Medical and Social Health Benefits Since Abortion Was Made Legal in the U.S.
Despite the claims of anti-choice ideologues, many demonstrable health benefits
- physical, emotional, and social - have accrued to Americans since 1973, when
the U.S. Supreme Court legalized abortion in its decision, Roe v. Wade.
The most important benefit, of course, has been the end of an era that
supported the proliferation of "back alley butchers" who were motivated by
money alone and performed unsafe, medically incompetent abortions that left
many women dead or injured. And compassionate mainstream physicians, who
provided clandestine, medically safe abortions, who did not exploit their
patients, and who were motivated by principle rather than by financial
concerns, no longer had to fear imprisonment and the loss of their medical
licenses for performing abortions after Roe was decided (Joffe, 1995). Today,
as the 30th anniversary of this landmark decision approaches, it is important
to remember how far Roe has brought us as a society and to note some of the
many benefits that resulted from the legalization of abortion.
Roe v. Wade did not "invent" abortion.
Estimates of the annual number of illegal abortions in the 1950s and 1960s
range from 200,000 to 1.2 million (Tietze & Henshaw, 1986).
In 1969, one year before New York State legalized abortion, complications from
abortions accounted for 23 percent of all pregnancy-related admissions to
municipal hospitals in New York City (Institute of Medicine, 1975).
After California liberalized its abortion law in 1967, the number of admissions
for infection resulting from illegal abortion at Los Angeles County/University
of Southern California Medical Center fell by almost 75 percent (Seward, et
al., 1973).
Since Roe v. Wade, women have obtained abortions earlier in pregnancy when
health risks to them are at the lowest.
In 1973, only 36 percent of abortions were performed at or before eight weeks
of pregnancy (CDC, 1999).
Today, 88 percent of all legal abortions are performed within the first 12
weeks of pregnancy, and 56 percent take place within the first eight weeks of
pregnancy. Only 1.4 percent occur after 20 weeks (CDC, 2002).
Deaths from abortion declined dramatically during the past two decades.
In 1965, when abortion was still illegal nationwide except in cases of life
endangerment, at least 193 women died from illegal abortions, and illegal
abortion accounted for nearly 17 percent of all deaths due to pregnancy and
childbirth in that year (NCHS, 1967).
In 1973, the risk of dying from an abortion was 3.4 deaths per 100,000 legal
abortions. This rate fell to 1.3 by 1977 (Gold, 1990). Today, abortion is one
of the most commonly performed clinical procedures, and the current death rate
from abortion at all stages of gestation is 0.6 per 100,000 procedures. This is
eleven times safer than carrying a pregnancy to term and nearly twice as safe
as a penicillin injection (Paul et al., 1999; Gold, 1990).
Medically safe, legal abortion has had a profound impact on American women and
their families.
Couples at risk of having children affected with severe and often fatal genetic
disorders have been willing to conceive because of the availability of
amniocentesis and safe, legal abortion (Milunsky, 1989).
Following the legalization of abortion, the largest decline in birthrates were
seen among women for whom the health and social consequences of unintended
childbearing are the greatest - women over 35, teenagers, and unmarried women
(Levine, et al., 1999). Today, thirty-one percent of the abortions in the U.S.
are provided to women over 35 and to teenagers (Jones, et al., 2002).
More than half of all abortions are performed at or before eight weeks of
pregnancy, when the procedure is the safest - 0.2 deaths per 100,000 procedures
(Gold, 1990).
Half of all pregnancies in the U.S. each year are unintended, and about half of
these are terminated by medically safe, legal abortions. In 2000, 1.31 million
abortions took place, down from an estimated 1.61 million in 1990. From 1973
through 1997, more than 35 million legal abortions occurred (AGI, 2002;
Henshaw, 1998).
If safe, legal abortion were not available, more women would experience
unwanted childbearing, and unwanted childbearing affects the entire family.
Mothers with unwanted births suffer from higher levels of depression and lower
levels of happiness than mothers without unwanted births. They spank and slap
their children more often than other mothers, and spend less leisure time
outside the home with their children. Lower-quality mother/child relationships
are not limited to the child born as a result of the unwanted pregnancy - all
the children in the family suffer (Barber, et al., 1999).
The legalization of abortion has also improved the average living conditions of
children. Because of increased access to abortion, cohorts born after 1973 are
less likely than those born before 1973 to be in single-parent households, to
live in poverty, and to receive welfare. They also experience lower infant
mortality rates (Gruber, et al., 1999).
The health and well-being of women and children suffer the most in states that
have the most stringent anti-abortion laws.
Compared to pro-choice states, anti-abortion states spend far less money per
child on a range of services such as foster care, education, welfare, and the
adoption of children who have physical and mental disabilities (Schroedel,
2000).
The states that have the strongest anti-abortion laws are also the states in
which women suffer from lower levels of education and higher levels of poverty,
as well as from a lower ratio of female-to-male earnings. They also have a
lower percentage of women in the legislature and fewer mandates requiring
insurance providers to cover minimum hospital stays after childbirth
(Schroedel, 2000).
The legalization of abortion was a significant factor in the dramatic drop in
crime in the U.S. in the 1990s.
Previous research has established that a strong link exists between an adverse
family environment and future criminal behavior; that maternal rejection is
counted among the various qualitative aspects of parenting that provide the
most accurate predictors of juvenile delinquency; and that having been born of
a pregnancy that was unwanted by one's mother is a circumstance that increases
a person's risk of committing violent crime (David, et al., 1988; Donohue &
Levitt, 2001).
At least one study reported that legalized abortion can account for about half
the observed decline in crime in the U.S. since 1991. Homicide rates have
fallen more than 40 percent, and violent crime and property crime have fallen
more than 30 percent.
The timing of the drop in crime corresponds to the period in which the first
generation of children born after the legalization of abortion are reaching
what are considered to be the peak ages of criminal activity (18-24 years old).
Furthermore, states that legalized abortion before the rest of the nation did
so were also the first states to experience decreasing crime rates.
States with high abortion rates have seen a greater fall in crime since 1985,
even after taking into account other factors that would be expected to
influence the crime rate. Furthermore, these declines in crime rates in
high-abortion states are disproportionately concentrated among those under the
age of 25. (Donohue & Levitt, 2001)
In sum, no amount of controversy over abortion can negate the evidence that
American women, men, children, and families have reaped great benefits to their
physical, mental, and social health from the U.S. Supreme Court's historic
decision in Roe v. Wade. Any erosion of a woman's right and access to medically
safe, legal abortion jeopardizes the health of women, their families, and the
nation as a whole.
Cited References
AGI - Alan Guttmacher Institute. (2002, accessed October 16). Facts in Brief:
Induced Abortion [Online]. http://www.agi-usa.org/pubs/fb_induced_abortion.html
Barber, Jennifer S., et al. (1999). "Unwanted Childbearing, Health, and
Mother-Child Relationships." Journal of Health and Social Behavior, 40
(September), 231-257.
CDC - Centers for Disease Control and Prevention. (1999, July 30). "Abortion
Surveillance - United States, 1996." Morbidity and Mortality Weekly Report,
48(SS-4).
_____. (2002, June 7). "Abortion Surveillance - United States, 1998." Morbidity
and Mortality Weekly Report, 51 (SS-3).
David, Henry P., et al. (1988). Born Unwanted. New York: Springer Publishing
Company.
Donohue, John J. III, & Steven D. Levitt. (2001). "The Impact of Legalized
Abortion on Crime." The Quarterly Journal of Economics, 66(2), 379-420.Gold,
Rachel Benson. (1990). Abortion and Women's Health: A Turning Point for
America? New York: The Alan Guttmacher Institute.
Gruber, Jonathan, et al. (1999). "Abortion Legalization and Child Living
Circumstances: Who Is the "Marginal Child"?" The Quarterly Journal of
Economics, 114(1), 263-291.
Henshaw, Stanley. (1998). "Abortion Incidence and Services in the United
States, 1995-1996." Family Planning Perspectives, 30(6), 263-270 & 287.
Institute of Medicine. (1975). Legalized Abortion and the Public Health.
Washington, DC: National Academy of Sciences.
Joffe, Carole. (1995). Doctors of Conscience: The Struggle to Provide Abortion
Before and After Roe v. Wade. Boston, MA: Beacon Press.
Jones, Rachel, et al. (2002). "Patterns in the Socioeconomic Characteristics of
Women Obtaining Abortions in 2000-2001." Perspectives on Sexual and
Reproductive Health, 34(5), 226-235.
Levine, Phillip, et al. (1999). "Roe v Wade and American Fertility." American
Journal of Public Health, 89(2), 199-203.
Milunsky, Aubrey. (1989). Choices, Not Chances: An Essential Guide to Your
Heredity and Health. Boston, MA: Little, Brown and Company.
NCHS - National Center for Health Statistics. (1967). Vital Statistics of the
United States, 1965: Vol. 11 - Mortality, Part A. Washington, DC: U.S.
Government Printing Office (GPO).
Paul, Maureen, et al. (1999). A Clinician's Guide to Medical and Surgical
Abortion. New York: Churchill Livingstone.
Schroedel, Jean Reith. (2000). Is the Fetus a Person? A Comparison of Policies
across the Fifty States. Ithaca, NY: Cornell University Press.
Seward, Paul N., et al. (1973). "The Effect of Legal Abortion on the Rate of
Septic Abortion at a Large County Hospital." American Journal of Obstetrics and
Gynecology, 115(335), 353-338.
Tietze, Christopher & Stanley K. Henshaw. (1986). Induced Abortion: A World
Review, 1986. New York: The Alan Guttmacher Institute.
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