Induced Abortion in the United States
May 18, 2005
INCIDENCE OF ABORTION
49% of pregnancies among American women are unintended; 1/2 of these are terminated by abortion.[1] 24% of all pregnancies (excluding miscarriages) end in abortion.[2]
In 2002, 1.29 million abortions took place, down from an estimated 1.36 million in 1996. From 1973 through 2002, more than 42 million legal abortions occurred.[3]
Each year, 2 out of every 100 women aged 15-44 have an abortion; 48% of them have had at least one previous abortion.[4]
| The number of abortions per 1,000 women aged 15-44, by year |
|---|
 |
| Eighty-eight percent of abortions occur in the first 12 weeks of pregnancy, 2001. |
WHO HAS ABORTIONS
52% of U.S. women obtaining abortions are younger than 25: Women aged 20-24 obtain 33% of all abortions, and teenagers obtain 19%.[5]
Black women are more than 3 times as likely as white women to have an abortion, and Hispanic women are 2 1/2 times as likely.[6]
43% of women obtaining abortions identify themselves as Protestant, and 27% identify themselves as Catholic.[7]
2/3 of all abortions are among never-married women.8]
Over 60% of abortions are among women who have had 1 or more children.[9]
On average, women give at least 3 reasons for choosing abortion: 3/4 say that having a baby would interfere with work, school or other responsibilities; about 2/3 say they cannot afford a child; and 1/2 say they do not want to be a single parent or are having problems with their husband or partner.[10]
CONTRACEPTIVE USE
54% of women having abortions used a contraceptive method during the month they became pregnant. 76% of pill users and 49% of condom users reported using the methods inconsistently, while 13% of pill users and 14% of condom users reported correct use.[11]
8% of women having abortions have never used a method of birth control; nonuse is greatest among those who are young, poor, black, Hispanic or poorly educated.[12]
49% of the 6.3 million pregnancies that occur each year are unplanned;[13] 47% of these occur among the 7% of women at risk of unintended pregnancy who do not practice contraception.[14]
As much as 43% of the decline in abortion between 1994 and 2000 can be attributed to the use of emergency contraception.[15]
PROVIDERS AND SERVICES
The number of abortion providers declined by 11% between 1996 and 2000 (from 2,042 to 1,819). 87% of all U.S. counties lacked an abortion provider in 2000. These counties were home to 34% of all 15-44-year-old women.[16]
97% of abortion facilities provide abortion at 8 weeks, and 86% provide services at 12 weeks, but provision drops off steeply after that, with only 13% of providers offering services at 24 weeks.[17]
A growing proportion of providers offer very early abortion (at 4 weeks gestation), and increase from 7% in 1993 to 37% in 2000.[18]
In 2000, the cost of a nonhospital abortion with local anesthesia at 10 weeks of gestation ranged from $150 to $4,000, and the average amount paid was $372.[19]
MEDICATION ABORTION
In September, 2000, the U.S. Food and Drug Administration approved the abortion drug mifepristone to be marketed in the United States as an alternative to surgical abortion.
About 37,000 medication abortions were performed in the first half of 2001; these procedures involved the use of mifepristone or methotrexate.[20]
Approximately 600 providers offered medication abortion in the first half of 2001.[21]
In nonhospital facilities offering mifepristone for use in medication abortion in 2000, the average cost of a medical abortion was $490.[22]
| When Women Have Abortions (in weeks) |
|---|
 |
| Eighty-eight percent of abortions occur in the first 12 weeks of pregnancy, 2001. |
SAFETY OF ABORTION
The risk of abortion complications is minimal; less than 1% of all abortion patients experience a major complication.[23]
There is no evidence of childbearing problems among women who have had a vacuum aspiration abortion, the most common procedure, within the first 12 weeks of pregnancy.[24]
The risk of death associated with abortion increases with the length of pregnancy, from 1 death for every one million abortions at 8 or fewer weeks to 1 per 29,000 at 16-20 weeks and 1 per 11,000 at 21 or more weeks.[25]
The risk of death associated with childbirth is about 11 times as high as that associated with abortion.[26]
Almost half of the women having abortions beyond 15 weeks of gestation say they were delayed because of problems in affording, finding or getting to abortion services.[27]
Teens are more likely than older women to delay having an abortion until after 15 weeks of pregnancy, when medical risks associated with abortion increase significantly.[28]
LAW AND POLICY
In the 1973 Roe v. Wade decision, the Supreme Court ruled that women, in consultation with their physician, have a constitutionally protected right to have an abortion in the early stages of pregnancy--that is, before viability--free from government interference.
In 1992, the 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.
33 states currently enforce parental consent or notification laws for minors seeking an abortion: AL, AR, AZ, CO, DE, GA, IA, ID, IN, KS, KY, LA, MA, MD, MI, MN, MO, MS, NC, ND, NE, OH, PA, RI, SC, SD, TN, TX, UT, VA,WI, WV, and WY. The Supreme Court ruled that minors must have the alternative of seeking a court order authorizing the procedure.[29]
45% of minors who have abortions tell their parents, and 61% undergo the procedure with at least one parent's knowledge. The great majority of parents support their daughter's decision.[30]
In Stenberg v. Carhart in 2000, the Court declared Nebraska's law criminalizing so-called partial birth abortion unconstitutional because it lacked an exception to protect the woman's health. The Court also found that the law imposed an undue burden on women because it was written so broadly as to ban not only dilation and extraction (D&X) procedures, but also dilation and evacuation (D&E) procedures.
PUBLIC FUNDING
The U.S. Congress has barred the use of federal Medicaid funds to pay for abortions, except when the woman's life would be endangered by a full-term pregnancy or in cases of rape or incest.[31]
17 states (AK, AZ, CA, CT, HI, IL, MA, MD, MN, MT, NJ, NM, NY, OR, VT, WA and WV) do use public funds to pay for abortions for some poor women. About 14% of all abortions in the United States are paid for with public funds (virtually all from state governments).[32]
Without publicly funded family planning services, an estimated 1.3 million additional unplanned pregnancies would occur annually; about 632,300 would end in abortion.
Sources
1. Henshaw SK, Unintended pregnancy in the United States, Family Planning Perspectives, 1998, 30(1):24-29&46.
2. Finer LB and Henshaw SK, Estimates of U.S. Abortion Incidence in 2001 and 2002, The Alan Guttmacher Institute, 2005,
3. Ibid.
4. Jones RK, Darroch JE and Henshaw SK, Patterns in the socioeconomic characteristics of women obtaining abortions in 2000-2001, Perspectives on Sexual and Reproductive Health, 2002, 34(5):226-235.
5. Ibid.
6. Ibid.
7. Ibid.
8. Ibid.
9. Ibid.
10. Torres A and Forrest JD, Why do women have abortions? Family Planning Perspectives, 1988, 24(4):169-176.
11. Jones RK, Darroch JE and Henshaw SK, Contraceptive use among U.S. women having abortions in 2000-2001, Perspectives on Sexual and Reproductive Health, 2002, 34(6):294-303.
12. Ibid.
13. Henshaw SK, 1998, op. cit. (see reference 1).
14. AGI, 2000, op. cit. (see reference 13).
15. Jones RK, Darroch JE and Henshaw SK, 2002, op. cit. (see reference 11).
16. Finer LB and Henshaw SK, Abortion incidence and services in the United States in 2000, Perspectives on Sexual and Reproductive Health, 2003, 35(1):6-15.
17. Henshaw SK and Finer LB, The accessibility of abortion services in the United States, 2001, Perspectives on Sexual and Reproductive Health, 2003, 35(1):16-24.
18. Ibid.
19. Ibid.
20. Finer LB and Henshaw SK, 2003, op. cit. (see reference 17).
21. Ibid.
22. Ibid.
23. AGI, Abortion and Women's Health: A Turning Point for America? New York: AGI, 1990, p. 30.
24. Ibid.
25. Bartlett LA et al., Risk factors for legal induced abortion-related mortality in the United States, 2004, Obstetrics and Gynecology, 103(4):729-737.
26. Ibid.
27. Torres A and Forrest JD, 1988, op. cit. (see reference 10).
28. Centers for Disease Control and Prevention, Abortion surveillance--United States, 1999, Morbidity and Mortality Weekly Report, 2002, 51(SS09).
29. AGI, Parental involvement, State Policies in Brief, Dec. 2002, .
30. Henshaw SK and Kost K, Parental involvement in minors' abortion decisions, Family Planning Perspectives, 1992, 24(5):196-207&213.
31. AGI, State funding of abortion under Medicaid, State Policies in Brief, Dec. 2002, .
32. Forrest JD and Samara R, Impact of publicly funded contraceptive services on unintended pregnancies and implications for Medicaid expenditures, Family Planning Perspectives, 1996, 28(5):188-195.