How Stupak's stubbornness may lead to more abortions.

How to fix health policy.
March 15 2010 1:11 PM

Stupak = More Abortions

T.R. Reid explains how health reform would decrease the number of abortions.

Click here for a guide to following the health care reform story online.

If you want to reduce the number of abortions, rather than simply grandstand about them, you should want health care reform to pass. That's the important message of an op-ed by former Washington Post reporter T.R. Reid ("Universal Health Care Tends To Cut the Abortion Rate") that appeared in the Post March 14. Every pro-life member of Congress should stop whatever he or she is doing right now to read it.

Reid, whose 2009 book The Healing of Americais one of two or three indispensible books about the health care crisis (see also his excellent Frontline documentary, Sick Around the World), makes the simple point that if a pregnant woman knows she will have access to decent prenatal, maternity, and pediatric care, she will less likely choose abortion, even if she has access to abortion, too. And if she has access to contraception, which often requires going to the doctor, she'll less likely get pregnant in the first place.


The United States has a very high abortion rate relative to other industrialized nations. Reid cites comparative statistics from the United Nations that show the abortion rate per 1,000 women to be 20.8 in the United States, compared with 15.2 in Canada, 7.8 in Germany, 12.3 in Japan, 16.9 in France, and 17 in Britain. The only countries found to have more abortions than the United States in the U.N. survey were Belarus, Bulgaria, China, Cuba, Estonia, Hungary, Kazakhstan, Latvia, Mongolia, Romania, the Seychelles, Ukraine, Vietnam, and the Russian federation (which leads the world with 53.7). With the exception of Cuba, all of these countries have lousy health care systems. (In Cuba the availability of pretty good health care is likely balanced out by the fact that Cuba is a very poor country.)

Rep. Bart Stupak, D-Mich., who leads the pro-life opposition to health care reform, would answer that he's all in favor of expanding access to prenatal, maternity, and pediatric care; he just doesn't want to expand access to (unsubsidized) abortion. But the choice Stupak's faced with isn't a health reform bill that permits abortion coverage and a health reform bill that doesn't. It's between a health reform bill that permits abortion coverage and no health reform bill at all—an outcome Stupak (following the lead of the U.S. Conference of Catholic Bishops) says he's willing to accept.

If Stupak prevails, then health care reform won't pass. If health care reform doesn't pass, then pregnant women won't get improved access to health care. And if pregnant women don't get improved access to health care, then there will be more abortions. In a practical sense, then, Stupak's anti-abortion amendment (to be more precise: Stupak's insanely stubborn advocacy for his amendment) will likelier increase the number of abortions than reduce them.

Update, March 17: On the New England Journal of Medicine's Web site, Patrick Whelan examines the impact of Romneycare on abortion rates in Massachusetts. Unlike Obamacare, Romneycare provided direct government funding for abortions.But guess what?The abortion rate dropped 7.4 percent among teens and 1.5 percent overall in the two years after Romneycare became law, even as the nonelderly insured population increased by 5.9 percent.

E-mail Timothy Noah at

Timothy Noah is a former Slate staffer. His  book about income inequality is The Great Divergence.



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