Abortion surveillance, United States, 1984-1985

Since 1983, the number of legal abortions reported to CDC increased by 5% to 1,333,521 in 1984; in 1985, that number decreased by less than 1% to 1,328,570. The national abortion rate was the same for both years-24 per 1,000 females ages 15-44 years. The abortion ratio for 1984 was 364 legally induced abortions per 1,000 live births; the ratio for 1985 was 354 per 1,000. Abortion ratios were higher among women of black and other minority races and among women younger than 15 years of age. Women undergoing legally induced abortions tended 1) to be young, white, and unmarried, 2) to have had no previous live births, and 3) to be having the procedure for the first time. Curettage was the procedure used in 96% of the reported cases. Eleven deaths were associated with legally induced abortions in 1984, and six in 1985. The case-fatality rate in 1985 was 0.5 deaths per 100,000 legally induced abortions, down from the 0.8 per 100,000 reported in 1983 and 1984. Overall, since 1980, the numbers and rates of abortion have had only slight year-to-year fluctuations. The steady increase in the percentage of repeat abortions since 1972 reflects the ongoing availability of legal abortions. Since the beginning of CDC's abortion mortality surveillance, the number of deaths related to legal abortions has decreased 75%, from 24 deaths in 1972 to six deaths in 1985.     

Abortion surveillance, 1986-1987

Since 1980, the number of legal abortions reported to CDC has remained fairly stable, varying each year by less than 3%. In 1986, 1,328,112 abortions were reported; in 1987, that number increased by approximately 2% to 1,353,671. The abortion ratio for 1986 was 354 legally induced abortions per 1,000 live births; the ratio for 1987 was 356 per 1,000. The national abortion rate was 23/1,000 females ages 15-44 years for 1986 and 24/1,000 females ages 15-44 years in 1987. Abortion ratios were higher among women of black and other minority races and among women less than 15 years of age. Women undergoing legally induced abortions tended 1) to be young, white, and unmarried, 2) to have had no previous live births, and 3) to be having the procedure for the first time. In 1987, approximately half of all abortions were performed before the eighth week of gestation, and greater than 85% were performed during the first trimester of pregnancy (less than 13 weeks of gestation).     

Estimates of pregnancies and pregnancy rates for the United States, 1976-85.

After increasing by 9 per cent in the period 1976-80 in the United States, pregnancy rates declined by 4 per cent between 1980 and 1984 (from 111.9 to 107.3 pregnancies per 1,000 women aged 15-44 years). Between 1984 and 1985, the rate rose by less than 1 per cent to 108.2. More detailed data by age and race, available only through 1983, indicate that the decline in the 1980-83 period was not shared by all age groups. For example, pregnancy rates continued to increase for women in their thirties, and teenage pregnancy remained substantially the same. In 1983, 61 per cent of all pregnancies ended in live birth, 26 per cent in induced abortion, and 13 per cent in fetal loss. Pregnancy rates in that year were two-thirds higher for women of races other than White than for White women, and pregnancies of other-than-White women were more likely to terminate as an induced abortion or fetal loss. However, White teenagers and teenagers of other races were about equally likely to have their pregnancy end in induced abortion or fetal loss.     

The analysis of trends in induced abortion in Japan—An increasing consequence among adolescents

Objectives  The purpose of this study was to examine trends in induced abortions in Japan. Methods  The Ministry of Health, Labour, and Welfare compiled data on induced abortions, live births, and the population of women aged 15–49 years. These data were provided by 47 prefectures in Japan and were used to examine the number of induced abortions and various characteristics of women who received abortions from 1955 through 2001. We examined abortion numbers, abortion ratios (number of legal abortions per 1,000 live births), and abortion rates (number of legal abortions per 1,000 women aged 15–49). We were particularly interested in examining abortion trends among adolescents. These trends were also compared to those in the United States. Results  A total of 341,588 legal induced abortions were reported in Japan in 2001, representing a 2.5% increase from 1998 to 2001. From 1998 to 2001, the abortion ratio (292) increased by 5.4%; from 1996 through 2001, the abortion rate (11.8) increased by 8.3%. Women less than 20 years old contributed most to these increases. In 1999, the abortion ratio among Japanese adolescents was 5.7 times as high as the ratio among U.S. adolescents, while the abortion rate among U.S. adolescents was 1.8 times as high as the rate among Japanese adolescents. Conclusions  Recent increases in induced abortion among Japanese women may be related to several factors, including changes in sexual behavior among adolescents and a decline in their use of contraceptives. More appropriate educational efforts and interventions are needed to prevent unintended pregnancies.     

Teenage abortion and pregnancy statistics by state, 1996

CONTEXT: State-level teenage pregnancy rates, birthrates and abortion rates are needed for state-specific programs and policies. Accurate and complete state-level data were last published in 1992. METHODS: Teenage abortion rates according to state of residence, race and ethnicity were calculated from the results of The Alan Guttmacher Institute's survey of abortion providers and from information compiled by state health statistics agencies and the Centers for Disease Control and Prevention. Natality data were obtained from the National Center for Health Statistics, and population denominators from the Census Bureau. RESULTS: In 1996, some 97 pregnancies, 54 births and 29 abortions occurred per 1,000 U.S. women aged 15-19. At the national level and in virtually all states, these rates have fallen since 1992, yet they remain higher than rates in most other developed countries. The decline in the teenage abortion rate (from 36 per 1,000 in 1992) has been proportionately greater than the drop in the birthrate (from 61 per 1,000), indicating that an increasing proportion of pregnant teenagers are continuing their pregnancies. Pregnancy rates, birthrates and abortion rates vary enormously among the states for reasons that are largely unexplained. Pregnancy rates and birthrates tend to be highest in the South and Southwest, while abortion rates are highest in the most urban states. CONCLUSIONS: Teenage pregnancy is declining in all parts of the country. Although rates have fallen, further progress is possible, as is indicated by the low rates in certain states and in other developed countries. More research is needed to identify the factors influencing the reproductive behavior of adolescents.     

School achievement: risk factor in teenage pregnancies?

A review of live births, spontaneous fetal deaths, and induced abortions in residents of Upstate New York ages 12--17 shows that pregnancy rates increased during the period 1971 through 1974. This increase was attributable to pregnancies ending in induced abortion while live births remained relatively stable. White teenagers had a higher frequency of induced abortions than non-white teenagers, but induced abortions increased more rapidly among non-whites over the four-year period. School achievement as reflected by highest grade completed at the end of pregnancy was related to risk of pregnancy as well as to election of induced abortions. The distribution of pregnancies by age and school grade suggests that an increased risk of pregnancy is associated with below average but also, and unexpectedly, with above average grade attainment. Incongruity of age and school achievement may identify groups of teenage schoolgirls with special needs for preventive programs.     

Characteristics of U.S. women having abortions, 1982-1983

In 1982 and 1983, as in previous years, the majority of abortions in the United States were obtained by young women (62 percent), white women (70 percent) and unmarried women (81 percent). Half of all abortions were performed eight or fewer weeks after the last menstrual period, and 91 percent, at 12 weeks or earlier. The proportion of abortions that were repeat procedures continued to rise, to 37 percent in 1982 and 39 percent in 1983. The rate of abortion, 29 per 1,000, has remained essentially the same since 1981. Women aged 18-19 continue to have the highest abortion rate of any age-group (60 per 1,000). While most abortions are obtained by white women, the nonwhite abortion rate is more than twice that of whites. Thirty percent of all pregnancies were terminated by abortion in 1983, the same proportion as in 1982 and 1981. The highest abortion ratios are found among unmarried women (63 percent), women 40 and older (51 percent), teenagers (42 percent) and nonwhites (40 percent). Teenage nonwhites and whites have about the same abortion ratios. After rising during the 1970s, the adolescent pregnancy rate peaked around 1980-1981 and fell slightly in 1982-1983. The relative differentials between the pregnancy, birth and abortion rates of nonwhite and white teenagers narrowed somewhat between 1978 and 1981, but then widened slightly between 1981 and 1983.     

Births and abortions among Amsterdam teenagers according to ethnicity, 1996-1998

OBJECTIVE: To determine the number of teenage births and abortions in Amsterdam, the Netherlands, in total and according to age and ethnic origin. DESIGN: Retrospective analysis of routinely collected data. METHOD: Based on data collected from the municipal population register and the abortion clinics in Amsterdam, birth rates, abortion rates and abortion ratios were calculated for the period 1996-1998. The birth rate was the number of live births and the abortion rate the number of abortions per 1000 teenage girls. The abortion ratio was the number of abortions per 100 pregnancies. RESULTS: The average birth rate and abortion rate for the period 1996-1998 were 3.2 and 7.6 for 14- to 16-year-old girls respectively, and 25.0 and 29.5 for 17- to 19-year-old girls respectively. Among 14- to 16-year-old girls 70 pregnancies out of 100 ended in an abortion and among 17- to 19-year-old girls 54 pregnancies out of 100. In both age groups the birth rate for Surinamese, Antillian, Moroccan, Turkish and Ghanian girls was higher than for Dutch girls. There was one exception: Moroccan girls aged 14-16 years did not have a higher birth rate than Dutch girls of the same age. Surinamese, Antillian and Ghanian girls aged 14-16 years and 17-19 years also had a higher abortion rate compared with Dutch girls of the same age. The Turkish and Moroccan girls did not have (much) higher abortion rates. In both age groups the abortion ratio was lowest for Turkish teenagers and highest for Ghanian teenagers. The figures for second-generation immigrant teenagers were more akin to those of the native Dutch girls than those of first-generation immigrants. CONCLUSION: In Amsterdam unwanted pregnancies were most frequent in Surinamese, Antillian and Ghanian teenage girls. To prevent these pregnancies further research into the (cultural) determinants of sexual behaviour is necessary.     

A portrait of American women who obtain abortions

In 1981, as in 1980, most abortions in the United States were obtained by young women, unmarried women and white women, and were performed in the first eight weeks following the last menstrual period (approximately six weeks after conception). The proportion of abortions obtained by unmarried women has increased slightly, and the fraction obtained by teenagers has decreased, mainly because of shifts in the distribution of these groups in the population. The percentage of abortions that are repeat procedures has increased, representing more than one-third of all abortions. The increase is due largely to the rise in the number of women who have had a first abortion, and who are, therefore, exposed to the risk of having a second procedure. Eighty-five percent of all abortions are performed by vacuum aspiration. Dilatation and evacuation is the method used in two-thirds of abortions performed more than 12 weeks past the last menstrual period, and in nine out of 10 abortions that are performed between the 13th and the 15th week. About three percent of women aged 15-44 obtained abortions in 1981, and 26 percent of pregnancies were terminated by abortion--the same fractions as in 1980. About six percent of 18-19-year-olds had abortions--the highest rate of any age-group. The abortion rate (the number of abortions per 1,000 women aged 15-44) and ratio (the number of abortions per 100 live births and abortions) are much higher for unmarried than for married women.(ABSTRACT TRUNCATED AT 250 WORDS)     

Abortion surveillance--United States, 1989.

Since 1980, the number of legal induced abortions reported to CDC has remained stable, varying each year by < 5%. In 1989, 1,396,658 abortions were reported--a 1.9% increase from 1988. The abortion ratio for 1989 was 346 legal induced abortions/1,000 live births, and the abortion rate was 24/1,000 women ages 15-44 years. The abortion ratio was highest for black women and women of other minority racial groups and for women < 15 years of age. Overall, women undergoing abortions tended to be young, white, and unmarried; to have had no previous live births; and to be having the procedure for the first time. Approximately half of all abortions were performed before the eighth week of gestation, and 87% were before the thirteenth week of gestation. Younger women tended to obtain abortions later in pregnancy than older women. This report also includes newly reported abortion-related deaths for 1986 and 1987, as well as an update on abortion-related deaths for the period 1978-1985. Ten deaths in 1986 and six deaths in 1987 were associated with legal induced abortion. The case-fatality rate in 1986 was 0.8 abortion-related deaths/100,000 legal induced abortions and 0.4/100,000 in 1987.     

The effect of legal abortion on teenage fertility in Trieste, Italy

Abortion has been legal and publicly funded in Italy since 1978. However, unmarried women under 18 must obtain parental consent or written permission from their legal guardian or from a judge to undergo the operation. In this study an assessment is made on whether the recent law has had a particular impact upon the fertility of teenagers living in Trieste, a city of 250,000 inhabitants, located in northeast Italy. Data were obtained on 1st births among women aged 15-19 for the years 1977-81. 1st births were classified as: premaritally conceived, uncertain or postmaritally conceived. During the study period, the total number of births to Trieste residents fell from 1878 to 1326, a 29% decline. The number of out-of-wedlock births remained quite stable and the number of postmarital cenceptions fluctuated. Marital births resulting from premarital conception declined appreciable from 66% to 51%. It seem s likley that the most relevant factor accounting for the overall decline in teenage fertility is the availability of legal abortion. The very high legal abortion ratios for all women of reproductive age further confirms this hypothesis. The ratios are particularly high among younger teenagers, who had just over 2 abortions, an average, for every live birth in 1980 and 1981. The estimated age-specific abortion rates for woman aged 15-19 living in Trieste are very much higher than the 1981 rate for Italy as a whole. The historical and geographical nature of Trieste may, to some extent, help explain why Trieste women resort to abortion more frequently than other Italian women. When it was an important seaport, Trieste was an affluent city, but today most citizens view its decline as irreversible and consequently try to enjoy the present. Couples have only 1 child not expecting life to improve for the future generation. The trend also probably reflects the enhanced capability of young women to assume control over their reproductive lives. Voluntary interruption of pregnancy is sought by those who feel not yet ready to start a family or to marry the father.     

Black teenage pregnancy: An obstetrician's viewpoint

The Black pregnant teen is a microcosm of the impact of society on the most vulnerable. Who is the pregnant adolescent? What racial and ethnic connotations are implied? What is the quality of her progeny? What health risks and mortality attend Black pregnant adolescents? What measures are indicated to address teen pregnancy? Health providers must more intensively address the essentials of the socio-medical phenomenon of Black teenage pregnancy. The United States leads other developed countries of the world by substantial margins in births to teenagers, ranging from 3/1,000 in Japan to 52/1,000 in the United States. In 1983 in New York City, 40,000 teenagers became pregnant resulting in 14,000 births, 20,000 abortions, and 6,000 miscarriages. Sixty-six percent of the births occurred in areas with large concentrations of residents of lower socioeconomic status. Special attention, then, needs to be focused on both pregnancy prevention and early prenatal care in these high risk areas. Most teenagers do not intend to become pregnant. There are suggested racial differences regarding both the intention of becoming pregnant and teen births. Twenty percent of pregnant teenagers conceive during the first sexual expsoure and fifty percent become pregnant within the first six months. The younger the age at initiation of intercourse, the greater the likelihood of pregnancy. The desire to terminate a teen pregnancy is more closely associated with socio-economic status than ethnicity. The course of pregnancy in teenagers is more likely to be complicated by a variety of clinical problems than in adults. Further, the maternal mortality rate in pregnant black teenagers is significantly higher than in white teenagers. The younger the pregnant teenager is, irrespective of ethnicity, the higher the maternal mortality and morbidity rates. Future directions which are indicated vary. Further, it will take concerted effort by all segments of society to eliminate unplanned pregnancies, which continue to prove devastatingly costly.     

Mortality and morbidity associated with legal abortions in Hungary, 1960-1973.

In Hungary, with 10 million inhabitants, the number of induced abortions in the 1960's first approached and then reached 200,000 cases annually. These data mean that the number of induced abortions has increased substantially compared with earlier decades. A qualitative change has also occurred, from criminal abortions to, in most cases, legally induced abortions performed in hospitals. On the basis of 32 deaths directly resulting from legal induced abortion in the first trimester during 1960-1972, maternal mortality is about 1.5 per 100,000 abortions in Hungary, the lowest rat observed until the present anywhere in the world. According to a special survey conducted in Budapest in 1966, the overall morbidity rate was 41.6 per 1,000 abortions of which 0.9 was due to perforations, 22.7 to post-abortal hemorrhages, and 18.0 to inflammatory complications, i.e., early post-abortal complications had to be reckoned with in every 25th case. Data in the present study suggest a correlation between induced abortions and the incidence of placenta previa, premature separation of the placenta, and premature births.     

The social and economic correlates of pregnancy resolution among adolescents in New York City, by race and ethnicity: a multivariate analysis.

This study utilizes a data set combining vital records from live birth and induced abortion certificates in New York City in 1984 to examine the correlates of the two outcomes among pregnant adolescents. Four groups totaling 31,207 teenagers were examined: Black non-Latinos (51 per cent), White non-Latinos (17 per cent), Puerto Ricans (25 per cent), and non-Puerto Rican Latinos (8 per cent). Multivariate regressions were fit for each group. Simulations based on the regressions reveal that the proportion of live births plus induced abortions among unmarried 18-year-olds, on Medicaid, with a previous live birth, no previous induced abortions, and nine years of completed schooling was .55 in the case of Puerto Ricans, .34 for non-Puerto Rican Latinos, .60 for Blacks, and .51 for Whites. For nulliparous adolescents of the same age and marital status, with an additional year of schooling, but not on Medicaid, and with a previous induced abortion, the fraction of pregnancies that were terminated rose to .84 in the case of Puerto Ricans, .81 for non-Puerto Rican Latinos, .87 for Blacks, and .96 for Whites. The results suggest that attitudes toward abortion as proxied by previous induced terminations substantially increase the likelihood of aborting as well as narrow the racial and ethnic differences with respect to pregnancy resolution.     

The consequences of the legalization of abortion within the Rostock area (GDR)

On March 9, 1972, the German Democratic Republic legalized abortion as one of the social and health policy measures with humanitarian goals to promote family life and improve living conditions. In evaluating the effect of the law, the development of fertility and frequency of abortion in Rostock District were studied for the years 1965 to 1973. In the first year after the new law went into effect, legal abortions increased about fivefold, which was expected; hospital abortions in 1973 decreased by about 40%. Compared to other Eastern European countries and to New York City, the frequency of abortion was still low. In the second year of the law, a further increase in abortions was not seen either in Rostock or the GDR as a whole. More women decided to continue their pregnancies; the number of women on oral contraceptives increased from about 1 million at the beginning of 1972 to about 1.2 million at the beginning of 1973. In 1972, for every 1000 women of reproductive age, there were 33 legal abortions in Rostock District; in the same period, for every 100 live births, there were 56 abortions.     

Characteristics of U.S. women having abortions, 1987

In 1987, as in earlier years, women having abortions were predominantly white (65 percent), younger than 25 (59 percent), and unmarried (82 percent). A majority had no previous live births (53 percent), and most had no previous abortions (58 percent). About half the abortions were performed before nine weeks of gestation, and 97 percent were curettage procedures, usually suction curettage. Comparisons with 1980 data reveal a six percent decline in the U.S. abortion rate after changes in age, race and marital status within the population are controlled for; however, the decline occurred only among the white population and not among minority races. Among teenagers aged 15-19, the abortion rate declined slightly for whites and increased for minorities. The rate also increased among women younger than age 15.     

Estimated pregnancy rates by outcome for the United States, 1990-2004

OBJECTIVES: This report presents detailed pregnancy rates for 1990-2004, updating a national series of rates extending since 1976. Data from the National Survey of Family Growth (NSFG) are used to interpret trends in teenage pregnancy and in total pregnancy and fertility rates. METHODS: Tabular and graphical data on pregnancy rates by age, race and Hispanic origin, and by marital status are presented and described. Birth data are from the birth registration system for all births registered in the United States and reported by state health departments to the National Center for Health Statistics; abortion data are from the Guttmacher Institute and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention; and fetal loss estimates are from pregnancy history information collected by the NSFG. RESULTS: In 2004 an estimated 6,390,000 pregnancies resulted in 4.11 million live births, 1.22 million induced abortions, and 1.06 million fetal losses. The estimated pregnancy rate for 2004 was 103.0; the rate varied little between 1995 and 2004. The teenage pregnancy rate dropped 38 percent during 1990-2004, reaching an historic low of 72.2 pregnancies per 1,000 women aged 15-19 years. Rates for younger teenagers declined relatively more than for older teenagers.     

Trends in low birth weight infants and changes in Baltimore's childbearing population, 1972–77

Linked birth and death records provided the population for a study of trends in low birth weight (LBW) rates in Baltimore between 1972 and 1977 and of the effect of changes in the characteristics of the childbearing population on these trends. The impact of shifts in the birth weight distribution on neonatal mortality rates was also investigated. Trends were analyzed for unstandardized LBW rates as well as for rates standardized on the distributions of maternal age, education, gravidity, prior pregnancy losses, and marital status.Between 1972 and 1977, the 1,500 and 2,000 gm rates rose significantly by approximately 1 infant per 1,000 live births per year among whites and 2 infants per 1,000 live births among nonwhites. Despite declines in rates for most weights, the effect of these increases was a rise in neonatal mortality rates for both races, but especially for nonwhites.The population of women delivering in Baltimore in 1977 became slightly older, slightly more educated, and of higher gravidity than in 1972, but these changes had little impact on yearly fluctuations in LBW rates. In contrast, increases in births to unmarried women and to women with at least one prior pregnancy loss were related to rising LBW rates. For both races, standardization on marital status and prior pregnancy losses diminishes the increase in the LBW rate over the study period, especially when standardization is performed simultaneously for both variables. These findings hold within maternal age, education, and gravidity groups. However, the LBW rates for nonwhite teenage mothers and for nonwhite women with 12 years of less education increased significantly over the study period, regardless of standardization.     

The effects of legal abortion on legitimate and illegitimate birth rates: the California experience

The availability of legal abortion in California appeared to affect California fertility in 1971 with a downward trend in both legitimate and illegitimate births. In 1972 legitimate birth rates continued to fall as rapidly as in 1971 but illegitimacy rates declined less rapidly. Unmarried women continued to be the dominant recipients of legal abortion. Illegitimacy remained at a high level, however, and its rise among white teenagers pointed to the phenomena of women deliberately electing unwed motherhood.     

Racial and Ethnic Abortion Disparities Following Georgia's 22-Week Gestational Age Limit

IntroductionGeorgia's 2012 House Bill 954 (HB954) prohibiting abortions after 22 weeks from last menstrual period (LMP) has been associated with a significant decrease in abortions after 22 weeks. However, the policy's effects by race or ethnicity remain unexplored. We investigated whether changes in abortion numbers and ratios (per 1,000 live births) in Georgia after HB954 varied by race or ethnicity.MethodsUsing Georgia Department of Public Health induced terminations of pregnancy data from 2007 to 2017, we examined changes in number of abortions and abortion ratios (per 1,000 live births) by race and ethnicity following HB954 implementation.ResultsAfter full implementation of HB954 in 2015, the number of abortions and abortion ratios at or after 22 weeks (from last menstrual period) decreased among White (b_Number = –261.83, p < .001; b_Ratio = –3.31, p < .001), Black (b_Number = –416.17, p < .001; b_Ratio = –8.84, p < .001), non-Hispanic (b_Number = –667.00, p = .001; b_Ratio = –5.82, p < .001), and Hispanic (b_Number = –56.25, p = .002; b_Ratio = –2.44, p = .002) people. However, the ratio of abortions before 22 weeks increased for Black people (b_{LessThan22Weeks} = 44.06, p = .028) and remained stable for White (b_{LessThan22Weeks} = –6.78, p = .433), Hispanic (b_{LessThan22Weeks} = 21.27, p = .212), and non-Hispanic people (b_{LessThan22Weeks} = 26.93, p = .172).ConclusionThe full implementation of HB954 had differential effects by race/ethnicity and gestational age. Although abortion at 22 weeks or more decreased for all groups, abortion at less than 22 weeks increased among Black people. Additional research should elucidate the possible causes, consequences, and reactions to differential effects of abortion restrictions by race and ethnicity.