I take issue with Malcolm Potts and colleagues' contention that the “best way to prevent abortions is to invest heavily in accessible family planning” (Nature 542, 414; 2017). Counteracting socio-economic and gender inequalities is just as important.

From 1990 to 2014, the abortion rate declined in the developed world and remained relatively constant in the developing world, despite an increase in funding for contraception and family-planning services (G. Sedgh et al. Lancet 388, 258–267; 2016). Educating women and shifting social norms are as essential as improving access to contraception: only about 10% of women in the developing world who want to avoid pregnancy report being unaware of contraceptive methods, having inadequate access to them or finding the cost prohibitive (see go.nature.com/2okskfe).

Abortion may be a symptom of poverty. According to a 2014 census, 33.4% of the US population are in the low-income bracket (see go.nature.com/2ie6agn); this group accounts for 75% of abortions (see go.nature.com/2ns9qkj). One of the most common reasons given for seeking abortion is being unable to afford a child (M. Kirkman et al. Arch. Women's Ment. Health 12, 365–378; 2009). Furthermore, the high rate of sex-selective abortion in some parts of the world is driven by pejorative perceptions of women that are born out of gender inequality.