September 17, 2001
One of the most striking aspects of the automobile industry is the precision with which it makes calculations of life and death. The head restraint on the back of a car seat has been determined to reduce an occupant's risk of dying in an accident by 0.36 per cent. The steel beams in a car's side doors cut fatalities by 1.7 per cent. The use of a seat belt in a right-front collision reduces the chances of a front-seat passenger's being killed through ejection by fourteen per cent, with a margin of error of plus or minus one per cent. When auto engineers discuss these numbers, they use detailed charts and draw curves on quadrille paper, understanding that it is through the exact and dispassionate measurement of fatality effects and the resulting technical tinkering that human lives are saved. They could wax philosophical about the sanctity of life, but what would that accomplish? Sometimes progress in matters of social policy occurs when the moralizers step back and the tinkerers step forward. In the face of the right-to-life debate in the countryand show trials like the Bush Administration's recent handling of the stem-cell controversy, it's worth wondering what would happen if those involved in that debate were to learn the same lesson.
Suppose, for example, that, instead of focussing on the legality of abortion, we focussed on the number of abortions in this country. That's the kind of thing that tinkerers do: they focus not on the formal status of social phenomena but on their prevalence. And the prevalence of abortion in this country is striking. In 1995, for example, American adolescents terminated pregnancies at a rate roughly a third greater than their Canadian, English, and Swedish counterparts, around triple that of French teen-agers, and six times that of Dutch and Italian adolescents.
This is not because abortions are more readily available in America. The European countries with the lowest abortion rates are almost all places where abortions are easier to get than they are in the United States. And it's not because pregnant European teen-agers are more likely to carry a child to term than Americans. (If anything, the opposite is true.) Nor is it because American teen-agers have more sex than Europeans: sexual behavior, in the two places, appears to be much the same. American teen-agers have more abortions because they get pregnant more than anyone else: they simply don't use enough birth control.
Bringing the numbers down is by no means an insurmountable problem. Many Western European countries managed to reduce birth rates among teen-agers by more than seventy per cent between 1970 and 1995, and reproductive-health specialists say that there's no reason we couldn't follow suit. Since the early nineteen-seventies, for instance, the federal Title X program has funded thousands of family-planning clinics around the country, and in the past twenty years the program has been responsible for preventing an estimated nine million abortions. It could easily be expanded. There is also solid evidence that a comprehensive, national sex-education curriculum could help to reduce unintended pregnancies still further. If these steps succeeded in bringing our teen-age-pregnancy rates into line with those in Canada and England, the number of abortions in this country could drop by about five hundred thousand a year. For those who believe that a fetus is a human being, this is like saying that if we could find a few hundred million dollars, and face the fact that, yes, teen-agers have sex, we could save the equivalent of the population of Arizona within a decade.
But this is not, unfortunately, the way things are viewed in Washington. Since the eighties, Title X has been under constant attack. Taking inflation into account, its level of funding is now about sixty per cent lower than it was twenty years ago, and the Bush Administration's budget appropriation does little to correct that shortfall. As for sex education, the President's stated preference is that a curriculum instructing teen-agers to abstain from sex be given parity with forms of sex education that mention the option of contraception. The chief distinguishing feature of abstinence-only programs is that there's no solid evidence that they do any good. The right's squeamishness about sex has turned America into the abortion capital of the West.
But, then, this is the same movement that considered Ronald Reagan to be an ally and Bill Clinton a foe. And what does the record actually show? In the eight years of President Reagan's Administration, there was an average of 1.6 million abortions a year; by the end of President Clinton's first term, when the White House was much more favorably disposed toward the kinds of policies that are now anathema in Washington, that annual figure had dropped by more than two hundred thousand. A tinkerer would look at those numbers and wonder whether we need a new definition of "pro-life."