We know how to reduce abortions: vote for Democrats

With Donald Trump remaking the Republican Party in his image, a number of prominent conservatives, Republicans, and former Republicans have argued that the only way to save the GOP from racism, corruption, conspiracies, and alternative facts is to hand the party a big defeat at the polls by voting a straight Democratic ticket. For conservatives like Max Boot and Tom Nichols, the issue is straightforward.

The common rejoinder from their Republican-voting friends is always the same: abortion.

Often on this blog I'm repurposing writing and research that I've done in a professional capacity for other entities, adding some personal color or making it much more partisan. This time I'm not aligned with any organization. In fact, I'm about to go off-message. But when I see Republicans using abortion as a reason to give a blank check to an administration that threatens our democracy itself, I think...

Can we... can we be honest with each other for just a second?

I’m not interested in debating the ethics of abortion with those who oppose it. I know we disagree.
But I will tell you one true, factual thing: home abortion with FDA-approved abortion pills is secret, safe, and incredibly easy.

It’s about 10,000 times easier than 3-D printing your own gun, my favorite argument against gun control. In fact, researchers have found that in red states that have already effectively eliminated legal abortion, women have been performing home abortions (through various means) in large numbers. Which means...

You cannot legislate abortion out of existence

You never could. But these days you can’t even really make it that hard for all but the poorest and most isolated to do early home abortion safely.

In the pre-Roe era, wealthy women traveled to find safe, legal abortion care or found doctors willing to perform them. Many women without those resources, died. But the development of medication abortion (abortion with FDA-approved pills) in the intervening decades has completely re-written the landscape.

The risks today of medication abortion are the same as those of a naturally occurring miscarriage—and significantly lower than carrying a pregnancy to term. According to the FDA, out of the 3.4 million American women who've used medication abortion to terminate a pregnancy since its approval in 2000, only 22 have died. In contrast, 700 American women die each year as a result of pregnancy and childbirth—approximately one out of every 5,600 women, according to the CDC—and more than 50,000 women face life-threatening complications.

Abortion pills are easy to access online and through informal networks. In Mexico and a number of other countries, one of the two pills (misoprostol) is available over the counter to treat ulcers and other common ailments. In a post-Roe world, there would almost certainly be a thriving black market for abortion medication. And while an unregulated flow of pharmaceuticals obviously isn't great for either women or policymakers, it's also a reality.

I think it's even possible that abortion could actually increase in a post-Roe world. Right now, most of the infrastructure of abortion services—both for and against—has been focused on clinic-based abortion, even as clinic access has always been harder for some than others and for many has already disappeared. But in a world where women can order pills online or buy them on the black market without anyone knowing, skipping the drive to a far-off clinic and the hassle of fighting clinic protesters, that's a world where a lot of abortion still takes place, just under the radar. And in fact, that's what researchers have already found.

I'm not arguing whether that's good or bad, only that it is a fact. Whether you're in favor of abortion rights or opposed, home abortion is really, really easy to do and impossible to legislate away.*

But you can use public policy to reduce the number of women seeking abortions

Neither the Left nor the Right talks openly and honestly about how to actually reduce abortion. The Left won't because they don't want to stigmatize abortion and the Right won't because they need the votes of abortion opponents to pass corporate tax cuts and environmental deregulation. And while I understand the Left's logic here, the result is an information vacuum.

When I first posted a shorter version of this piece on Facebook, a friend wrote: "It's never been about abortions. It's about legislating sex."

That's true for some people. The pedophile-shielding U.S. Conference of Catholic Bishops comes to mind. And there are others who cynically use abortion for political gain, like those "pro-life" GOP pols who want their mistresses to get abortions. (See: Scott DesJarlais, Tim Murphy, and  Elliott Broidy. And that's just the last four years!)

But I know a lot of people who sincerely care deeply about abortion as a human life issue. They aren't persuaded by "shout your abortion" tactics, and never will be. I think it's a mistake to not talk about what will—and what won't—actually lead to a reduction in abortion.


Because if we’re being completely honest with each other, we know how to reduce abortion: comprehensive sex education, affordable birth control, protections for pregnant workers, and a strong safety net for parents and children.

And those are Democratic priorities.

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*That doesn’t mean criminalizing abortion won’t have consequences. A lot of women with wanted pregnancies will die awaiting emergency abortions while their doctors debate the seriousness of their situation. We know because that is exactly what happened to Savita Halappanavar and women like her. And because a naturally occurring miscarriage is indistinguishable from a home abortion, women grieving the miscarriage of a wanted pregnancy will have to go through a legal bureaucratic hell. Again, we know because that’s already happening in places that have criminalized abortion. But abortions won’t stop.