Journal Article•
Abortion surveillance--United States, 2001
TL;DR: Abortion surveillance in the United States continues to provide the data necessary for examining trends in numbers and characteristics of women who obtain legal induced abortions and to increase understanding of this pregnancy outcome.
Abstract: PROBLEM/CONDITION CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. REPORTING PERIOD COVERED This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2001. DESCRIPTION OF SYSTEM For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. In 2000 and 2001, Oklahoma again reported these data, increasing the number of reporting areas to 49. RESULTS A total of 853,485 legal induced abortions were reported to CDC for 2001 from 49 reporting areas, representing a 0.5% decrease from the 857,475 legal induced abortions reported by the same 49 reporting areas for 2000. The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2001, compared with 245 reported for 2000. This represents a 0.4% increase in the abortion ratio. The abortion rate was 16 per 1,000 women aged 15-44 years for 2001, the same as for 2000. For both the 48 and 49 reporting areas, the abortion rate remained relatively constant during 1997-2001. The highest percentages of reported abortions were for women who were unmarried (82%), white (55%) and aged 15 weeks' gestation, including 4.3% at 16-20 weeks and 1.4% at > or =21 weeks. A total of 35 reporting areas submitted data stating that they performed medical (nonsurgical) procedures, making up 2.9% of all reported procedures from the 45 areas with adequate reporting on type of procedure. In 2000 (the most recent year for which data are available), 11 women died as a result of complications from known legal induced abortion. No deaths were associated with known illegal abortion. INTERPRETATION During 1990-1997, the number of legal induced abortions gradually declined. When the same 48 reporting areas are compared, the number of abortions decreased during 1996-2001. In 2000 and 2001, even with one additional reporting state, the number of abortions declined slightly. In 2000, as in previous years, deaths related to legal induced abortions occurred rarely (less than one death per 100,000 abortions). PUBLIC HEALTH ACTION Abortion surveillance in the United States continues to provide the data necessary for examining trends in numbers and characteristics of women who obtain legal induced abortions and to increase understanding of this pregnancy outcome. Policymakers and program planners use these data to improve the health and well-being of women and infants.
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TL;DR: The rate of unintended pregnancy in 2001 was substantially above average among women aged 18-24, unmarried (particularly cohabiting) women, low-income women, women who had not completed high school and minority women, but increased among poor and less educated women.
Abstract: CONTEXT: Many pregnancies are unintended, particularly in certain population groups. Determining whether unintended pregnancy rates and disparities in rates between subgroups are changing may help policymakers target reproductive health services to those women most in need.
METHODS: To calculate rates of unintended pregnancy and related outcomes, data on pregnancy intendedness from the 2002 National Survey of Family Growth were combined with birth, abortion and population data from federal, state and nongovernmental sources.
RESULTS: In 2001, 49% of pregnancies in the United States were unintended. The unintended pregnancy rate was 51 per 1,000 women aged 15–44, meaning that 5% of this group had an unintended pregnancy. This level was unchanged from 1994. The rate of unintended pregnancy in 2001 was substantially above average among women aged 18–24, unmarried (particularly cohabiting) women, low-income women, women who had not completed high school and minority women. Between 1994 and 2001, the rate of unintended pregnancy declined among adolescents, college graduates and the wealthiest women, but increased among poor and less educated women. The abortion rate and the proportion of unintended pregnancies ending in abortion among all women declined, while the unintended birth rate increased. Forty-eight percent of unintended conceptions in 2001 occurred during a month when contraceptives were used, compared with 51% in 1994.
CONCLUSIONS: More research is needed to determine the factors underlying the disparities in unintended pregnancy rates by income and other characteristics. The findings may reflect a need for increased and more effective contraceptive use, particularly among high-risk groups.
1,898 citations
TL;DR: For instance, the authors found that nearly half (49%) of pregnancies were unintended in 2006, up slightly from 2001 (48%) and the unintended pregnancy rate increased to 52 per 1000 women aged 15-44 years in 2006 from 50 in 2001.
1,167 citations
01 Jan 2011
TL;DR: Efforts to help women and couples plan their pregnancies, such as increasing access to effective contraceptives, should focus on groups at greatest risk for unintended pregnancy, particularly poor and cohabiting women.
Abstract: Background: The incidence of unintended pregnancy is among the most essential health status indicators in the field of reproductive health. One ongoing goal of the US Department of Health and Human Services is to reduce unintended pregnancy, but the national rate has not been estimated since 2001. Study Design: We combined data on women's pregnancy intentions from the 2006–2008 and 2002 National Survey of Family Growth with a 2008 national survey of abortion patients and data on births from the National Center for Health Statistics, induced abortions from a national abortion provider census, miscarriages estimated from the National Survey of Family Growth and population data from the US Census Bureau. Results: Nearly half (49%) of pregnancies were unintended in 2006, up slightly from 2001 (48%). The unintended pregnancy rate increased to 52 per 1000 women aged 15–44 years in 2006 from 50 in 2001. Disparities in unintended pregnancy rates among subgroups persisted and in some cases increased, and women who were 18–24 years old, poor or cohabiting had rates two to three times the national rate. The unintended pregnancy rate declined notably for teens 15–17 years old. The proportion of unintended pregnancies ending in abortion decreased from 47% in 2001 to 43% in 2006, and the unintended birth rate increased from 23 to 25 per 1000 women 15–44 years old. Conclusions: Since 2001, the United States has not made progress in reducing unintended pregnancy. Rates increased for nearly all groups and remain high overall. Efforts to help women and couples plan their pregnancies, such as increasing access to effective contraceptives, should focus on groups at greatest risk for unintended pregnancy, particularly poor and cohabiting women.
1,130 citations
TL;DR: In this paper, the authors found that in children aged from two years, nasal spray vaccines made from weakened influenza viruses were better at preventing illness caused by the influenza virus than injected vaccine made from the killed virus.
Abstract: Children (< 16 years old) and the elderly (above 65 years old) are the two age groups that appear to have the most complications following an influenza infection. Influenza has a viral origin and often results in an acute respiratory illness affecting the lower or upper parts of the respiratory tract, or both. Viruses are mainly of two subtypes (A or B) and spread periodically during the autumn-winter months. However, many other viruses can also cause respiratory tract illnesses.
Diffusion and severity of the disease could be very different during different epidemics. Efforts to contain epidemic diffusion rely mainly on widespread vaccination. Recent policy from several internationally-recognised institutions, recommend immunisation of healthy children between 6 and 23 months of age (together with their contacts) as a public health measure.
The review authors found that in children aged from two years, nasal spray vaccines made from weakened influenza viruses were better at preventing illness caused by the influenza virus than injected vaccines made from the killed virus. Neither type was particularly good at preventing 'flu-like illness' caused by other types of viruses. In children under the age of two, the efficacy of inactivated vaccine was similar to placebo. It was not possible to analyse the safety of vaccines from the studies due to the lack of standardisation in the information given, but very little information was found on the safety of inactivated vaccines, the most commonly used vaccine in young children.
564 citations
TL;DR: It is believed that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions.
548 citations
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TL;DR: Rates of unintended pregnancy have declined, probably as a result of higher contraceptive prevalence and use of more effective methods, and efforts to achieve further decreases should focus on reducing risky behavior, promoting the use of effective contraceptive methods and improving the effectiveness with which all methods are used.
Abstract: Context Current debates on how to reduce the high U.S. abortion rate often fail to take into account the role of unintended pregnancy, an important determinant of abortion. Methods Data from the 1982, 1988 and 1995 cycles of the National Survey of Family Growth, supplemented by data from other sources, are used to estimate 1994 rates and percentages of unintended birth and pregnancy and the proportion of women who have experienced an unintended birth, an abortion or both. In addition, estimates are made of the proportion of women who will have had an abortion by age 45. Results Excluding miscarriages, 49% of the pregnancies concluding in 1994 were unintended; 54% of these ended in abortion. Forty-eight percent of women aged 15-44 in 1994 had had at least one unplanned pregnancy sometime in their lives; 28% had had one or more unplanned births, 30% had had one or more abortions and 11% had had both. At 1994 rates, women can expect to have 1.42 unintended pregnancies by the time they are 45, and at 1992 rates, 43% of women will have had an abortion. Between 1987 and 1994, the unintended pregnancy rate declined by 16%, from 54 to 45 per 1,000 women of reproductive age. The proportion of unplanned pregnancies that ended in abortion increased among women aged 20 and older, but decreased among teenagers, who are now more likely than older women to continue their unplanned pregnancies. The unintended pregnancy rate was highest among women who were aged 18-24, unmarried, low-income, black or Hispanic. Conclusion Rates of unintended pregnancy have declined, probably as a result of higher contraceptive prevalence and use of more effective methods. Efforts to achieve further decreases should focus on reducing risky behavior, promoting the use of effective contraceptive methods and improving the effectiveness with which all methods are used.
1,543 citations
"Abortion surveillance--United State..." refers background in this paper
...Additionally, 31% of births in 1995 were reported as unintended at conception; 21% were considered mistimed, and 10% were considered unwanted (9,63)....
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...Unintended pregnancy is a problem not just for adolescents, unmarried women, or women of low socioeconomic status; it is a pervasive public health problem for all women of reproductive age (9,15,54,63)....
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...Research has indicated that approximately 49% of all pregnancies in 1994 were unintended at conception (63)....
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07 Jan 2009
TL;DR: The number of births, the birth rate, fertility rate, and total fertility rates all declined 1 percent in 2001; the teenage birth rate reached another historic low and twin birth rate continued to climb.
Abstract: Objectives—This report presents 2006 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, con genital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother’s state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods—Descriptive tabulations of data reported on the birth certificates of the 4.3 million births that occurred in 2006 are presented. Denominators for population-based rates are postcensal estimates derived from the U.S. 2000 census. Results—In 2006, births and fertility rates increased for most states, age groups, and race and Hispanic origin groups. A total of 4,265,555 births were registered in the United States in 2006, 3 percent more than in 2005, and the largest number of births in more than four decades. The crude birth rate was 14.2, up slightly from the previous year; the general fertility rate was 68.5, up 3 percent. Birth rates increased for women in nearly all age groups, with the largest increases for teenagers and for women aged 20–24 and 40–44 years. Teenage childbearing increased, interrupting the 14-year decline from 1991– 2005. The mean age at first birth for U.S. women was down in 2006, to 25.0 years. The total fertility rate increased to 2,100.5 births per 1,000 women. All measures of unmarried childbearing reached record levels in 2006. Women were less likely to receive timely prenatal care in 2006. The cesarean delivery rate climbed to 31.1 percent, another all-time high. Preterm and low birthweight rates continued to rise; the twin birth rate was unchanged for the second consecutive year; the rate of triplet and higher order multiple births declined 5 percent. 2006 1996
940 citations
"Abortion surveillance--United State..." refers background in this paper
..., Mexican, Puerto Rican, Cuban, and other Hispanic) and nonHispanic (white, black, and other) subpopulations, comparisons between Hispanic and non-Hispanic populations are of limited value (7)....
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...The abortion ratio for women aged 20–34 years (those with the highest fertility rates) (7) has declined slightly since the mid-1980s....
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...Census Bureau estimates and birth certificate data indicate that a substantial majority of Hispanic women report themselves as white (7)....
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...NCHS vital statistics reports indicate that fertility and live birth rates were substantially higher for Hispanic women as a whole than for non-Hispanic women for all age groups in 2001 (7)....
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...The overall declines in the abortion ratio and rate over time might reflect multiple factors, including a decrease in the number of unintended pregnancies (9); a shift in the age distribution of women toward the older and less fertile ages (7); reduced or limited access to abortion services, including the passage of abortion laws that affect adolescents (e....
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01 May 1997
TL;DR: It appears that the prevalence of pelvic inflammatory disease (PID) and vaginal douching have both decreased since 1988, and the proportion of teenagers who have ever had sexual intercourse decreased slightly between 1990 and 1995.
Abstract: This report presents data on wide range of topics from the 1995 National Survey of Family Growth including: pregnancy and birth marriage divorce cohabitation sexual intercourse contraception infertility use of family planning and other conditions and behavior. The data reported are based on in-person interviews with a national sample of 10847 women 15-44 years of age. The interviews lasted an average of 103 minutes. The response rate was 79% and the sample data are adjusted for nonresponse and are national estimates. Following large increases in the 1970s and 1980s the proportion of teenagers who have ever had sexual intercourse decreased slightly between 1990 and 1995; condom use both at first intercourse and currently has increased markedly since the 1970s. These changes may have contributed to the decrease in teen birth rate observed in the 1990s. For all women 15-44 years of age the number whose partner was currently using the condom (at the date of the interview) increased from 3.6 million in 1982 to 5.1 million in 1988 and to 7.9 million in 1995. About 8% of women reported that their first intercourse was not voluntary. This result is consistent with an earlier national survey. Furthermore about 20% reported that they have been forced by a man to have intercourse at some time in their lives. About 10% of births in 1990-95 were unwanted by the mother compared with 12% in 1984-88. The decrease of unwanted birth was particularly high for Black women.
859 citations
"Abortion surveillance--United State..." refers background or methods in this paper
...Additionally, 31% of births in 1995 were reported as unintended at conception; 21% were considered mistimed, and 10% were considered unwanted (9,63)....
[...]
...Unintended pregnancy is a problem not just for adolescents, unmarried women, or women of low socioeconomic status; it is a pervasive public health problem for all women of reproductive age (9,15,54,63)....
[...]
...The overall declines in the abortion ratio and rate over time might reflect multiple factors, including a decrease in the number of unintended pregnancies (9); a shift in the age distribution of women toward the older and less fertile ages (7); reduced or limited access to abortion services, including the passage of abortion laws that affect adolescents (e....
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...only coitus-dependent contraceptive methods†† during the 3 months before the interview used these methods inconsistently (9)....
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Journal Article•
TL;DR: In the United States, a total of 861,789 legal induced abortions were reported to the Centers for Disease Control and Prevention (CDC) for 1999, representing a 2.5% decrease from the 884,273 reported by the same 48 reporting areas for 1998 as discussed by the authors.
Abstract: PROBLEM/CONDITION: CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions and to monitor unintended pregnancy. REPORTING PERIOD COVERED: This report summarizes and describes data reported to CDC regarding legal induced abortions obtained in the United States in 1999. DESCRIPTION OF SYSTEM: For each year since 1969, CDC has compiled abortion data by state or area of occurrence. From 1973 through 1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. Beginning in 1998, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these areas were not estimated. The availability of data regarding the characteristics of women who obtained an abortion in 1999 varied by state and by the number of states reporting each characteristic. The total number of legal induced abortions is reported by state of residence and also by state of occurrence for most areas; characteristics of women obtaining abortions in 1999 are reported by state of occurrence. RESULTS: A total of 861,789 legal induced abortions were reported to CDC for 1999, representing a 2.5% decrease from the 884,273 legal induced abortions reported by the same 48 reporting areas for 1998. The abortion ratio, defined as the number of abortions per 1,000 live births, was 256 in 1999, compared with 264 reported for 1998; the abortion rate for these 48 reporting areas was 17 per 1,000 women aged 15-44 years for 1999, the same as in 1997 and 1998. The highest percentages of abortions were reported for women aged or = 21 weeks. A total of 27 reporting areas submitted data stating that they performed medical (nonsurgical) procedures (two of these areas categorized medical abortions with "other" procedures), making up < 1.0% of all procedures reported from all reporting areas. In 1998 (for which data have not been published previously and the most recent year for which such data are available), nine women died as a result of complications from known legal induced abortion; no deaths were associated with known illegal abortion. INTERPRETATION: From 1990 through 1997, the number of legal induced abortions gradually declined. In 1998 and in 1999, the number of abortions continued to decrease when comparing the same 48 reporting areas. In 1998, as in previous years, deaths related to legal induced abortions occurred rarely. PUBLIC HEALTH ACTION: Abortion surveillance in the United States should continue so that trends and characteristics of women who obtain legal induced abortions can be examined and efforts to prevent unintended pregnancy can be enhanced.
633 citations
TL;DR: A prospective, randomized trial to compare oral with vaginal administration of the prostaglandin E1 analogue misoprostol for first-trimester abortion in women treated initially with mifepristone in women seeking abortion within 63 days after the onset of amenorrhea.
Abstract: Background Medical termination of pregnancy can be successfully performed with a combination of mifepristone (RU 486) and a prostaglandin analogue. We conducted a prospective, randomized trial to compare oral with vaginal administration of the prostaglandin E1 analogue misoprostol for first-trimester abortion in women treated initially with mifepristone. Methods The study population consisted of 270 women seeking abortion within 63 days after the onset of amenorrhea. The dose of mifepristone was 600 mg, and the dose of misoprostol was 800 μg. The study had two primary end points: expulsion of the conceptus without the need for a surgical procedure, and abortion within four hours after the administration of misoprostol. Results Expulsion of the conceptus without the need for a surgical procedure occurred in 95 percent of the women who received misoprostol vaginally and in 87 percent of those who received it orally (P = 0.03). The rate of continued pregnancy was 7 percent with the oral regimen and 1 percent...
396 citations