Destroying the Village to Save It: Undermining Planned Parenthood May Increase Abortions

During the Vietnam War, an unnamed U.S. Major became famous for telling a reporter during the bombing of the village of Ben Tre: “It became necessary to destroy the town to save it.” Reading about the Trump administration’s new rule that would strip millions of dollars from Planned Parenthood clinics brought this to mind.

USAF F-100 strike in South Vietnam during the Vietnam War (USAF Archives, public domain)

The new rule — which is sure to be challenged would require that any Planned Parenthood facility that provides or otherwise facilitates abortions be denied federal funds previously available through the federal Title X family planning program. In order to continue receiving funding Planned Parenthood would have to establish separate facilities for abortion providers and would be barred from referring pregnant women to these or any facility that provides abortions. Because the rule also prohibits any referrals for abortion, it has been termed a “gag rule” by opponents and has been opposed by most major medical organizations, including the American Medical Association and the American College of Obstetricians and Gynecologists as an unwarranted intrusion into medical practice. Current federal law already prohibits the direct use of federal funds for abortion.

In practical terms, the new rule would require hundreds of Planned Parenthood clinics to either end family planning services entirely, or spend millions of dollars to provide entirely separate facilities and staff for abortion services. Anti-abortion advocates see the sharing of space and staff as a way of using federal funds to support abortion. A press release from the Susan B. Anthony list, for example, quoted their president, Marjorie Dannenfelser. “The Title X program was not intended to be a slush fund for abortion businesses like Planned Parenthood, which violently ends the lives of more than 332,000 unborn babies a year and receives almost $60 million a year in Title X taxpayer dollars.”

We will never bridge the philosophical divide between those who sincerely believe human life begins at conception and those who see life, in any meaningful sense, as involving consciousness or viability. But there is one area of broad agreement among those who are pro-choice and those who are anti-abortion — the only completely effective way to prevent abortion is to prevent unintended pregnancy — -and the most effective way to prevent unintended pregnancy is to increase access to contraception.

Planned Parenthood is the only comprehensive source of family planning services in many communities, with more than 600 clinics nationwide. The organization issued a press release, commenting that the new rule would disproportionately impact low-income and under-served women.

The most striking recent decline in abortion occurred after implementation of the Affordable Care Act (aka ObamaCare) greatly increased free access to contraception. A study in the journal Obstetrics and Gynecology published in December 2012 titled “Preventing Unintended Pregnancies by Providing No-Cost Contraception” documented a fifty percent decline in abortion rates following the advent of the ACA. A thorough discussion of the study appeared in Scientific American. (“Free Birth Control Access Can Reduce Abortion Rate by More than Half.”) Other research has also shown conclusively that better access to contraception leads to a decline in abortion.

Those hailing the new rule contend that the loss of access to contraception is outweighed by the moral imperative of preventing abortion. This assumes, however, that making it harder to get an abortion will make a meaningful, overall reduction in the procedure. There is research, however, that suggests otherwise.

The Guttmacher Institute has found that abortion rates in countries where it is illegal are similar to those where it is legal. “Abortions occur as frequently in the two most-restrictive categories of countries (banned outright or allowed only to save the woman’s life) as in the least-restrictive category (allowed without restriction as to reason) — 37 and 34 per 1,000, respectively,” according to the institute’s most recent report.

While abortion continues, the lack of access to the procedure under safe, medically supervised circumstances has led to tens of thousands of maternal deaths annually, with the incidence estimated from approximately 5 percent to 13 percent of all maternal deaths, according to the World Health Organization.

I do not question the sincerity of those who are opposed to abortion — and a recent Marist poll commissioned by the Knights of Columbus indicates that Americans are evenly split as to whether they define themselves as “pro-choice” or “pro-life” — and that a majority favor limiting the procedure to the first trimester of pregnancy.

Even if further restrictions on abortion in the United States are allowed — as seems likely given the current makeup of the U.S. Supreme Court, the denial of ready access to contraception is almost certainly going to lead to more unwanted pregnancies and a consequent increase in abortions.

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