3

Relative Safety of Early vs. Late Abortions

For most women, early abortion is far safer than childbirth (see page 8.).

Medical complications of abortion are significantly lower when the procedure is conducted at an early stage of pregnancy. JPSA reports on complication rates, by period of gestation, for "abortion only" patients with no preexisting complications or concurrent sterilization: total patients and local patients with follow-up (FU)

*

Includes perforation of the uterus, hemorrhage with blood loss of 500 ml
or more and/or requiring transfusion, pelvic infection including septic
incomplete abortion with 2 or more days of fever, other categories with
roughly comparable risk of death, prolonged illness or permanent function-
al impairment.

(Source: "Early Medical Complications of Legal Abortion", Tietze and Lewit, Studies in Family Planning 3, No. 6 (June) 1972)

The JPSA study shows that late abortions have been most frequent among women under the age of 18; mothers of six or more children; Black women; and patients in non-private hospital facilities.

(Source: A National Medical Experience: The Joint Program for the Study of Abortion [JPSA])

Method Used

The three techniques most commonly used for induced abortion are vacuum aspiration, or "suction" (used only for early procedures, and now the most widely and frequently used technique at that stage) dilatation and curettage ("D and C"); and saline injection (for late abortions). Uterine surgery is rarely used.

Statistics from New York City reveal the following usage patterns of the various procedures:

(Source: The New York City Experience, Pakter et al; NYC Health Services Administration)

Where Performed

4

Most abortions are still performed in a hospital setting, with a growing number being performed in free-standing clinics, as more of these are established. Figures are not available in most places as to extent to which physicians performing abortions in their private offices.

are

In New York City, the proportion of recorded resident abortions performed in free-standing clinics increased wetween the first and second year of legal abortion from 6.6% of the total to 23.1%.

5

11. The Patient Who?

The typical patient presenting herself for legal abortion has been a young, single, white woman, pregnant for the first time. At the same time, the incidence of legal abortion has been:

Age

relatively high among women nearing the end of their
tertile years;

. relatively high, proportionately, among non-whites;

broadly similar between Catholics and non-Catholics.

The number of abortions per 1000 live births, for selected age groups, during 1971, in 16 states where there was data available, were as follows:

The same pattern of higher ratios at the two extremes of the age range appears in statistics for Hawaii, California and New York City:

(Sources:

448

181

Hawaii Department of Health, HPBCA Study Data; Impact of Legalized Abortion on Fertility in California, Sklar; First Nine Months

(New York City), Pakter)

Religion

Diverse data from several states suggest that Catholics avail themselves of
legal abortion no less than do other groups. In fact, for each of the
examples listed below, the proportion of abortion patients reported as
Catholic exceeds the Catholic representation in the state's population as
a whole:

6

(Source: The Abortion Experience, Howard Osofsky, M.D., Ed., Harper & Row, NY.)

Race

In the days when "therapeutic abortion" was available only under very restrictive circumstances, a disproportionate number of those who obtained it were Thus:

white and affluent.

a 1971 study in Georgia showed that the ratio of abortions
per 1,000 live births was four times as high among white

women as among blacks;

(Source: The Abortion Experience, Osofsky, Ed.)

a 1965-67 New York study showed marked ethnic difference among abortion patients:

(Source: U.S.: Therapeutic Abortions in New York City, Studies in FP 51 8-9 March 1970.)

7

By contrast, data for the second year of New York's reformed abortion law
(1971-72) show that non-whites availed themselves of legal abortion in pro-
portions greater than did whites:

Commenting on these figures, Christopher Tietze has suggested that the higher abortion ratios for non-whites reflects "a differential in successful utilization of the most effective contraceptive methods" that is, the poor have less access to the most effective contraceptive methods than do the more affluent.

(Source: "Two Years Experience with New York's Abortion Law", Tietze, Perspectives, Vol. 5 No. 1)

Marital Status

Data for three states 1970-71 show rates of legal abortion among nevermarried women more than twice the rate among ever-married women:

(Source: The Abortion Experience, Howard Osofsky, M.D., Ed., Harper & Row, NY.)

In the national sample of abortion patients in 66 hospitals used by the Joint Program for the Study of Abortion (JPSA), 55.9% of the patients had never been married, and an additional 14.2% were separated, divorced or widowed.

(Source: Studies in Family Planning 3, June 1972)