“Making abortion free of charge results in an increased rate of abortions being used as a method of contraception.”

The appropriations for North Carolina's abortion fund have proven inadequate during five of the years between 1980 and 1994. This on-again, off-again funding pattern provides a natural experiment for estimating the short-run effect of changes in the cost of abortions on the number of abortions to indigent women. Overall, approximately one-third of pregnancies that would have resulted in an abortion, had state funds been available, are instead carried to term.

The ACA's elimination of contraception cost sharing led to increased contraception use, particularly LARC methods, and contributed to declines in both pregnancy and abortion rates. This suggests that improving access to effective contraception is a key strategy in reducing unintended pregnancies.

Evidence shows that restricting access to abortions does not reduce the number of abortions (1); however, it does affect whether the abortions that women and girls attain are safe and dignified. Countries and health systems could make substantial monetary savings by providing greater access to modern contraception and quality induced abortion.

During each of the approximately five years of follow-up, the predicted percentage using any contraceptive method was 86% among women who had the abortion and 81% among those denied it. However, they were less likely to rely on female sterilization, rather than no method (risk ratio, 0.5), and more likely to use barrier methods (1.7) or short-acting reversible contraceptives (2.6).

A new study by investigators at Washington University reports that providing birth control to women at no cost substantially reduces unplanned pregnancies and cuts abortion rates by a range of 62 to 78 percent compared to the national rate. The Contraceptive CHOICE Project enrolled 9,256 women and adolescents in the St. Louis area between 2007 and 2011, offering them their choice of birth control methods, including longer-acting options like IUDs and implants.

Reduced access [to abortion and family planning services] may lessen the frequency of contraceptive use, such as IUDs and condoms, which are often dispensed for free or reduced cost at such clinics. As a result, the incidence of unintended pregnancy may increase, possibly leading to either increased abortions, increased births, or both. Exploiting the quasi-experimental variation in abortion access in Texas, having no abortion provider within 50 miles in Texas reduced in-state abortion rates by 20%.

In fact, women having a repeat abortion are slightly more likely to have been using a highly effective hormonal method (e.g., the pill or an injectable). This finding refutes the notion that large numbers of women are relying on abortion as their primary method of birth control.

Women's sexual behaviour is influenced by the cost of having an abortion, new research in the United States shows. It found that a 10% increase in the cost of an abortion was associated with a 6.5% drop in the pregnancy rate among women of childbearing age. The authors wrote that their results “support the hypothesis that women's sexual behaviour is influenced by the direct cost of obtaining an abortion and to a lesser extent the indirect costs of obtaining an abortion either by reducing the frequency of sexual activity and/or increasing the use of effective contraception.”

Unintended pregnancy rates are highest in countries that restrict abortion access and lowest in countries where abortion is broadly legal. As a result, abortion rates are similar in countries where abortion is restricted and those where the procedure is broadly legal (i.e., where it is available on request or on socioeconomic grounds).

We found that participants who had contraceptive insurance coverage at the time of abortion had a 75% reduced risk of being pregnant in the subsequent year. They were also almost four times more likely to have received immediate post-abortion LARC or DMPA after their index abortion but had similar LARC or DMPA use 12 months later compared to those without insurance coverage.

Since the 1967 Abortion Act came into effect, the abortion rate has gradually risen from 5 to 18 per 1000 women aged 15-44 and is now plateauing; this is because service provision is now able to meet demand. The proportion of women having subsequent abortions tends to increase after legalization of abortion and to reach a steady state within about 30 years.

A new study that gave free birth control to low-income teens and women in St. Louis has found that the free contraception dramatically lowered rates for teen births and abortions. When more than 9,000 women ages 14 to 45 in the St. Louis area were given no-cost contraception for three years, abortion rates dropped from two-thirds to three-quarters lower than the national rate.

While the new rules were motivated by opposition to abortion, the state experiences we highlight in our paper show that increasing access to highly effective methods of contraception (and thus preventing unintended pregnancies) is a more effective way to reduce abortion rates. Barriers to contraceptive access will impede further progress in reducing unintended pregnancy rates, will raise government costs for Medicaid and other social programs, and will lead to more women seeking an abortion.

If the availability of state funding affects some women's decision of whether to abort a pregnancy, then the overall rate of abortion will tend to be higher during times when funding is available than when it is not. The expiration of funding is associated with a reduction in the overall abortion count of about 100 per month, which is approximately one-fourth of those who are ordinarily eligible.

Previous studies consistently show that access to contraception reduces abortion rates more reliably than another action, policy, or law.

A new peer-reviewed study of 2,162,600 Medicaid beneficiaries in 17 states with state taxpayer-funded abortion reveals that “rapid repeat pregnancy” (defined as a second pregnancy within 2 years) is most common among women who have abortions. The new study authored by researchers at the Charlotte Lozier Institute suggests that a high number of women are pressured into having unwanted first-time abortions. Building on these earlier studies, our new analysis of the raw Medicaid data suggests that when a woman is pressured into an unwanted first abortion, those same conditions are likely to persist and contribute to rapid repeat second abortions.

Widespread availability of free abortion services coupled with the unavailability of contraceptives led to very high rates of abortion during the Soviet era. In 1990, the annual abortion rate was 181 per 1,000 women of reproductive age and it was estimated that a woman had on average five abortions over the course of her life.

Research shows that approximately 60% of women who experience another unintended pregnancy after an abortion choose another abortion, most commonly because their financial, emotional, or relationship circumstances remain similar to those they were facing at the time of their earlier abortion decision. While this may lead some to a repeat abortion, the deeper need is often not simply another procedure, but meaningful change in the circumstances that led to the pregnancy.