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Abortion%20in%20the%20United%20States

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Title: Abortion%20in%20the%20United%20States


1
Abortion in the United States
2
US Public Opinions about Abortion
3
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4
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5
Incidence of Pregnancy and Abortion
6
Pregnancies in the United States(Approximately
6.3 Million Annually)
of Pregnancies
Unintended
Intended
Source Henshaw, 1998 (1994 data)
7

Outcomes of Unintended Pregnancies(Approximately
3.0 Million Annually)
of Unintended Pregnancies
Source Henshaw, 1998 (1994 data)
8
Incidence of Abortion
  • In 2002, 1.29 million pregnancies were terminated
    by abortion in the United States.
  • Some 2.1 of all women aged 1544 had an abortion
    in 2001.
  • Abortion is one of the most common surgical
    procedures in the United States.

Source Finer and Henshaw, 2005
9
Abortion Rates Among Women Aged 1544
Abortions per 1,000 women
Source Finer and Henshaw, 2005
10

Abortion Rates in Western Industrialized
Countries
Abortions per 1,000 women
Source Finer and Henshaw, 2005 Henshaw et al.,
1999 (1996 data)
11
Reasons for Abortions
12
Most Important Reason Given for Terminating an
Unwanted Pregnancy
Inadequate finances 21 Not ready for
responsibility 21 Womans 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)
13
Gestational Age
14
Abortions by Gestational Age(Weeks Since Last
Menstrual Period)
of Abortions
Weeks
Source Strauss et al., 2004 (2001 data)
15
Reasons for Abortions After 16 Weeks Since Last
Menstrual Period
Woman did not realize she was pregnant 71 Diffic
ulty 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 Didnt know timing was important 6 Didnt
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)
16
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

17
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

18
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

19
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

20
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)

21
Methods of Abortion
  • IV. Surgical Removal Through Caesarean Procedure
  • A. Hysterotomy

22
Safety of Abortion
23
Deaths per 100,000 Abortions or Births
Deaths per 100,000
Sources Birth Henshaw, 2004 (19951997 data)
Abortion Bartlett et al., 2004 (19881997 data)
24
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 1544 from Having sexual
intercourse (PID) 1 in 50,000 Using
tampons 1 in 350,000
Source Bartlett et al., 2004 (19881997 data)
25
Who Has Abortions
26
Who Has Abortions Age
Source Jones et al., 2002
27
Who Has Abortions Marital Status
Source Jones et al., 2002
28
Who Has Abortions Economic Status
In 2007 the Federal Poverty Level was 11,750
per fear for one person
Source Jones et al., 2002
29
Who Has Abortions Race/Ethnicity
Source Jones et al., 2002
Non-Hispanic
30
Who Has AbortionsReligious Identification
Source Jones et al., 2002
31
Who Has Abortions Prior Pregnancies
Source Jones et al., 2002
32
Who Provides Abortion Services
33
Number of Providers by Type
Number of Providers
Source Finer and Henshaw, 2003
34
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
35
Factors That Make It Difficult For Women to
Obtain Abortion Services
36
Percentage of Counties with No Provider And of
Women Living in Those Counties
Source Finer and Henshaw, 2003
37
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 Pick
eting homes of staff members 14 Bomb
threats 15
Source Henshaw and Finer, 2003
38
Legal Restrictions on Abortion
39
Federal Laws Policies about Abortion
  • Hyde Amendment - 1977
  • Freedom of Access to Clinic Entrances Act - 1994
  • Federal Health Benefits Program

40
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.

41
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 womens right to
    obtain abortions.
  • "the absence of a health exception will place
    women at an unnecessary risk of tragic health
    consequences."

42
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? case (Gonzales v. Carhart)
    and Planned Parenthood?s case (Gonzales v.
    Planned Parenthood), appellate courts declared
    the ban unconstitutional citing previous law
    established over the last thirty years.

43
APRIL 2007
  • With Bush-appointed judges Alito and Roberts,
    Supreme Court upholds the Federal partial birth
    abortion ban in a 5-4 decision.

44
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.

45
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.

46
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?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.

47
February 22, 2006South 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).

48
International Perspective on Abortion
49
U.S. Share of Abortions Worldwide
Source Henshaw et al., 1999 (1995 data)
50
Abortion Rate, United States and World
Abortions per 1,000 Women
Sources Finer and Henshaw, 2005 Henshaw et al.,
1999 (1995 data)
51
Abortion in Developed and Developing Countries
Source AGI, 1999
52
Many Abortions Occur in Countries Where Abortion
Is Illegal Under Most Circumstances
Illegal
Legal

Source Henshaw et al., 1999
(1995 data)
53
Maternal Mortality Worldwide Due to Unsafe
Abortion
Unsafe abortion
Other causes
Source WHO, 2004 (2000 data)
54
Research from Psychology on the Possible
Psychological Impact of Abortions upon Women who
have them
55
Women who have abortions
  • Up to 98 percent of the women who have abortions
    have no regrets and would make the same choice
    again in similar circumstances (Dagg, 1991).
  • More than 70 percent of women who have abortions
    express a desire for children in the future
    (Torres Forrest, 1988). There is no evidence
    that women who have had abortions make less
    loving or suitable parents (Bradley, 1984).

56
Normative Psychological Responses to Abortion
  • Lazarus (1985)
  • 292 women studied 2 weeks after
  • 76 reported happiness
  • 17 reported guilt

57
Post-abortion depression?
  • Mild, transient, immediately postoperative
    depressive symptoms that quickly pass occur in
    less than 20 percent of all women who have had
    abortions (Adler et al., 1990 Zabin et
    al.,1989).
  • Similar symptoms occur in up to 70 percent of
    women immediately following childbirth (Ziporyn,
    1984).

58
Serious psychological disturbances?
  • Serious psychological disturbances after abortion
    are less frequent than after childbirth.
  • Researchers suggest that the predictors of severe
    psychological disturbances after abortion
    aredelays in seeking abortion, medical or
    genetic indications for abortion, and severe
    pre-existing or concurrent psychiatric illness
    (Lazarus, 1985).

59
Normative Psychological Responses to Abortion
  • Russo Zierk (1992) -measured self-esteem -
  • women who had abortions gt women who had not had
    abortions
  • women who had abortions gt women who unwanted
    births
  • The positive relationship of abortion to
    well-being may be due in part to abortion's role
    in controlling fertility and its relationship to
    coping resources (Russo Zierk, 1992 Russo
    Dabul, 1997).

60
Abortion and teen pregnancy
  • A study of a group of teenagers who obtained
    pregnancy tests at one of two
    Baltimore clinics found that
    the young women who chose to have abortions were
    far more likely to graduate from high school at
    the expected age than those of similar
    socioeconomic status who carried their
    pregnancies to term or who were not pregnant.
    They showed no greater levels of stress at the
    time of the pregnancy and abortion and no greater
    rate of psychological problems two years after
    the abortion than did the other women (Zabin et
    al., 1989).

61
Abortion vs. adoption?
  • The psychological responses to abortion are far
    less serious than those experienced by women
    bringing their unwanted pregnancy to term and
    relinquishing the child for adoption (Sachdev,
    1993).

62
Summary Points
63
Incidence of Pregnancy and Abortion
  • Unintended pregnancy and abortion are common
    among all groups of women.
  • Almost half of all pregnancies are unintended.
  • Almost half of unintended pregnancies end in
    abortion.

64
Who Has Abortions, Why and When in Pregnancy
  • Women having abortions are predominantly
    young, single, from minority groups and
    low-income.
  • Most women have multiple reasons for choosing to
    have an abortion.
  • Almost 90 of abortions occur in the first
    trimester.

65
Safety of Abortion
  • Abortion is one of the safest surgical procedures
    for women in the United States.
  • Laws criminalizing abortion make abortions unsafe
    but do not eliminate them. In developing
    countries, where abortion is often illegal or
    highly restricted, abortion mortality rates are
    hundreds of times higher than rates in developed
    countries.

66
The Provision of and Access to Abortion Services
  • Most abortions occur in abortion clinics.
  • A steady decline in providers in the last two
    decades has left the majority of counties in the
    United States with no provider.
  • Many of the difficulties in providing and
    obtaining access to abortion would disappear if
    the procedure were integrated with other health
    care services.

67
International Perspective on Abortion
  • A very small proportion of abortions worldwide
    take place in the United States
  • Most unsafe abortions occur in countries where
    abortion is illegal.
  • Scientific studies do not suggest a link between
    abortion and subsequent psychological problems in
    women.
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