Want fewer abortions? Think like an engineer

A program in Colorado shows what is truly effective: treating problem of unplanned pregnancies, not politics

Recent events have given the pro-life movement an unprecedented opportunity to drastically slash the number of abortions in Texas. Unfortunately, by letting politicians focus on the self-destructive goal of defunding Planned Parenthood instead of thinking like engineers, prolife activists risk continued frustration and more abortions.

What does engineering have to do with abortion? A lot — potentially. To achieve their objectives, engineers have to deal with the world as it exists, not as we wish it to be. Good engineers develop backup plans when their first plans encounter difficulty. Great engineers understand the political and social environment they operate in and mobilize stakeholders to achieve their goals.

Abortion results from unintended pregnancy. The simplest and most effective way to eliminate abortion by preventing pregnancy is abstinence. In reality, however, people have sex. The backup plan is birth control — more specifically, effective birth control. As we will see, this is one area where America notoriously fails.

The exciting news for the pro-life movement comes from Colorado, where the Colorado Family Planning Initiative provided long-acting reversible contraceptives to low-income patients from 2009 to 2011. The results were dramatic: Between 2009 and 2013, abortion rates for women 20-24 fell 18 percent, and birth rates declined 9 percent. For women 1519, the rates dropped even more — by 42 percent and 40 percent, respectively.

Furthermore, the proportion of highrisk births dropped 24 percent while the caseload of new infants in the Women, Infants and Children supplemental nutrition program dropped 29 percent between 2010 and 2013, saving taxpayers money. In short, providing long-term contraceptives sharply reduced the number of abortions, pregnancies and high-risk births.

The implications of this study are huge. Compared with Europeans, Americans have the same rate of sexual activity, but much higher rates of pregnancy. In 2011, the pregnancy rate per 1000 women ages 15-19 was 57 in the United States compared with 25 in France and an astonishing 8 in Switzerland.

Since human biology does not shift with the continents, that difference is so- cial, cultural and technological. Specifically, Americans use less effective forms of contraception and use them less effectively than their European counterparts.

From an engineering perspective, the least effective forms of birth control rely on people. The biggest challenge of condoms is using them. While more effective, the pill demands taking a pill daily, a surprisingly difficult task — roughly half of people taking medicine do not follow their prescribed regimes. One tool for reducing unwanted pregnancies has proven to be the cellphone with its ability to provide daily reminders to take the pill.

In contrast to the attention needed to use a condom or the pill, long-acting reversible contraceptives last several months with no action needed. The intrauterine device can be easily implanted and removed with no or minimal side effects. As with most technologies, the new generation is vastly improved and safer.

Many Texas politicians are trying to ensure Planned Parenthood does not receive any federal or state money to provide any services to Texas women. These efforts (which should raise broader questions about the state’s power in deciding what qualified groups receive state contracts) will probably increase, not reduce, the number of abortions in Texas by reducing poor women’s access to preventive care.

To actually reduce abortions means providing access to effective contraceptives. Thinking like engineers to attack the real problem of unplanned pregnancies instead of trying to gain political points by attacking Planned Parenthood will reduce abortions.

In an age of angry, “no compromise” politics, providing long-acting contraceptives may seem morally inadequate because it does not ban abortions. But if Texas follows the Colorado experiment and provides long-acting contraceptives, then the number of abortions should fall significantly. It’s not a full loaf, but it is a half- or third-loaf that pro-choice as well as pro-life advocates can accept. That acceptance and the resulting drop in abortions are two reasons to act.

Engineers seek real solutions to real problems. Shouldn’t we demand the same from our elected representatives?

“Compared with Europeans, Americans have the same rate of sexual activity, but much higher rates of pregnancy. ... Americans use less effective forms of contraception and use them less effectively than their European counterparts.”