Legalized Abortion and the Public Health Report of a Study (1975) / Chapter Skim
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2. The Medical and Demographic Aspects of Legal Abortion in the United States
2. The Medical and Demographic Aspects of Legal Abortion in the United States
Pages 19-46
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From page 19... ...
who undergo legal abortion. It concludes with a discussion of the trend in illegal abortions in recent years, the extent to which legal abortions have replaced illegal abortions, and a short summary of the demographic effects of the legalization of abortion in the United States.
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Fertilization F rst Missed Period Pregnancy Tests Are Not Reliable Prior to 6th Week LMP i: i | I Men* 1 Suction No trual | Dilation & Standard Prostaglandin Saline Hysterotomy8 Hysterectomy3 i | laTon | Curetta9e I Method III 1 1 1 1 12 /\ 14 16 20 26 FIRST TRIMESTER SECOND TRIMESTER TIME IN WEEKS FROM LAST PERIOD a/ These two methods can also be used in the first trimester.
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(Dr. Elton Kesse1, director of the International Fertility Research Program at the University of North Carolina, found no pregnancy in two-thirds of women whose menstrual periods were five days late, nor in one-third who were two weeks late.2/ If a woman is pregnant and menstrual regulation does not completely empty the uterus, there is a risk of continuing pregnancy or prolonged bleeding.3/ *
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During 1972, 65 percent of the abortions were performed by suction, 23 percent by D&C, and 10 percent by the saline method.6/ During 1973, the percentage of abortions performed by suction increased to 74 percent while those performed by D&C declined to 13 percent; the percentage of abortions performed by saline remained at 10 percent.? / Characteristics of Abortion in the United States Most of the national data on legal abortion in this report were obtained from Abortion Surveillance Reports, published by the Center for Disease Control (CDC)
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1969 Number of states 8 from which statewide abortion data were reported a/ Additional states 2 7 7 8 26 from which abortion data are reported from individual hospitals or facilities Total Number of 10 24 25 28 51 states from which partial or complete abortion data are reported a/ Total Number of 22,670 193,491 485,816 586,760 615,831 abortions reported to CDC a/ Including the District of Columbia, beginning in 1970. Source: U.S.
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From page 24... ...
Although the Supreme Court decisions that legalized abortion in all 50 states were handed down in January, 1973, many states have not yet developed adequate reporting systems for channeling abortion data to their public health departments, which in turn report to CDC. Therefore, the number of abortions reported to CDC for 1973 (25 states reported statewide data)
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From page 25... ...
"Legal Abortions in the United States Since the 1973 Supreme Court Decisions," Family Planning Perspectives 7: 25 January/February 1975.
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From page 26... ...
The Supreme Court decisions did not necessarily increase the number of abortions; many of those obtained under non-restrictive abortion practices would earlier have been obtained illegally. Legalization of abortion and the establishment of reporting systems has caused them to become visible.
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From page 27... ...
. According to The Alan Guttmacher Institute survey, the number of abortions in New York during 1973 was 216,000, a decline of 83,000 from the 1972 figure of 299,900 reported by CDC.
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From page 28... ...
28 TABLE 3 Number of Reported Legal Abortions in 1972 and 1973, By State, and Legal Status of Abortion in 1972 1972 a/b/ 1972 c/ 1973 d/ 1973 e_/ Non-restrictive States Abortions Rates Abortions Rates Alaska 1,172 12.0 1,200 16.5 Hawaii 4,546 25.7 4,600 26.1 New York f/ 299,891 75.9 216,000 53.7 Washington 17,767 23.8 17,200 22.5 District of Columbia i/%J 38,868 207.9 44,500 233.4 Moderately Restrictive States Arkansas 793 2.0 1,100 2.8 California 138,584 30.6 143,400 30.7 Colorado 5,260 10.3 7,600 14.3 Delaware 1,342 10.8 2,000 15.6 Florida 3,378 i/ 2.4 23,600 16.4 Georgia 2,509 ~~ 2.4 11,000 10.3 Kansas t] 12,248 26.6 12,600 27.0 Maryland 9,093 10.1 11,100 11.8 New Mexico £/ 5,989 h/ 26.7 4,600 20.3 North Carolina 8,365 7.4 12,100 10.7 Oregon 7,143 15.7 8,000 17.4 South Carolina 854 1.5 2,200 3.6 Virginia 4,496 4.3 9,000 8.5 Restrictive States Alabama Arizona Connecticut Idaho Illinois Indiana Iowa Kentucky Louisiana Maine Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada 1,156 h/ 1.5 4,500 6.1 275 h/ .7 2,900 7.2 2,579 h/ 3.9 6,800 10.1 y 300 2.0 n/ 32,500 13.4 k/ 1,800 1.6 I/ 3,400 5.9 1 2,600 3.8 m/ m/ 600 3.5 3,394 J/ 2.8 14,100 11.5 k/ 37,200 18.6 k/ 7,600 9.2 61 .1 100 0.2 k/ 3,200 3.4 k/ 400 2.8 789 h/ 2.6 2,100 7.1 k/ 1,200 9.9
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From page 29... ...
Dryfoos. "Legal Abortions in the United States since the 1973 Supreme Court Decisions," Family Planning Perspectives 7:25 January/February 1975.
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From page 30... ...
Burr. "Abortions in the United States: Before and After the Supreme Court Decision,' paper presented at Twelfth Annual Meeting, Association of Planned Parenthood Physicians, Memphis, Tennessee, April 1974, pp.
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From page 31... ...
The largest number of abortions obtained by New York City residents, by facility, was the 40,246 abortions performed in the municipal hospitals. According to The Guttmacher Institute survey of clinics, hospitals, and private physicians, the public hospitals have been the slowest to respond to the mandate implied in the Supreme Court's decision.
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From page 32... ...
"Two Years Experience in New York City with the Liberalized Abortion Law - Progress and Problems," American Journal of Public Health 63: 526, June 1973.
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show that the age distribution for women obtaining abortions almost exactly parallels the distribution by age during 1972. FIGURE 6 Percent Distribution of Reported Legal Abortions by Age, Selected States, 1973^/ Less than 15 years 1.5% a/ There were 489,735 abortions, out of a total of 615,831, for which age was reported.
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From page 34... ...
In states with moderate or restrictive legislation prior to the Supreme Court decisions (Georgia, Maryland, North and South Carolina and Virginia) , many more white women tend to leave their state for an abortion than non-white women, thereby artifically lowering the abortion rates for white women.
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From page 35... ...
Of the 132,040 abortions provided to non-residents of New York City during the period July 1, 1971 to June 30, 1972, about 114,000 (86 percent) were obtained by white and Puerto Rican women, and only 14 percent by non-white women.
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From page 36... ...
This may have led historically to a greater reliance on illegal abortion as a method of birth contro1, which has continued to be reflected in the reported data on legal abort ion .JjJ/ A 1968 survey in North Carolina estimated that one conception in seven among white women resulted in an illegal abortion, compared with one out of three among black women.19/* If non-white women are more likely to resort to abortion but are less likely to take advantage of out-of-state abortion opportunities, it would appear that non-white women have easier access to legal abortion only when all legal obstacles to abortion are reduced in their home states.
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From page 37... ...
"The Effects of Legal Abortion on Legitimate and Illegitimate Birth Rates: The California Experience," Studies in Family Planning, New York: The Population Counci1, 1973, p.
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From page 38... ...
Tietze has calculated that 70 percent of the legal abortions obtained in New York City from July 1, 1970 to June 30, 1972 by resident women replaced illegal abortions which had previously taken place, and that the remainder was responsible for about one-half of the decline in live births that occurred between 1970 and 1972.26/ Other Demographic Effects of the Legalization of Abortion Although Tietze has argued that the predominant effect of the legalization of abortion has been a substitution of legal abortions for what otherwise would have been illegal abortions, he and other authors agree that there has been a demographic effect as wel1, namely that there has been a more rapid decline in the birth rate in states with non-restrictive abortion practices than in other states, and particularly in the rates of out-ofwedlock births.27/
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From page 39... ...
Again, this was the first decline since 1966 when records on legitimacy status began to be kept. Concomitant with this decline was an increase in the teenage abortion rate from 30.8 per 1,000 women aged 15-19 during July 1970-June 1971, to 41.2 per 1,000 in 1971-1972, an increase of 22.8 percent.3JV From a detailed analysis of the relationship between legal abortion and out-of-wedlock births in California since 1970, Sklar and Berkov have concluded that the availability of legal abortion was a significant factor in the decline in illegitimacy for California between 1970 and 1972.•32_/ A comparison of out-of-wedlock birthrates from 1965 to 1971 for the United States as a whole and for those states that had introduced less restrictive abortion legislation suggests that abortion may have had an immediate downward push on illegitimacy (Table 6)
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From page 40... ...
Source: June Sklar and Beth Berkov. "Teenage Family Formation in Postwar America," Family Planning Perspectives 6: 86, Spring 1974; and U.S.
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From page 41... ...
Infants with these characteristics have a greater risk of mortality than normal birth weight children.•35_/ Although it should be possible to prove an effect of increased frequency of teenage abortions on the total proportion of newborns weighing less than 2,500 grams, the data to analyze this issue are not now available to the study group. However, there are data on overall infant mortality rates for the United States and selected states with non-restrictive abortion practices during part of that period.
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From page 42... ...
An examination by race shows that 73 percent of the women obtaining abortions were white and 27 percent were black or of other nonwhite origins, although in 1972 non-white women had legal abortion rates more than twice as great as those of white women. A national survey of abortion providers conducted by The Alan Guttmacher Institute in 1974 provides comprehensive data on the number of abortions performed in the U.S.
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From page 43... ...
Similarly, legalization of abortion has not been shown to result in a dramatic reduction in infant mortality. However, no final conclusions on the causal relationship between non-restrictive abortion legislation and the trend in out-of-wedlock births or infant mortality rates can be drawn at this time.
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From page 44... ...
"Legal Abortions in the United States Since the 1973 Supreme Court Decision," Family Planning Perspectives,7: 3, January/February, 1975.
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From page 45... ...
"Teenage Family Formation in Postwar America," Family Planning Perspectives 6: , Spring 1974; Sklar and Berkov, Science: 909-915; and Jean Pakter and Frieda Nelson. "Factors in the Unprecedented Decline in Infant Mortality in New York City," Bulletin of the New York Academy of Medicine 2nd series, July-August 1974.
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From page 46... ...
"The Effects of Legal Abortion on Legitimate and Illegitimate Birth Rates: The California Experience," Studies in Family Planning New York: The Population Counci1, 1973, pp.
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