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Abortion Surveillance: Preliminary Data -- United States, 1994

For 1994, CDC received data on legal induced abortions from the 50 states, New York City, and the District of Columbia. This report presents preliminary data for 1994. Final abortion data for 1993 and 1994 will be published during spring 1997.

In 1994, a total of 1,267,415 legal induced abortions were reported to CDC (Table_1), a decrease of 4.7% from the number reported for 1993 (1). The number of live births decreased by 1.1% over the same period (2). Fewer abortions were reported from 43 of the 52 reporting areas in 1994 than during the previous year. The national abortion ratio (number of legal abortions per 1000 live births) decreased from 334 in 1993 to 321 in 1994 (Table_1, Figure_1), and the national abortion rate (number of legal abortions per 1000 women aged 15-44 years) decreased from 22 to 21. 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 1994 were predominately aged <25 years, white, and unmarried. As in 1993, approximately one fifth of women who obtained a legal abortion in 1994 were adolescents (aged less than or equal to 19 years). Curettage (suction and sharp) remained the primary abortion procedure, accounting for 99% of all procedures. As in previous years, approximately 54% of legal abortions were performed during the first 8 weeks of gestation; specifically, 15.7% were at less than or equal to 6 weeks, 16.5% at 7 weeks, and 21.6% at 8 weeks. Approximately 88% of abortions 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: During 1980-1994, the annual number of legal induced abortions in the United States varied by less than or equal to 5% (Table_1). However, since 1990 (the year in which the number of abortions was highest), the number of reported abortions has steadily decreased. In 1994, a total of 83% of reporting areas reported fewer abortions compared with 1993.

During 1972-1980, the national abortion rate increased each year; during 1981-1993, the rate remained stable, fluctuating between 22 and 24 per 1000 women of reproductive age (i.e., aged 15-44 years) (Figure_1). The 1994 rate of 21 was the lowest rate recorded since 1976 (3).

In 1994, the national ratio of abortions to live births (321 abortions per 1000 live births) was lower than for any year since 1976 (3). Factors that could have contributed to this decrease in the proportion of pregnancies that ended in an abortion include reduced access to abortion services, changes in attitudes about the decision to have an abortion or to carry a pregnancy to term, and the possibility that the number of unintended pregnancies has decreased (4-6).

The number of live births and the national fertility rate (number of live births per 1000 women of reproductive age) peaked in 1990 (Figure_1). Subsequent declines in the annual number of abortions and live births suggest decreases in the number of pregnancies each year in the United States. Although the actual number of women of reproductive age has increased by 12% since 1980, the age distribution in this population has shifted toward the later, less fertile reproductive years (2). For example, the proportion of women of reproductive age who were aged <30 years (the age associated with the highest fertility) declined from 58% in 1980 to 46% in 1994 (Bureau of the Census, unpublished data, 1996), whereas women aged 35-44 years (the age associated with the lowest fertility) accounted for 25% of reproductive-aged women in 1980 and 35% in 1994.

Since 1992, most reporting areas have reported abortions by weeks of gestation for abortions performed at less than or equal to 8 weeks. Because of the emergence of medical methods for terminating pregnancies primarily at less than or equal to 8 weeks of gestation, these data will continue to be important for monitoring trends in legal abortions (7-10).

Many states emphasize the prevention of unintended pregnancy, particularly among teenagers. During 1994, 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 characteristics (e.g., age or race) of women obtaining legal abortions. To assist efforts to prevent unintended pregnancy, each state needs an accurate assessment of abortion on an ongoing basis (including the number and characteristics of women obtaining legal abortions).

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

References

  1. CDC. Abortion surveillance: preliminary data -- United States, 1993. MMWR 1996;45:235-8.

  2. NCHS. Advance report of final natality statistics, 1994. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1996; DHHS publication no. (PHS)96-1120. (Monthly vital statistics report; vol 44, no. 11, suppl).

  3. CDC. Abortion surveillance, 1976. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1978.

  4. Council on Scientific Affairs, American Medical Association. Induced termination of pregnancy before and after Roe v. Wade: trends in the mortality and morbidity of women. JAMA 1992;268:3231-9.

  5. Henshaw SK. The accessibility of abortion services in the United States. Fam Plann Perspect 1991;23:246-52,263.

  6. Henshaw SK, VanVort J. Abortion services in the United States, 1991 and 1992. Fam Plann Perspect 1994;26:100-6,112.

  7. Peyron R, Aubeny E, Targosz V, et al. Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol. N Engl J Med 1993;328:1509-13.

  8. Winikoff B. Acceptability of medical abortion in early pregnancy. Fam Plann Perspect 1995;27:142-8,185.

  9. Hausknecht RU. Methotrexate and misoprostol to terminate early pregnancy. N Engl J Med 1995;333:537-40.

  10. Creinin MD, Vittinghoff E, Galbraith S, Klaisle C. A randomized trial comparing misoprostol three and seven days after methotrexate for early abortion. Am J Obstet Gynecol 1995:173:1578-84.


Table_1
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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, 1972-1994
============================================================================================================================================
Characteristic                 1972       1976       1980        1985         1990        1991        1992       1993 &       1994 @
--------------------------------------------------------------------------------------------------------------------------------------
Reported no.
 legal abortions              586,760    988,267   1,297,606   1,328,570    1,429,577   1,388,937   1,359,145   1,330,414    1,267,415

Abortion ratio                  180        312        359         354          345         339         335         334          321
Abortion rate                    13         21         25          24           24          24          23          22           21

                                                                    Percentage distribution **
                              --------------------------------------------------------------------------------------------------------
Residence
  In-state                     56.2       90.0       92.6        92.4         91.8        91.6        92.0        91.4         91.7
  Out-of-state                 43.8       10.0        7.4         7.6          8.2         8.4         8.0         8.6          8.3

Age group (yrs)
   <=19                        32.6       32.1       29.2        26.3         22.4        21.0        20.1        20.0         20.2
  20-24                        32.5       33.3       35.5        34.7         33.2        34.4        34.5        34.4         33.5
   >=25                        34.9       34.6       35.3        39.0         44.4        44.6        45.4        45.6         46.3

Race
  White                        77.0       66.6       69.9        66.6         64.8        63.8        61.5        60.9         60.5
  Black                        23.0       33.4       30.1        29.8         31.8        32.5        33.9        34.9         34.7
  Other ++                      --         --         --          3.5          3.4         3.7         4.6         4.2          4.8

Ethnicity
  Hispanic                      --         --         --          --           9.8        13.5        15.2        14.7         15.4
  Non-Hispanic                  --         --         --          --          90.2        86.5        84.8        85.3         84.6

Marital status
  Married                      29.7       24.6       23.1        19.3         21.7        21.4        20.8        20.4         19.9
  Unmarried                    70.3       75.4       76.9        80.7         78.3        78.6        79.2        79.6         80.1

No. live births &&
    0                          49.4       47.7       58.4        56.3         49.2        47.8        45.9        46.3         46.2
    1                          18.2       20.7       19.4        21.6         24.4        25.3        25.9        26.0         25.9
    2                          13.3       15.4       13.7        14.5         16.9        17.4        18.0        17.8         17.8
    3                           8.7        8.3        5.3         5.1          6.1         6.4         6.7         6.6          6.7
  >=4                          10.4        7.9        3.2         2.5          3.4         3.4         3.5         3.3          3.4

Type of procedure
  Curettage                    88.6       92.8       95.5        97.5         98.8        98.9        98.9        99.1         99.1
    Suction                    65.2       82.6       89.8        94.6         96.0        97.3        97.0        94.8         95.0
    Sharp                      23.4       10.2        5.7         2.9          2.8         1.6         1.9         4.3          4.1
  Intrauterine instillation    10.4        6.0        3.1         1.7          0.8         0.7         0.7         0.6          0.5
  Other @@                      1.0        1.2        1.4         0.8          0.4         0.4         0.4         0.3          0.4

Weeks of gestation
    <=8                        34.0       47.0       51.7        50.3         51.6        52.3        52.1        52.3         53.7
     <=6                        --         --         --          --           --          --         14.3 ***    14.7 +++     15.7 &&&
       7                        --         --         --          --           --          --         15.6 ***    16.2 +++     16.5 &&&
       8                        --         --         --          --           --          --         22.2 ***    21.6 +++     21.6 &&&
   9-10                        30.7       28.1       26.2        26.6         25.3        25.1        24.2        24.4         23.5
  11-12                        17.5       14.4       12.2        12.5         11.7        11.5        12.0        11.6         10.9
  13-15                         8.4        4.5        5.1         5.9          6.4         6.1         6.0         6.3          6.3
  16-20                         8.2        5.1        3.9         3.9          4.0         3.9         4.2         4.1          4.3
   >=21                         1.2        0.9        0.9         0.8          1.0         1.1         1.5         1.3          1.3
--------------------------------------------------------------------------------------------------------------------------------------
  * Number of legal induced abortions per 1000 live births.
  + Number of legal induced abortions per 1000 women aged 15-44 years.
  & Updated preliminary data. The number of areas reporting a given characteristic varied. For 1993, the number of areas reporting
    residence was 43; age, 44; race, 36; ethnicity, 23; marital status, 37; number of live births, 39; type of procedure, 41; and weeks of
    gestation, 41. Data may differ from previously published data, due to late revisions from several reporting areas.
  @ The number of areas reporting a given characteristic varied. For 1994, the number of areas reporting residence was 43; age, 44;
    race, 37; ethnicity, 23; marital status, 36; number of live births, 39; type of procedure, 41; and weeks of gestation, 40.
 ** Percentage distributions are based on known values in data from all areas reporting a given characteristic, except where the
    proportion of unknown values exceeded 15%.
 ++ Reported as "other" race.
 && For years 1972 and 1976, data indicate number of living children.
 @@ Includes hysterotomy and hysterectomy.
*** Data are for 36 of 39 areas reporting weeks of gestation.
+++ Data are for 38 of 41 areas reporting weeks of gestation.
&&& Data are for 38 of 40 areas reporting weeks of gestation.
============================================================================================================================================

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Figure_1

Figure_1
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