Access to Abortion: Red State, Blue State, Interstate

Women who need access to abortion services are using the Internet, so the Internet is where the information they need should be.

It’s a small study, but one with big implications for how we understand the relationship between policy, culture, and reproductive rights: a study performed by two doctors in a Chicago children’s hospital found that people in areas with more restrictive abortion policies search for the word “abortion” more than in more liberal areas.  The researchers assumed women in these areas are more likely to look to the Internet for help in finding abortion providers because they feared asking their primary care doctors.  I’d add that anti-abortion policies tend to coincide—because anti-choicers are in this because of a mix of misogyny and sex panic—with general cultural and legal obstacles to contraception access.  This raises the unintended pregnancy rate, thus the more frequent searching for abortion services.

It also disproves the contention made by Ross Douthat that the main reason that red states have higher divorce rates, as well as rates of teenage childbirth and other problems that point to a general inability to live up to the “family values” ideal, is that the noble salt-of-the-earth red-state ladies endure unwanted pregnancies as the punishment coming to them for the sin of fornication. They sin, he argues, but they’re morally superior to blue state sisters because they take their childbirth medicine instead of using abortion.  Douthat imagined that red state ladies think of themselves in the same lowly terms he imagines them, more as sinful creatures deserving of punishment than human beings deserving of rights and social investment.

Noble women who grimly take their punishment of unwanted pregnancy and shotgun marriages for the fleeting pleasures of fornication—perhaps with hair shirt maternity clothes as an added bonus?—appears to be a fantasy of sexist male New York Times columnists safely ensconced in the Sodom of New York City.  Having grown up in Texas, I can’t say I’m surprised.  Red state women aren’t especially more likely than blue state women to think they owe the world a baby because someone didn’t pull out when he said he would. They’re just more likely to find that it’s hard to find an abortion provider when a fleet of moral scolds and gleefully misogynist blowhards have convinced legislators to pass laws making abortion harder to get.

Not that Douthat will likely admit it, but the lower abortion rates in more conservative areas are far more likely to be the result of lack of access than they are an unwillingness on the part of women to terminate unwanted pregnancies.  If you don’t have a doctor in your county performing abortions, the abortion rate in your county is probably zero.  But if you drive to the next county to get an abortion, their abortion rate goes up.  We know that women will often travel across many states in order to avoid bearing unwanted children.  (In Texas, women will often travel into Mexico, often just to avoid being seen in the local abortion clinics.)  Claiming a low abortion rate indicates a lack of desire for abortion services is like claiming teenagers love “Beowulf” because they’re assigned to read it in high school.

What then should we learn from this study?  Mostly what pro-choicers have said for a long time, which is that many women are drastically underserved in the reproductive health department.  It’s not just that they don’t have decent access to abortion when they want or need it, and therefore have to go through hell and high water to obtain this simple procedure.  It’s also that they don’t have adequate access to the means to prevent those unwanted pregnancies and abortions in the first place.  Places where the moral scolds and misogynists make it hard for you to get abortions are places where moral scolds and misogynists make it hard for you to buy condoms or get a birth control prescription.  Needless to say, when moral scolds and misogynists have a lot of power in a community, young people are given less access to sex education that teaches them how to prevent unwanted pregnancies.

The question is, how to best improve this access?  On a recent episode of “Reality Cast”, Emily Bazelon suggested that the pro-choice movement might consider if it’s a better use of resources to try to bring women who want abortions to the providers rather than try to increase the number of providers in areas where they face endless amount of grief from protesters and legislators.  It’s a tempting idea, and certainly a stopgap measure already in place through organizations that provide information, funding, and housing to needy women seeking abortion.  But it doesn’t do much for the larger problem, which is that women with poor access to abortion services also face poorer access to contraception services that could prevent the need for abortion in the first place.  We’ve all been tempted to simply give up and create a system of free states and anti-choice states, but such a system would almost surely increase the rate of unwanted pregnancy.

The other thing we can learn from this is that women who have poor access to abortion services are turning to the Internet, so the Internet is where the information they need should be.  Websites that connect women to abortion services already exist, and they need to be optimized so they come up quickly on searches.  Efforts to connect remote patients with doctors who can assist them through the internet with non-surgical abortion options should continue, with more effort invested in making sure women who would want this option have access to it.  We must resist anti-choicers who work tirelessly to make sure anti-abortion propaganda is the first thing a woman seeking an abortion sees when she searches for abortion services online.  The Internet can be a great place to find information and services, but sadly it’s also a place where emboldened right wing demagogues can spread lies and misinformation.