Abortion

Abortion

Abortion 2004 John B. Pryor, Ph.D. Human Sexuality Psychology 123 WORLD TRENDS IN ABORTION Abortion Rate, United States and World 35 40 35 30 23 25 20 15 10 Rate per 1,000 women 5 0 United States

World Source: Henshaw et al., 1999 (1995 data) Abortion in Developed and Developing Countries Annual abortions per 1,000 women 15-44 World Developed Countries Developing Countries 0 Legal 10 20 30 40 Illegal Source: AGI, 1999

50 ABORTION TRENDS IN THE UNITED STATES STATES Abortion Abortion Practices Practices before before Roe Roe v. v. Wade Wade (1973) (1973) estimated 200,000 to 1,200,000 per year in U.S. In 1965 20% of all pregnancy-related deaths attributable to illegal abortions In 1970 98% of all legal abortions in California were for mental health reasons Abortion Abortion Practices

Practices after after 1973 1973 Each year, 2 out of every 100 women aged 1544 have an abortion; 47% of them have had at least one previous abortion and 55% have had a previous birth. An estimated 43% of women will have at least 1 abortion by the time they are 45 years old. Annual Number of Abortions Per 1,000 Women Aged 1544 35 30 25 20 15 Rate10 per 1,000 5 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 Source: Finer and Henshaw, 2003

Pregnancies in the United States (Approximately 6.3 Million Annually) 60% 52% 48% 50% 40% 30% 20% % of pregnancies 10% 0% Intended Unintended Source: Henshaw, 1998 (1994 data) Outcomes of Unintended Pregnancies (Approximately 3.0 Million Annually) 60%

50% 47% 40% 40% 30% 20% 13% %10% of unintended pregs. 0% Abortions Births Miscarriages Source: Henshaw, 1998 (1994 data) Abortions by Gestational Age (Weeks Since Last Menstrual Period) 70% 60%

57.6% 50% 40% 30% 20.3% %20% of abortions 10.2% 6.2% 10% 0% <9 9-10 11-12 13-15 Weeks 4.3% 16-20 1.5% 21+ Source: Elam-Evans et al., 2002 (1999 data) Federal Federal Laws Laws & & Policies Policies about about Abortion Abortion Hyde Amendment - 1977

Freedom of Access to Clinic Entrances Act - 1994 Federal Health Benefits Program State State Laws Laws about about Abortion 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. State Laws Regulating Abortions Parental Mandatory Involvement Waiting Period following counseling

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky x Restrict Medicade funding to life, rape, or incest x

x "Partial Birth" Abortion Ban x Restrict after specified point in pregnancy x x x x x x x x x

x x x x x x x x x x x x x x x

x x x x x x x x x x x x x State Laws Regulating Abortions Parental

Mandatory Involvement Waiting Period following counseling Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri * Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon x

x x Restrict Medicade funding to life, rape, or incest "Partial Birth" Abortion Ban Restrict after specified point in pregnancy x x x

x x x x x x x x x x x x x x

x x x x x x x x x x x x x x x

x x x x x x x x x x x State Laws Regulating Abortions Parental Mandatory Involvement Waiting

Period following counseling Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming # with restrictions x x x x x

x x Restrict Medicade funding to life, rape, or incest "Partial Birth" Abortion Ban x x x x x x

x x x x x x x x x x Restrict after specified point in pregnancy x

x x x x x x x x x x x 30 14 x x

x x 33 11 40 Stenberg Stenberg v. v. Carhart, Carhart, 530 530 U.S. U.S. 914 914 (2000) (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 secondtrimester 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." Federal Federal Laws Laws in in the the Works 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.

Research Research from from Psychology Psychology on on the the Possible Possible Psychological Psychological Impact Impact of of Abortions Abortions upon upon Women Women who who have have them them Women Women who who have have abortions 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). Normative Normative Psychological Psychological Responses Responses to to Abortion Abortion Lazarus (1985) 292 women studied 2 weeks after 76% reported happiness 17% reported guilt Serious

Serious psychological psychological disturbances? disturbances? Serious psychological disturbances after abortion are less frequent than after childbirth. Researchers suggest that the predictors of severe psychological disturbances after abortion are:delays in seeking abortion, medical or genetic indications for abortion, and severe pre-existing or concurrent psychiatric illness (Lazarus, 1985). Normative Normative Psychological Psychological Responses Responses to to Abortion Abortion Russo & Zierk (1992) -measured self-esteem women who had abortions > women who had not had abortions women who had abortions > 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). Abortion Abortion and and teen teen pregnancy 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). Post-abortion Post-abortion depression? 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). Abortion Abortion vs. vs. adoption? 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). 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) Methods Methods of of Abortion 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

Methods Methods of of Abortion 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 Methods Methods of of Abortion 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 Methods Methods of

of Abortion Abortion II. Surgical Removal Through Cervix A. Dilation and Curretage 1. Performed 8-15 weeks 2. Lining of uterus is scraped with surgical instrument Methods Methods of of Abortion Abortion III. Induced Labor A. Saline Abortion 1. Performed early to middle parts of 2nd trimester 2. Saline injected into Amniotic sac (kills fetus) Methods Methods of of Abortion Abortion IV. Surgical Removal Through Caesarean Procedure A. Hysterotomy

Risks Risks -- Deaths Deaths per per 100,000 100,000 Suction Methods Induced Labor Hysterotomy Normal Childbirth 0.5 4.0 58.9 11.0 Abortion Risks in Perspective Risk from terminating pregnancy: Before 9 weeks Between 9 and 10 weeks Between 13 and 15 weeks After 20 weeks Chance of death

per year: 1 in 500,000 1 in 300,000 1 in 60,000 1 in 8,000 Risk to persons who participate in: Motorcycling Automobile driving Power- boating Playing football 1 in 1,000 1 in 5,900 1 in 5,900 1 in 25,000 Risk to women aged 1544 from: Having sexual intercourse (PID) Using tampons 1 in 50,000 1 in 350,000 Source: Gold, 1990; Trussell, 1998

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