator today.

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16 Responses to “Restricting Abortion as a Birth Control Method”

  1. sbfphc Says:

    It is sad that the burden of this problem falls on the less educated and poor – I am not sure of the cost of an abortion, but would help that family planning methods would have been cheaper – so we seem to have an access problem – and that access may be inhibited by social and cultural factors, which unfortunately trump the purely health factors involved in saving women’s lives. Hopefully we all have a better grasp of these social and cultural factors now.

    • friso vr Says:

      The Guttmacher Institute estimate abortions to cost the healthcare system some $40 million every two years; with each individual abortion costing roughly $500, where women usually pay $100 out-of-pocket and the rest is subsidized.

      This pales in comparison to having an unwanted child, of course. And is negligible compared to the average price of an IUD or Implanon, an injectable hormonal contraceptive.

      http://www.guttmacher.org/pubs/MedicaidLitReview.pdf

  2. iikoiwak09 Says:

    The high rate of repeat abortions is an indicator of the unmet need for contraception in the country. Policies should focus on improving funding for family planning programs which should include patient education, contraceptive and counseling services.

  3. hfoley518 Says:

    This is a topic I am incredibly passionate about; many thanks to you friso vr for deciding to write about this for your Lab #5. I think prevention, education, culture, and support are very significant factors; furthermore, accessibility plays a pivotal role here as well. About ½ of all pregnancies in the U.S. are unintended and roughly 40% end in abortion, resulting in 1 out of 3 women having an abortion before the age of 45. With 50% of pregnancies being unintended, it makes me think deeper about the various systems (health care system, education system, et cetera) in place and how the very infrastructure of these systems impacts things like access to contraception, efficacy of birth control methods utilized, and sex education in the United States. Multiple abortions are an indicator of the larger problem of unintended pregnancy. Looking at the issue of multiple abortions is very complex; even in terms of the language we use to talk about it. Tackling this from a policy standpoint seems so tricky; implementing policy while simultaneously reframing how we think and talk about this issue. The Guttmacher Institute is right there with you in terms of policy analysis! They are a non-for-profit corporation advancing sexual and reproductive health worldwide through research, policy analysis, and public education. They came out with a report in 2006 titled: “Repeat Abortion in the United States” by Rachel K. Jones, Susheela Singh, Lawrence B. Finer, and Lori F. Frohwirth. They are an amazing institute; I try to read everything I can get my hands on that they’ve created. This report in particular presents an overview of what is known about repeat abortion by utilizing published literature and statistics in addition to being based on new analyses of data available from multiple national surveys. This article begins by revealing that indeed “little is known about U.S. women who have repeat abortions.” I think sometimes the real factors concerning repeated abortion in the United States are overlooked, such as variation state by state (states with higher abortion rates are more likely to have higher rates of repeat abortions), age of the woman (the older a woman is, the longer/greater exposure to the risk of having an unintended pregnancy and an abortion), and prior births (women having repeat abortions are more likely than first-time abortion patients to have had prior births). I was surprised to learn that first-time and repeat abortion patients do not differ by poverty status; however, repeat abortion patients are slightly more likely to have Medicaid coverage, which is yet another indicator of economic disadvantage.

    Again, thank you for sharing with all of us.

    • friso vr Says:

      Thank you for your engaged interest in this important topic. I appreciate your lengthy reply and research on the Guttmacher Institute, where I pulled some of my statistics and research from besides a PubMed and EBM Navigator search.

  4. hfoley518 Says:

    Also, this past March, a nurse practitioner student, Dolores P. wrote a piece for TheHairpin.com titled, “Ask an Abortion Provider.” I really loved this article for numerous reasons; I have it bookmarked as one of my favorites on the desktop of my computer. In my opinion, it’s a must-read for anyone who is interested in reproductive health & women’s health who is hoping to enter the field as a clinician himself/herself. She speaks of the longer-time birth control options you mentioned, friso vr, by elaborating on some of the barriers to this. She explains that “if a patient who has just gotten an abortion wants an IUD — the most effective form of birth control, little chance for user error, good for five or ten years depending on which kind you get — they have to come back for it, not because there’s any clinical reason to wait, but because Medicaid doesn’t cover two procedures in one day. Most of the time the way this ends up breaking down is they come back for their follow-up appointment, then again for a pap smear/pelvic exam to ‘clear’ them for the IUD, then one more time for the insertion. All to make sure it gets covered. And also please don’t get pregnant at any point in that month-long process where you don’t have your preferred method of contraception because then the process repeats.” The author has a very unique, gusty writing style & humor, which I enjoy 🙂

  5. shannonmccook Says:

    Thank you for covering such an interesting topic for your blog, friso vr. I was shocked to learn that 48% of abortions are now repeat abortions. Thus, it seem a logical approach to try to lobby to reduce the number of repeat abortions in the United States each year. I agree that this is not a matter of being pro-choice or pro-life, but a matter of identifying where our system is failing these women of reproductive age. How can we best meet their needs (with preventative medicines such as contraceptives)? I think that sometimes the parties involved in this issue can get wrapped up in their emotions and moral stance that they fail to properly and logically address the issues at hand. Thanks again for the post.

  6. itan2 Says:

    It is alarming that almost half the abortions are repeat abortions. The brunt of the problems was borne out by the less educated women. I think it is a reflection how the system has failed these women. The opportunity to educate women after the first abortion on more effective contraception was not utilized; so as to prevent subsequent unwanted pregnancies. The unmet needs of these women must be addressed more effectively. The stakeholders must work harder together to target these women at risk of repeated abortions. Perhaps pressure should applied on the abortion clinics to educate women about contraception. The psychological trauma from repeated abortions must not be overlooked; in addition to potential albeit small risk of morbidity and mortality associated with repeated abortions.

  7. thebumslost Says:

    While I agree that women need easy access to family planning and contraceptive products, I am against any policy that would make it harder for a woman to access an abortion, even if it is is a repeat abortion. The evidence is very clear that making legal abortion difficult to access only increases illegal and unsafe abortion, it does not decrease abortion rates. Let’s focus on getting women the contraception they need, not preventing them from having a safe abortion if they seek one.

    http://www.nytimes.com/2007/10/12/world/12abortion.html

    -Emily Dorman

    • friso vr Says:

      I agree with you, Emily, that legal and professional abortions should be accessible to all women. Providing women with repeat abortions with effective education and contraception to avoid future abortions should be a desired outcome for these women when they realize that abortions destroy their reproductive and other systems. These women need help besides easy access to abortion clinics.

  8. wandadavis Says:

    While I agree that women should use other methods to prevent unwanted pregnancies, Rather than condemning the poor and less educated who are socio-economically disadvantaged, look for solutions to solve the problems that place women in situations that force them to have multiple abortions. Mandate counseling programs or educational programs that teach the risk associated with abortions as well as programs that focus on behavior change.

  9. hbbos Says:

    You wrote “Repeat abortions are a signal to healthcare professionals and policy makers that these women need enhanced support and education. Modifications in women’s behaviors will likely prevent health issues as a result of an abortion.”

    I would disagree.

    Education is not likely to help this population. They know how they are getting pregnant, and have likely be told steps to not get pregnant. Modifying the women’s behaviour is also unlikely to have much impact.

    It comes down to who is having the repeat abortions. Although socioecomic factors were discussed, the role of partners is often overlooked. It is important to remember, first and foremost, that it takes two individuals to get pregnant. Where is the education for the fathers? Where is the focus on their behaviour? Many of these women are in less than ideal relationships, with varying degrees of abusive of surprssive partners. They are not choosing to become pregnant over and over, but rather are limited by their current living situation to prevent it. The may have not even be able to discuss this with their partners. They may not have control over their own money to by contraceptives. They likely have no power to influence condom use. The other daek concern is that the sex may not be entirely consentual, but a part of a complicated dysfunctional relationship. The issue of repeat abortions is much more complicated then contraceptive education. It requires us to look at society as a whole and strive to protect these women who can not protect themselves. Any limitation or restrictions that would make it more difficult to get an abortion who put future children at risk.

    I have delivered a baby, only to have it murdered by it’s father 11 days later. Things are way more complicated than they look!!

    • friso vr Says:

      I agree that education and behavior modification en sec or at face value will not improve their situation. Especially not for cases where the father of the child that actually is born is murdered. No doubt that these women are living in unstable environments.

      My argument promotes the advocacy of educating women and intervening with a type of birth control that necessitates little action from the woman and is accessible, of high quality and effective. This policy could take the form of an injectable rod for women immediately after a repeat abortion. Again, this is for their own benefit and where the education comes into play.

      My experience with abortion clinics in the Hartford, CT area also opened my eyes to some less than appealing stories and socioeconomic conditions. I feel for your connection to a story like you mentioned and understand that women’s health is an integrated and complicated topic that requires thoughtful attention.

  10. jkmatson Says:

    Thanks to Friso Vr and all the other comment providers on this topic … very interesting to hear all viewpoints.
    When I initially read the post, I also was concerned about the socioeconomic factors surrounding the large number of repeat abortions.
    The example of the Medicaid limitations on being able to provide long term effective birth control immediately after an abortion procedure definitely highlights an area in the healthcare system that could be targeted to help reduce the numbers of repeat abortions.

  11. cnreyes Says:

    Like many people have already commented, restricting repeat abortions is important for both individual women’s physical and mental health. Although many of the patients receiving repeat abortions are teenagers and younger women, there needs to be some level of accountability for one’s actions, no matter what a pregnant woman’s age. Of course curbing the amount of repeat abortions is multi-factoral and will not be decreased solely by limiting repeat abortions. However it is a step in the right direction in acknowledging that there is a problem with this ongoing trend. Education and awareness needs to be enhanced to reach successful behavioral change.

  12. judypressleyphillips Says:

    I am glad I read your blog. This is something I have never thought about! After reading your blog I am going to try to become involved in this issue. You are correct, since the statisitics point to the need for education especially of the poor, then even I can do this. Thank you for bringing this issue alive in my heart. I did not realize this was an issue until now
    I always want to help in another countiry, and I never get an opportunity, this is something I can do right here.

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