First you must accept that completely ending abortion is a pipe dream. As long as women get pregnant, as long as pregnancies go bad, it will be a medical necessity.
Second, it is a truism that ending legal abortion doesn't end the practice, it just makes women resort to home methods, including douching with drain cleaner, taking herbs where the effective dose is the same as the lethal and inserting sharp objects into their bodies. Criminalizing abortion only causes dead women.
Third, the abortion rate hit its lowest point ever in 2014, with fewer than 17 pregnancies out of 1000 ending this way.
For the record, the infant mortality rate in Mississippi is 8 per 1000 (which is the same as the rate for white women having abortions nationally)
So, what can be done?
Simply saying "Everyone must stop having non-procreative sex" does not work. We have proven this over ten thousand years of human civilization. Where rules are placed on human behavior, humans work to get around them. Witness places that punished adultery by execution, and people still had affairs.
Abstinence has a 100% user failure rate.
The sane way to approach this is "Why do women have abortions?" A better question is "Why do 40% of women, regardless of religion, class, color or lifestyle find themselves in the position where they need to not be pregnant?'
The answer is not, as some would have you believe "because they are stupid, evil baby-eating ogresses." Maybe one or two are, but not 40% of the population.
The primary answer is finances. This is borne out by numerous studies.
The second most common is school/job interruption.
(there's a 1% variation in the placement of these reasons in the Guttmacher study)
Abortions decline when the economy improves. Notice the sharp drop in the graph around 1996. (the earliest Baby Boomers hitting 50 may have had something to do with it as well.) It mostly leveled with slight decline and then spiked again in the mid-2000s, during the recession. Since 2008, the decline has been steady. (and the early Baby Busters/GenX started turning 40 about then and hitting menopause)
Improved birth control: IUDs and implants are responsible for some of this. People tend to be more diligent about birth control in harder times, because they can't afford another mouth.
And that's what it comes down to. When I was driving, I came to the conclusion that if I got pregnant, tubal be damned, I would have to end the pregnancy. It would end my career and I carried the insurance on the kids, including two chronically ill ones. And if I did get pregnant, it would likely be an ectopic pregnancy, which would be fatal.
Job interruption at that point would have been damaging. And it was when it happened a few years later. We're still recovering 4 years down the road.
Now, multiply that by ending school, or by killing a career at the beginning, when the woman has no resources. That is the why.
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So what can be done?
The answers are relatively simple, but very unpalatable for most of the Pro-Life movement.
1) Accurate sex education, with talk of birth control, not just failure rates, beginning at age 11 and up. I know, they're still kids. But they are developing, even at that age. My daughters were making college age men walk into walls and street signs at 12. At 11, middle-aged men were attempting to follow them off elevators.
2) Access to birth control, including long term forms. This means insurance and medicaid need to pay for it and employers need to butt out. Over the counter pills are just one more way for insurance to get out of paying.
3) Education and empowerment. Girls must be taught to say no if they don't want something and everyone must be taught to listen. Educated women are less likely to get pregnant when they don't want to, and have fewer children as a rule.
4) Economic changes. I favor a Guaranteed Minimum Income. Unplanned pregnancies are more likely to be continued in good economic times, when the woman feels secure in her ability to take care of the child. Living wages, good jobs, and day care that doesn't cost as much as an Ivy League education are all part of this.
It's not a hard concept. It is very hard to change people's minds when they look at that list and see "Teach Immorality, Encourage Immorality, Teach Immorality, Socialism" and not actual ideas that will help real people.
Then again, these are people who think women get third trimester abortions out of carelessness and evil and not out of wanted pregnancies going heartbreakingly wrong.
Can we end abortion? No. Not completely. Not even if we made pregnancy an opt-in decision instead of an opt-out. If everyone was on the IUD or implant, and had to make a conscious effort to get pregnant, not even then. Those wanted planned pregnancies would still go bad.
Can we reduce abortion still further, make actual infant mortality higher? possibly. The above 4 ideas would be a start.
A brief illustration on the opt-in/opt-out: I was in a high school role-playing game and the sex ed class was discussing pregnancy. The kids from space milieus (Star Trek, Star Wars, Farscape, Etc) treated pregnancy as an opt-in event, something one had to make a decision to have happen. The kids from contemporary milieus treated it as opt-out, something to be actively avoided. The kids from fantasy milieus were pretty much agog at the idea of sex without reproduction and wanted to be part of this shiny future.
So, do we want to move into the future, stay where we are, or regress to a place where sex and childbirth are inextricably linked? I know where some groups want to take us. And don't think it can't happen. Bear in mind, we lost indoor plumbing for nearly 1400 years.
Roe is the first target. Griswold is the next. And that has been the game-plan since the 1980s. Strange how the stated goal is directly at odds with the most-effective practices for achieving it.
