Census and natality data, respectively, were used to calculate abortion rates number of abortions per 1, women and ratios number of abortions per 1, live births. Results: A total of , abortions were reported to CDC for Of these abortions, Among these same 46 reporting areas, the abortion rate for was In , all three measures reached their lowest level for the entire period of analysis — In and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, and women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates.
In , women aged 20—24 and 25—29 years accounted for These decreases were greater than the decreases for women in any older age group. In contrast to the percentage distribution of abortions and abortion rates by age, abortion ratios in and throughout the entire period of analysis were highest among adolescents and lowest among women aged 30—39 years.
In , most Few abortions 7. In , among reporting areas that included medical nonsurgical abortion on their reporting form, a total of Deaths of women associated with complications from abortions for are being investigated as part of CDC's Pregnancy Mortality Surveillance System. In , the most recent year for which data were available, 10 women were identified to have died as a result of complications from known legal induced abortions.
No reported deaths were associated with known illegal induced abortions. Interpretation: Among the 46 areas that reported data every year during —, large decreases in the total number, rate, and ratio of reported abortions from to , in combination with decreases that occurred during —, resulted in historic lows for all three measures of abortion.
Public Health Actions: Unintended pregnancy is the major contributor to abortion. Because unintended pregnancies are rare among women who use the most effective methods of contraception, increasing access to and use of these methods can help further reduce the number of abortions performed in the United States. The data in this report can help program planners and policy makers identify groups of women at greatest risk for unintended pregnancy and help guide and evaluate prevention efforts.
This report is based on abortion data for that were provided voluntarily to CDC by the central health agencies of 49 reporting areas the District of Columbia; New York City; and 47 states, excluding California, Maryland, and New Hampshire. Data were obtained every year during — from 46 reporting areas excluding Alaska, California, Louisiana, Maryland, New Hampshire, and West Virginia and were used for trend analyses.
Since , CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States 1. Following nationwide legalization of abortion in , the total number, rate number of abortions per 1, women aged 15—44 years , and ratio number of abortions per 1, live births of reported abortions increased rapidly, reaching the highest levels in the s before decreasing at a slow yet steady pace 2—4.
However, the incidence of abortion has varied considerably across demographic subpopulations 5—9. Moreover, during —, an interruption occurred in the previously sustained pattern of decrease 10—13 , but was then followed in subsequent years by even greater decreases 14— Continued surveillance is needed to monitor long-term changes in the incidence of abortion in the United States.
Each year, CDC requests tabulated data from the central health agencies of 52 reporting areas the 50 states, the District of Columbia, and New York City to document the number and characteristics of women obtaining legal induced abortions in the United States. In most states, collection of abortion data is facilitated by the legal requirement for hospitals, facilities, and physicians to report all abortions to a central health agency These central health agencies then voluntarily report the abortion data they have collected through their independent surveillance systems and provide only aggregate numbers to CDC Although CDC obtains aggregate abortion numbers from most of the central health agencies, the level of detail that it receives on the characteristics of women obtaining abortions varies considerably from year to year and by reporting area.
However, because the collection of abortion data is not federally mandated, many reporting areas have developed their own forms and do not collect all the information that CDC compiles. Each year, CDC sends suggested templates to the central health agencies for compilation of abortion data in aggregate. Aggregate abortion numbers, without individual-level records, are requested for the following variables:.
Before , few reporting areas returned these alternative templates. Finally, both the original and alternative templates provided by CDC request that aggregate numbers for certain variables be cross-tabulated by a second variable. In this report, medical abortions and abortions performed by curettage are further categorized by gestational age.
Four measures of abortion are presented in this report: 1 the total number of abortions in a given population, 2 the percentage of abortions obtained by women in a given population, 3 the abortion rate number of abortions per 1, women aged 15—44 years or other specific group within a given population , and 4 the abortion ratio number of abortions per 1, live births within a given population.
Although total numbers and percentages are useful for determining how many women have obtained an abortion, abortion rates adjust for differences in population size and reflect how likely abortion is among women in particular groups. Abortion ratios measure the relative number of pregnancies in a population that end in abortion compared with live birth.
Abortion ratios are influenced both by the proportion of pregnancies in a population that are unintended and the proportion of unintended pregnancies that end in abortion.
Census Bureau estimates of the resident female population of the United States, compiled by CDC, were used as the denominator for calculating abortion rates Overall abortion rates were calculated from the population of women aged 15—44 years living in the areas that provided data.
For the calculation of abortion ratios, live birth data were obtained from CDC natality files 34 and included births to women of all ages living in the reporting areas that provided abortion data.
This report provides state-specific and overall abortion numbers, rates, and ratios for the 49 areas that reported to CDC for excludes California, Maryland, and New Hampshire. In addition, this report describes the characteristics of women who obtained abortions in Because the completeness of reporting on the characteristics of women varies by year and by variable, this report only describes the characteristics of women obtaining abortions in areas that met reporting standards i.
Cells with a value in the range of 1—4 have been suppressed to maintain confidentiality. Although most of the data in this report are presented by the reporting area in which the abortions were performed, 48 reporting areas also provided the number of abortions by maternal residence. Three other reporting areas Iowa, Louisiana, and Massachusetts provided only the total number of abortions for out-of-state residents without specifying individual states or areas of residence from which these women came.
As a result, abortion statistics in this report by area of residence should be interpreted with caution as they are minimum estimates and might be disproportionately low for reporting areas from which many women travel to other states to obtain abortion services.
To evaluate overall trends in the number, rate, and ratio of reported abortions, annual data are presented for the 46 areas that reported every year during — Linear regression analysis was used to assess the overall rate of change among these areas during the entire 10 year period of analysis — and during the first and second half of the period of analysis — and — Percentage change calculations for to and for to also were calculated with the same 46 areas that provided data for every year included in this report.
For the analysis of certain additional variables i. For other variables i. To evaluate trends in the use of different methods for performing an abortion, reporting areas were included only if they met reporting standards and if they specifically included medical abortion as a method on their reporting form.
Some of the 49 areas that reported for were not included in certain trend analyses. As a result, summary measures for comparisons over time might differ slightly from the point estimates presented for all areas that reported for CDC has reported data on abortion-related deaths periodically since information on abortion mortality first was included in the abortion surveillance report 15, An abortion-related death is defined as a death resulting from a direct complication of an abortion legal or illegal , an indirect complication caused by a chain of events initiated by an abortion, or an aggravation of a preexisting condition by the physiologic or psychologic effects of abortion All deaths determined to be related causally to induced abortion are classified as abortion-related regardless of the time between the abortion and death.
In addition, any pregnancy-related death in which the pregnancy outcome was induced abortion regardless of the causal relation between the abortion and the death is considered an abortion-related death.
An abortion is defined as legal only if it is performed by a licensed clinician. Sources of data for abortion-related deaths have included state vital records; media reports, including computerized searches of full-text newspaper and other print media databases; and individual case reports by public health agencies, including maternal mortality review committees, health-care providers and provider organizations, private citizens and citizen groups.
For each death that possibly is related to abortion, CDC requests clinical records and autopsy reports. Two medical epidemiologists independently review these reports to determine the cause of death and whether the death was abortion related. Discrepancies are discussed and resolved by consensus. Each death is categorized by abortion type as legal induced, illegal induced, spontaneous, or unknown type.
This report provides data on induced abortion-related deaths that occurred in , the most recent year for which data are available. Data on induced abortion-related deaths that occurred during — already have been published 15 and possible abortion-related deaths that occurred during — are under investigation. Thus, national legal induced abortion case-fatality rates were calculated with denominator data from a more complete source on the total number of abortions performed in the United States Among the 49 reporting areas that provided data for , a total of , abortions were reported.
Of these abortions, , All three measures of abortion reached the lowest level reported during the entire period of analysis. Among the same 46 areas that reported every year during —, the annual rate of decrease fitted from the regression analysis for both the total number and rate, but not the ratio of reported abortions, was greater during — than during — During —, the number of reported abortions decreased by 26, abortions per year, the abortion rate decreased by 0.
In contrast, during —, the number of reported abortions decreased by abortions per year, and the abortion rate decreased by 0. Abortion numbers, rates, and ratios for have been calculated by individual state or reporting area of occurrence and the residence of the women who obtained the abortions Table 2. By occurrence, a considerable range existed in the abortion rate ranging from 3.
Because of variation that occurred among reporting areas in the percentage of abortions obtained by out-of-state residents ranging from 0. However, because states vary in the level of detail they collect on maternal residence, Among the 46 areas that reported by maternal age for , women in their 20s accounted for the majority Among the 43 reporting areas that provided data every year during —, this pattern across age groups was stable, with the majority of abortions and the highest abortion rates occurring among women aged 20—29 years and the lowest percentages of abortions and abortion rates occurring among women in the youngest and oldest age groups Table 4.
However, from to the abortion rate and percentage of abortions accounted for by younger women decreased, whereas the abortion rate and percentage of abortions accounted for by older women increased.
Among women aged 30—39 years, abortion rates varied from year to year, resulting in smaller overall changes. However, for women aged 20—24 years, abortion ratios decreased from to but then increased from to Table 4. Among the 44 areas that reported age by individual year among adolescents for , adolescents aged 18—19 years accounted for the majority Among the 40 reporting areas that provided data for adolescents by individual year of age every year during —, this pattern across age groups became even more pronounced Table 6.
The percentage of abortions accounted for by older adolescents increased, and decreases in the abortion rate were greater for younger as compared with older adolescents. Among adolescents of all ages, abortion rates decreased both from to and from to , but decreases were greatest from to , and large decreases continued from to In , the adolescent abortion ratio decreased with increasing age and was lowest among adolescents aged 19 years Table 5.
Among the 39 areas that reported gestational age at the time of abortion for Table 7 , the majority Few abortions were performed between 14—20 weeks' gestation 7. Among the remaining abortions between 7 and 13 weeks' gestation, the percentage contribution was progressively lower for each additional week of gestation: Among the 40 areas that reported by method type for and included medical abortion on their reporting form for medical providers, Large increases in medical abortion occurred both from to from 5.
Non-Hispanic white women had the lowest abortion rate 8. Data are reported separately by race and by ethnicity for Tables 13 and 15 and for — Tables 14 and Among the 37 areas that reported by marital status for , The abortion ratio was 43 abortions per 1, live births for married women and abortions per 1, live births for unmarried women. Data from the 40 areas that reported the number of previous live births for women who obtained abortions in show that Among the areas included in this comparison, Pregnancy intentions were measured with the London Measure of Unplanned Pregnancy.
It is a continuous scale ranging from 1—12, with 0—3 indicating unplanned pregnancies, 4—9 ambivalent pregnancies and 10—12 planned pregnancies. Self-rated health is a dichotomous variable of rating health prior to pregnancy as good or very good versus fair, poor or very poor. History of depression or anxiety diagnosis is a dichotomous variable indicating whether the participant has ever been told by a health professional if she suffers from a major depressive or anxiety disorder.
All participants were asked two open-ended questions about their reasons for seeking an abortion. Therefore, the answers to both questions were combined to identify all reasons given by respondents for seeking abortion. The analytic team was comprised of two of the study authors. A non-hierarchical list of themes was generated and agreed upon by both researchers after reviewing an initial responses.
The next set of responses was coded using the agreed upon themes and were revised iteratively, as appropriate.
The list of themes was finalized after review of all responses. Once the final set of themes was generated, both researchers recoded all the responses until reaching consensus on all items. Occasionally the underlying reasons that motivated a particular response were not evident.
Respondents could also be coded under multiple subthemes within an overarching theme e. Once all of the codes were finalized, the reasons for abortion were analyzed quantitatively using Stata Version Multivariable mixed effects logistic regression was used to assess the characteristics associated with having higher odds of reporting each of the major themes as a reason for seeking abortion.
Continuous predictors included age, pregnancy intentions and parity. Additional categorical predictors included a four-part race variable, a three-part marital status variable, and a three-part gestational age variable. Our quantitative analysis approach accounted for clustering by recruitment site.
Two women did not answer either question on reason for seeking an abortion, leaving a final sample of A description of study participants is presented in Table 1.
Women gave a wide range of responses to explain why they had chosen abortion. The reasons were comprised of 35 themes which were categorized under a final set of 11 overarching themes Table 2. Many women reported multiple reasons for seeking an abortion crossing over several themes.
I already have one baby, money wise, my relationship with the father of my first baby, relationship with my mom, school. Six percent of women mentioned this as their only reason for seeking abortion. I didn't have money to buy a baby spoon. If we had another child it would be undue burden on our financial situation. Four respondents 0. Due date was at the same time as my externship at school. Entering the workforce with a newborn would be difficult - I just wasn't ready yet.
So busy with school and work I felt it [having an abortion] would be the right thing to do until I really have time to have one [a child]. It's like starting over and my nerves are bad. My son…he's going to be 2b0 next month and I don't want to start over.
It's just bad timing. Six percent mentioned partners as their only reason for seeking abortion. For a more extensive analysis of partner-related reasons for seeking an abortion see Chibber et al. Six percent of women mentioned only this theme. His treatment requires driving 10 hours and now we found out we need to go to New York for some of his treatment.
The stress of that and that he relies on me. I'd been waiting a while to get into the bachelor's program and I finally got it. My work doesn't offer maternity leave and I have to work [to afford to live] here. If I took time off I would lose my job so there's just no way.
Some women, particularly younger women, expressed the feeling that having a baby at this time would negatively impact multiple aspects of their future lives. If I had the baby it would be tough to do school work, thinking about my future. I know that I wouldn't be able to do what I want to do.
I still want to be free and have my youth. I don't want to have it all gone because of one experience. I still want to study abroad. I don't want to ruin that. For a more extensive analysis of substance use as reasons for seeking an abortion see Roberts et al. Twelve percent of women gave reasons for choosing abortion related to their desire to give the child a better life than she could provide. I couldn't and the man was abusive and horrible… I didn't want my kid to grow up with a father like that knowing his father had left.
An abortion was the best option. I can't get anyone to rent to me because I have had an eviction and haven't had a steady job. While never mentioned as the only reason for choosing abortion, 13 respondents said that lack of help to care for the baby was one reason they chose abortion.
I can't take care of myself yet, let alone another person. I wouldn't want to bring a baby into this world with parents who aren't ready to be parents.
I don't think that I would be strong enough to give it up for adoption. Using mixed effects multivariate logistic regression analyses, we examined the social and demographic predictors of the predominant themes women gave for seeking an abortion Table 3. Significant predictors of reporting financial reasons for seeking an abortion included marital status, education level, and not having enough money to meet basic living needs.
This fear began with the election of President Donald Trump in November Although Trump has not signed any legislation doing so, he has indeed followed through on the first two promises. Although Kavanaugh has not spoken directly about his views on the Supreme Court decision of Roe v. However, despite the possible personal opinions of Kavanaugh, he has stated that he believes Roe v. This would mean that Kavanaugh himself is not even confident in the fact that the Supreme Court could overturn the landmark decision.
Although the possibility of Roe v. These laws are blatant state bans put on abortion, but are presently unconstitutional, therefore, unenforceable. Wade gets overturned, if ever Rose, , p. When getting elected, President Trump also promised to withhold federal funding from Planned Parenthood. This means that organizations meant to help women, such as Planned Parenthood, could potentially lose millions of dollars in funding Belluck, As of this writing a federal court in Washington state issued a nationwide injunction that stops the rule from taking effect while various lawsuits are pending Barbash, Aside from being present within the United States, every recent Republican Administration has enforced such gag rules internationally.
When the Clinton Administration came into power, this global gag rule was overturned. This back-and-forth has continued ever since, with the Bush Administration reinstating the global gag rule, and then the Obama Administration overturning it Gezinski, , pp.
Predictably, President Trump reinstated it — on his first day in office. Before being able to fully understand the potential effects of an abortion, one should know exactly what the abortion process consists of. There are multiple different kinds of abortion procedures a woman can receive that vary in methods and depend on how far along the pregnancy is.
By being fully educated on the details of the actual procedure, individuals are able to understand the issues surrounding abortion on a more comprehensive level. The following paragraphs will go through the vital specifics of each procedure. Currently, there are two different forms of first-trimester abortions: a medication abortion or an aspiration abortion.
A woman is able to choose which one she wishes to receive. As of , aspiration abortion is more commonly used than medication abortion, but the interest for the latter continues to rise.
Later, when at home, the woman takes another drug, misoprostol, either by inserting it vaginally or letting is dissolve inside her mouth. The abortion begins a few hours later, consisting of heavy bleeding and cramping. To ensure the abortion worked, the woman must go back to the doctor one week later for a follow-up appointment. In 95 to 98 percent of cases, this method is effective. For second and third trimester abortions, the procedures differ from those in the first trimester.
This method is more commonly used, and quite similar to the aspiration abortions performed during the first trimester. The earlier a woman is in her pregnancy, the less time this portion of the abortion takes. These drugs cause contractions of the uterus, thus sending the woman into labor. While the specific reasoning behind every abortion is different in each individual situation, in many cases, there are common themes of reasoning.
In , a study was done by the Guttmacher Institute to explore the reasons why a woman may seek an abortion. In the study, over abortion patients at 11 providers completed a survey that asked questions regarding their reasoning. The first portion of the survey was open ended, asking the woman to briefly explain why she was choosing to get an abortion at that time. If there were multiple reasons, she was asked to give them in order from most to least important. After that, there were specific reasons listed that the woman had to confirm whether or not were applicable to her.
There were three large reasons listed that then provided even more specific sub-reasons underneath. Finally, the questionnaire provided a space where the woman could write in her own reasons that were not listed or did not qualify within the given categories.
This study provided many possible reasons as to why a woman may seek an abortion. Although the premise of the Turnaway Study was not to focus on the reasons why women wanted an abortion, those who participated were required to give their reasoning. However, some women delved into other reasons motivating their decision. One woman explained that the medication she had been taking for her bipolar disorder was known to cause birth defects and felt it would be considered child abuse to bring a baby into the world knowing that it may have life-altering defects.
Five percent of respondents mentioned reasons that included family members. One woman was scared her family would not accept that she would be having a biracial child, while another stated that her dad wanted her to finish school before having a child Biggs et al.
The study differed from the study in the fact that the women were only given open ended questions to answer, rather than checking off possible reasons from a provided list. It is important to note that every woman and situation is different. While these studies show a plethora of reasons why women decide to get abortions, the circumstances surrounding every single abortion are personal to the individual s involved.
A hypothetical woman who wanted an abortion did it. She jumped through all the hoops: she was granted the fundamental right to receive one by the federal government, came to the educated and reasonable decision that she wanted one, overcame any legal barriers her state instituted on the matter, and was able to get the abortion she sought out to get.
Now what? Does the life-altering procedure she just underwent truly alter her life? Or does she return to her regular weekly schedule, viewing the abortion as a minor inconvenience in her life? The general consensus on this matter is contradicting. When speaking about physical, sociological, and psychological health, some research states that there are no effects on women who receive an abortion, while other research state that they are indeed affected.
After receiving an abortion, there is research concluding that women may suffer from possible physical health effects in the future. The effects that will be discussed below are increased risk of breast cancer and future reproductive health issues. One health risk that has been linked to abortion is an increased risk to breast cancer. According to biologist and endocrinologist Joel Brind, Ph.
Breast lobules, which are the lactational apparatus of the breast, remain in their immature Type 1 and 2 states unless they are stimulated by a pregnancy. This multiplication continues until the thirty-second week of pregnancy, when the milk cells are fully mature. If a woman has an abortion or delivers prematurely before the thirty-second week, cancer is more likely to develop in the immature cells. Mature milk cells are much less prone to becoming cancerous Adamek, , p.
Many other health professionals agree upon this statement and have offered further medical information. Another physical health risk that has been linked to abortion is the risk of future reproductive health issues. Serious infections can cause major issues to these, including chronic pelvic pain and damage to the fallopian tubes.
Despite these statements, there have been dissenting opinions on the idea that induced abortions and breast cancer are linked. This disagreement upon health professionals makes it hard for women to know the true risk. The scientific facts of the development of breasts points to a clear correlation between abortion and breast cancer, but the highly respected National Cancer Institute dissents from that idea.
Similarly, in regard to the possible development of an upper genital tract infection, it is difficult for women to measure the possible risk.
Within every society, there are certain human behaviors that become normalized over time. Stigmas are created and reproduced through a social process. In the first component, people distinguish and label human differences. In the second, dominant cultural beliefs link labelled persons to undesirable characteristics — to negative stereotypes. In the fourth, labelled persons experience status loss and discrimination that lead to unequal outcomes , p. Throughout history, worldwide, societies have constructed and enforced stereotypical social norms on women as a whole.
Some of the most widely held stereotypes are based around the fact that women bear children. Due to this, societal norms may expect women to be instinctually warm, kind, caring, and nurturing. By terminating a fetus, which would eventually develop into a baby, a woman getting an abortion deviates from the assumption that she should be naturally maternal. Consequentially, for those who accept these social norms about women, abortion can be seen as a stigmatized act Kumar et al.
Over the past several decades, surveys have been an essential way for researchers to gather data on topics they are studying. Personal topics like these can easily have some type of stigma attached to them if a person deviates from any type of social norm within the matter. Survey data involving these topics may be inaccurate if people refuse to participate, even if they are affected by the topic, in fear of being a social deviant.
As previously mentioned, abortion is a controversial issue in society that has been stigmatized. The social construction of deviance in regard to abortion creates an ongoing cycle of silence about the topic.
This cycle is demonstrated in the following chart, provided by Kumar , p. Underreporting of the issue makes it seem uncommon, which makes it a deviant from social norms. Those who do not behave in accordance with social norms are typically outcasted or discriminated against, making women who get abortions fear stigmatization and not report it, consequentially creating inaccurate data due to underreporting. This then brings the issue back to the beginning of the cycle Kumar et al.
Similar to the physical health effects linked with abortion, the idea that there are mental health consequences after receiving the procedure is a topic of controversy.
However, the issue with psychological compared to physical is the fact that every individual is different, and every mind works in unique ways. Physical effects are a matter of science and fact, while psychological effects rely on the unpredictability of the human brain. There is research concluding that after receiving an abortion, women may suffer from possible mental health effects. Over the years, studies have been done that concur with the idea that abortion is linked to post-abortion syndrome and further mental health problems.
Research has stated that most panic disorders in adults form in the six months following a major stressful life event. Aside from anxiety disorders, a study found:. Women who have aborted are at a higher risk for a variety of mental health problems including anxiety panic attacks, panic disorder, agoraphobia, PTSD , mood bipolar disorder, major depression with and without hierarchy , and substance abuse disorders when compared to women without a history of abortion Coleman et al.
Despite the studies claiming that women who get abortions are at a higher risk for mental health issues, there is also research that opposes this view. One study examined women over a two-year period to assess their mental health after receiving an abortion.
Those who participated were evaluated one hour before the abortion, and then one hour, one month, and two years after. From pre-abortion to post-abortion, depression decreased, self-esteem increased, and some women reported feeling a sense of relief more than any negative emotions Major et al.
For example, a woman may feel a sense of sadness following the procedure, but that does not imply she is clinically depressed. When looking at whether abortion has a psychological effect on women, it is important to note the intersectionality between sociology and psychology.
As discussed above, culturally developed societal norms and stigmas influence individuals to behave and think certain ways. Therefore, the way abortion is socially accepted within a certain group may have an impact on the psychological effects a woman experiences after getting the procedure. If a woman belongs to a community where there are stereotypes put on women, and stigma surrounding abortion, she may have a poor view of herself afterwards.
This interrelationship shows how important it is to be socially accepted within society, and how being outcasted may cause real psychological issues within human beings.
This syndrome claims that abortion is an event so traumatic that it may lead to serious psychological effects for women. However, this poses the question: is the abortion the traumatic life event triggering psychological issues, or is it the unwanted pregnancy?
Making the choice to get an abortion is a huge decision. Women are forced to decide whether they want to alter their lives by going through pregnancy and bringing a child into the world, or if they want to terminate the fetus and risk the possible side effects. However, for some women, the burden of this choice is not the only difficult part about the situation. Depending on circumstances, even if a woman wants to get an abortion, the likelihood of getting one may be close to impossible.
As discussed above, states have been able to pass statutes within their borders that make it difficult for a woman to get an abortion. These legislative barriers include zoning laws, mandatory counseling, waiting periods, and minor consent or notification.
On top of these legal obstacles put in place by the state, there may be additional conditions that cause prevention of the procedure. One large obstacle for women who wish to receive an abortion is the ability to access a provider. As discussed above, some local governments attempt to block abortion providers from residing in an area by using zoning laws, applicable under the police powers given to each state.
The use of these zoning ordinances to limit providers can make it extremely difficult for women who want to get an abortion to be able to find a place to receive the procedure within a reasonable geographical range. A couple current examples of the use of these zoning laws to limit access to abortion providers can be seen in Manassas, Virginia, and San Antonio, Texas.
This means that for the women who want an abortion but do not live in that small thirteen-percent that have providers, they must travel outside of their local community to get one. Just like anything in life, the abortion procedure has a cost.
According to Planned Parenthood, an abortion can cost anywhere between zero and almost a thousand dollars. Whether it is performed in a clinic or hospital, and is paid for by the patient, insurance, or government funding, someone is paying for it in the end. However, the price tag of the procedure is not one-size-fits-all. Another factor is the type of abortion a woman decides to get, as discussed above.
Due to the fact that these abortions include various differences: where they take place home vs. Further, if a woman has to get an aspiration abortion after the failure of a medication abortion, she is forced to pay for both.
A few final factors that involve the cost of an abortion are whether or not a woman has health insurance and her overall financial situation, which will be further discussed below Emily Planned Parenthood, A large factor that plays into the cost of the procedure is whether or not the patient has health insurance. This factor is different from the rest because it does not determine the actual cost of the procedure, but rather how the procedure will be paid for.
If she does have health insurance, it may cover some or all of the costs of the abortion. The patient must call her insurance provider to find out about her coverage. Sara was supposed to come back to the hospital after several weeks to undergo the amniocentesis aimed at identifying the DNA of the genitor.
Her father signed the consent for abortion, but she never came back. She had probably already planned an abortion in the private sector, where legal procedures never take place. This means that girls and women who can afford to turn to the private sector do not have to go through the same social and legal procedures and thus have more rights than women who cannot.
Providers in the public and private sectors do not apply the law with the same rigor, generating discriminations that mark socioeconomic and regional divides. Other inequalities also exist between women from rural areas and from central and southern Tunisia and women living in the capital or in the major coastal cities.
The former have to travel to the capital or the larger coastal cities if they want to get abortion care because this service is usually not available in the areas where they live. In some cases, even if abortion services are available, unmarried women who can afford it choose to travel to another city, as they are afraid to be seen by family members or acquaintances if they attend the government clinic of the city where they live.
Fawziyya was a year-old woman who lived in a small city located kilometers from Tunis. She was married, did not have a job, and belonged to an underprivileged social milieu. In June , she came to Hospital T to get an abortion, declaring that she was not married because, as she confessed, she thought that it was the only way to avoid involving her husband in the decision.
When they realized that Fawziyya was married, they immediately suspected that the pregnancy was the result of an extramarital relationship and that she was seeking an abortion out of fear that her husband would find out about the affair.
Fawziyya did not know that she was entitled to receive all medical services in the public hospital and that asking her to undergo an ultrasound in the private sector constituted a violation of her rights. Social rules and moral judgments interfere with the law and hospital rules, pushing some employees of the public health sector to misinterpret the law and infringe on legal norms. Women who resort to public facilities usually lack the financial means to obtain an abortion in the private sector.
There is thus a fundamental asymmetry between patients and health care providers in the public sector that allows the latter to exert a power that can seldom be opposed by the former if they want to obtain the desired services. First, they show that despite the existence of a relatively liberal abortion law, women in Tunisia have trouble getting abortion care not only for economic and organizational reasons but also for ideological and political ones.
The predicaments of the public health system that appeared as early as the mids have become more apparent in the aftermath of the revolution and the political and economic crisis that it has spurred. Many women and health care providers oppose abortion because they consider it haram religiously illicit.
Practitioners use religious or moral arguments to justify their refusal to offer abortion care, ignoring the law and the discourse of rights. Interestingly, however, when in January Najba Berioul, a deputy of the Islamist party Ennahdha, tried to re-criminalize abortion, she claimed the right of the fetus to be born, an argument typical of European and American anti-abortion movements rather than of the Malekite or other Islamic discursive traditions.
Third, the abortion stories we highlight show that strong social control is exerted on women who seek abortion care in the public health sector. The idea that abortion is exceptional, morally despicable, and a transgression of ordinary feminine identity was expressed by many of the health practitioners we interviewed, who turned women who abort into pathological subjects.
Therefore, women who are legal adults or married are often treated like minors or unmarried individuals, making their abortion itineraries longer and more painful.
The relevance of these laws—which largely reflect existing social norms—affected the provision of abortion care in the public sector, such as with regard to the treatment of minors seeking abortion services. Even though a law was promulgated in lowering the age of majority for women from 21 to 18, many health providers at Hospital T, the regional delegate mandub jihawi , and the Brigade for the Protection of Minors went on to apply the ancient law in the initial years after the revolution.
Thus, women between the ages of 18 and 20 were forced to go through the procedures designed for minor women that, as mentioned, imply a stronger interference by the state and the family.
Fourth, a lack of coordination between the police, the legal system, and the medical sector makes the abortion experiences of some groups of women—especially prisoners, minors, and the unmarried—very difficult. These women are subject to structural and institutional forms of violence that increases their social suffering. To sum up, the revolution has reinforced some attitudes and practices already present in the previous period on account of political instability, rising religious conservatism, a lack of financial resources leading to shortages of health equipment and personnel , and a growing reluctance to offer abortion care in many public hospitals and family planning clinics.
Class and regional divides have become more visible: women who live in the capital and coastal cities, as well as women from the middle and upper classes, enjoy a greater chance of their sexual and reproductive rights being respected compared to women who live in rural areas or in the cities of the interior.
In addition, the private sector is gaining ground over the public sector, where abortion services are more and more difficult to get. This reflects a larger trend in which the public health care system is being increasingly neglected and the private sector is on the rise, thanks in part to the medical travels of patients coming to Tunisia from neighboring countries.
Michelsen Institute, Bergen, Norway. Please address correspondence to Irene Maffi. Email: irene. Hajri, S.
0コメント