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Abortion in the United States

Abortion in the United States. US Public Opinions about Abortion. Incidence of Pregnancy and Abortion. Pregnancies in the United States (Approximately 6.3 Million Annually). % of Pregnancies. Intended. Unintended. Source: Henshaw, 1998 (1994 data).

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Abortion in the United States

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  1. Abortion in the United States

  2. US Public Opinions about Abortion

  3. Incidence of Pregnancy and Abortion

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

  5. Outcomes of Unintended Pregnancies(Approximately 3.0 Million Annually) % of Unintended Pregnancies Source: Henshaw, 1998 (1994 data)

  6. Incidence of Abortion • In 2002, 1.29 million pregnancies were terminated by abortion in the United States. • Some 2.1% of all women aged 15–44 had an abortion in 2001. • Abortion is one of the most common surgical procedures in the United States. Source: Finer and Henshaw, 2005

  7. Abortion Rates Among Women Aged 15–44 Abortions per 1,000 women Source: Finer and Henshaw, 2005

  8. Abortion Rates in Western Industrialized Countries Abortions per 1,000 women Source: Finer and Henshaw, 2005; Henshaw et al., 1999 (1996 data)

  9. Reasons for Abortions

  10. 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)

  11. Gestational Age

  12. Abortions by Gestational Age(Weeks Since Last Menstrual Period) % of Abortions Weeks Source: Strauss et al., 2004 (2001 data)

  13. Reasons for Abortions After 16 Weeks Since 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)

  14. Methods of Abortion I. Suction Methods A. Endometrial Aspiration 1. Performed 4-6 weeks after LMP 2. Use of flexible tube 3. May be done without pregnancy confirmation 4. Side effects may include cramps & intermittent menstrual bleeding

  15. Methods of Abortion I. Suction Methods (continued) B. Early Abortion 1. Same as A. only pregnancy confirmed C. Vacuum Curretage 1. Performed after 8 weeks 2. Larger fetal tissue 3. Use of rigid tube with more suction 4. Dilation of cervix is required

  16. Methods of Abortion I. Suction Methods (continued) D. Dilation and Evacuation 1. Performed 13-16 weeks 2. Fetus is broken up with surgical instrument prior to suction 3. More dilation is needed

  17. Methods of Abortion II. Surgical Removal Through Cervix A. Dilation and Curretage 1. Performed 8-15 weeks 2. Lining of uterus is scraped with surgical instrument

  18. Methods of Abortion III. Induced Labor A. Saline Abortion 1. Performed early to middle parts of 2nd trimester 2. Saline injected into Amniotic sac (kills fetus)

  19. Methods of Abortion IV. Surgical Removal Through Caesarean Procedure A. Hysterotomy

  20. Safety of Abortion

  21. Deaths per 100,000 Abortions or Births Deaths per 100,000 Sources: Birth: Henshaw, 2004 (1995–1997 data); Abortion: Bartlett et al., 2004 (1988–1997 data)

  22. Abortion Risks in Perspective Chance of death Risk from terminating pregnancy: per year: Before 9 weeks 1 in 1,000,000 Between 9 and 10 weeks 1 in 500,000 Between 13 and 15 weeks 1 in 60,000 After 20 weeks 1 in 11,000 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: Bartlett et al., 2004 (1988–1997 data)

  23. Who Has Abortions

  24. Who Has Abortions: Age Source: Jones et al., 2002

  25. Who Has Abortions: Marital Status Source: Jones et al., 2002

  26. Who Has Abortions: Economic Status In 2007 the Federal Poverty Level was $11,750 per fear for one person Source: Jones et al., 2002

  27. Who Has Abortions: Race/Ethnicity *Non-Hispanic Source: Jones et al., 2002

  28. Who Has Abortions:Religious Identification Source: Jones et al., 2002

  29. Who Has Abortions: Prior Pregnancies Source: Jones et al., 2002

  30. Who Provides Abortion Services

  31. Number of Providers by Type Number of Providers Source: Finer and Henshaw, 2003

  32. Factors Contributing to the Decline in the Number of Abortion Providers • Antichoice harassment and violence • Social stigma/marginalization • Professional isolation/peer pressure • The “graying of providers” • Inadequate economic/other incentives • Lack of medical training opportunities Source: NAF & ACOG, 1991

  33. Factors That Make It Difficult For Women to Obtain Abortion Services

  34. Percentage of Counties with No Provider And % of Women Living in Those Counties Source: Finer and Henshaw, 2003

  35. Percentage of Providers of 400 or More Abortions Per Year Who HaveReported Harassment in 2000 Picketing 80% Picketing with physical contact with patients 28% Vandalism 18% Picketing homes of staff members 14% Bomb threats 15% Source: Henshaw and Finer, 2003

  36. Legal Restrictions on Abortion

  37. Federal Laws & Policies about Abortion • Hyde Amendment - 1977 • Freedom of Access to Clinic Entrances Act - 1994 • Federal Health Benefits Program

  38. State Laws about Abortion • In 1992, the US Supreme Court upheld the right to abortion in Planned Parenthood v. Casey. However, the ruling significantly weakened the legal protections previously afforded women and physicians by giving states the right to enact restrictions that do not create an "undue burden" for women seeking abortion.

  39. Stenberg v. Carhart, 530 U.S. 914 (2000) • US Supreme Court overturned a Nebraska statute banning "partial-birth abortion." • Court found that the ban would outlaw the safest and most commonly used methods of second-trimester abortion, and therefore constituted an undue burden on women’s right to obtain abortions. • "the absence of a health exception will place women at an unnecessary risk of tragic health consequences."

  40. Federal Laws in the Works • Despite that ruling, Congress passed an almost identical ban on so-called “partial birth abortion” that was signed into law by President George W. Bush on November 5, 2003. • Also on November 5, 2003, minutes after Bush signed it into law, a Nebraska federal judge issued a temporary restraining order preventing the first-ever federal abortion ban from being enforced against the plaintiffs in the Nebraska lawsuit challenging the ban. • Three Federal Courts in New York, California, and Nebraska have struck down this law as unconstitutional. In January of 2006, 2 Federal Appeals Courts upheld these rulings. • On November 8, 2006 the U.S. Supreme Court heard arguments in two challenges to the Federal Abortion Ban, also known as the "Partial-Birth Abortion Ban Act of 2003." In both the Center for Reproductive Rightsﾕ case (Gonzales v. Carhart) and Planned Parenthoodﾕs case (Gonzales v. Planned Parenthood), appellate courts declared the ban unconstitutional citing previous law established over the last thirty years.

  41. APRIL 2007 • With Bush-appointed judges Alito and Roberts, Supreme Court upholds the Federal partial birth abortion ban in a 5-4 decision.

  42. STATES ENACTED 52 LAWS RESTRICTING ABORTION IN 2005 • Of the 195 state-level abortion restrictions adopted since 2000, one-quarter were enacted in 2005 alone.

  43. State Laws Restricting Abortion • Twenty-nine states mandate that a woman seeking an abortion be given counseling including information intended to discourage her from obtaining the procedure; • 24 states require a woman seeking an abortion to wait a specified period of time, usually 24 hours, between when she receives counseling and when the procedure is performed.

  44. State Laws Restricting Abortion • Thirty-three states and the District of Columbia prohibit the use of public funds to pay for abortion for low-income women, even when it is medically necessary, generally making exceptions only in cases of life endangerment, rape or incest. Only 17 states use their own funds to pay for all or most medically necessary abortions for Medicaid enrollees. • Thirty-four states require some type of parental involvement in a minorﾕs decision to have an abortion: Twenty-one states require one or both parents to consent to the procedure, while 13 require that a parent be notified.

  45. February 22, 2006:South Dakota lawmakers approved the nation's most far-reaching ban on abortion The measure, which passed the state Senate 23 to 12, makes it a felony for doctors to perform any abortion, except to save the life of a pregnant woman. The proposal was signed by Gov. Mike Rounds (R) on March 6, 2006. In November of 2006, South Dakotans voted to reject the ban (55% to 45%).

  46. International Perspective on Abortion

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

  48. Abortion Rate, United States and World Abortions per 1,000 Women Sources: Finer and Henshaw, 2005; Henshaw et al., 1999 (1995 data)

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