Number of abortions (millions) Abortion ratea aAbortions per 1,000 women aged 15–44. From Sedgh G, Henshaw S, Singh S, et al. Induced abortion: estimated rates and trends worldwide. Lancet 2007;370:1338–1345 [Table 2. P1342], with permission.
(315). In 1972, 24 women died of complications of legal abortion and 39 died from known illegal abortions. In 2005, the most recent year for which complete data are available, there were seven deaths from legally induced abortion and no deaths from illegal abortion (abortion induced by a nonprofessional) in the entire United States (316). The American Medical Association’s Council on Scientific Affairs reviewed the impact of legal abortion and attributes the decline in deaths during this century to the introduction of antibiotics to treat sepsis; the widespread use of effective contraception beginning in the 1960s, which reduced the number of unwanted pregnancies; and the shift from illegal to legal abortion (317). The United States has a serious problem with teenage pregnancy. Without legal abortion, there would be almost twice as many teenage births each year.
The number of abortions reported each year in the United States—1.2 million in 2006—has been declining since the peak level of 1.61 million in 1990. In 2006, the national abortion ratio was 22.4 abortions for every 1,000 live births, and the national abortion rate was 19.4 per 1,000 women aged 15 to 44 years (318). While abortion rates for all racial and ethnic groups have declined, they are significantly higher for black and Hispanic women. Non-Hispanic white women have 22% of all abortions, black women have 37%, and Hispanic women 22%. Most women who obtain abortions are unmarried, 83.5% in 2006 (316). Use of abortion varies markedly with age. In 2006, 16.9% of women obtaining abortions were between 15 and 19 years of age, and 49.6% were 24 years of age or younger. In 2006, the abortion ratio for women younger than 15 years of age was 759 per 1,000 live births, almost as many abortions as births (Fig. 10.1). The lowest abortion ratio, 141 per 1,000 live births, is for women aged 30 to 34 years.
Regardless of personal feelings about the ethics of interrupting pregnancy, health professionals have a duty to know the medical facts about abortion and to share them with their patients (319). Providers are not required to perform abortions against their ethical principles, but they have a duty to help patients assess pregnancy risks and to make appropriate referrals.