abort slides

8/2/2019 Abort Slides

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An Overview of Abortion

in the United States

Guttmacher Institute August 2011


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Objectives

Provide an overview of unintended pregnancy andabortion 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 provision of and access to abortion services.

Provide a comparative international perspective on

abortion.


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Incidence of UnintendedPregnancy and Abortion


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Pregnancies in the United States(Approximately 6.7 Million in 2006)

51 49

0

20

40

60

80

100

UnintendedIntended

% of pregnancies


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Outcomes of Unintended Pregnancies

(Approximately 3.2 Million in 2006)

43 57

0

20

40

60

80

100

Abortions Births

% of unintended pregnancies (excluding miscarriages)


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Incidence of Abortion

In 2008, some 1.21 million pregnancies wereterminated by abortion in the United States.

Almost 2% of all women aged 1544 had anabortion in 2008.

Abortion is one of the most common surgicalprocedures in the United States.


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Abortion Rates Among WomenAged 1544

0

5

10

15

20

25

30

1973 1978 1983 1988 1993 1998 2003 2008

Abortions per 1,000 women


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Gestational Age


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Abortions Overwhelmingly OccurEarly in Pregnancy

62

179 7

3 20

20

40

60

80

100


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Incidence of EarlyMedication Abortion, 2008

Early medication abortion accounted for 17%(199,000) of all nonhospital abortions, an increasefrom 6% in 2001.

An estimated one-quarter of eligible abortions (thoseperformed up to nine weeks) were early medicationabortions.

Fifty-nine percent of all known providers offer this

service, compared with 33% in early 2001.*

*Mifepristone was approved by the US Food and Drug Administration for use in earlymedication abortion in September 2000.


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Reasons for Abortions


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Most Important Reasons Given forTerminating an Unwanted Pregnancy

Concern for/responsibility to other individuals 74%

Cannot afford a baby now 73%

A baby would interfere with school/

employment/ability to care for dependents 69%

Would be a single parent/

having relationship problems 48%

Has completed childbearing 38%


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Reasons for Abortions After16 Weeks Since Last Menstrual Period

Did not recognize the pregnancy 71%

Had difficulty making arrangements for abortion 48%

Was afraid to tell parents or partner 33%

Needed time to make decision 24%

Hoped relationship would change 8%

Was pressured not to have abortion 8%

Something changed during pregnancy 6%

Did not know timing was important 6%Did not know abortion was an option 5%

Fetal abnormality was diagnosed late 2%

Other 11%


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Safety of Abortion


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Abortion Is Safer the Earlier inPregnancy It Is Performed

0.1 0.2 0.4

1.7

3.4

8.9

0.6

7.1

0

2

4

6

8

10


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Causes of Abortion-Related Deaths

27

24

17 16 15

0

20

40

60

80

100

Infection Hemorrhage Embolism Anesthesia Other

% of deaths


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Long-Term Safety of Abortion

First trimester abortions pose virtually no risk of

Infertility

Ectopic pregnancy

Miscarriage

Birth defect

Preterm delivery or low birth weight

Abortion is not associated with breast cancer.

Abortion does not pose a hazard to womensmental health.


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Who Has Abortions


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Disparities in Unintended Pregnancyand Abortion Are Increasing

The overall U.S. unintended pregnancy rateremained stagnant between 2001 and 2006.

Unintended pregnancy has increasedby 10%

among poor women while decreasing14%among higher-income women between 2001and 2006.


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Poor30%

Poor16%

Poor Women Account for a DisproportionateShare of Unintended Pregnancies

Women at risk of unintendedpregnancy

Unintended pregnancies by womenspoverty status


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42%

27%

14%

17%


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Black Women Account for a DisproportionateShare of Unintended Pregnancies

Black14% Black

26%

Women at risk of unintendedpregnancy

Unintended pregnancies by womens

racial status

Hi i W Al A t f


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Hispanic Women Also Account for aDisproportionate Share of Unintended

Pregnancies

Hispanic,14%

Hispanic,22%

Women at risk of unintended

pregnancy

Unintended pregnancies by womens

ethnic status


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And Both Groups Are OverrepresentedAmong Abortion Patients

Non-Hispanicwhite, 36%

Non-Hispanicblack, 30%

Non-Hispanicother, 9%

Hispanic, 25%


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Women in Their 20s Make Up theMajority of Abortion Patients


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Nearly Half of Abortions Are Obtainedby Never-Married Women

Married, 15%

Cohabiting,

not married,29%

Never-married,not cohabiting,

45%

Previouslymarried, notcohabiting,

11%


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Most Women Obtaining AbortionsReport a Religious Affiliation

Protestant,37%

RomanCatholic, 28%

Other, 7%

None, 28%


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Six in 10 Women Having Abortions AreAlready Mothers

Previousabortion, 13%

Previousabortion and

previousbirth, 37%

Previousbirth, 24%

Neither, 26%


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Who Provides Abortion Services


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Percentage of Abortions Performed byEach Type of Provider

0

20

40

60

80

100

1980 1984 1988 1992 1996 2000 2004 2008

Abortion clinic Other clinic Hospital Physician's office

% of abortions


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Number of Providers by Type

0

200

400

600

800

1,000

1,200

1,400

1,600

1980 1984 1988 1992 1996 2000 2004 2007

Abortion clinic Other clinic Hospital Physician's office

No. of providers


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Facilities Providing Only MedicationAbortion Had a Significant Impact

A minimum of 164 providers, or 9%, offered onlyearly medication abortion in 2008; most werenonspecialized clinics or physicians offices with

small abortion caseloads.

The use of medication abortion, particularly byproviders who do not offer surgical abortion, has

slowed the decline in providers seen in previousyears.


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Factors Contributing to the Decline in

the Number of Abortion Providers

Antiabortion harassment and violence

Social stigma/marginalization

Professional isolation/peer pressure

The graying of providers

Inadequate economic/other incentives

Lack of medical training opportunities

Percentage of Providers of 400 or More


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Percentage of Providers of 400 or MoreAbortions per Year Who

Reported Harassment in 2008

Picketing 88%

Picketing with physical

contact with patients 37%

Vandalism 19%

Picketing homes of staff members 7%

Bomb threats 5%

Patient pictures posted on the Internet 5%


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Factors That Make It DifficultFor Women to Obtain

Abortion Services


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Percentages of Counties with No Provider andof Women Living in Those Counties

0

20

40

60

80

100

1978 1983 1988 1993 1998 2003 2008

Unserved counties Women in unserved counties


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State Restrictions on Abortion

Parental consent or notificationfor minors 36 states

Mandatory counseling 34 states

Waiting periods 24 states

State Policies on


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State Policies onMedicaid Coverage of Abortion

State pays for all or most medicallynecessary abortions

State does not pay for abortion


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State Policies on Private InsuranceCoverage of Abortion

Prohibit coverage except in cases of lifeendangerment

Prohibit coverage except in cases of lifeendangerment, rape or incest

Restrict abortion coverage only in plans thatwill be offered through the state exchanges


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International Perspectiveon Abortion


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Abortion has declined worldwide

0

10

20

30

40

50

60

1995 2003 1995 2003 1995 2003

World Moredevelopedcountries

Less developedcountries

3529 29

39

26

34

Abortions per 1,000 women aged 1544

Th L l S f Ab i D


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The Legal Status of Abortion DoesNot Predict Its Incidence

The lowest abortion rates in the worldlessthan 10 per 1,000 women of reproductiveageare in Europe, where abortion is legaland available.

By contrast, in Africa and in Latin America

and the Caribbean, where abortion law ismost restrictive, the regional rates are 29and 31 per 1,000 women, respectively.


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20 Million Unsafe AbortionsOccur Each Year

0 10 20 30 40

Developingcountries

Developedcountries

World

Annual abortions per 1,000 women 1544

Safe abortions Unsafe abortions


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Complications of Unsafe Abortion

An estimated five million women are hospitalizedeach year for treatment of abortion-relatedcomplications, such as hemorrhage and sepsis.

Complications from unsafe abortion proceduresaccount for 13% of maternal deaths, or 67,000per year.

Approximately 220,000 children worldwide losetheir mothers every year because of abortion-related deaths.

Al All Ab i R l d D h


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Almost All Abortion-Related DeathsOccur in Developing Countries

10

350

650

300

500

100

200

300

400

500

600

700

Developedcountries

Developingcountries

Africa Asia Latin America& Caribbean

Deaths per 100,000 unsafe abortions, 2003

Ch i Ab ti L B t


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Changes in Abortion Law Between1995 and 2007

Seventeen countries liberalized their laws toincrease access to safe abortion: Albania, Benin,Bhutan, Burkina Faso, Cambodia, Chad,

Colombia, Ethiopia, Guinea, Mali, Nepal,Portugal, Saint Lucia, South Africa, Swaziland,Switzerland and Togo.

Three countries tightened restrictions on abortion:El Salvador, Nicaragua and Poland.


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Summary Points

I id f P d Ab ti


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Incidence of Pregnancy and Abortion

in the United States

Women in all social, economic and demographicgroups experience unintended pregnancies.

Certain groups of womenpoor, cohabiting, andminority women; those aged 1824; and those withone previous birthare at greater risk ofunintended pregnancy than are others.

Almost half of all pregnancies are unintended.

About four in 10 unintended pregnancies end in

abortion.

Wh H Ab ti Wh d


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Who Has Abortions, Why andWhen in Pregnancy

Disadvantaged women bear a disproportionateburden of unintended pregnancies and abortions.

The most frequent reasons women give are thathaving a child or another child would limit theirability to meet current responsibilities and that theycannot afford a child at this point in their lives.

Almost 90% of abortions occur in the firsttrimester.


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Safety of Abortion

Abortion is one of the safest common surgicalprocedures for women in the United States.

Abortion is safe over the long term and carrieslittle or no risk of fertility-related problems, canceror psychological illnesses.

Laws criminalizing abortion make abortionsunsafe, but do not eliminate them.


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Provision of and Access toAbortion Services

Most abortions occur in abortion clinics.

Many women have to travel long distances to find

a provider, which can pose significant problems forthose with limited resources, or work or familyresponsibilities.

Obstacles to Obtaining


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Obstacles to ObtainingAbortion Services

Although most women obtain abortions early in pregnancy,some women face substantial obstacles to access.

Nearly four in 10 women of reproductive age receive coverageunder Medicaid, yet 32 states allow Medicaid funding forabortion only in cases of rape, incest or life endangerment.

Lacking insurance coverage, poor women often require time to

find the money to pay for an abortion, if they are able to at all. Legal requirements such as parental consent for minors or

waiting periods are likely to cause further delays, increasing therisk of complications.


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International Perspective on Abortion

A very small proportion of abortionsworldwide take place in the United States.

Most unsafe abortions occur in countries

where abortion is illegal.


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About Guttmacher

The Guttmacher Institute is a nonprofitorganization that advances sexual andreproductive health worldwide throughresearch, policy analysis and public

education.

For more information about Guttmacher,please click here.

Read our report Abortion in WomensLives here.
http://www.guttmacher.org/http://www.guttmacher.org/pubs/2006/05/04/AiWL.pdfhttp://www.guttmacher.org/pubs/2006/05/04/AiWL.pdfhttp://www.guttmacher.org/

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