abortion © 2004 john b. pryor, ph.d. human sexuality psychology 123

AbortionAbortion

© 2004 John B. Pryor, Ph.D.© 2004 John B. Pryor, Ph.D.

Human SexualityHuman Sexuality

Psychology 123Psychology 123

WORLD TRENDS

IN ABORTIONWORLD TRENDS

IN ABORTION

Abortion Rate, United States and World

23

35

0

5

10

15

20

25

30

35

40

Rate per 1,000 women

United States World

Source: Henshaw et al., 1999 (1995 data)

Abortion in Developed and Developing Countries

Annual abortions per 1,000 women 15-44

0 10 20 30 40 50

DevelopingCountries

DevelopedCountries

World

Legal Illegal

Source: AGI, 1999

ABORTION TRENDS IN THE

UNITED STATESSTATES

ABORTION TRENDS IN THE

UNITED STATESSTATES

Abortion Practices before Abortion Practices before Roe Roe v. Wade v. Wade (1973)(1973)Abortion Practices before Abortion Practices before Roe Roe v. Wade v. Wade (1973)(1973)

• • estimated 200,000 to 1,200,000 per estimated 200,000 to 1,200,000 per year in U.S.year in U.S.

• • In 1965 20% of all pregnancy-related In 1965 20% of all pregnancy-related deaths attributable to illegal abortionsdeaths attributable to illegal abortions

• • In 1970 98% of all legal abortions in In 1970 98% of all legal abortions in California were for “mental health California were for “mental health reasons”reasons”

Each year, 2 out of every 100 women aged 15-Each year, 2 out of every 100 women aged 15-44 have an abortion; 47% of them have had at 44 have an abortion; 47% of them have had at least one previous abortion and 55% have had least one previous abortion and 55% have had a previous birth.a previous birth.

An estimated 43% of women will have at least An estimated 43% of women will have at least 1 abortion by the time they are 45 years old.1 abortion by the time they are 45 years old.

Abortion Practices after 1973Abortion Practices after 1973Abortion Practices after 1973Abortion Practices after 1973

Annual Number of Abortions Per 1,000 Women Aged 15–44

0

5

10

15

20

25

30

35

1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000

Rate per 1,000

Source: Finer and Henshaw, 2003

Pregnancies in the United States(Approximately 6.3 Million Annually)

52%48%

0%

10%

20%

30%

40%

50%

60%

% of pregnancies

UnintendedIntended

Source: Henshaw, 1998 (1994 data)

Outcomes of Unintended Pregnancies

(Approximately 3.0 Million Annually)

47%

40%

13%

0%

10%

20%

30%

40%

50%

60%

% of unintended pregs.

Abortions Births Miscarriages

Source: Henshaw, 1998 (1994 data)

Abortions by Gestational Age(Weeks Since Last Menstrual Period)

57.6%

20.3%

10.2%6.2% 4.3%

1.5%

0%

10%

20%

30%

40%

50%

60%

70%

% of abortions

<9 9-10 11-12 13-15 16-20 21+Weeks

Source: Elam-Evans et al., 2002 (1999 data)

Federal Laws & Policies about Federal Laws & Policies about AbortionAbortionFederal Laws & Policies about Federal Laws & Policies about AbortionAbortion

Hyde Amendment - 1977Hyde Amendment - 1977Freedom of Access to Clinic Freedom of Access to Clinic

Entrances Act - 1994Entrances Act - 1994Federal Health Benefits ProgramFederal Health Benefits Program

State Laws about AbortionState Laws about AbortionState Laws about AbortionState Laws about Abortion

In 1992, the US Supreme Court upheld In 1992, the US Supreme Court upheld the right to abortion in the right to abortion in Planned Planned Parenthood v. CaseyParenthood v. Casey. However, the . However, the ruling significantly weakened the legal ruling significantly weakened the legal protections previously afforded women protections previously afforded women and physicians by giving states the and physicians by giving states the right to enact restrictions that do not right to enact restrictions that do not create an "undue burden" for women create an "undue burden" for women seeking abortion.seeking abortion.

Parental Involvement

Mandatory Waiting Period following counseling

Restrict Medicade funding to life, rape, or incest

"Partial Birth" Abortion Ban

Restrict after specified point in pregnancy

Alabama x x x x

AlaskaArizona x x

Arkansas x x x

California x

Colorado x

Connecticut x

Delaware x x x

Florida x x

Georgia x x x x

HawaiiIdaho x x

Illinois x

Indiana x x x x x

Iowa x x x

Kansas x x x x x

Kentucky x x x x

State Laws Regulating AbortionsState Laws Regulating Abortions






Louisiana x x x x

Maine x x x

Maryland x x

Massachusetts x x

Michigan x x x

Minnesota x x

Mississippi x x x x

Missouri * x x x

Montana x

Nebraska x x x x

Nevada x x

New Hampshire x

New JerseyNew MexicoNew York x

North Carolina x x x

North Dakota x x x x

Ohio x x x x

Oklahoma x x x

Oregon







Pennsylvania x x x x

Rhode Island x x x

South Carolina x x x x x

South Dakota x x x x

Tennessee x x x

Texas x x

Utah x x x x x

VermontVirginia x x x x

Washington x

West Virginia x

Wisconsin x x x x

Wyoming x x x

# with restrictions 30 14 33 11 40


Stenberg v. Carhart, 530 U.S. 914 (2000)Stenberg v. Carhart, 530 U.S. 914 (2000)

US Supreme Court overturned a Nebraska US Supreme Court overturned a Nebraska statute banning "partial-birth abortion."statute banning "partial-birth abortion."

Court found that the ban would outlaw the safest Court found that the ban would outlaw the safest and most commonly used methods of second-and most commonly used methods of second-trimester abortion, and therefore constituted an trimester abortion, and therefore constituted an undue burden on women’s right to obtain undue burden on women’s right to obtain abortions.abortions.

"the absence of a health exception will place women at an unnecessary risk of tragic health consequences."

Federal Laws in the WorksFederal Laws in the Works

Despite that ruling, Congress passed an almost Despite that ruling, Congress passed an almost identical ban on so-called “partial birth abortion” that identical ban on so-called “partial birth abortion” that was signed into law by President George W. Bush on was signed into law by President George W. Bush on November 5, 2003.November 5, 2003.

Also on November 5, 2003, minutes after Bush Also on November 5, 2003, minutes after Bush signed it into law, a Nebraska federal judge issued a signed it into law, a Nebraska federal judge issued a temporary restraining order preventing the first-ever temporary restraining order preventing the first-ever federal abortion ban from being enforced against the federal abortion ban from being enforced against the

plaintiffs in the Nebraska lawsuit challenging the ban.plaintiffs in the Nebraska lawsuit challenging the ban.

Research from Psychology on the Possible

Psychological Impact of Abortions upon Women

who have them

Research from Psychology on the Possible

Psychological Impact of Abortions upon Women

who have them

Women who have abortionsWomen who have abortions

Up to 98 percent of the women who have abortions Up to 98 percent of the women who have abortions have no regrets and would make the same choice have no regrets and would make the same choice again in similar circumstances (Dagg, 1991).again in similar circumstances (Dagg, 1991).

More than 70 percent of women who have abortions More than 70 percent of women who have abortions express a desire for children in the future (Torres & express a desire for children in the future (Torres & Forrest, 1988). There is no evidence that women Forrest, 1988). There is no evidence that women who have had abortions make less loving or suitable who have had abortions make less loving or suitable parents (Bradley, 1984).parents (Bradley, 1984).

Normative Psychological Responses Normative Psychological Responses to Abortionto Abortion

Normative Psychological Responses Normative Psychological Responses to Abortionto Abortion

• • Lazarus (1985) Lazarus (1985)

292 women studied 2 weeks after292 women studied 2 weeks after

76% reported happiness76% reported happiness

17% reported guilt17% reported guilt

Serious psychological disturbances?Serious psychological disturbances?

Serious psychological disturbances after Serious psychological disturbances after abortion are less frequent than after abortion are less frequent than after childbirth.childbirth.

Researchers suggest that the predictors of Researchers suggest that the predictors of severe psychological disturbances after severe psychological disturbances after abortion are:delays in seeking abortion, abortion are:delays in seeking abortion, medical or genetic indications for abortion, medical or genetic indications for abortion, and severe pre-existing or concurrent and severe pre-existing or concurrent psychiatric illness (Lazarus, 1985).psychiatric illness (Lazarus, 1985).

Normative Psychological Responses Normative Psychological Responses to Abortionto AbortionNormative Psychological Responses Normative Psychological Responses to Abortionto Abortion

• • Russo & Zierk (1992) -measured self-esteem -Russo & Zierk (1992) -measured self-esteem -

• • women who had abortions > women who had not had women who had abortions > women who had not had abortionsabortions

• • women who had abortions > women who unwanted women who had abortions > women who unwanted birthsbirths

The positive relationship of abortion to well-being may be The positive relationship of abortion to well-being may be due in part to abortion's role in controlling fertility and its due in part to abortion's role in controlling fertility and its relationship to coping resources (Russo & Zierk, 1992; relationship to coping resources (Russo & Zierk, 1992; Russo & Dabul, 1997).Russo & Dabul, 1997).

Abortion and teen pregnancyAbortion and teen pregnancy

A study of a group of teenagers who obtained A study of a group of teenagers who obtained pregnancy tests at one of two Baltimore clinics pregnancy tests at one of two Baltimore clinics found that the young women who chose to have abortions found that the young women who chose to have abortions were far more likely to graduate from high school at the were far more likely to graduate from high school at the expected age than those of similar socioeconomic status who expected age than those of similar socioeconomic status who carried their pregnancies to term or who were not pregnant. carried their pregnancies to term or who were not pregnant. They showed no greater levels of stress at the time of the They showed no greater levels of stress at the time of the pregnancy and abortion and no greater rate of psychological pregnancy and abortion and no greater rate of psychological problems two years after the abortion than did the other problems two years after the abortion than did the other women (Zabin et al., 1989).women (Zabin et al., 1989).

Post-abortion depression?Post-abortion depression?

Mild, transient, immediately postoperative Mild, transient, immediately postoperative depressive symptoms that quickly pass depressive symptoms that quickly pass occur in less than 20 percent of all women occur in less than 20 percent of all women who have had abortions (Adler et al., 1990; who have had abortions (Adler et al., 1990; Zabin et al.,1989). Zabin et al.,1989).

Similar symptoms occur in up to 70 percent Similar symptoms occur in up to 70 percent of women immediately following of women immediately following childbirth (Ziporyn, 1984).childbirth (Ziporyn, 1984).

Abortion vs. adoption?Abortion vs. adoption?

The psychological responses to The psychological responses to abortion are far less serious than those abortion are far less serious than those experienced by women bringing their experienced by women bringing their unwanted pregnancy to term and unwanted pregnancy to term and relinquishing the child for adoption relinquishing the child for adoption (Sachdev, 1993).(Sachdev, 1993).

Most Important Reason Given for Terminating an Unwanted Pregnancy

Inadequate finances 21%

Not ready for responsibility 21%

Woman’s life would be changed too much 16%

Problems with relationship; unmarried 12%

Too young; not mature enough 11%

Children are grown; woman has all she wants 8%

Fetus has possible health problem 3%

Woman has health problem 3%

Pregnancy caused by rape, incest 1%

Other 4%

Average number of reasons given 3.7

Source: Torres and Forrest, 1988 (1987 data)

Methods of AbortionMethods of Abortion

I. Suction MethodsI. Suction MethodsA. Endometrial AspirationA. Endometrial Aspiration

1. Performed 4-6 weeks after LMP1. Performed 4-6 weeks after LMP2. Use of flexible tube2. Use of flexible tube3. May be done without pregnancy 3. May be done without pregnancy

confirmationconfirmation4. Side effects may include cramps & 4. Side effects may include cramps &

intermittent menstrual bleedingintermittent menstrual bleeding


I. Suction Methods (continued)I. Suction Methods (continued)B. Early AbortionB. Early Abortion

1. Same as A. only pregnancy 1. Same as A. only pregnancy confirmedconfirmedC. Vacuum CurretageC. Vacuum Curretage

1. Performed after 8 weeks1. Performed after 8 weeks2. Larger fetal tissue2. Larger fetal tissue3. Use of rigid tube with more suction3. Use of rigid tube with more suction4. Dilation of cervix is required4. Dilation of cervix is required


I. Suction Methods (continued)I. Suction Methods (continued)D. Dilation and EvacuationD. Dilation and Evacuation

1. Performed 13-16 weeks1. Performed 13-16 weeks

2. Fetus is broken up with surgical 2. Fetus is broken up with surgical

instrument prior to suctioninstrument prior to suction

3. More dilation is needed3. More dilation is needed


II. Surgical Removal Through CervixII. Surgical Removal Through CervixA. Dilation and CurretageA. Dilation and Curretage

1. Performed 8-15 weeks1. Performed 8-15 weeks

2. Lining of uterus is scraped with 2. Lining of uterus is scraped with

surgical instrumentsurgical instrument


III. Induced Labor III. Induced Labor A. Saline AbortionA. Saline Abortion

1. Performed early to middle parts of 1. Performed early to middle parts of

2nd trimester2nd trimester

2. Saline injected into Amniotic sac 2. Saline injected into Amniotic sac

(kills fetus)(kills fetus)


IV. Surgical Removal Through IV. Surgical Removal Through Caesarean ProcedureCaesarean ProcedureA. HysterotomyA. Hysterotomy

Risks - Deaths per 100,000Risks - Deaths per 100,000

Suction Methods Suction Methods 0.50.5Induced Labor Induced Labor 4.04.0Hysterotomy Hysterotomy 58.958.9Normal Childbirth Normal Childbirth 11.011.0

Abortion Risks in Perspective

Chance of deathRisk from terminating pregnancy: per year:

Before 9 weeks 1 in 500,000 Between 9 and 10 weeks 1 in 300,000 Between 13 and 15 weeks 1 in 60,000 After 20 weeks 1 in 8,000

Risk to persons who participate in:

Motorcycling 1 in 1,000 Automobile driving 1 in 5,900 Power- boating 1 in 5,900 Playing football 1 in 25,000

Risk to women aged 15–44 from:

Having sexual intercourse (PID) 1 in 50,000 Using tampons 1 in 350,000

Source: Gold, 1990; Trussell, 1998

abortion © 2004 john b. pryor, ph.d. human sexuality psychology 123

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