Legalized Abortion and the Public Health Report of a Study (1975) / Chapter Skim
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7. Contraception and Abortion
7. Contraception and Abortion
Pages 115-127
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From page 115... ...
Finally, there is a discussion of the effect of contraceptive counseling on post-abortion contraceptive use, and on the importance of providing contraceptive devices along with counseling services at the time of the abortion. The Substitution of Abortion for Contraception Because contraceptive practice and induced abortion share the common objective of regulating fertility and preventing unwanted births, it has been suggested that legalization of abortion could lead to a growing reliance on abortion rather than contraception to control fertility.Tj In the United States, only very limited data exist for an analysis of this substitution effect primarily because abortion has been widely available only since January 1973.
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From page 116... ...
The lowest mortality is incurred when legal abortion is used to back up failures of only moderately effective contraception (i.e., condom or diaphragm) , while a greater mortality accompanies the exclusive use of highly effective contraception (i.e., the pill or IUD)
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From page 117... ...
A similar comparative analysis of the medical complications associated with varying combinations of contraception and abortion is also possible, and clearly related to health. However, because of the extensive and somewhat inconclusive literature on medical complications associated with contraceptive use, this topic will not be addressed here.8/ Repeated Abortions as an Indicator of Substitution A more specific measure of the substitution of legal abortion for contraception use is the incidence of repeated abortions.
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From page 118... ...
And, since none of the current contraceptive methods is completely failure proof, nor likely to be used with maximum care on all occasions, there is a minimum level of repeated abortions that is expected to occur for reasons of contraceptive failure alone.10/ A recent study by Rovinsky (1972) of a group of 82 women seeking repeated legal abortions at a New York hospital between January and August 1971 attempted to classify the reasons for the additional unwanted pregnancies.
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From page 119... ...
In his review of the literature on contraceptive use prior to abortion, Lerner notes that most studies quote between 40 and 80 percent as the proportion of women obtaining abortions who were not using any means of contraception at the time they became pregnant.1^/ For example, a study of 1,022 women obtaining abortions at a proprietary hospital in a suburb of New York City in 1971-1972 found that only 46 percent of the sample had used any method of contraception during the prior 12 months.L4/ At the time of conception, less than 20 percent of the total sample was practicing any form of contraception.L5/ This unusually low figure is probably explained by the fact that the sample was disproportionately young and with no living children. Teenage Contraceptive Use Contraceptive use is closely related to age, in that younger women are less likely to have practiced contraception at al1, or if they have used some method, to have used it less carefully and consistently than older women.
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From page 120... ...
This lack of services for teenagers persists notwithstanding a June 1972 Gallup Organization national survey which indicated that nearly three-fourths of those questioned believed "professional birth control information, services and * As has been indicated above, many teenagers have chosen abortion to deal with unwanted pregnancy.
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From page 121... ...
For many, this interaction serves as the primary entry point into the system of fertility regulation, an entry otherwise denied them by virtue of relatively inaccessible or unavailable services. The Impact of Contraceptive Counseling Many facilities providing abortions offer some form of contraceptive counseling and, more importantly, supply contraceptive methods to their patients in order that they may avoid future unwanted pregnancies.
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From page 122... ...
abortions in New York City provides additional data on the effect of contraceptive counseling. In an examination of 355 women obtaining repeated abortions in the first half of 1972 at 12 of the 14 New York City municipal hospitals that were performing abortions, the authors found that nearly 90 percent of these women had received contraceptive counseling at the time of their previous abortion and, since then, had increased their use of contraception substantially (i.e.
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From page 123... ...
In 18 New York City freestanding clinics and 60 hospitals reporting data in 1972, only seven clinics and 31 hospitals provided comprehensive family planning services at no extra cost to their abortion patients. Four clinics and 13 hospitals had reduced programs, and an additional four clinics and three hospitals provided information only.
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From page 124... ...
"Two Years' Experience with a Liberal Abortion Law: Its Impact on Fertility Trends in New York City," Family Planning Perspectives 5: 41, Winter 1973.
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From page 125... ...
Arnold. "Abortion Programs in New York City: Services, Policies and Potential Health Hazards," The Milbank Memorial Fund Quarterly: Health and Society 52: 30, Winter 1974.
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From page 126... ...
"Contraception after Abortion," Family Planning Perspectives 6: 56-60, Winter 1974.
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