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abortion, Contraception

Against abortion? Here’s why you should vote for Hillary Clinton

I am a doctor who has dedicated her career to helping woman. If abortion is what matters to you in this election I’d like to put rhetoric aside and focus on the facts.

There are approximately 700,000 abortions per year in the United States. The four main reasons women seek abortion are unplanned/mistimed pregnancy, rape, health of the mother, and birth defects (fetal anomalies). Approximately 16,000 of these abortions are the result of rape or 2.3%. Exact data on health of mother and birth defects is unknown.

45% of pregnancies in the United States are unplanned  

These are the pregnancies most likely to end in abortion, in fact 42% of unplanned pregnancies end in abortion and 58% end in a live birth (this statistic excludes miscarriages). If you want to reduce abortion you have to work on unplanned pregnancies.

Most pregnancies are unplanned because of issues with access to highly reliable contraception, but some will be rape and some will be health of the mother, i.e. women who hadn’t planned on getting pregnant and are happy they are pregnant, but their health is deteriorating. For example, a 21-year-old woman who had post partum cardiomyopathy (heart failure) after her last pregnancy and survived (the mortality is at least 50%). She had limited access to health care after delivery and didn’t really understand the risks her doctor mentioned about a next pregnancy. She thought she was tired because she was a new mom and not sleeping well. She shows up in the emergency department short of breath. She finds out she is 7 weeks pregnant and that the strain of this second pregnancy is causing her damaged heart to fail. She is admitted to the intensive care unit. Pregnancy is a huge strain on the heart and most of that impact occurs early on in the pregnancy. She didn’t plan on being pregnant and would not choose an abortion, except her pregnancy is killing her and unless the pregnancy ends she will die leaving her 5 month old motherless. She is so ill that she cannot be transported to the operating room for an abortion, so it is done on her bed in the intensive care unit. These cases are fortunately uncommon, but they happen.

pregnanciesbyintentionstatuschart

Most abortions happen before 8 weeks

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Two-thirds of abortions (66%) happen before 8 weeks. It is unlikely any of these are for birth defects as the earliest tests cannot be done until 10 weeks and it takes a week to get the results back. A small percentage will be rape and health of the mother (like the case described above), but the majority are unplanned pregnancies and thus preventable.

Birth control prevents abortion by preventing unplanned pregnancies

Only 5% of women who have an abortion were using contraception correctly and consistently.

moderncontraworksrevupgraph

Studies tell us that access to long acting reversible contraception dramatically reduces the abortion rate

In Colorado a program that provided free long acting reversible contraception (the kind that is impossible to use inconsistently) resulted in a 42% reduction in abortions for teens and an 18% reduction for women ages 20-24.

In 2014 government-funded family planning helped women avoid two million unintended pregnancies, approximately 700,000 abortions would have ended in abortion.

Laws do not reduce abortion, they reduce safe abortions. 

In the 1950s and the 1960s there were an estimated 200,000 to 1.2 million illegal abortions. There are currently around 700,000 abortions/year in the United States.

The abortion rate is similar in countries where it is illegal and where it is widely available, legal, and safe. According to the most recent data approximately 7 million women in developing countries are treated for complications from unsafe abortions annually and at least 22,000 die.

In Texas, where the abortion laws have become more restrictive and access has dropped more than 100,000 women and possibly up to 240,000 have attempted home or illegal abortions.

I trained with men who were OB/GYNs in the 1960s and the 1970s and they saw the women who survived when they came to the emergency room.

“Every night we admitted a woman. Every night. Sometimes three. And we were one hospital.” Those are the words of one of my mentors.

Think about that. Every night one or more woman with a pelvis abscess or an injured bowel. At every hospital.

If you really want to reduce abortion you must vote for the candidate who will improve access to highly reliable contraception

 

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This is what Donald Trump said about birth control to Dr. Oz, “I think what we have in birth control is, you know, when you have to get a prescription, that’s a pretty tough something to climb. And I would say it should not be a prescription, it should not be done by prescription.”

Making birth control over the counter does not help women access the forms of birth control that are most effective at preventing pregnancy: IUDs and implants. Taking away health plan contraceptive coverage makes the birth control that reduces abortion unaffordable for many women. The cash price for the implant is $825.74 and you still have to pay for insertion. IUDs are in the $600-1,000 range for the device and the insertion (depending on where you go).

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If your candidate focuses on restrictive laws you will drive women underground, which will increase their financial hardship and many will risk their health and lives, but you will not reduce abortions.

If your candidate wants to lift the birth control mandate from the Affordable Care Act or repeal the Affordable Care Act and replace it with health care that does not cover birth control you will not reduce abortions.

If your candidate wants to get rid of Planned Parenthood, a source of subsidized highly-reliable contraception that would otherwise be unaffordable, you will increase abortions.

If your candidate focuses on maintaining and even expanding government and employer funding of highly reliable contraception your vote will reduce abortions.

It really is that simple.

 

 

 

 

 

 

 

 

Discussion

13 thoughts on “Against abortion? Here’s why you should vote for Hillary Clinton

  1. It should be obvious that the so-called pro-life people are actually after making sex dangerous. Birth control makes sex safer. This argument doesn’t work.

    Posted by Loren Pechtel | November 7, 2016, 1:23 pm
    • I share your frustration! I have given thanks for decades to my Mother who took me to the county health department for birth control when I started going steady (and having sex) with my first serious boyfriend at age 17. She was against it, and was completely mortified, but she was pragmatic and determined that I attend college and succeed in life. Once again, thanks Mom for loving me more than some “ideal”.

      Posted by Anita Murphy | November 8, 2016, 7:37 am
  2. Since God gives life, do you think He made a mistake putting life into these babies????

    Posted by Ann Mirabello | November 7, 2016, 3:25 pm
    • Did you read the post?

      Posted by Dr. Jen Gunter | November 7, 2016, 3:41 pm
    • I suggest paying attention to what she’s saying.

      Rather than Bible-thumping about banning abortion she’s actually trying to do something about it by lowering the need for it. When the thumpers get their way the result is back-alley abortion, when proper sex ed is used the number of oopses is far below the back-alley abortion rate in the places that ban it.

      Posted by Loren Pechtel | November 7, 2016, 10:24 pm
  3. Just wanted to let you know how much I appreciate the post. It might get frustrating sometimes, dealing with issues like this where people’s positions are deeply entrenched and it’s hard to put aside the rhetoric, as you ask. Still, briefly: I’m 46, and starting from my teen years, I considered myself committed to the pro-life/anti-abortion cause. Demonstrated outside clinics, marched on Washington, the whole nine yards. My position started to shift probably sixteen or seventeen years ago, and shifted completely to pro-choice about maybe eight years ago, for reasons other than what you provide here.

    All this to say, we do change our minds some times, when everyone is able to move past the angry rhetoric and discuss things respectfully. I feel your post does that; I find the data you share both interesting and pertinent; and I wanted you to know.

    Thanks for taking the time to share.

    Posted by David Learn | November 7, 2016, 8:35 pm
  4. Just wanted to let you know how much I appreciate the post. It might get frustrating sometimes, dealing with issues like this where people’s positions are deeply entrenched and it’s hard to put aside the rhetoric, as you ask. Still, briefly: I’m 46, and starting from my teen years, I considered myself committed to the pro-life/anti-abortion cause. Demonstrated outside clinics, marched on Washington, the whole nine yards. My position started to shift probably sixteen or seventeen years ago, and shifted completely to pro-choice about maybe eight years ago, for reasons other than what you provide here.

    All this to say, we do change our minds some times, when everyone is able to move past the angry rhetoric and discuss things respectfully. I feel your post does that; I find the data you share both interesting and pertinent; and I wanted you to know.

    Thanks for taking the time to share.

    Posted by maradanto | November 7, 2016, 8:36 pm
  5. Dear Dr Gunter,

    What a great post once again. Thanks for sharing your experience in obstetrics and gynecology on so many women’s health issues. I have been thinking recently about how polarized some issues can get, especially abortion, and how a more nuanced approach would be more in line with reality. I can’t agree with the extreme argumentation from conservatives on the abortion issue, however there are also extreme opinions on the pro-choice side as well. I am just wondering about your statement “laws do not reduce abortion, they reduce safe abortions”. My feeling is that laws that reduce abortions DO reduce safe abortions, however the total abortion rate would also decrease. Some of the women who would have a safe, legal abortion if it was available would elect to continue their pregnancy rather than seek an unsafe abortion if the laws changed to restrict abortion access. Or would the chance of having to continue every unplanned pregnancy mean that women are much more careful about using contraceptives to prevent mistakes? In any case, I think the problems caused by lack of abortion access is not only that unsafe abortions would increase, it would also mean forcing women to carry unwanted or non-viable pregnancies to term, or they would have to continue a pregnancy in the face of their own serious health issues, and this is a direct consequence of a lower abortion rate.

    Posted by juliakbird | November 15, 2016, 6:24 am

Trackbacks/Pingbacks

  1. Pingback: Against Abortion? You Should Vote For Hillary Clinton. | business via blog - November 7, 2016

  2. Pingback: Against Abortion? You Should Vote For Hillary Clinton. | BuzzJour - November 7, 2016

  3. Pingback: Against Abortion? You Should Vote For Hillary Clinton. « CauseHub - November 7, 2016

  4. Pingback: Using the myth of 9th month abortions to defend voting for Trump | Dr. Jen Gunter - November 13, 2016

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