Second trimester abortions and health care funding

There is a useful analysis of the relationship between second trimester abortions and health care funding over at the economics blog, Dollars and Sex.

From “The Economics of Second Trimester Abortions: Market Demand” by Marina Adshade: “Among women who both had second trimester abortions, and would have preferred to have one earlier in the pregnancy, 36% said the delay was caused by a need to raise the enough money to pay for the procedure. The U.S. isn’t the only nation that makes women pay for abortions, but it is the only one, that I know of, in which abortions for low-income women go unsubsidized by governments.”

Dollars and Sex, by the way, is an excellent resource for feminist philosophers. The blog covers economic aspects of dating and marriage, promiscuity, infidelity, risky sexual behavior, the relation between sex and happiness, and markets for sex such as prostitution, pornography, and lap dancing.

11 thoughts on “Second trimester abortions and health care funding

  1. Is the take-away here supposed to be that if the government would subsidize abortions for low-income women in the US, and the pro-life movement would hold fewer protests near US clinics, etc., more US late-term abortions could be turned into earlier-term abortions?

  2. I think the idea is that not funding abortion leads to more late term abortions, not fewer abortions.

  3. I think in general, it is safer for the woman to have the abortion as early in the pregnancy as possible. Thus, the policy puts women who are going to have an abortion regardless at greater risk.

  4. Sam, I didn’t see anything in the piece tending to suggest that the overall incidence of abortion wouldn’t increase if US abortions were subsidized. I’m pretty sure it *would* increase; besides being economically intuitive, it’s supported by a recent review of literature conducted by the Guttmacher Institute (which might be like citing Council on Tobacco Research material on smoking issues, but still). The review found that restrictions on Medicaid abortion funding had a fairly significant effect on reducing abortion, but tended to delay slightly the decisions of some women to abort — thus, fewer abortions but slightly later average term.

    Click to access MedicaidLitReview.pdf

    The blog article is obviously an advocacy piece, but what I can’t quite figure out is what audience the author thinks the implicit argument will find traction with. Logically, I guess, it would be people [i] who aren’t already in favor of subsidizing abortion and [ii] whose disapproval of second-trimester abortion is so much stronger than, or is so distinguishable from, their disapproval of abortion generally that they could be persuaded to want to help pay for strangers’ abortions if they thought it would have the effect of somewhat reducing the average age (but definitely not the number) of aborted fetuses. But although a majority of Americans fit the first criterion, I would think that hardly anyone fits both the first and the second.

  5. Have you ever taught a medical ethics class? The media likes to make it seem like everyone is clearly on one side or the other. Talking with students, at least, makes you realize that many people are keen to find some kind of middle ground. One of those middle grounds is an acceptance of earlier term abortions coupled with ethical concerns about later term ones. It’s a very common position, in my experience.

  6. JAFP, to be sure, I should have clarified that I was including in the second category people who accept first-trimester abortion but have objections to second-trimester ones. That is a common enough minority position, I agree. Subtract from the second category the people in it who are already inclined to include abortion coverage in Medicaid. Of the ones remaining, I have the impression that those who would change their mind and want Medicaid to fund both first- and second-trimester abortions in order to achieve a very slight decrease in the average age at which fetuses are aborted (while at the same time increasing the absolute number of both first- and, presumably, second-trimester abortions) is a very narrow slice of the population. It occurs to me while writing this that the surest way to boost support for Medicaid abortion funding might be to ban second-trimester abortions, but I’m assuming the author of the blog piece would oppose going so far in pursuit of subsidies.

  7. A few thoughts: First, I was surprised that finances were the factor influencing whether someone had a first or second trimester abortion. I think it would be horrible to be pregnant, knowing you were hoping to abort if you could get the funds together, and then having to wait until second trimester. Second, I can’t find the source but I recall reading an article this week about abortion rates being being pretty much constant across a wide range of societies. The difference was that in the societies with good access to legal abortion the abortions were earlier and safer.

  8. This is Marina Adshade, author of the blog post you are discussing. Nemo is right that the piece isn’t intended to advocate for funding abortions since the point of the blog is not to tell people what to think, but rather to encourage them to think about these issues from the perspective of data and theory (rather than emotion or moral codes). There is a part two, which will be up on Saturday, that will address this but if you ban second term abortions AND you don’t fund them then the women who are affected by those policies are the women who could not get the funds together fast enough to pay for the first trimester abortion or didn’t have the resources available to them to make an informed decision (for example, not being able to identify how many weeks pregnant they were).

    And Sam, you are right it would be horrible to know that you are pregnant and struggling to get funds together to have an abortion. I didn’t mention this in my piece but a number of these women already have children and it must be devastating to have to deprive those children of the things they need today in order to avoid having to deprive them even more in the future with the arrival of another child.

    Thanks for reporting my blog. It is nice to see some informed discussion here before I start getting emails today telling me where I am likely to be living out eternity.

  9. Prof. Adshade has posted the sequel to the blog post linked in the OP, which I think merits an update to this thread:

    Whereas the first post dealt with supply-side issues, the new one addresses market demand for second-trimester abortions.

  10. Whoops, I got the two posts mixed up: it was the earlier one that addressed economic DEMAND for second-trimester abortion, the new one addresses SUPPLY.

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