abortion

An Overview of Abortion in the United States: 

An Overview of Abortion in the United States Developed by Physicians for Reproductive Choice and Health® (PRCH) and The Alan Guttmacher Institute (AGI) © October 2001

Objectives: 

Objectives · Provide an overview of unintended pregnancy and abortion in the United States. · Review the incidence of pregnancy and abortion. · Identify who has abortions, why and when in pregnancy. · Review the safety of abortion. · Discuss the provision of and access to abortion services. · Provide a comparative international perspective on abortion.

Incidence of Pregnancy and Abortion: 

Incidence of Pregnancy and Abortion

Pregnancies in the United States(Approximately 6.3 Million Annually): 

Pregnancies in the United States (Approximately 6.3 Million Annually) Unintended Intended Source: Henshaw, 1998a (1994 data)

Slide5: 

Unintended Pregnancies (Approximately 3.0 Million Annually) Source: Henshaw, 1998a (1994 data)

Incidence of Abortion: 

Incidence of Abortion · Each year, about 1.3 million pregnancies are terminated by abortion in the United States. · Some 2.2% of all women aged 15–44 had an abortion in 1997. · Abortion is one of the most common surgical procedures in the United States. · By age 20, 1 in 7 women have had at least one abortion; by age 45, 4 in 10 have done so. Source: AGI 2001b; Henshaw, 1998a

Annual Number of Abortions Per 1,000 Women Aged 15–44 : 

Annual Number of Abortions Per 1,000 Women Aged 15–44 Source: Henshaw, 1998b

Slide8: 

Abortion Rates in Western Industrialized Countries Source: Henshaw et al., 1999a (1996 data)

Reasons for Abortions: 

Reasons for Abortions

Most Important Reason Given for Terminating an Unwanted Pregnancy: 

Most Important Reason Given for Terminating an Unwanted Pregnancy Inadequate finances 21% Not ready for responsibility 21% Woman’s life would be changed too much 16% Problems with relationship; unmarried 12% Too young; not mature enough 11% Children are grown; woman has all she wants 8% Fetus has possible health problem 3% Woman has health problem 3% Pregnancy caused by rape, incest 1% Other 4% Average number of reasons given 3.7 Source: Torres and Forrest, 1988 (1987 data)

Gestational Age: 

Gestational Age

Abortions by Gestational Age(Weeks Since Last Menstrual Period): 

Abortions by Gestational Age (Weeks Since Last Menstrual Period) Source: Koonin et al., 2000 (1997 data)

Reasons for Abortions After 16 Weeks from Last Menstrual Period: 

Reasons for Abortions After 16 Weeks from Last Menstrual Period Woman did not realize she was pregnant 71% Difficulty making arrangements for abortion 48% Afraid to tell parents or partner 33% Needed time to make decision 24% Hoped relationship would change 8% Pressure not to have abortion 8% Something changed during pregnancy 6% Didn’t know timing was important 6% Didn’t know she could get an abortion 5% Fetal abnormality diagnosed late 2% Other 11% Average number of reasons given 2.2 Source: Torres and Forrest, 1988 (1987 data)

Safety of Abortion: 

Safety of Abortion

Deaths per 100,000 Abortions or Births: 

Deaths per 100,000 Abortions or Births Source: Gold 1990 (1981–1985 data)

Percentage Distribution of Abortion Deaths: 

Percentage Distribution of Abortion Deaths Source: Lawson et al., 1994 (1983–1987 data)

Abortion Risks in Perspective: 

Abortion Risks in Perspective Chance of death Risk from terminating pregnancy: per year: Before 9 weeks 1 in 500,000 Between 9 and 10 weeks 1 in 300,000 Between 13 and 15 weeks 1 in 60,000 After 20 weeks 1 in 8,000 Risk to persons who participate in: Motorcycling 1 in 1,000 Automobile driving 1 in 5,900 Power- boating 1 in 5,900 Playing football 1 in 25,000 Risk to women aged 15–44 from: Having sexual intercourse (PID) 1 in 50,000 Using tampons 1 in 350,000 Source: Gold, 1990; Hatcher, 1998

Who Has Abortions: 

Who Has Abortions

Who Has Abortions: Age: 

Who Has Abortions: Age Source: Ventura et al., 2001 (1997 data)

Who Has Abortions: Marital Status: 

Who Has Abortions: Marital Status Source: Henshaw and Kost, 1996 (1995 data)

Who Has Abortions: Family Income: 

Who Has Abortions: Family Income Source: Henshaw and Kost, 1996 (1995 data)

Who Has Abortions: Race/Ethnicity: 

Who Has Abortions: Race/Ethnicity Source: Ventura et al., 2001 (1997 data) *Non-Hispanic

Who Has Abortions:Religious Identification: 

Who Has Abortions: Religious Identification Source: Henshaw and Kost, 1996 (1995 data)

Who Has Abortions: Number of Prior Abortions: 

Who Has Abortions: Number of Prior Abortions Source: AGI, 2001a (1997 data)

Who Provides Abortion Services: 

Who Provides Abortion Services

Percent of Abortions Performed by Each Type of Provider: 

Percent of Abortions Performed by Each Type of Provider Source: Henshaw, 1998b

Number of Providers by Type: 

Number of Providers by Type Source: Henshaw, 1998b

Factors Contributing to the Decline in Number of Abortion Providers: 

Factors Contributing to the Decline in Number of Abortion Providers Antiabortion harassment and violence Social stigma/marginalization Professional isolation/peer pressure The “graying of providers” Inadequate economic/other incentives The perception of abortion as an unexciting field of medicine Source: NAF & ACOG, 1991

Factors That Make It Difficult For Women to Obtain Abortion Services: 

Factors That Make It Difficult For Women to Obtain Abortion Services

Percentage of Counties with No Provider And % of Women Living in Those Counties: 

Percentage of Counties with No Provider And % of Women Living in Those Counties Source: Henshaw, 1998b

Medicaid Coverage of Abortion: 

Medicaid Coverage of Abortion States that cover abortion under Medicaid for reasons beyond rape, incest and life endangerment, as of September 2001: Alaska Minnesota California Montana Connecticut New Jersey Hawaii New Mexico Idaho New York Illinois Oregon Indiana Vermont Maryland Washington Massachusetts West Virginia Source: AGI, 2001b

Percentage of Providers of 400 or More Abortions Per Year Who HaveReported Harassment: 

Percentage of Providers of 400 or More Abortions Per Year Who Have Reported Harassment Picketing 78% Picketing with physical contact with patients 32% Vandalism 24% Picketing homes of staff members 18% Bomb threats 18% Source: AGI, 2001b (1996 data)

State Restrictions on Abortion: 

State Restrictions on Abortion Parental consent or notification required for minors 32 states Mandatory delay and state-directed counseling 17 states Limitations on private insurance coverage for abortion 5 states Source: AGI, 2001b (2001 data)

International Perspective on Abortion: 

International Perspective on Abortion

U.S. Share of Abortions Worldwide: 

U.S. Share of Abortions Worldwide Source: Henshaw et al., 1999b (1995 data)

Abortion Rate, United States and World: 

Abortion Rate, United States and World Source: Henshaw et al., 1999b (1995 data)

Abortion in Developed and Developing Countries: 

Abortion in Developed and Developing Countries Source: Henshaw et al., 1999b (1995 data)

Many Abortions Occur in Countries Where Abortion Is Illegal Under Most Circumstances: 

Many Abortions Occur in Countries Where Abortion Is Illegal Under Most Circumstances Source: Henshaw et al., 1999b (1995 data) Illegal Legal

Percentage of Maternal Mortality Worldwide Due to Unsafe Abortion: 

Percentage of Maternal Mortality Worldwide Due to Unsafe Abortion Source: WHO, 1998 (Estimates for 1995–2000) Unsafe abortion Other causes

Summary Points: 

Summary Points

Incidence of Pregnancy and Abortion:: 

Incidence of Pregnancy and Abortion: · Unintended pregnancy and abortion are common among all groups of women. · Almost half of all pregnancies are unintended. · Roughly 40% of unintended pregnancies end in abortion.

Who Has Abortions, Why and When in Pregnancy:: 

Who Has Abortions, Why and When in Pregnancy: · Women having abortions are predominantly young, single, white and of modest means. · Most women have multiple reasons for choosing to have an abortion. · Almost 90% of abortions occur in the first trimester.

Safety of Abortion:: 

Safety of Abortion: · Abortion is one of the safest surgical procedures for women in the United States. · Laws criminalizing abortion make abortions unsafe but do not eliminate them. In developing countries, where abortion is often illegal or highly restricted, abortion mortality rates are hundreds of times higher than rates in developed countries.

The Provision of and Access to Abortion Services:: 

The Provision of and Access to Abortion Services: · Most abortions occur in abortion clinics. · A steady decline in providers in the last two decades has left the majority of counties in the United States with no known provider. · Many of the difficulties in providing and obtaining access to abortion would disappear if the procedure were integrated with other health care services.

International Perspective on Abortion:: 

International Perspective on Abortion: A very small proportion of abortions worldwide take place in the United States. · Most unsafe abortions occur in countries where abortion is illegal.