Abortion bans do work: the Irish experience

There’s a big question at the moment about where pro-lifers should be putting their energy. Legal protections for the pre-born? Socio-economic supports for women? Cultural change? Individual conversations? My answer, for what it’s worth, is all of these options can be beneficial, but depending on context, more emphasis can be placed on one over another. There are some places, like Ireland, where comprehensive legal protections are out of reach for the moment and the focus should largely be elsewhere. In other places legal restrictions may be more feasible and the calculations may be different.

But I’m noticing an increasing trend among pro-lifers away from pursuing legal restrictions on abortion basically anywhere. It’s a trend that’s more common among the nebulous group that I think of as ‘new’ or ‘non-traditional’ pro-lifers – people who call themselves ‘whole-life’ or who focus more on cultural change, or pro-life feminists, or pro-lifers on the political left. (Lest there be any doubt, as a left-winger who’s involved with an organisation primarily focused on having better conversations about abortion, I’m pretty squarely in the ‘new pro-lifer’ camp myself).

I’m not going to name particular examples, but a quick look at the Twitter reaction whenever a republican state in the US puts in place a new abortion restriction reveals that the phenemenon I’m talking about is on the increase. This isn’t quite an opposition to legal restrictions or bans in principle. The pro-lifers I’m talking about are (usually) fine with saying that in an ideal world abortion would be banned. But they are increasingly sceptical about the usefulness of bans in the actual world.

There are a lot of reasons for this, but probably the biggest one is the idea that abortion bans just don’t work – that is, they don’t reduce the abortion rate. This is a common belief among pro-choice people, but there’s nothing to stop a person who believes that pre-born humans have an equal right to life believing it too. Even if you don’t think that, in principle, that right is overridden by a woman’s right to control her body, you might think that there’s just no point banning abortion and would rather work to end it another way.

I think that particular reason for opposing abortion bans is wrong. They do, in fact, work to reduce the abortion rate, and ‘new’ pro-lifers should not help spread the idea that they don’t, or allow that idea to become associated with us.

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Before getting into the nuts and bolts of why that’s true, it’s worth stopping to think about where our starting point should be. I think a lot of people approach this question from a presumption or an intuitive sense that abortion bans don’t work, and that people who think otherwise need to have some serious evidence in their back pocket. The burden of proof is firmly on those trying to show that bans are effective. This is, I think, very strange. The primary reason we have most laws is that those laws change behaviour. If you forbid something by law you generally get less of it. If that wasn’t true… I don’t know what to say, really. A lot of things about our world would be very different!

The idea that laws against things normally reduce the prevalence of those things should be really obvious. But the contrary view (at least about certain issues) has become so lodged in the public consciousness that it now feels almost gauche to point out the truth of the obvious position. I feel a bit embarrassed writing about it now. Look at this rube, he thinks making things illegal stops them from happening!

One big source of this confusion is the idea that people who favour laws against things actually do think those laws will literally stop those things from happening – that is, reduce the incidence of them to zero. This comes up a lot in discussions of drug laws. “Yeah, you can ban drugs, but do you actually think that will stop young people taking them?” Of course, no law made has ever achieved this. Murder, rape, slavery, theft, assault, fraud: all these things happen all the time in jurisdictions where they’re forbidden by law. But these laws are still pretty effective! By making these things illegal we make them a lot less common than if there were no restrictions on them at all. That’s all we can ever really hope for with legal restrictions. 

The more sophisticated version of this idea holds that banning certain things just ‘forces them underground’ without meaningfully reducing their prevalence. I’m sure this phenomenon, of a legal ban forcing a practice underground without reducing its prevalence, does sometimes happen. But a lot of the examples of it happening… aren’t.

Take Prohibition of alcohol in the United States in the early 20th century. The idea that Prohibition didn’t actually stop people drinking and just made it a black-market pursuit is conventional wisdom. It’s also completely wrong. As this article from Vox’s German Lopez helpfully outlines, historians are essentially unanimous now that Prohibition cut alcohol consumption levels pretty drastically. There’s significant disagreement about just how much (was it 30% or 70% lower than pre-Prohibition levels?) but it made an extremely significant dent. And not just in consumption itself: rates of death from alcohol-related illness like liver cirrhosis also fell during Prohibition. None of this is to say that banning alcohol was a good goal, or that the costs of Prohibition outweighed the benefits. But it pretty clearly did work at its stated aim of reducing alcohol consumption.

As I’ve said I’m sure this isn’t true of everything. But I do think it should be our starting point. The basic, obvious-seeming, gauche idea that legal bans generally reduce the incidence of the things they ban is correct. Laws do this in a number of ways: most obviously, they make the thing they ban more difficult to access. But the knowledge that something is banned or restricted often changes behaviour long before the stage of trying to access the thing.

So what about bans on abortion?


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The studies most widely used to make the claim that abortion bans make no difference to rates are from the Lancet and the Guttmacher institute. These studies were widely reported on in the media, see e.g. the Guardian, ‘Criminalising abortion does not cut number of terminations, says study’. 

The central claim they make is that abortion rates are similar in places where abortion is illegal and places where it is legal. That claim is true (sort of). But the conclusion a lot of people reach from it (that abortion bans don’t reduce abortion rates) is wrong. Why?

Our own Statistics Fairy has done an analysis of the Lancet study before – check it out. The short answer, though, is that these studies don’t control for socioeconomic status. 

They compare a bucket containing all the countries where abortion is heavily restricted with a bucket containing all the countries where it isn’t. That kind of broad comparison, of course, obscures more than it reveals. Most of the countries in which abortion is heavily restricted are very poor, and poorer countries tend to have much higher abortion rates. It’s a massive confounding variable that these studies just don’t address.

So what happens when you actually compare like with like? One way is to examine the same jurisdiction after a change in the law. In the United States, there’s a raft of evidence suggesting that changes in levels abortion restrictions had an impact on rates, in both directions. Secular Pro-life have an excellent collection of links to many of the studies here. These studies often measure the effects of abortion restrictions on the birth rate: if legal abortions were simply replacing or being replaced by legal ones there’d be no change in births.

The same pattern seems to have held in eastern Europe. This study compares different countries and, crucially, controls for socioeconomic factors. It finds that legal restrictions made a substantial difference to abortion rates. Prof. Michael J New at the Lozier Institute has a great analysis of the data from this study and a variety of U.S ones.

Then, of course there’s Ireland – socioeconomically similar to many rich western countries where abortion is legal. When abortion was banned by the eighth Amendment, Ireland had the lowest abortion rate in Europe. What’s more, we managed this while having a maternal mortality rate that was one of the lowest in the world, (consistently similar to or lower than the rates of maternal death in the UK, France, and the Netherlands). We were also ranked above average in the EU on their gender equality index (measuring factors like levels of educational attainment by women, financial equality, and divergence in health outcomes) when the ban was in place. We were 8th highest in 2015 and 7th in 2017. While we could have done much more to build a real culture of life in Ireland, we were a basically standard liberal democracy: except that we banned abortion.

What happened when we repealed the eighth? As we’ve blogged about before, abortion rates went way up. We made generous estimates for the number of abortions obtained by Irish women pre-repeal (official figures + travel + pills), using information from the NHS and abortion pill providers themselves. We still found an increase of 38% in the year after repeal.

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So in conclusion: the best evidence we have suggests that abortion bans do indeed make a substantial difference to abortion rates. They are not the only thing that does. Socioeconomic and cultural factors are hugely important too. But there’s no necessary contradiction between those two. Legal restrictions on abortion and socioeconomic supports for women and babies should not be an either / or, but a both / and. Pro-lifers shouldn’t set up a false dichotomy here. There’s a temptation for ‘new’ pro-lifers especially to see what’s sometimes an excessive focus on law to the exclusion of culture and economic factors in the ‘traditional’ pro-life movement and react against it by opposing legal restrictions. But that’s just making the opposite mistake. It’s letting polarisation rule us.

It would be very sad if pro-lifers who think that building a culture of life has to go far beyond just the laws on the books (as I do) ended up turning against legal protections for the pre-born based on the false belief that they don’t work.

Ben