The debate over abortion has divided Americans for decades and seems like it will never be resolved. But while pro-life and pro-choice groups argue, a trend quietly unfolding in the background may eventually reduce the scope and the intensity of the issue.
That trend is greater access to long-term contraception. It shows up clearly in the latest numbers for a group for which abortion has been an urgent option – pregnant teenagers. After peaking in the 1990s, the teen pregnancy rate has plunged 60 percent to an all-time low, the Centers for Disease Control reports.
The rate is falling in every region and across all demographic groups. Nationally, teen pregnancy peaked in 1991 with 61.8 births per 1,000 teen girls. In 2014, the latest year for complete statistics, the rate was 24.2 births per 1,000.
North Carolina has followed the sharp decline. Since 1991, the pregnancy rate among girls 15 to 19 has fallen 63 percent. In 1990, there were over 26,000 teen pregnancies and 9,100 abortions. In 2014, the numbers dropped to 10,328 teen pregnancies and 1,975 abortions. The abortion rate overall is also at a historic low.
Experts cite several reasons for the decline, including a trend toward a rise in the median age of first-time sex – up from 16 in the 1990s to almost 18 today – and a shift from the sexual revolution of the baby boomers to millennials who take a more cautious approach. But a major driver is greater access to long-term conception such as long-acting injectable and implantable methods that can last years.
Teenagers previously knew little about these options and those who did often lacked the financial resources or access to doctors to obtain long-term contraception. But the Affordable Care Act, the Obama administration’s Teen Pregnancy Initiative and other federal health programs, along with better communications through social media and the Internet, are changing that pattern – and cutting the number of abortions.
The long-term contraception methods are “whoops-proof,” says Elizabeth Finley a spokeswoman for Shift NC (Sexual Health Initiatives For Teens), a North Carolina nonprofit focused on improving adolescent and young adult sexual health. “Ninety-five percent of all abortions are to someone not planning on a pregnancy,” she says, “When we see access (to contraception) go up, we see fewer pregnancies and fewer abortions.”
Despite this success, the General Assembly last year eliminated funding teen pregnancy prevention programs run by organizations that provide abortions, meaning the end of state funding for two programs run by Planned Parenthood.
Abortion opponents in the legislature are also at cross purposes by refusing to expand Medicaid, a change that would make long-term contraception available to low-income women at little or no cost. Paige Johnson, a Planned Parenthood spokeswoman, said the change would produce “incredible results” in reducing unwanted pregnancies.
Reducing the need for an abortion is a common goal. Expanding contraception should be, too.