Do Abortion and Hormonal Contraception Explain Family Size Decline?
The number of children born per woman fell steadily from 1800 to 1920 to 1930, when the number reached a little over two per woman. After that, the number falls in line with child mortality rates.
Note: This is part one of a two-part series.
What can be learned from examining the fertility decline from 1800 to today?
What can we learn from declining family size in a bigger picture than 1950 to the present?
What effect did abortion legalization, hormonal contraception have on the fertility rate?
Do policies like the “Global Gag Rule” that restricts funding to global health services to organizations that agree not to discuss abortion with women?
We’re about to find out—so here we go.
Abortion, Hormonal Contraception Unrelated to Fertility Decline
The number of children born per woman fell steadily from 1800 to 1920 to 1930, when the number reached a little over two per woman. After that, the number falls in line with child mortality rates, excepting “boom” periods following rare circumstances like war.
1800’s-era American women birthed an average of six or seven children--higher than women in Europe at the time. Child mortality in the US was also greater than in Europe; not many children weren’t dying there. Parents in the US saw nearly half of their children die before the age of five.
Fertility Decline Similar in Despite Legal, Cultural Differences
If a woman had six or seven children, she might reasonably expect to see three become adults. The difference between Europe and the US may further support that child mortality is the primary determinant in children born to women.
What Today Can Show Us About the Past
In 1800, development in Europe had a centuries-long head start on the US, and more children died in the US, child-for-child. That alone would not show the two are linked. Looking at what affects mortality can provide more clues.
Children born in a “developed” country are more likely to survive today.
Even within the US, people who live farther away from healthcare, mostly rural citizens, are more likely to suffer preventable death.
Nearly half of counties in the present-day United States are without an OB-GYN. Areas where women don’t have access to testing for conditions like cervical cancer—ordinarily very treatable with an over 90% 5-year survival rate—die instead.
Shortages of pediatricians are just as dire, and it costs lives today.
The CDC reported in 2019 that potentially preventable deaths from the five leading causes are consistently higher in rural counties.
While not an identical situation, we know that limited access to experienced healthcare providers means preventable deaths. That was almost certainly the case in the 1800s too.
The drop in the number of children born to American women, and women in several other developed countries, shows no relation to hormonal contraception, legalization or restriction of abortion, or religious pronouncement. On the contrary, decline preceded all three by decades.
The US fertility rate dropped below three children per woman from 1926 to 1946, conflicting with cultural wisdom that asserts everyone had large families before the modern era.
Fertility Decline Similar in Despite Legal, Cultural Differences
Fertility rates in the US and peer countries were remarkably similar despite differences in abortion access, regulation, religious composition, income, geography, and many other differences. A general decline of child mortality was the shared variable to which fertility rates responded.
Fertility Rate (202 Countries) Vs Child Mortality (185 Countries)
Countries differ in abortion access, cultural norms, and attitudes about family planning. We might have expected different countries to respond to policies in-country. Largely, that appears not to be the case.
The evidence taken together shows that the number of children born to a woman increases when child mortality increases and falls when child mortality falls.
Following World War II, countries involved in or affected by the war saw a “baby boom,” like the US. However, these boom periods ended relatively the same time frame, and countries returned to the pre-war low that appeared in the early 1900s after a century of consistent decline.
The Tragedies Hidden by Rose-Colored Glasses
Records from the 17th and 18th centuries show it was relatively common for a family to have as many as 10 to 12 children but have four or fewer make it to adulthood. In addition, many families consisted of a man who had two or three wives, one after the other, because complications in pregnancy or labor were a major killer of women and still are in some parts of the world.
In some of the oldest cemeteries in the US, one will frequently see two or three headstones for women—one or two of which died in childbirth, a headstone for a man, and many, many nameless smaller stones or tiles. What drove this phenomenon in cemeteries appears to be that which drove the changes in family and societal structures today.
Take Mary and John Evelyn, who lost their first child in 1658, for example. They would go on to have eight children in total. Seven died before adulthood. The strain this placed on a family was extreme, and just as today, parents mourned.
“Here ends the joy of my life...5 years and 3 days old onely, but at that tender age a prodigy for witt and understanding; for beauty of body a very angel; for endowment of mind of incredible and rare hopes.”
Diary of John Evelyn,1641 to 1705-6
Another couple: English barrister William Brownlow and Elizabeth Duncombe, had 19 children, an impressive number even in their time.
The English politician and barrister William Brownlow and his wife Elizabeth Duncombe had 19 children together. Thirteen of them died. Some periods of their life were particularly tragic: in just eight years between 1638 and 1646 they had seven children. All of them – Thomas, Francis, Benjamin, George, James, Maria, and Anne – died in a row.
The parents’ heartbreak is obvious from William’s diary records: when George, their fifteenth child, died in 1842 his father wrote, “Thou O God hast broken me asunder and shaken me to pieces.”
--Max Roser, 2019
Idealizing large families while ignoring the tragedy that underpinned them is to forget the many children who never got to live. Tremendous suffering was seemingly everywhere in records from the 1800s and backward. At times, as in outbreak, one gets the impression that society was arrested in collective grief.
Regardless of how society viewed the role of women, the tremendous emotional and physical strain placed on them, women like Elizabeth Duncombe, who had 19 children, including seven who died one after the other, likely prevented women from participating in civil society.
Having more children than could easily be cared for wasn’t necessarily because people could do nothing to prevent pregnancy. Instead, it seems to be an outward sign acknowledging that a grim fate that awaited many children.
Our Fertility Rate Reflects Our Exceptional Fortune
When child mortality fell, so too did the fertility rate. This can be seen in country after country, except boom periods reflecting an extraordinary circumstance in society.
Today, we have smaller families, not because of hormonal contraception or abortion, but because we can reasonably expect to see our children to adulthood. Women’s rights and feminism are not the cause of smaller families, as some assert.
Rather, smaller families are the consequence of children living, which left women the potential to pursue other interests. A woman no longer has to have eight children to see one survive like Mary Evelyn of the 17th century. In that case, she has time to participate in society and rectify the inequalities she could not have in the past. Large families in that time were not the norm—they were a privilege because most families that had many babies ended with a few adults.
Seeing all of one’s children to adulthood was something about which people in the past could only dream. As a result, our fertility rates, and the societal changes that followed, reflect our exceptional fortune.
The past was a time when women's bodies were consumed with near-constant pregnancy and caring for children whom they loved but knew would not survive. They buried their hearts and resolved to try again and again, knowing the results could be the same.
To portray that as idyllic, often as a way to explains one's preference for "traditional" society without overt sexism, is to—unwittingly or not—yearn for a time when women and children died.
