What's Been Overlooked in America's Decades-Long Abortion Debate?

No one wants more abortions in the U.S. If we are seeking to reduce the number of abortions, we should target its root cause: unintended pregnancy. In the U.S., about half of all women will have had an unintended pregnancy by age 45, and approximately a third of them will have an abortion.

The most effective way to reduce unintended pregnancy is to ensure access to safe, effective contraception. But our nation is headed in the wrong direction. The proportion of women who want to avoid a pregnancy but are not using a birth control method has risen from 5 percent in 1995 to 7 percent in 2002. Nonuse of contraception only increases the likelihood of an unintended pregnancy—something both sides of the abortion debate would like to avoid.

Nearly half of all women seeking abortion report they were not using contraception during the month they unintentionally became pregnant. Among those not contracepting, the key reasons were a belief that they were at low risk for pregnancy, and concerns about the potential side effects of using contraception. Both of these reasons can be addressed through education. The U.S. policy push toward abstinence-only education and the failure to teach about contraception in school are not helping the prevention of abortion. The U.S. should also promote healthy decision making and communication about sexual activity, including having both partners willing to act to protect themselves from STIs and unplanned pregnancies.

Removing barriers, such as the need for prescriptions for hormonal contraceptives, is a key policy step to avoid unintended pregnancies and abortion. That's a strategy that we can learn from developing nations.