Race-specific patterns of abortion use by American teenagers.

Between 1972 and 1978, as legal abortion became more widely available nationally, abortion rates (abortions per 1,000 women) and ratios (abortions per 1,000 live births) increased for all American teenagers; from 1972 to 1975, the rates and ratios for teenagers for Black and other races increased faster than those for White teenagers. For all seven years, abortion rates were higher for teenagers of Black and other races than for white teenagers. This reflected both higher proportions of sexually active teenagers of Black and other races and a greater risk of pregnancy in these teenagers compared with White teenagers. Race-specific differences in legal abortion ratios narrowed during the seven-year interval, as did differences in alternative outcomes of teenage premarital pregnancies (term births, illegal abortions).     

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.     

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.     

Estimated pregnancy rates for the United States, 1990-2000: an update.

OBJECTIVES: This report presents detailed pregnancy rates for 1990-2000, updating a national series of rates extending since 1976. METHODS: Tabular data on pregnancy rates by age, race, and Hispanic origin, and by marital status are presented and briefly described. RESULTS: In 2000 an estimated 6,401,000 pregnancies resulted in 4.06 million live births, 1.31 million induced abortions, and 1.03 million fetal losses. The 2000 pregnancy rate of 104.0 pregnancies per 1,000 women aged 15-44 years is 10 percent lower than the 1990 peak of 115.6. The teenage pregnancy rate dropped 27 percent during 1990-2000, reaching an historic low of 84.5 pregnancies per 1,000 women aged 15-19 years. Rates for younger teenagers declined relatively more than for older teenagers.     

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 services in rural Washington State, 1983-1984 to 1993-1994: availability and outcomes

CONTEXT: Fewer rural health providers offer abortion services than a decade ago. It is unknown how the reduction in service availability has affected women's pregnancy outcomes, the extent to which they must travel to obtain an abortion or whether abortions are delayed as a result. METHODS: Population, birth and fetal death data, as well as pregnancy termination reports, obtained from Washington State were used to calculate abortion rates and ratios and birthrates for Washington residents in 1983-1984 and in 1993-1994. Residence of abortion patients was classified by county only, and location of providers was recorded as large urban county, small urban county, large rural county or small rural county. Distances that women traveled to obtain an abortion were calculated. Chi-square tests were used to compare urban and rural rates and ratios within time periods, and to compare changes that occurred between time periods. RESULTS: Birthrates and abortion rates decreased for both rural and urban Washington women between 1983-1984 and 1993-1994, but the magnitude of the decrease was greater for rural women. The rural abortion rate fell 27%, from 14.9 abortions per 1,000 women to 10.9 per 1,000, while the urban rate dropped 17%, from 21.8 to 18.2 per 1,000. The decline in the abortion rate was larger for adolescents than it was for other age-groups. In rural areas, the abortion rate decreased from 16.5 per 1,000 adolescents aged 10-19 in 1983-1984 to 10.8 per 1,000 in 1993-1994, while it declined from 23.3 per 1,000 to 16.9 per 1,000 in urban areas. From the earlier to the later time period, rural women traveled on average 12 miles farther each way to obtain an abortion, and the proportion who obtained the procedure in a rural county decreased from 25% to 3%. In the earlier time period, 62% of rural women traveled 50 miles or more to obtain an abortion, compared with 73% in 1993-1994. From 1983-1984 to 1993-1994, the proportion of rural women who traveled out of state for an abortion increased from 8% to 14%. The proportion of rural women terminating their pregnancy after the first trimester increased from 8% in 1983-1984 to 15% in 1993-1994. CONCLUSION: Rural Washington women are traveling farther and more often to urban and out-of-state locations for abortion services, and are obtaining their abortions at a later gestational age, which is associated with a decade-long decline in the number of abortion providers.     

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.     

Trends in pregnancy rates for the United States, 1976-97: an update.

OBJECTIVES: This report presents detailed pregnancy rates for 1996 and 1997 to update a recently published comprehensive report on pregnancies and pregnancy rates for U.S. women. METHODS: Tabular and graphic data on pregnancy rates by age, race, and Hispanic origin, and by marital status are presented and described. RESULTS: In 1997 an estimated 6.19 million pregnancies resulted in 3.88 million live births, 1.33 million induced abortions, and 0.98 million fetal losses. The 1997 pregnancy rate of 103.7 pregnancies per 1,000 women aged 15-44 years is the lowest recorded since 1976 (102.7), the first year for which a consistent series of national pregnancy rates is available. The 1997 rate was 10 percent lower than the peak rate in 1990 (115.6). The teenage pregnancy rate dropped steadily through 1997, falling to a record low of 94.3 pregnancies per 1,000 teenagers 15-19 years, 19 percent below the 1990 level (116.3). Rates for younger teenagers declined more than for older teenagers.     

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.     

Highlights of trends in pregnancies and pregnancy rates by outcome: estimates for the United States, 1976-96.

OBJECTIVES: This report presents key findings from a comprehensive report on pregnancies and pregnancy rates for U.S. women. The study incorporates birth, abortion, and fetal loss data to compile national estimates of pregnancy rates according to a variety of characteristics including age, race, Hispanic origin, and marital status. Summary data are presented for 1976-96. Data from the National Survey of Family Growth (NSFG) are used to show information on sexual activity and contraceptive practices, as well as women's reports of pregnancy intentions. METHODS: Tabular and graphic data on pregnancy rates by demographic characteristics are presented and interpreted. Birth data are from the birth registration system for all births registered in the United States and reported by State health departments to NCHS; abortion data are from The Alan Guttmacher Institute (AGI) and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC); and fetal loss data are from pregnancy history information collected in the NSFG. RESULTS: In 1996 an estimated 6.24 million pregnancies resulted in 3.89 million live births, 1.37 million induced abortions, and 0.98 million fetal losses. The pregnancy rate in 1996 was 104.7 pregnancies per 1,000 women aged 15-44 years, 9 percent lower than in 1990 (115.6), and the lowest recorded since 1976 (102.7). Since 1990 rates have dropped 8 percent for live births, 16 percent for induced abortions, and 4 percent for fetal losses. The teenage pregnancy rate has declined considerably in the 1990's, falling 15 percent from its 1991 high of 116.5 per 1,000 women aged 15-19 to 98.7 in 1996. Among the factors accounting for this decline are decreased sexual activity, increases in condom use, and the adoption of the injectable and implant contraceptives.     

The resolution of teenage first pregnancies

First conceptions occuring in tennage women in the U.S., the outcomes of the pregnancies, the marital status of the teenage women at conception and at the outcome, whether the pregnancy was intended or not, and whether contraception was used to prevent the pregnancy are discussed. It was determined that 30% of a cross section of teenage women have had premarital intercourse and 58% of those married had premarital intercourse. Of those experiencing premarital intercourse, 30% were pregnant before marriage, i.e., fewer than 10% of all females 15-19. Twice as many blacks have premarital intercourse than whites, and twice as many of these become pregnant. 35% of those who have a premarital first pregnancy marry before the baby is born. 64% of premarital first pregnancies are unintended. Of those who did not want to become pregnant, 13-16% used contraception to prevent the premarital pregnancy. 86% of births to blacks from first pregnancies are illegitimate compared with 23% for whites. More than 1/5 of the women who do not marry end the pregnancy by induced abortion. White teenagers who do not marry prior to the outcome of the pregnancy are 7 times more likely to have an induced abortion than blacks. 18% of the whites who have illegitimate births from first pregnancies give up their children for adoption compared with 2% blacks. Fewer than 30% of postmarital first pregnancies of teenage women are unintended. Blacks appear to display less anxiety than whites over illegitimate births. It may be that escape via abortion and marriage is less accessible to blacks than to whites both economically and psychologically.     

Adolescent pregnancy in the United States: an interstate analysis

Rates of teenage pregnancy, birth and abortion vary greatly among states. Because states that have high birthrates tend to have low abortion rates, pregnancy levels vary much less than do the birth and abortion measures. The role of unintended pregnancy is highlighted by the fact that in states that have very high pregnancy rates, the adolescent abortion rate is higher than the birthrate and the abortion rate combined in states that have the lowest pregnancy rates. A series of multivariate analyses that controlled for the percentage of the state population that was black, poor and metropolitan showed that social factors tend to be more important determinants of state differences in teenage pregnancy, birth and abortion levels than are policy-related variables, particularly for whites. Nevertheless, some policy measures have important associations for both races, especially for blacks. Social factors. High rates of population growth and residential mobility over the previous decade, a high crime rate, a high teenage suicide rate, extensive circulation of sexually explicit magazines, a large percentage not voting in elections and a high level of stress are all associated with high pregnancy-related rates for teenagers. The percentage of children living in female-headed households correlates positively with abortion and pregnancy levels among white teenagers, but has no significant association with the birthrate. The percentage of a state's population that belongs to fundamentalist religious groups is positively associated with adolescent birthrates. Political liberalism correlates with relatively low pregnancy rates and birthrates but with a somewhat higher likelihood of pregnancies being terminated by abortion. In states where women's status is higher, birthrates are lower, but abortion levels are higher. Policy measures. States that have high proportions of teenagers dropping out of school and of young women not graduating from high school tend to have high pregnancy rates and birthrates and a somewhat lower proportion of pregnancies ending in abortion. Increased spending on education is associated with relatively high abortion rates (and, therefore, pregnancy rates). The higher the teacher-student ratio, the lower the adolescent birthrate and the more likely the pregnant teenager is to have an abortion. Welfare payments to teenage mothers are negatively associated with both black and white teenage birthrates, and higher maximum payments are associated with relatively high abortion levels.(ABSTRACT TRUNCATED AT 400 WORDS)     

Tobacco smoke exposure and pregnancy outcome among working women. A prospective study at prenatal care centers in Orebro County, Sweden

Among 4,687 women undergoing prenatal care in Orebro County, Sweden, from October 1980 to June 1983, 678 nonsmokers reported passive exposure to tobacco smoke. Of these women, 267 had been passively exposed at work, and the risk ratio (RR) for intrauterine death (spontaneous abortion or stillbirth) among these pregnancies was increased to 1.53 (95% confidence interval (CI) 0.98-2.38) compared with pregnancies of unexposed working women. This could not be explained by age, previous spontaneous abortion, educational level, planning of pregnancy, or alcohol use. The effect was confined to first-trimester fetal loss (adjusted RR = 2.16, 95% CI 1.23-3.81), while active smoking was associated with intrauterine death after the first trimester. Passive exposure in the workplace was weakly associated with preterm birth (less than 37 weeks) but not with low birth weight (less than 2,500 g) among full-term livebirths. Active smoking clearly increased the risk of both of these outcomes. However, passive exposure in the home only did not seem to affect pregnancy outcome. The lack of quantitative exposure data points to the need for more research before passive exposure to tobacco smoke can be regarded as an established hazard to fetal development and survival.     

Induced abortion and the risk of subsequent ectopic pregnancy.

This study assessed the effect of legal induced abortion on ectopic pregnancy risk by using a comparison group of reproductive-age women who were at risk of becoming pregnant during the same time period the women with ectopic pregnancy conceived. Cases were members of Group Health Cooperative of Puget Sound who were hospitalized for ectopic pregnancy from October 1981 through September 1986 (N = 211). Controls were randomly selected members matched to cases on age and county of residence (N = 457). All subjects in this analysis had had one or more prior pregnancies. Eighty-eight cases (41.7 per cent) and 177 controls (38.7 per cent) had a history of one or more induced abortions. The relative risk of ectopic pregnancy associated with one abortion was 0.9 (95 per cent confidence interval 0.6, 1.3), adjusted for age, county, reference date, religion, gravidity, age at first pregnancy, lifetime number of sexual partners, and miscarriage history. Among women with two or more prior pregnancies, the risk associated with two or more abortions was 1.2 (0.6, 2.4). Controlling for pelvic inflammatory disease and use of intrauterine devices did not alter these risks. We conclude that legal abortion as performed in the US since 1970 has little or no influence on a woman's risk of ectopic pregnancy in subsequent pregnancies.     

Induced abortion in a rural area of Bangladesh

Mortality rates from indigenous abortion practices have not been described previously. From September 1982 to August 1983, traditional birth attendants, under medical supervision, collected data on all identifiable pregnant women and pregnancy outcomes in a geographically defined population in rural Bangladesh. Of 9,906 pregnancies, 9,317 ended in live birth, 412 in induced abortion, and 177 in spontaneous abortion. All abortions were induced by indigenous health practitioners. The abortion-to-live-birth ratio was 44.2 per 1,000. Ten women died after induced abortion, yielding a death-to-case rate of 2.4 percent. The death-to-case rate was highest for women 35 and older and women of parity five and higher. The authors conclude that improved distribution of safe, acceptable means of fertility regulation may save many mothers' lives.     

Induced abortions and births. Trends in seven counties, Norway, 1972-1983

This paper discusses the changes in the frequencies of induced abortions and births according to changes in the abortion legislation in Norway during the 1970s. The study material consists of women aged 15-44 years having undergone induced abortion or giving birth in seven Norwegian counties during the period 1972-83. Since the liberalization of the abortion legislation in 1976 and later when the law on abortion on women's request came into force in January 1979, the number of induced abortions per 1000 women 15-44 years of age has decreased by 20%, until December 31, 1983. For no age group has the number of induced abortions per 1000 women increased since the liberalization of the abortion legislation. While the number of terminations of pregnancy per 1000 women below the age of 25 has remained unchanged since 1975, the number of abortions per 1000 women aged 25-29 has decreased by nearly 18% and for women aged 30-44, by 34%. The number of terminated pregnancies per 1000 women of fertile age has shown a decrease corresponding to the reduction in births per 1000 women. Thus the liberalization of the abortion law cannot account for the decreased number of births after 1975.     

Revised pregnancy rates, 1990-97, and new rates for 1998-99: United States.

OBJECTIVES: This report presents detailed pregnancy rates for 1990-99. Rates for 1991-97 are revised using populations consistent with the April 1, 2000, census; the revised populations are also used for the new 1998-99 rates. METHODS: Tabular and graphic data on pregnancy rates by age, race, and Hispanic origin, and by marital status are presented and described. RESULTS: In 1999, an estimated 6.23 million pregnancies resulted in 3.96 million live births, 1.31 million induced abortions, and 1.0 million fetal losses. The pregnancy rate in 1999 was 102.1 pregnancies per 1,000 women aged 15-44 years. The 1999 rate was similar to the rates since the mid 1990s, but it was 12 percent below the peak rate in 1990 (115.6). These data extend a consistent series of pregnancy rates from 1976 through 1999. The teenage pregnancy rate dropped steadily through the 1990s, reaching a record low of 86.7 per 1,000 aged 15-19 years in 1999, 25 percent lower than the 1990 peak (116.3). Rates fell more for younger than for older teenagers. The declines reflect reductions in births and abortions.     

Smoking during pregnancy, 1967-80.

Data from two national samples of live births to married mothers (the 1967 and 1980 National Natality Surveys) were used to document changes in smoking during pregnancy. Smoking among married teenagers remained essentially constant between 1967 and 1980. For married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 40 to 25 per cent among Whites and 33 to 23 per cent among Blacks. There were striking differences in the magnitude of the decrease by educational attainment. Among the White married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 48 to 43 per cent for those with less than 12 years education and from 34 to 11 per cent for those with 16 or more years education.     

Risk of spontaneous abortion in workers exposed to toluene.

Rates of spontaneous abortions were determined using a reproductive questionnaire administered by personal interview to 55 married women with 105 pregnancies. They were employed in an audio speaker factory and were exposed to high concentrations of toluene (mean 88, range 50-150 ppm). These rates of spontaneous abortion were compared with those among 31 women (68 pregnancies) who worked in other departments in the same factory and had little or no exposure to toluene (0-25 ppm), as well as with a community control group of women who underwent routine antenatal and postnatal care at public maternal health clinics (190 women with 444 pregnancies). Significantly higher rates for spontaneous abortions were noted in the group with high exposure to toluene (12.4 per 100 pregnancies) compared with those in the internal control group (2.9 per 100 pregnancies) and in the external control group (4.5 per 100 pregnancies). Among the exposed women, significant differences were also noted in the rates of spontaneous abortion before employment (2.9 per 100 pregnancies) and after employment in the factory (12.6 per 100 pregnancies). Almost all the women were nonsmokers and did not drink; other known risk factors such as maternal age at pregnancy, order of gravidity, and race were not likely to explain the results. Thus, specific exposure to toluene seems to be associated with a risk of foetal loss.