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Abortion Surveillance: Preliminary Analysis -- United States, 1996

For 1996, CDC compiled data about legal induced abortions from the 50 states, New York City, and the District of Columbia. The total number of legal induced abortions was available from all reporting areas; however, not all areas collected information about the characteristics of women who obtained abortions. This report presents preliminary data for 1996; final abortion data for 1996 will be published during spring 1999.

In 1996, a total of 1,221,585 legal induced abortions were reported to CDC (Table_1), a slight increase of 0.9% from the number reported for 1995 (1). The number of live births decreased slightly by 0.2% during the same period (2). From 1995 to 1996, the number of reported abortions decreased in 26 of 52 reporting areas. From 1995 to 1996, the national abortion ratio (number of legal abortions per 1000 live births reported by all reporting areas) increased slightly, from 311 to 314, respectively (Table_1), and the national abortion rate (number of legal abortions per 1000 women aged 15-44 years) remained stable at 20. Consistent with previous years, approximately 92% of women who had legal abortions were residents of the state in which the procedure was performed.

Women who obtained legal induced abortions in 1996 were predominately white and unmarried. As in 1995, approximately 20% of women who obtained legal abortions in 1996 were aged less than or equal to 19 years; 32% were aged 20-24 years. Curettage (suction and sharp) remained the primary abortion procedure (99% of all procedures). As in previous years, more than half of legal abortions (55%) were performed during the first 8 weeks of gestation; specifically, 16% were at less than or equal to 6 weeks; 17% at 7 weeks; and 21% at 8 weeks. Approximately 88% of abortions were performed during the first 12 weeks of pregnancy.

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

Editorial Note

Editorial Note: From 1980 to 1990, the number of legal induced abortions in the United States varied by less than or equal to 5% annually and increased overall by 10% (1). However, from 1990 (the year in which the number of abortions was highest) to 1995, the number of reported abortions decreased by 15%. In 1996, the number increased slightly by 0.9%.

During 1972-1980, the national legal abortion rate increased each year; during 1980-1992, the rate remained stable, then declined during 1992-1995. The 1996 abortion rate of 20 per 1000 women of reproductive age (i.e., aged 15-44 years) remained unchanged from 1995 and was the lowest rate recorded since 1975 (1,3).

From 1987 to 1995, the national ratio of abortions to live births steadily declined each year reaching the lowest level in 1995 for any year since 1975 (1,3). In 1996, despite an increase in the ratio, the ratio was still at its lowest recorded level since 1976 (1,4). The ratio increased in 1996 because the numerator of this ratio (the number of abortions) increased slightly, and the denominator (the number of live births) decreased slightly. Factors contributing to the decrease in the proportion of pregnancies that ended in abortion since 1990 include a reduction in the number of unintended pregnancies, attitudinal changes concerning the decision to have an abortion or to carry a pregnancy to term, and reduced access to abortion services (5-7).

The decline in the abortion ratios also may be attributed to a shift in the age distribution of reproductive-aged women obtaining abortions. Although the actual number of women of reproductive age in the United States has increased by 12% since 1980, the proportion who are older (i.e., in later, less fertile reproductive years) has increased (2). For example, from 1980 to 1996, the percentage of women of reproductive age who were aged less than 30 years (the age group having highest fertility) declined from 58% to 45%, respectively (Bureau of the Census, unpublished data, 1998), and the percentage of women aged 35-44 years (the age group having lowest fertility) increased from 25% to 37%, respectively.

During 1996, the total number of legal induced abortions were available for all 52 reporting areas. However, approximately 31% of abortions were reported from states that, in 1996, did not have centralized reporting of abortions (four states) or from states whose state health departments did not collect, and therefore could not provide, information about characteristics (e.g., age or race) of women obtaining legal abortions (two states). To track 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). Since 1992, most reporting areas have reported abortions by gestational age in weeks of gestation for abortions performed at less than or equal to 8 weeks. As new medical methods are introduced and used for terminating pregnancies primarily at less than or equal to 8 weeks' gestation, these data will continue to assist in monitoring trends in legal abortions (8-10).

Additional statistical and epidemiologic information about legal induced abortions is available from CDC's automated Reproductive Health Information line, telephone (888) 232-2306, which provides information by fax, by voice recordings, or through the mail; or from CDC's World-Wide Web site, http://www.cdc.gov.

References

  1. Koonin LM, Smith JC, Ramick M, Strauss LT. Abortion surveillance: United States, 1995. MMWR 1998;47(no. SS-2):31-68.

  2. Ventura SJ, Martin JA, Curtin SC, Mathews TJ. Report of final natality statistics, 1996. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1998; DHHS publication no.(PHS)98-1120. (Monthly vital statistics report; vol 46, no. 11, suppl 2).

  3. CDC. Abortion surveillance -- 1975. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, CDC, 1977.

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

  5. Abma J, Chandra A, Mosher W, Peterson L, Piccinino L. Fertility, family planning, and women's health: new data from the 1995 National Survey of Family Growth. Vital Health Stat 1997;23:1-114.

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

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

  8. 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.

  9. 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.

  10. Population Council. U.S. mifepristone clinical trials: summary of findings. New York, New York: Population Council, 1997.




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 -- United States, selected years, 1972-1996
===========================================================================================================================================================
Characteristic          1972       1976        1980         1985         1990        1991         1992        1993         1994        1995        1996&
-----------------------------------------------------------------------------------------------------------------------------------------------------------
Reported no.         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   1,210,883    1,221,585
  legal abortions
Abortion ratio           180        312         359          354          345         339          335         334          321         311          314
Abortion rate             13         21          25           24           24          24           23          22           21          20           20

                                                                        Percentage distribution@
                        -----------------------------------------------------------------------------------------------------------------------------------
Residence
 In-state               56.2       90.0        92.6         92.4         91.8        91.6         92.0        91.4         91.5        91.7         91.9
 Out-of-state           43.8       10.0         7.4          7.6          8.2         8.4          8.0         8.6          8.5         8.3          8.1

Age group (yrs)
  <=19                  32.6       32.1        29.2         26.3         22.4        21.0         20.1        20.0         20.2        20.1         20.3
 20-24                  32.5       33.3        35.5         34.7         33.2        34.4         34.5        34.4         33.5        32.5         31.9
  >=25                  34.9       34.6        35.3         39.0         44.4        44.6         45.4        45.6         46.3        47.4         47.8

Race
 White                  77.0       66.6        69.9         66.6         64.8        63.8         61.5        60.9         60.5        59.5         59.1
 Black                  23.0       33.4        30.1         29.8         31.8        32.5         33.9        34.9         34.7        35.0         35.2
 Other**                  --         --          --          3.5          3.4         3.7          4.6         4.2          4.8         5.5          5.7

Ethnicity
 Hispanic                 --         --          --           --          9.8        13.5         15.2        14.7         14.5        15.4         16.1
 Non-Hispanic             --         --          --           --         90.2        86.5         84.8        85.3         85.5        84.6         83.9

Marital status
 Married                29.7       24.6        23.1         19.3         21.7        21.4         20.8        20.4         19.9        19.7         20.1
 Unmarried              70.3       75.4        76.9         80.7         78.3        78.6         79.2        79.6         80.1        80.3         79.9

No. live births++
 0                      49.4       47.7        58.4         56.3         49.2        47.8         45.9        46.3         46.2        45.2         44.2
 1                      18.2       20.7        19.4         21.6         24.4        25.3         25.9        26.0         25.9        26.5         26.8

 2                      13.3       15.4        13.7         14.5         16.9        17.4         18.0        17.8         17.8        18.0         18.4
 3                       8.7        8.3         5.3          5.1          6.1         6.4          6.7         6.6          6.7         6.8          7.0
 >=4                    10.4        7.9         3.2          2.5          3.4         3.4          3.5         3.3          3.4         3.5          3.6

Type of procedure
 Curettage              88.6       92.8        95.5         97.5         98.8        98.9         98.9        99.0         99.1        98.9         98.8
  Suction               65.2       82.6        89.8         94.6         96.0        97.3         97.0        96.4         96.5        96.6         96.5
  Sharp                 23.4       10.2         5.7          2.9          2.8         1.6          1.9         2.6          2.6         2.3          2.3
 Intrauterine
  instillation          10.4        6.0         3.1          1.7          0.8         0.7          0.7         0.6          0.5         0.5          0.4
 Other&&                 1.0        1.2         1.4          0.8          0.4         0.4          0.4         0.4          0.4         0.6          0.8

Weeks' gestation
  <=8                   34.0       47.0        51.7         50.3         51.6        52.3         52.1        52.3         53.7        54.0         54.6
   <=6                    --         --          --           --           --          --         14.3@@      14.7***      15.7+++     15.7+++      16.4&&&
     7                    --         --          --           --           --          --         15.6@@      16.2***      16.5+++     17.1+++      17.4&&&
     8                    --         --          --           --           --          --         22.2@@      21.6***      21.6+++     21.2+++      20.9&&&
  9-10                  30.7       28.1        26.2         26.6         25.3        25.1         24.2        24.4         23.5        23.1         22.6
 11-12                  17.5       14.4        12.2         12.5         11.7        11.5         12.0        11.6         10.9        10.9         11.0
 13-15                   8.4        4.5         5.1          5.9          6.4         6.1          6.0         6.3          6.3         6.3          6.0
 16-20                   8.2        5.1         3.9          3.9          4.0         3.9          4.2         4.1          4.3         4.3          4.3
  >=21                   1.2        0.9         0.9          0.8          1.0         1.1          1.5         1.3          1.3         1.4          1.5
-----------------------------------------------------------------------------------------------------------------------------------------------------------
*   Number of legal induced abortions per 1000 live births.
+   Number of legal induced abortions per 1000 women aged 15-44 years.
&   Preliminary data.  The number of areas reporting a given characteristic varied.  For 1996, the number of areas reporting
    residence was 45; age, 45; race, 35; ethnicity, 23; marital status, 34; number of live-born infants, 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 and procedures reported as "other."
@@  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.
&&& Data are for 37 of 40 areas reporting weeks of gestation.
===========================================================================================================================================================



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