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Current Trends Abortion Surveillance: Preliminary Analysis -- United States, 1981

A total of 1,300,760 legal abortions were reported to CDC for 1981 from 50 states and the District of Columbia. This is less than a 1% increase over the number reported for 1980 (Table 2). The national abortion ratio decreased slightly from 359 legal abortions per 1,000 live births in 1980 to 358/1,000 in 1981. Since 1980, the national abortion rate decreased from 25 legal abortions/1,000 women aged 15-44 years in 1980 to 24/1,000 in 1981.

As in previous years, women obtaining abortions in 1981 tended to be young, white, and unmarried and to have had no live births (Table 2). Sixty-three percent were under 25 years of age; approximately 70% were white; and 78% were unmarried at the time of abortion. Fifty-eight percent of the abortions were obtained by women who had had no live births.

Curettage (suction curettage, sharp curettage, and dilatation and evacuation) accounted for 96% of abortion procedures in 1981. Slightly less than 3% were performed by intrauterine instillation, and less than 1% were performed by hysterotomy and hysterectomy. In 1981, more than half of all reported legal abortions were performed in the first 8 weeks of gestation; and 90%, in the first 12 weeks of gestation.

Eleven deaths associated with abortion were reported for 1981. Of these, three were associated with spontaneous abortion; one, with illegal abortion; and seven, with legal abortion. The death-to-case rate for legal abortions in 1981 was 0.5 per 100,000 procedures, compared with 0.6/100,000 for 1980. Reported by Pregnancy Epidemiology Br, Research and Statistics Br, Div of Reproductive Health, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: This report presents a preliminary analysis; a more in-depth analysis of 1981 abortion data is forthcoming. Because of annual variation in the number of states reporting data on the specific abortion characteristics (Table 2), temporal trends based on these summary data should be viewed with caution. An analysis of temporal changes for areas that have reported specific abortion characteristics for each year since 1974 is under way.

Since 1969, when CDC began collecting information on legal abortions, the reported number of women obtaining abortions has increased yearly. Part of the increase from 1969 to 1973 is attributable to an expanded surveillance system. It is noteworthy that the annual percentage increase in numbers of abortions has continuously declined since 1976, with the lowest percentage increase being reported for 1981.

In 1981, for the first year since CDC began abortion surveillance, there was virtually no increase in the number of abortions reported, and for the first time, the abortion rate and abortion ratio declined. Examination of the national abortion surveillance system for 1981 suggests that the lower abortion rate and abortion ratio are real rather than an artifact of changes in completeness of reporting. In 28 reporting areas, the number of abortions reported for 1980 exceeded the number reported for 1981; in 24 reporting areas, more abortions were reported for 1981 than for 1980. Differences in the reported number of abortions between 1980 and 1981 exceeded 3,000 in only six reporting areas, and for these, there was a net increase of 6,725 abortions. Moreover, the sources of abortion data were identical in both years, with the exception of two states; for one, 2,746 more abortions were reported for 1981 than for 1980; for the other, 4,435 fewer abortions were reported for 1980 than for 1981.

Through the 1970s and into the 1980s, curettage steadily increased as the primary method of abortion. In 1981, virtually all first-trimester procedures were performed by curettage; moreover, in the 13- to 15-week interval, more procedures were performed by curettage than by all instillation and other procedures performed at any gestational week during the second trimester.

The 11 abortion-related deaths (legal, illegal, and spontaneous) reported in 1981 are the fewest reported since CDC's surveillance of abortion deaths began in 1972. Previous experience shows that 64% of abortion deaths are reported to CDC during the 12 months after the death and 96% within 3 years of the death. CDC investigates all reports of abortion-related deaths and uses late reports of confirmed abortion-related deaths to update data for previous years.

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