Abortion Surveillance: Preliminary Data -- United States, 1993

For 1993, CDC received data about legal induced abortions from 52 reporting areas (the 50 states, New York City, and the District of Columbia). This report presents preliminary data for 1993.

In 1993, a total of 1,330,414 legal induced abortions were reported to CDC (Table_1), a decrease of 2.1% from the number reported for 1992 (1), and the number of live births decreased by 1.6% (2). The number of reported abortions declined in 39 of 52 reporting areas. The national abortion ratio (number of legal abortions per 1000 live births) decreased from 335 in 1992 to 334 in 1993 (Figure_1). The national abortion rate was 23 legal abortions per 1000 women aged 15-44 years, unchanged from 1992. Consistent with previous years, approximately 92% of women who had a legal abortion were residents of the state in which the procedure was performed.

Women who obtained legal abortions in 1993 were predominately aged less than 25 years, white, and unmarried. In 1993, 20% of women who obtained a legal abortion were adolescents (aged less than or equal to 19 years), unchanged from 1992. Curettage (suction and sharp) remained the primary abortion procedure (99% of all procedures). As in previous years, approximately 52% of legal abortions were performed during the first 8 weeks of gestation and approximately 89% were performed during the first 12 weeks of pregnancy.

Reported by: Statistics and Computer Resources Br, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Editorial Note

Editorial Note: Since 1980, the annual number of legal induced abortions reported in the United States has remained stable, varying each year by less than or equal to 5% (Table_1). However, since 1990 (the year in which the number was highest), the number of reported abortions has decreased each year. From 1972 through 1980, the national abortion rate increased each year; since 1980, the rate has remained stable, fluctuating between 23 and 24 (Figure_1).

In 1993, the national ratio of abortions to live births (334 abortions per 1000 live births) was lower than for any year since 1977 (325 abortions per 1000 live births), indicating that a smaller proportion of pregnancies ended in an abortion (3). Factors that could have contributed to this recent change include reduced access to abortion services, changes in contraceptive practices, attitudinal changes concerning the decision to have an abortion or to carry a pregnancy to term, and a possible decline in the number of unintended pregnancies (4-6).

The number of live births and the national fertility rate (number of live births per 1000 women of reproductive age {i.e., aged 15-44 years}) peaked in 1990 (Figure_1). Subsequent declines in the annual number of abortions and live births indicate decreases in the numbers of pregnancies each year in the United States. Although the actual number of women of reproductive age has increased by 11% since 1980, the age distribution in this population has shifted and a higher proportion of women are now in later reproductive years (aged 35-44 years); among these women, fertility is lower when compared with younger women (2). For example, in 1980, approximately 58% of women of reproductive age were aged less than 30 years (the age with highest fertility), compared with 47% in 1992 (Unpublished data, Bureau of the Census). In addition, in 1980, women aged 35-44 years accounted for 25% of reproductive-aged women, compared with 34% in 1992.

Many states emphasize the prevention of unintended pregnancy, particularly among teenagers. During 1993, the total number of legal induced abortions was available for all 52 reporting areas; however, approximately 26% of abortions were reported from states without centralized reporting, and these states could not provide information about the characteristics of women obtaining abortions. To assist efforts to prevent unintended pregnancy, an accurate assessment of abortion (including the number and characteristics of women obtaining legal abortions in all states) is needed on an ongoing basis.

Additional statistical and epidemiologic information on legal induced abortions is available from CDC's automated Reproductive Health Information line at (404) 330-1230, which provides information by fax, by voice recordings, or through the mail.

References

1. CDC. Abortion surveillance: preliminary data -- United States, 1992. MMWR 1994;43:930-3,939.

2. NCHS. Advance report of final natality statistics, 1993. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1995; DHHS publication no.(PHS)95-1120. (Monthly vital statistics report; vol 44, no. 3, suppl).

3. CDC. Abortion surveillance, 1977. Atlanta: US Department of Health and Human Services, Public Health Service, CDC 1979.

4. Council on Scientific Affairs. Induced termination of pregnancy before and after Roe v. Wade. JAMA 1992;268:3231-9.

5. Henshaw SK. The accessibility of abortion services in the United States. Fam Plann Perspect 1991;23:246-52.

6. Henshaw SK, VanVort J. Abortion services in the United States, 1991 and 1992. Fam Plann Perspect 1994;26:100-12

TABLE 1. Reported number of legal induced abortions, abortion ratios, * abortion rates, + and characteristics of women
who obtained legal induced abortions, by year -- United States, selected years, 1972-1993
==========================================================================================================================
Characteristic    1972        1976        1980        1985        1988        1990        1991        1992       1993 &
Reported no.
 legal induced
 abortions       586,760    988,267    1,297,606   1,328,570   1,371,285   1,429,577   1,388,937  1,359,145  1,330,414
Abortion ratios    180        312          359         354         352         345         339        335        334
Abortion rates      13         21           25          24          24          24          24         23         23

                                                   Percentage distribution @
Residence
 In-state         56.2       90.0         92.6        92.4        91.4        91.8        91.6       92.0       91.9
 Out-of-state     43.8       10.0          7.4         7.6         8.6         8.2         8.4        8.0        8.1

Age (yrs)
  <=19            32.6       32.1         29.2        26.3        25.3        22.4        21.0       20.1       20.0
 20-24            32.5       33.3         35.5        34.7        32.8        33.2        34.4       34.5       34.4
  >=25            34.9       34.6         35.3        39.0        41.9        44.4        44.6       45.4       45.6

Race
 White            77.0       66.6         69.9        66.6        64.4        64.8        63.8       61.5       62.0
 Black            23.0       33.4         30.1        29.8        31.1        31.8        32.5       33.9       34.1
 Other **          ---        ---          ---         3.5         4.5         3.4         3.7        4.6        3.9

Ethnicity
 Hispanic          ---        ---          ---         ---         ---         9.8        13.5       15.2       14.5
 Non-Hispanic      ---        ---          ---         ---         ---        90.2        86.5       84.8       85.5

Marital status
 Married          29.7       24.6         23.1        19.3        20.3        21.7        21.4       20.8       20.6
 Unmarried        70.3       75.4         76.9        80.7        79.7        78.3        78.6       79.2       79.4

No. live births ++
  0               49.4       47.7         58.4        56.3        52.4        49.2        47.8       45.9       46.8
  1               18.2       20.7         19.4        21.6        23.4        24.4        25.3       25.9       25.9
  2               13.3       15.4         13.7        14.5        16.0        16.9        17.5       18.0       17.6
  3                8.7        8.3          5.3         5.1         5.6         6.1         6.4        6.7        6.5
>=4               10.4        7.9          3.2         2.5         2.6         3.4         3.0        3.5        3.2

Type of procedure
 Curettage        88.6       92.8         95.5        97.5        98.6        98.8        98.9       98.9       99.0
  Suction         65.2       82.6         89.8        94.6        95.1        96.0        97.3       97.0       98.1
  Sharp           23.4       10.2          5.7         2.9         3.5         2.8         1.6        1.9        0.9
 Intrauterine
  instillation    10.4        6.0          3.1         1.7         1.1         0.8         0.7        0.7        0.6
 Other &           1.0        1.2          1.4         0.8         0.3         0.4         0.4        0.4        0.4

Weeks' gestation
   <=8            34.0       47.0         51.7        50.3        48.7        51.6        52.3       52.1       52.2
   <=6            ---         ---         ---         ---         ---         ---         ---        14.1@@     14.3***
     7            ---         ---         ---         ---         ---         ---         ---        15.4@@     16.1***
     8            ---         ---         ---         ---         ---         ---         ---        21.9@@     20.9***
  9-10            30.7       28.1         26.2        26.6        26.4        25.3        25.1       24.2       24.6
 11-12            17.5       14.4         12.2        12.5        12.7        11.7        11.5       12.0       11.8
 13-15             8.4        4.5          5.1         5.9         6.6         6.4         6.1        6.0        6.1
 16-20             8.2        5.1          3.9         3.9         4.5         4.0         3.9        4.2        4.0
  >=21             1.2        0.9          0.9         0.8         1.1         1.0         1.1        1.5        1.3
--------------------------------------------------------------------------------------------------------------------------
*   Per 1000 live births.
+   Per 1000 women aged 15-44 years.
&   Preliminary data.
@   Excludes unknown values. The number of areas reporting a given characteristic varied. For 1993, the number of areas
    reporting residence was 40; age, 43; race, 35; ethnicity, 23; marital status, 37; number of live births, 39; type of
    procedure, 40; and weeks' gestation, 39.
**  Reported as "other race."
++  For 1972-1976, data indicate number of living children.
&&  Includes hysterotomy and hysterectomy.
@@  Data are for 36 reporting areas only.
*** Data are for 37 reporting areas only.
==========================================================================================================================

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