.. em. ADOLESCENT ABORTION LEGALIZATION Less then twenty-five years ago, any women who elected to terminate her pregnancy usually had to resort to illegal, unsanitary, and unsafe means. Abortion was frequently considered a criminal offense committed by the woman and the physician performing the procedure. The Supreme Court cases leading to the legalization of abortion began in 1963 with Griswold v.
Connecticut. The court invalidated a Connecticut statute that made possession and use of contraceptives by married couples a criminal offense. The case of Griswold was later expanded to encompass the woman’s right not only to prevent but also to terminate her pregnancy. In the case of Roe v. Wade, the court held that state regulation of woman’s access to abortion at all times during her pregnancy is impermissible.
In finding unconstitutional a Texas statute that did not allow abortion unless it was performed to save the mother’s life, the Court eliminated most restrictions on an adult woman’s right to an abortion. STATISTICS According to the book, abortion data are difficult to collect , and national statistics can only be considered estimates. The figures included in this paper are primarily based on the data provided by the Alan Guttmacher Institute (AGI). AGI data are based on national surveys of health institutions and private physicians providing abortion services. Today, about 40% of the 1.1 million pregnancies of females under the age of twenty annually are terminated by induced abortions. Nearly one-third of all abortions are done on women under the age of twenty.
(Melton, 1986:41) A substantial number and proportion of abortions are obtained by teenagers. In 1981 more than 1 in 4 of the estimated 1,577,340 abortions performed were to teenagers; 6 out of 10 to 15-19 year olds were to teenagers 18-19 years of age. The chart that I included on the following page lists the number and distribution of legal abortions, abortion rates per 1,000 women, and percentage of pregnancies terminated by abortion, by age group from 1973 to 1981. (Melton 1986:43) The number of teenage abortions has risen since the Supreme Court decision in 1973, but not as rapidly as the number of abortions to other woman of childbearing age. From 1973 to 1981, the number of abortions to women aged 20-44 went from744,620 to 1,577,340 a rise of 112%.
In contrast, the number of abortions to teenagers increased from 244,570 a rise of 84%. (Melton 1986:45) The increase in number of abortions has been greater for older teenagers. Between the ages 15-19, the number of abortions went from 232,440 in 1973 to 433,330 in 1981, an increase of 86%. Below age 15, the increase was 31%, from 11,630 to 15,240. (Melton 1986:45) Teenagers between 18 and 19 years of age have the highest demand for abortion services for women of any age, at 61.8 per 1,000 in 1981. For teenagers aged 15-17 years, the rate was 30.1%. For teenagers below age 15 it was 8.6.
(Melton 1986:60) The rise in teenage abortion rates has been greater than that for women of childbearing age overall. Between 1973 and 1981, abortion rates for teenagers between 15 and 19 years went from 22.8 to 43.3 an increase of 90%. For teenagers below 15, the increase was 54%, from 5.6 to 8.6. In comparison the increase for all females of childbearing age was 80%, from 16.3 to 29.3 (Melon 1986:46) The rising rates of abortion in 1973 reflect a substantial rise in teenage sexual activity. By 1979 premarital sexual intercourse was not uncommon, with one out of two woman aged 15-19 reporting they had ever had sexual intercourse. For women, the average age for initial intercourse was 16.2 years.
The average age for males was 15.7 years. Black women experienced intercourse at younger ages than whites. Over 36% of black females aged 15-19 had first experienced intercourse before age 15 and for whites it was 19%. (Melton 1986:81) Among sexually active woman who wish to avoid pregnancy but do not practice effective contraception, the percentage of pregnancies terminated by abortion is high because many unwanted pregnancies are aborted. A majority of teenage abortions are obtained by unmarried women, and abortion rates are higher for unmarried than for married teenagers overall.
PSYCHOLOGICAL EFFECTS Women who receive abortions usually have a number of psychological effects. Often, at first, the teenager feels relieved. This feeling of relief is present because they are glad that they won’t ever have to deal with that baby again. In the long run the teenager have life-long damage such as feelings of guilt and regret. In addition to all of these negative feelings, it has been shown that there are, but few, positive results of an abortion.
The teenager is most likely to have an increased use of birth control and usually more feelings of responsibility. CONSEQUENCES Abortion seems to have fewer and less socioeconomic consequences for a teenager than carrying a pregnancy to term and raising a child. Although having an abortion requires a young woman to raise a large sum of money on short notice, once the abortion is performed there are no financial obligations in the future. The interpersonal consequences of an abortion center mainly on the possible damage to a young women’s relationships if her abortion is against others’ wishes or moral standards. For example, if the father of the baby wants to keep the child and the woman disagrees, there can be some conflicting factors.
Another example would be that if the parents of the teenager don’t want her to have an abortion because of religious reasons or maybe they are afraid of possible damage of the procedure, and the teenager goes ahead with the abortion anyway, they may be very angry at her and it could cause some family problems. At the present time, a teenager in most cases has control over the interpersonal consequences of having an abortion because she decides who should be able to know the information that she is seeking or has had an abortion. In other words, a teenager can keep her abortion a secret by either not telling anyone about it or by telling certain trustworthy people. LENGTH OF GESTATION The length of gestation at which abortion is performed is a critical factor in evaluating the medical and psychological context of abortion. Younger women obtained abortions later in pregnancy than older women. The younger the teenager, the more likely the delay. For the 32 states reporting to the CDC in 1980, women under 19 years of age accounted for 29% of all abortions but accounted for more than 40% of abortions performed at more than 16 weeks of gestation.
Of abortions obtained by adolescents aged 15 or less, 34% were performed at eight weeks or earlier in gestation, compared with 41% among 15-19 year olds and 51% among women aged 20-24. (Melton 1986:56) NOTIFICATION REQUIREMENTS Parental notification requirements, or the belief that such requirements exist even when clinics do not have such a policy, may also contribute to delay in seeking abortion. More than 4 in 10 facilities have parental notification requirements for girls aged 15 or younger, and 3 in 10 require parental consent or notification for 17-year olds. COST Length of gestation affects cost and access to clinic service providers as well. In 1981 the average clinic charge for a first-trimester abortion was $190.00. The cost for a second-trimester dilation and evacuation averaged $358.00. Since only 21% of clinics provide second-trimester services, teenagers who delay seeking abortion must have them in the more expensive hospital setting, where the average cost of a second trimester is $740.00.
Cost continues to be an issue for teenagers. 9 in 10 teenagers aged 17 years or younger rely on their partners, parents, or Medicaid to defray the cost of abortion. In 1979, for teens 15 years or younger, 2 out of 5 had abortions paid for by their parents, one-fifth by their partners, and one-fourth by Medicaid. One-tenth shared the cost with parents or partner, and only 1 in 25 paid alone. COMPLICATIONS It is well documented that the risk of dying from complications related to childbirth is about 7 times the risk from having an abortion, combining all weeks of gestation. Recent research suggests that teenagers have an even lower risk of death from abortion than women aged 20 years or older and have no higher risk of experiencing most of the complications associated with abortion, including fever of three or more days’ duration, transfusion, and unintended surgery.
Cervical injury is the only complication for which teenagers have a higher risk. From 1972 to 1978, the crude death-to-case rate for teenagers was 1.3 per 100,000 procedures. In contrast, the rate was 2.9 for women 30 and older. Death-to-case rates generally increased with the woman’s age within each gestation period. Although abortions performed on teenagers are generally safer than those on older women, the finding of 5.5 cervical injuries per 1,00 procedures prompted researchers to suggest that more gradual dilation of the cervix may help reduce the rate of cervical injury. THE MALE ADOLESCENT There is an increasing interest in the rights and responsibilities of the male partner regarding the outcome of pregnancy. Little is known about the effects an abortion has on the young male involved.
There appears to be significant differences in attitudes toward abortion between black and white adolescent males. There was a reported study of more than 1,000 males, finding that the large majority of blacks were opposed to abortion on moral grounds and would not want their partner to have an abortion. On the other hand white males expressed the opposite attitude on both issues. The attitudes, desires, and reactions of the male partner are largely unknown to researchers and healthcare providers, but there seems to be more interest in this area. THEME OF THE BOOK The overall theme of the book we chose to read is that since legalization in 1973, there has been lower costs, better medical results and overtime there has been more concentration on psychological effects and consequences of abortion. More recently, there has been more attention given to the effects of the adolescent male. PERSONAL OPINION If we may add our personal opinion, we felt the book was very informative about the percents and ratios of adolescent abortions.
We both feel that instead of the teenage pregnancy and abortion rates increasing, we would like to see more of an educational increase not only in schools, but also in the families in this area. We would also like our teens to be educated not only on the possibility of pregnancy, but also the risk of fatal sexually transmitted diseases that every teen thinks will never happen to them. Social Issues.