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What we know about abortion February 20, 2010

Posted by Sara Imershein MD in Healthcare.
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In 1969 the CDC began data collection on “abortion.”  The medical term abortion refers to ANY pregnancy that ends prior to viability, whether spontaneous or induced, whether a normal pregnancy or abnormal, or even a tubal pregnancy.  The CDC however, uses the political term abortion to refer to the termination of a pregnancy by a licensed, qualified health care practitioner. The Handbook on the Reporting of Induced Termination of Pregnancy, published in 1988 and updated in 1997, uses the correct alternative medical terminology induced termination of pregnancy

read onWell-respected obstetrician-gynecologist and medical researcher David Grimes and Gretchen Stuart criticize the terminology confusion in their article published recently in Contraception, “Abortion jabberwocky: the need for better terminology.”

The contentious issue of abortion is riddled with jabberwocky…terminology that is contradictory, obsolete, ambiguous and misleading. Both the lay and professional literature uses obstetrical terms improperly, including “abortion.”

Of note, Sociology Professor and abortion historian Carole Joffe addresses the political implications and ambiguity of the word CHOICE in her RHrealityCheck blog.

Compounding confusion about terminology, the CDC reveals data reporting by States is voluntary. It is likely these statistics do not include terminations performed in doctors’ offices or paid for privately. Anecdotally, some Institutional Review Boards (IRB) at otherwise well-respected university medical centers have refused permission for abortion-related research because of misplaced fear that the Hyde Amendment’s prohibition of Federal money for abortion services will result in a decrease in institutional grant money if they permit research, even if abortion is not funded by research funds.  The misperception of the Hyde Amendment’s reach further limits accurate data on abortion in America and compromises research benefiting women.

CDC data has several main uses in public health:

  • Identify characteristics of women who are at high risk of unintended pregnancy.
  • Evaluate the effectiveness of programs for reducing teen pregnancies and preventing unintended pregnancy among women of all ages.
  • Calculate pregnancy rates based on the number of pregnancies ending in abortion in conjunction with birth data and fetal loss estimates.
  • Monitor changes in clinical practice patterns related to abortion, such as changes in the types of procedures used, and weeks of gestation at the time of abortion.

CDC’s datasets are not available for public use.  Data is published in aggregate. States are assured strict confidentiality in exchange for releasing State data. The National Library of Medicine search engines can identify other sources of data on abortion, both domestic and global. CDC data on abortion is published regularly, although the most recent year for analysis is 2006, published in 2009.

What we do know from Guttmacher Institute and reliable physicians is:

  • Half of American Women experience an unintended pregnancy; about one-third have an abortion.
  • About 60% of abortions are obtained by women who are already mothers. The majority of abortion patients are women in their 20s.
  • Adolescents 17 and younger represent less than 7% of abortion patients.
  • Nearly 90% of U.S. counties lack a facility that provides abortions, and 35% of U.S. women live in those counties.
  • Nearly two-thirds of abortions are performed in the first eight weeks of pregnancy, i.e. six weeks after conception.
  • Abortion is an extremely low-risk medical procedure. Less than 0.3% of U.S. abortion patients experience complications requiring hospitalization.
  • In a 2004 study of women’s reasons for having abortions, nearly one-third said they had children or other dependents to care for.
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Comments»

1. Renee Hill - February 21, 2010

Very interesting Sarah. I didnt know about the terminology issues. It seems as though people all define it for themselves and there is a need for the terminology to be better clarified.

2. Gretchen Giannelli - February 22, 2010

Great point about ambiguity in terminology. I have noticed this for a long time. It is awkward when trying to choose terms to explain what you mean when there is no established terminology for such a common procedure. This is a stretch comparison, but it makes me think of ozone. Well. what ozone do you mean? The ozone that is in the upper atmosphere and is protective or the ozone produced by pollution which is in the lower atmosphere and is destructive. Very interesting data from the Guttmacher insitute too.
Regarding CDC, I too have noticed that much of the data I look for is only available up to 2006. Why does it take them so long?


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