(typically, postponed). This statistical exercise helps provide an understanding of the consequences of current demographic patterns of unintended pregnancy and subsequent childbearing.

Abortion as a Consequence Of Unintended Pregnancy

As the Chapter 2 discussed, about half of all unintended pregnancies end in abortion. Accordingly, the occurrence of abortion can be seen as one of the primary consequences of unintended pregnancy. Voluntary interruption of pregnancy is an ancient and enduring intervention that occurs globally whether it is legal or not. The legalization of abortion in all of the United States, accomplished through the 1973 Supreme Court ruling Roe v. Wade, served in large part to replace illegal abortion (as well as abortion obtained outside of the United States) with legal abortion in this country. It is estimated that before the legalization of abortion, about 1 million abortions were being performed annually, few of them legally, and somewhere between 1,000 and 10,000 women died annually from complications following these often poorly performed procedures. Before the Supreme Court ruling, abortion was probably the most common criminal activity in this country, surpassed only by gambling and narcotics violations (Luker, 1984; Jaffe et al., 1981).

A 1975 report by the Institute of Medicine documented the benefits to public health by the legalization of abortion. The Supreme Court decision was followed not only by a decline in the number of pregnancy-related deaths in young women (Cates et al., 1978) but also by a decline in hospital emergency room admissions because of incomplete or septic abortions, conditions that are more common with illegally induced abortions (Institute of Medicine, 1975).

Given the long-standing reliance on abortion to resolve many unintended pregnancies, it is important to consider available information about the major medical and psychological risks that this procedure may pose (Centers for Disease Control and Prevention, Reproductive Epidemiology Unit, 1994; Frye et al., 1994; Lawson et al., 1994). From the voluminous data available for review, two important findings stand out that are often overlooked in the controversy over this procedure. First, whatever the risks associated with legal abortion in the United States, it remains a far less risky medical procedure for the woman than childbirth; over the 1979–1985 interval, for example, the mortality associated with childbirth was more than 10 times that of induced abortion (Council on Scientific Affairs, American Medical Association, 1992). Second, abortion in the first trimester of pregnancy carries fewer risks to health than abortion in the second trimester of pregnancy and beyond.

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