Birth Mom Missions

Reasons given for having abortions in the United States

by Wm. Robert Johnston
last updated 9 October 2008

Summary: This report reviews available statistics regarding reasons given for obtaining abortions in the United States, including surveys by the Alan Guttmacher Institute and data from seven state health/statistics agencies that report relevant statistics (Arizona, Florida, Louisiana, Minnesota, Nebraska, South Dakota, and Utah). The official data imply that AGI claims regarding "hard case" abortions are inflated by roughly a factor of three. Actual percentage of U.S. abortions in "hard cases" are estimated as follows: in cases of rape or incest, 0.3%; in cases of risk to maternal health or life, 1%; and in cases of fetal abnormality, 0.5%. About 98% of abortions in the United States are elective, including socio-economic reasons or for birth control. This includes perhaps 30% for primarily economic reasons.

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Contents:

• Introduction
• AGI studies
• Issues with rape-related statistics
• Abortions for sex selection
• State statistics
• Adjusted figures
• Data on federally-funded abortions
• "Partial-birth abortions" and other late-term abortions
• Summary and conclusions
• Sources

Introduction: The reasons given for having abortions are relevant to the policy debate on the abortion issue. In many countries, abortions are permissible only for limited reasons.[1] In the United States, abortion on demand and for any reason is the existing state of law (with a few limitations in some states[2]). As debate continues regarding this practice, advocates of unrestrained abortion often cite the "hard cases"--cases of rape, incest, life or health of the mother or baby--in defending access to abortion. It is widely acknowledged that such cases are rare; however, available data suggest that some commonly cited figures are exaggerated.

Further, the prevailing preferences of the American electorate are often cited in regard to U.S. abortion legislation. Some will claim, for example, that most Americans support legal abortion. While majority vote is an unconstitutional means of limiting human rights (regardless of what position on abortion one thinks is the one consistent with human rights), the claim itself is a half-truth. Most Americans would oppose banning abortions for hard cases, but at the same time most Americans would support limits on elective abortions, e.g. abortions for convenience or for sex selection.

This article will review some available data that addresses the reasons cited for abortions in the United States.

AGI studies: The Alan Guttmacher Institute (AGI) has published several studies examining reasons for abortions in the United States. Two studies surveyed women obtaining abortions; these were conducted in 1987 and 2004. A third survey conducted in 2000-2001 surveyed abortion seekers about contraceptive use; this study provided limited data on reasons for abortions. These studies are discussed in chronological order.

The 1987 AGI study (published in 1988)[3] surveyed 1,900 women who had abortions. The results of this survey are among the most commonly cited figures regarding reasons for abortions in the United States. The 1,773 women who responded gave an average of 3.7 reasons from the list, with the most important reasons cited by respondents tabulated below. It should be noted that only rounded percentages, not raw numbers, were provided; an AGI review article in 1998 [4] cited the 1988 study but gave slightly different figures, shown below in parenthesis (the parenthetical figure for rape and incest is a range of uncertainty derived from breakdowns in the 1988 report).

 

REASONS GIVEN FOR ABORTIONS: AGI SURVEY, 1987 [3, 4]

reason	% of abortions
rape or incest	1	(0.4-1.3)
mother has health problems	3	(2.8)
possible fetal health problems	3	(3.3)
unready for responsibility	21
is too immature or young to have child	11	(12.2)
woman's parents want her to have abortion	<0.5
has problems with relationship or wants to avoid single parenthood	12	(14.1)
husband or partner wants her to have abortion	1
has all the children she wanted or all children are grown	8	(7.9)
can't afford baby now	21	(21.3)
concerned about how having baby would change her life	16
doesn't want others to know she had relations or is pregnant	1
other	3

Another AGI study[5], conducted in 2000-2001, examined contraceptive use but provides some information relating to reasons for abortion. Some data from this survey of 10,683 women obtaining abortions is given below:

 

REASONS GIVEN FOR ABORTIONS: AGI SURVEY, 2000-2001 [5]

reason or situation		number	% of abortions
not using contraception		4,957	46.40
	forced to have relations	~64	0.6
using contraception		5,726	53.60
	contraceptive failed despite proper use	~1,808	16.9
total		10,683	100

In this survey, 0.6% reported being forced to have relations (although a figure as high as 0.8% is possible depending on data breakdown). It is also interesting to note that 17% of abortions were for pregnancies following "proper" use of contraception. This would tend to undermine the claims regarding the efficacy of contraception methods, something highly promoted by groups such as Planned Parenthood.

An AGI study published in 2005 [6] was modeled after the 1987 study, providing an update to that work. This survey was conducted from December 2003 to March 2004; of approximately 2,000 women obtaining abortions who were surveyed, 1,209 completed questionnaires. As with the 1987, only rounded percentages as opposed to raw numbers were reported. Again, respondents could give multiple reasons, and the median number of four reasons were given. The table below gives reported percentages for the most important reason and for all reasons cited.

 

REASONS GIVEN FOR ABORTIONS: AGI SURVEY, 2004 [6]

reason	% of abortions, most important reason	% of abortions, all reasons
rape	<0.5	(1)
incest		(<0.5)
mother has health problems	4	(12)
possible fetal health problems	3	(13)
unready	25	(32)
is too immature or young to have child	7	(22)
woman's parents want her to have abortion	<0.5	(6)
has problems with relationship or wants to avoid single parenthood	8	(48)
husband or partner wants her to have abortion	<0.5	(14)
has all the children she wanted or all children are grown	19	(38)
can't afford baby now	23	(73)
--unmarried		(42)
--student or planning to study		(34)
--can't afford baby and child care		(28)
--can't afford basic life needs		(23)
--unemployed		(22)
--can't leave job to care for baby		(21)
--would have to find new place to live		(19)
--not enough support from husband/partner		(14)
--husband/partner unemployed		(12)
--currently on welfare or public assistance		(8)
concerned about how having baby would change her life		(74)
--would interfere with education plans	4	(38)
--would interfere with career plans		(38)
--would interfere with care of children or dependents		(32)
doesn't want others to know she had relations or is pregnant	<0.5	(25)
other	6

Recent AGI literature has given figures of abortions following rape or incest. For example, an April 2005 information sheet [7] states that about 13,000 women have abortions following rape or incest. This is 1.0% of AGI-estimated annual abortions in 2000-2002. This figure appears to be derived from the 1987 survey percentage (or from preliminary results of the 2004 survey).

Issues with rape-related statistics: The AGI-based figure of 1% of abortions for cases of rape or incest is widely cited. However, it is the product of a limited survey by an organization with a stated objective of advocating unlimited access to abortion services. It is thus desirable to seek an independent source of such figures, such as that provided by the state reported statistics reviewed below. Evaluating this claim involves issues of reliability of rape-related statistics.

If the AGI figure for 1987 is correct, it would imply that 15,600 abortions in 1987 were for such cases.[8] Since the FBI only reported 91,110 forcible rapes in the U.S. in that year[9], this would imply that one out of six rapes resulted in pregnancy. This is higher fraction than appears to be supported by medical research--although the degree to which rapes go unreported is an issue here.

According to the FBI, reported annual numbers of rapes rose from just over 90,000 in the late 1980s to a peak of 109,000 in 1992, then dropped to about 90,000 for the years 1999-2002. Some sources estimate much larger unreported numbers. Stewart and Trussell [10] cite 333,000 rapes and sexual assaults reported in 1998, and additionally cite a National Women's Study which claimed 683,000 rapes in 1992. The latter figure would mean 5.3 unreported rapes for every reported rape. The wide range in estimates of unreported rapes is evidence of the problem of quantifying these figures.

Another issue is the frequency of rape-related pregnancy. Some sources claim very low frequencies, citing medical studies, and concluding the total number of pregnancies resulting from rape each year is on the order of 200-500.[11] Others obtain somewhat higher frequencies. Holmes et al. [12] surveyed 4,008 women and found a rate of pregnancy following rape of 5%. Additionally, of 34 cases of pregnancy after rape, they found 17 (50%) had an abortion, 11 (32%) kept the baby, 2 (6%) gave the baby up for adoption, and 4 (12%) miscarried. This frequency of 5% is representative of cited values.

Taking currently reported rapes of 90,000 per year and assuming 5% result in pregnancy and 50% of these are aborted, this implies 4,500 pregancies per year following rape of which 2,250 are aborted. The most extreme claimed rates of underreporting are necessary to bring this in line with AGI's claim of 13,000 rape-related abortions per year. Even higher levels of rape-related pregnancies have been claimed: Stewart and Trussell [10] cite the previously mentioned National Women's Study claiming 32,000 per year in 1992, and this figure is repeated by Holmes et al. [12] and by an AGI article in 2002 [13]. Stewart and Trussell extrapolate this to 25,000 per year in 1998 merely by considering lower crime rates. These higher rates are required to support the AGI claim of 1% of abortions for rape. Alternately, if only 50% of rapes are unreported then (using Holmes et al. data) a percentage of only 0.35% of abortions for rape is implied.

Such statistical approaches are very uncertain. The reasons for abortion are of course self-reported by the abortion seeker and thus not verifiable. It could be hypothesized that for various reasons women seeking abortions might falsely give rape as a reason, or alternately conceal rape as a reason. Apart from the issue of the rate of underreporting, certainly it is the case that many rapes go unreported. Thus, rape-related abortion data interpretation is hampered by the particularly traumatic circumstances of such cases. Nonetheless, it will be seen below that the larger sampling in states that report figures for rape-related abortions give consistent results, supporting the reasoning for lower figures than the AGI figures.

Abortions for sex selection: While not a major issue in the United States, abortions for the purpose of selecting the sex of the child are quite common in Asia, where they are generally used to abort female fetuses. Several Asian countries, including the People's Republic of China, India, and South Korea, are beginning to show significant demographic impacts resulting from such practices. India and the PRC have both been compelled to legislate against sex-selection abortions despite their otherwise broad support of abortion practice.[14]

Regarding the United States, in 1998 JAMA published a study[15] reporting a 0.2% decrease in the ratio of male to female live births from 1970 to 1990. The authors of the 1998 study discuss a variety of health factors that could influence this ratio. Data from the CDC in 2002[16] suggested that the decrease in the male/female birth ratio was 0.3% from 1970 to 2000. In 2005 the CDC completed a more detailed analysis[17] of trends in the U.S. male/female birth ratio. The authors identified several up or down trends in the ratio between 1940 and 2002, including a 0.6% decline in the male/female birth ratio from 1970 to 2002. They analyzed possible factors (age of mother, birth order, ethnicity) and noted additional parental/environmental characteristics that naturally influence the birth ratio. They did note that family preference can affect the birth ratio (although they did not explicitly point out that this is via such means as sex selection abortions) and that this does affect it in some countries, but do not report any indication that it is a factor in the United States. The historical variation in U.S. male/female birth ratio is within the range observed in connection to biological influences (e.g. parental/environmental).

Nonetheless, of reported trends in male/female birth ratio by ethnic group, the 2005 CDC study finds the greatest increase from 1970 to 2002 among children of Chinese and Japanese ethnicity: a trend of an increase of 0.022 for Chinese and 0.013 Japanese children, respectively. The result is that births of Chinese ethnicity have the highest average male/female ratio in 1998-2002, 1.076 versus the national average of 1.048.[17]

The overall change in the male/female birth ratio from 1970 to 2002 represents about 13,000 fewer annual male births by 2002, which would correspond to about 1% of abortions.[18] Still, this is too small a change in sex ratio to be distinguished among other potential causes for the population at large. Some observers suggest that this is an issue in some ethnic groups[14]. Were the change in birth ratio among Asian Americans to be attributed to abortions, it would represent on the order of 1,000-2,000 abortions per year, or about 0.1% of abortions. This may be considered an upper limit.

State statistics: In the United States, limited official statistics are available. Abortion reporting varies significantly from state to state. Seven states report data on the reasons given for obtaining abortions (with varying definitions and levels of detail). These figures are self-reported by women obtaining abortions, as in the case of the AGI studies discussed above. However, they are independent data and involve a larger sample. Below are results for these states--Arizona, Florida, Louisiana, Minnesota, Nebraska, South Dakota, and Utah:

 

REASONS GIVEN FOR ABORTIONS: ARIZONA [19]

reason	1985	1986	1987	1988	1989	1990	1991	1992	1993	1994	1995	1996	1997	1998
medical	16	7	11	11	7	10	3	6	11	9	17	10	6	12
elective	15,274	14,300	15,228	14,068	11,078	13,075	13,504	12,709	11,739	11,891	10,588	10,768	11,012	14,144
unknown	314	148	376	271	490	805	375	178	102	360	1,133	90	3	450
total	15,604	14,455	15,615	14,350	11,575	13,890	13,882	12,893	11,852	12,260	11,738	10,868	11,021	14,606

reason	1999	2000	2001	2002	2003	2004	2005	2006	total 1985-2006	% of abortions	% of abortions, known reasons
medical	19	15	10	21	43	207	78	8	537	0.20	0.21
elective	10,390	9,614	8,210	9,910	9,602	10,770	9,987	10,436	258,297	96.79	99.79
unknown	247	2	6	466	449	1,324	381	62	8,032	3.01	N/A
total	10,656	9,631	8,226	10,397	10,094	12,301	10,446	10,506	266,866	100.00	100.00

REASONS GIVEN FOR ABORTIONS: FLORIDA [20]

reason	1998	1999	2000	2001	2002	2003	2004	2005	2006	total 1998-2006	% of abortions	% of abortions, known reason
physical condition	401	346	453	350	439	514	460	514	649	4,126	0.52	0.52
mental condition	159	150	143	109	72	80	19	54	144	930	0.12	0.12
abnormal fetus	470	474	430	454	482	457	501	606	676	4,550	0.57	0.57
personal choice	80,889	82,589	87,199	84,343	86,445	88,409	90,315	90,866	93,541	784,596	98.29	98.30
other	416	412	330	314	521	535	411	473	574	3,986	0.50	0.50
unknown	0	0	8	19	5	0	4	0	2	38	0.00	N/A
total	82,335	83,971	88,563	85,589	87,964	89,995	91,710	92,513	95,586	798,226	100.00	100.00

REASONS GIVEN FOR ABORTIONS: LOUISIANA [21]

reason	1996	1997	1998	1999	2000	2001	2002	total 1996-2002	% of abortions	% of abortions, known reason
rape or incest	4	4	3	1	1	1	0	14	0.02	0.49
physical health	8	17	19	16	14	8	3	85	0.11	2.98
mental health	392	415	164	77	140	52	37	1,277	1.60	44.84
risk of fetal deformity	9	21	7	9	13	10	7	76	0.10	2.67
other	114	421	250	258	192	143	18	1,396	1.75	49.02
unknown	11,357	10,861	10,908	11,647	11,024	10,718	10,386	76,901	96.43	N/A
total	11,884	11,739	11,351	12,008	11,384	10,932	10,451	79,749	100.00	100.00

REASONS GIVEN FOR ABORTIONS: MINNESOTA [22]

reason*		Oct-Dec1998	1999	2000	2001	2002	2003	2004	2005	2006	2007	total Oct1998-Dec2007	% of abortions	% of abortions, known reason
rape		30	113	124	98	81	75	69	71	90	91	842	0.64	0.92
incest		2	3	6	7	14	9	6	6	12	7	72	0.06	0.08
emotional health		270	653	793	859	844	1,001	1,019	1,206	699	828	8,172	6.26	8.89
physical health		149	510	584	636	622	844	778	808	588	651	6,170	4.73	6.71
pregnancy will impair major bodily function		22	49	44	34	30	27	31	20	30	21	308	0.24	0.34
fetal anomalies		86	177	210	158	113	147	133	129	162	155	1,470	1.13	1.60
economic reasons		734	1,601	2,379	2,512	2,546	2,499	2,647	4,091	5,020	5,148	29,177	22.34	31.74
does not want children now		1,215	4,449	5,618	6,482	6,080	5,655	5,576	8,281	9,598	10,190	63,144	48.36	68.69
other elective*		779	2,854	3,315	3,227	2,239	2,479	2,510	3,536	3,145	3,334	27,418	21.00	29.83
	--single parent		749	788	724	359	802	752	793	791	1,024	6,782	5.19	7.38
	--to pursue educational goals		551	754	872	419	500	270	838	616	886	5,706	4.37	6.21
	--already have enough children		362	406	369	368	351	230	434	485	341	3,346	2.56	3.64
	--relationship issues		307	490	498	356	335	182	417	318	364	3,267	2.50	3.55
	--other		885	1,604	1,294	1,009	1,109	1,242	1,558	1,413	1,519	11,633	8.91	12.66
unknown		1,371	6,674	4,767	4,618	5,054	5,460	5,443	2,310	1,681	1,280	38,658	29.60	N/A
total		3,508	14,342	14,477	14,833	14,186	14,174	13,791	13,362	14,065	13,843	130,581	100.00	100.00

Note: The Minnesota questionnaire allows respondents to indicate more than one reason. The category identified as "other elective" includes other reasons (some listed) from which respondents may select more than one.

REASONS GIVEN FOR ABORTIONS: NEBRASKA [23]

reason*	2000	2001	2002	2003	2004	2005	2006	2007	total 2000-2007	% of abortions
rape	35	18	11	10	18	10	6	5	113	0.40
incest	0	0	1	1	1	0	0	0	3	0.01
maternal life endangered	2	6	1	6	8	3	1	2	29	0.10
maternal physical health	33	48	45	160	85	67	45	2	485	1.73
mental health	654	691	667	733	316	14	1	1	3,077	10.95
fetal anomaly	16	25	17	35	11	8	25	24	161	0.57
socio-economic	2,878	2,550	2,567	3,096	3,240	2,853	2,854	2,447	22,485	80.05
contraceptive failure	664	750	687	766	1,047	734	619	623	5,890	20.97
no contraception used	808	850	766	1,185	850	831	852	1,113	7,255	25.83
unknown	0	0	0	0	0	0	0	0	0	0.00
total	4,178	3,982	3,775	3,990	3,584	3,173	2,927	2,481	28,090	100.00

Note: The Nebraska questionnaire allows respondents to indicate multiple reasons, so numbers add to more than total abortions.

REASONS GIVEN FOR ABORTIONS: SOUTH DAKOTA [24]

reason*	1999	2000	2001	2002	2003	2004	2005	2006	total 1999-2006	% of abortions	% of abortions, known reason
rape or incest	12	16	14	20	21	23	9	3	118	1.81	1.85
substantial/irreversible bodily impairment	7	9	19	16	16	29	22	11	129	1.98	2.03
emotional health	28	51	84	94	104	119	58	16	554	8.49	8.70
fetal abnormality*					6	16	14	16	52	1.63	1.66
can't afford child	176	233	353	384	366	397	205	160	2,274	34.85	35.71
doesn't want child	459	503	547	536	525	576	640	633	4,419	67.72	69.39
other	110	139	144	103	124	127	103	48	898	13.76	14.10
unknown	15	41	34	27	33	5	2	0	157	2.41	N/A
total	740	878	895	826	819	814	805	748	6,525	100.00	100.00

Note: The South Dakota questionnaire allows respondents to indicate multiple reasons, so numbers add to more than total abortions. Number of abortions for reason of fetal abnormality is not reported, but number of abortions where a fetal abnormality was reported present (regardless of the reason for the abortion) is provided.

REASONS GIVEN FOR ABORTIONS: UTAH [25]

reason	1996	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006	total 1996-2006	% of abortions	% of abortions, known reason
rape	38	39	28	40	44	30	11	3	4	2	1	240	0.66	0.66
incest	2	3	1	1	0	0	0	0	0	0	0	7	0.02	0.02
maternal life endangered	19	10	5	6	8	6	11	10	12	22	18	127	0.35	0.35
fetal malformation	21	17	5	8	7	20	8	8	11	13	32	150	0.41	0.42
HIV positive	0	0	0	0	0	0	0	1	0	1	0	2	0.01	0.01
therapeutic	3,154	3,054	3,184	3,092	3,206	3,289	3,251	3,304	3,327	3,220	3,207	35,288	97.42	97.67
elective	3	2	0	0	4	25	13	4	17	19	181	268	0.74	0.74
other	39	2	1	2	0	0	0	0	0	1	4	49	0.14	0.14
unknown	17	13	13	11	10	2	6	8	8	1	1	90	0.25	N/A
total	3,293	3,140	3,237	3,160	3,279	3,372	3,300	3,338	3,379	3,279	3,444	36,221	100.00	100.00

Together, the available statistics from these seven states represent 1,346,258 abortions from 1985 to 2007. The definitions and reporting of reasons vary from state to state. It should be noted that these states are not necessarily representative of the nation as a whole; some implications of this are analyzed below.

Adjusted figures: Use of these figures to estimate nationwide percentages is affected by differences from state to state. As an example, consider the figures for abortions in cases of rape. The occurrence of rape varies from state to state and also has declined nationwide by 14% since the 1987 AGI study [9]. Further, the fraction of pregnancies that end in abortion varies considerably from state to state, with these figures dominated by abortions for personal choice and not particularly linked to hard cases. The following table illustrates the adjustments implied by making a few assumptions. (In this table and those that follow, figures for rapes, pregnancies, etc., for recent years are extrapolated if not yet available.)

 

ADJUSTED FIGURES FOR ABORTIONS IN THE CASE OF RAPE

region	year(s)	abortions where rape is cited		forcible rapes during sample period [9]	abortions in cases of rape as a percentage of reported rapes	implied U.S. number of abortions in cases of rape in 2005	% of 2005 abortions [26]
		%	number
Louisiana	1996-2002	0.49	14	11,098	0.13	120	0.01
Minnesota	1998-2007	0.64	842	19,660	4.28	4,020	0.33
Nebraska	2000-2007	0.40	113	4,100	2.76	2,590	0.21
South Dakota	1999-2006	1.81	118	2,741	4.30	4,040	0.33
Utah	1996-2006	0.66	240	9,844	2.44	2,290	0.19
USA (AGI survey)	1987	1		91,110	17.11	16,100	1.33
USA (AGI survey)	2000-2001	0.6		180,677	8.69	8,160	0.68
USA (AGI survey)	2004	0.5 1		72,240	8.95 17.90	8,410 16,800	0.70 1.39

The data for the five states listed give results significantly below figures based on AGI studies. The correlation between the numbers of abortions reported in cases of rape and respective state rates of forcible rape tend to support the credibility of these figures. If the various assumptions used here are valid, they would imply only about 0.3% of abortions nationwide are in cases of rape.

Similarly, if it is assumed that abortions in cases where there are maternal or fetal health problems are a consistent fraction of pregnancies, the implied nationwide percentages in such cases would be as given below. Note that "total known pregnancies" for states includes only pregnancies ending in live births or reported abortions; this excludes miscarriages, stillbirths, and additional abortions represented in AGI estimates; U.S. figures for abortions and pregnancies use AGI abortion figures.

 

ADJUSTED FIGURES FOR ABORTIONS IN THE CASE OF MATERNAL HEALTH PROBLEMS

region	year(s)	abortions where mother's health is cited		total known pregancies [27]	cited abortions as a percentage of known pregnancies	implied U.S. number of abortions in such cases in 2005	% of 2005 abortions [26]
		%	number
Arizona	1985-2006	0.20	537	1,949,562	0.028	1,470	0.12
Florida	1998-2006	0.52	4,126	2,699,787	0.153	8,170	0.68
Louisiana	1996-2002	0.11	85	543,124	0.016	840	0.07
Minnesota	1998-2006	4.97	6,478	687,352	0.942	50,370	4.18
Nebraska	2000-2006	1.83	514	205,585	0.250	13,360	1.11
South Dakota	1999-2006	1.98	129	94,319	0.137	7,310	0.61
Utah	1996-2006	0.35	127	562,712	0.023	1,210	0.10
USA (AGI survey)	1987	3			0.867	46,300	3.84
USA (AGI survey)	2004	4			0.973	52,000	4.31

ADJUSTED FIGURES FOR ABORTIONS IN THE CASE OF FETAL HEALTH PROBLEMS

region	year(s)	% of abortions where fetal health is cited		total known pregancies [27]	cited abortions as a percentage of known pregnancies	implied U.S. number of abortions in such cases in 2005	% of 2005 abortions [26]
		%	number
Florida	1998-2006	0.57	4,550	2,699,787	0.169	9,010	0.75
Louisiana	1996-2002	0.10	76	543,124	0.014	750	0.06
Minnesota	1998-2006	1.13	1,470	687,352	0.214	11,430	0.95
Nebraska	2000-2006	0.57	161	205,585	0.078	4,190	0.35
South Dakota*	2003-2006	1.63	52	48,930	0.106	5,680	0.47
Utah	1996-2006	0.41	152	562,712	0.027	1,440	0.12
USA (AGI survey)	1987	3			0.867	46,300	3.84
USA (AGI survey)	2004	3			0.730	39,000	3.23

In the case of South Dakota, data by reason for abortion is not available; figures are for abortions where fetal abnormalities were reported, regardless of the indicated reason for the abortion.

Data on federally-funded abortions: Federal medicare funds may currently be used to pay for abortions in cases of rape, incest, or threat to the mother's life. Some state-level data on these abortions emerged in 2008 in an inquiry from Congress to the Secretary of Health and Human Services regarding a significant increase in such payments in one state. [28] Specifically, claims from Illinois for abortions in cases of rape increased by a factor of 18 from FY 2005 to FY 2007. Data are shown below:

 

FEDERALLY-FUNDED ABORTIONS IN THE CASE OF RAPE [28]

state	FY 2005	FY 2006	FY 2007
Alabama	0	0	0
Alaska	0	0	0
Arizona	0	0	1
Delaware	0	0	0
Georgia	0	1	0
Idaho	0	0	0
Iowa	0	1	0
Illinois	20	84	363
Kentucky	0	0	0
Maine	0	0	0
Michigan	0	0	0
Minnesota	7	8	3
New Hampshire	0	0	0
North Carolina	4	0	0
North Dakota	0	0	0
Ohio	2	1	0
South Carolina	0	1	1
South Dakota	0	0	0
Texas	0	0	0
Virginia	0	0	0
Wyoming	0	0	0
(unknown)	13	0	0
TOTAL	46	96	368

FEDERALLY-FUNDED ABORTIONS IN THE CASE OF INCEST [28]

state	FY 2005	FY 2006	FY 2007
Alabama	0	0	0
Alaska	0	0	0
Arizona	0	0	1
Delaware	0	0	0
Georgia	0	0	0
Idaho	0	0	0
Iowa	0	0	0
Illinois	0	0	5
Kentucky	0	0	0
Maine	0	0	0
Michigan	0	0	0
Minnesota	3	5	3
New Hampshire	0	0	0
North Carolina	0	0	0
North Dakota	0	0	0
Ohio	0	0	0
South Carolina	0	0	0
South Dakota	0	0	0
Texas	0	0	0
Virginia	0	0	0
Wyoming	0	0	0
TOTAL	3	5	9

FEDERALLY-FUNDED ABORTIONS IN THE CASE OF RISK TO MOTHER'S LIFE [28]

state	FY 2005	FY 2006	FY 2007
Alabama	6	2	10
Alaska	0	1	0
Arizona	0	0	1
Delaware	0	2	6
Georgia	1	6	1
Idaho	5	0	0
Iowa	1	3	0
Illinois	5	5	13
Kentucky	1	0	0
Maine	1	8	11
Michigan	0	0	3
Minnesota	1	0	2
New Hampshire	1	1	1
North Carolina	7	3	4
North Dakota	1	0	0
Ohio	14	18	10
South Carolina	17	11	6
South Dakota	1	0	0
Texas	17	4	4
Virginia	20	31	9
Wyoming	2	0	0
TOTAL	101	95	81

In the next table, the figures for abortions in the case of rape in Illinois are adjusted in the same manner as previously applied to state statistics, using AGI estimated annual abortions of about 50,000. Assuming that all abortions in cases of rape in Illinois were payed by federal Medicare, the FY 2007 figures are compatible with rates of rape-related abortions claimed by AGI, but they are 2-3 times higher than rates supported by analysis of data from other states. More importantly, the dramatic increase from FY 2005 to FY 2007 casts doubt on the reliability of the Illinois figures.

 

ILLINOIS CLAIMED FIGURES FOR ABORTIONS IN THE CASE OF RAPE

region	year(s)	abortions where rape is cited		forcible rapes during sample period [9]	abortions in cases of rape as a percentage of reported rapes	implied U.S. number of abortions in cases of rape in 2005	% of 2005 abortions [26]
		%	number
Illinois	FY 2005	0.04	20	4,280	0.47	440	0.04
Illinois	FY 2006	0.17	84	4,130	2.03	1,910	0.16
Illinois	FY 2007	0.73	363	4,100	8.86	8,320	0.69

"Partial-birth abortions" and other late-term abortions: Because of the particularly controversial nature of late-term and "partial-birth abortions" (PBAs), some statistics regarding these abortions has emerged. Partial-birth abortion roughly corresponding to what the medical community describes as intact dilation and extraction. Available data indicates that PBAs are mostly performed for reasons other that for the life or physical health of the mother, reasons including either fetal defects (minor or major) or purely elective reasons.

Kansas requires physicians to report reasons for performing PBAs. Of the 240 PBAs reported in Kansas in 1998 and 1999, there were none where the mother's life was at risk; in every case the attending physician certified "that continuing the pregnancy will constitute a substantial and irreversible impairment of the patient's mental function" and that there was not a substantial physical risk to the mother from the pregnancy.[29] No PBAs have been reported since 1999 in Kansas, but other abortions performed at 22 weeks gestation or later must similarly be reported. For these as well, few if any are cited as involving risk to the mother's life; typically, risk to the mother of "substantial and irreversible impairment of a major bodily function" is cited.[29]

Physicians who perform large numbers of PBAs have stated that many are performed for elective reasons. In an interview with American Medical News, M. Haskell stated that about 80% of the PBAs he performed were purely elective, with the remainder performed for genetic reasons.[30] In testimony to Congress, J. McMahon reported that for about 2,000-2,100 PBAs he had performed, 1,183 (56%) were for fetal "flaws" or "indicators", 175 (9%) were for maternal "indicators", and the remainder (about 700, or 35%) were elective.[31] McMahon further indicated that elective abortions comprised 20% of those he performed after 21 weeks gestation, and none of those he performed after 26 weeks.[32]

McMahon's 1995 testimony to the House Judiciary Committee gave more detailed statistics, which have been analyzed by physicians P. Smith and K. Dowling. Among maternal indicators, the single most frequent was maternal depression (39, or 1.9% of total), with 28 attributed to maternal health conditions "consistent with the birth of a normal child (e.g. sickle cell trait, prolapsed uterus, small pelvis)" (1.3% of total) and the remainder (5% of total) for other maternal factors ranging from maternal health risk to "spousal drug exposure" and "substance abuse". Those performed for fetal indicators included some for lesser conditions such as 9 (0.4% of total) for cleft lip-palate, 24 (1.1% of total) for cystic hydroma, and other for conditions either surgically correctable or involving lesser degrees of neurologic/mental impairment.[32, 33]

Estimates of the annual numbers of PBAs in the United States range from 2,200 to 5,000, with documented annual numbers between 1996 and 2005 ranging from 76 to 1,642.[34]

Summary and conclusions: Based on these figures, the following estimated percentages are suggested (along with ranges of values from the above studies and analyses):

 

REASONS FOR ABORTIONS: COMPILED ESTIMATES

rape	0.3 % (0.1-0.6 %)
incest	0.03 % (0.01-0.1 %)
physical life of mother	0.2 % (0.1-0.3 %)
physical health of mother	1.0 % (0.1-3 %)
fetal health	0.5 % (0.1-1.0 %)
mental health of mother	depends on definition
"personal choice" --too young/immature/not ready for responsibility --economic --to avoid adjusting life --mother single or in poor relationship --enough children already --sex selection	98% (78-99 %) --(32 %) --30% (21-36 %) --(16 %) --(12-13 %) --(4-8 %) --(<0.1 %)

Quantifying cases involving the "mental health" of the mother is difficult due to the highly subjective use of this term (as demonstrated by the wide range in percentage of abortions reported for this reason). It is likely that the number of cases involving clinical mental illness falls towards the low end of the range given above.

These official state statistics suggest that the commonly cited AGI figures for the "hard cases" are high, perhaps by a factor of three. In any case, however, there appears to be consensus that the hard cases--rape, incest, life/health of mother or baby--are a very small fraction of cases. They are arguably a poor premise for formulating general public policy regarding abortion. At the other extreme, AGI's surveys of 1987 and 2004 (as well as the detailed statistics from Minnesota) suggest that a significant fraction of abortions are obtained by mothers who have the means to care for a child but do not want their lives inconvenienced. This is an example of the consequences of the current extreme policy in the United States regarding abortion.

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Sources:

1. United Nations Population Division, Abortion Policies: A Global Review, 2002, United Nations (New York, NY), on line at United Nations [http://www.un.org/esa/population/publications/abt/fabt.htm].
2. Alan Guttmacher Institute, "State Policies in Brief," 2008, Alan Guttmacher Institute, on line [http://www.guttmacher.org/statecenter/spibs/index.html].
3. Torres, Aida, and Jacqueline Darroch Forrest, "Why Do Women Have Abortions?", July/Aug. 1988, Family Planning Perspectives (20:4:169-176).
4. Bankole, Akinrinola, Sushella Singh, and Taylor Hass, "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries," Aug. 1998, International Family Planning Perspectives (24:3:117-127,152), on line [http://www.guttmacher.org/pubs/journals/2411798.html].
5. Jones, Rachel K., Jacqueline E. Darroch, and Stanley K. Henshaw, "Contraceptive Use Among Women Having Abortions in 2000-2001," Nov./Dec. 2002, Perspectives on Sexual and Reproductive Health (34:6), on line at AGI [http://www.guttmacher.org/pubs/journals/3429402.html].
6. Finer, Lawrence B., Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh, and Ann M. Moore, "Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives," Sept. 2005, Perspectives on Sexual and Reproductive Health, 37(3):110-118, on line at AGI [http://www.guttmacher.org/pubs/journals/3711005.pdf].
7. AGI, "Induced Abortion in the United States," April 2005, AGI, on line [http://www.agi-usa.org/pubs/fb_induced_abortion.pdf].
8. Based on 1,559,100 abortions in 1987, from Henshaw, Stanley K., "Abortion Incidence and Services in the United States, 1995-1996," Nov./Dec. 1998, Family Planning Perspectives (30:6), on line at AGI [http://www.guttmacher.org/pubs/journals/3026398.html].
9. Federal Bureau of Investigation (Uniform Crime Reports), "Crime Statistics," 2001-2005, Federal Bureau of Investigation, on line [http://www.fbi.gov/ucr/ucr.htm].
10. Stewart, Felicia H., and James Trussell, "Prevention of pregnancy resulting from rape: A neglected preventive health measure," Nov. 2000, American Journal of Preventive Medicine, 19(4):228-229.
11. Willke, J. C., and Willke, "Why Can't We Love Them Both?", on line [http://www.abortionfacts.com/online_books/love_them_both/]; Hilger, Thomas W., cited in "Abortion: What About Rape & Incest?" at Lutherans for Life, on line [http://www.lutheransforlife.org/abortion/rape_or_incest.htm].
12. Holmes, M. M., H. S. Resnick, D. G. Kilpatrick, and C. L. Best, "Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women," Aug. 1996, American Journal of Obstetrics and Gynecology, 175(2):320-324.
13. Boonstra, Heather, "Emergency Contraception: Steps Being Taken to Improve Access," Dec. 2002, The Guttmacher Report on Public Policy, 5(5):10-13, on line at AGI [http://www.guttmacher.org/pubs/tgr/05/5/gr050510.pdf].
14. Chamie, Joseph, 29 May 2008, "The Global Abortion Bind," YaleGlobal, on line [http://yaleglobal.yale.edu/display.article?id=10886].
15. Davis, Devra Lee, Michelle B. Gottlieb, and Julie R. Stampnitzky, "Reduced Ratio of Male to Female Births in Several Industrial Countries: A Sentinel Health Indicator?", 1 April 1998, Journal of the American Medical Association (279:13:1018-1023) [abstract on line at http://jama.ama-assn.org/cgi/content/abstract/279/13/1018].
16. Centers for Disease Control, "Births: Final Data for 2000," 12 Feb. 2002, National Vital Statistics Reports (50:5), on line at CDC [http://www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_05.pdf].
17. Mathews, T. J., and Brady E. Hamilton, "Trend Analysis of the Sex Ratio at Birth in the United States," 14 Jun. 2005, National Vital Statistics Reports (53:20), on line at CDC [http://www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_20.pdf].
18. Based on 1,269,000 abortions in 2002, from Henshaw, Stanley K., and Kathryn Kost, Aug. 2008, "Trends in the characteristics of women obtaining abortions, 1974 to 2004," Alan Guttmacher Institute, on line [http://www.guttmacher.org/pubs/2008/09/18/Report_Trends_Women_Obtaining_Abortions.pdf].
19. Mrela, Christopher K., "Abortion Surveillance Report, Arizona, 1985-1995," 2001, Arizona Dept. of Health Services, on line [http://www.hs.state.az.us/plan/abortion/abortion.htm]; Batsche, Kurt, "Abortions by Reason for Termination and Year, Arizona, 1985-1995," Arizona Dept. of Health Services, on line [http://www.hs.state.az.us/plan/abortion/tables/abt9.htm]; "Abortions by Reason for Termination and Year, Arizona, 1993-2003," Arizona Dept. of Health Services, on line [http://www.hs.state.az.us/plan/abortion/]; "Characteristics of women receiving abortions, Arizona, 1994-2004", Arizona Dept. of Health Services, on line [http://azdhs.gov/plan/report/ahs/ahs2004/pdf/1d1.pdf]; "Characteristics of women receiving abortions, Arizona, 1996-2006", Arizona Dept. of Health Services, on line [http://azdhs.gov/plan/report/ahs/ahs2006/pdf/1d1.pdf].
20. Florida Department of Health, Florida Department of Health, on line: 1999, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/1998/termination.pdf]; 2000, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/1999/termination.pdf]; 2001, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2000/termination.pdf]; 2002, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2001/termination.pdf]; 2003, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2002/termination.pdf]; 2004, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2003/termination.pdf]; 2005, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2004/termination.pdf]; 2006, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2005/termination.pdf]; 2007, "Induced Terminations of Pregnancy," [http://www.flpublichealth.com/VSBOOK/pdf/2006/termination.pdf].
21. Louisiana State Center for Health Statistics, Louisiana Vital Statistics Report annual reports, 1996-2002, 1997-2003, on line [http://oph.dhh.state.la.us/recordsstatistics/statistics/page0cda.html].
22. Center for Health Statistics, Minnesota Dept. of Health, Report to the Legislature: Induced Abortions in Minnesota--, on line at MDH: Oct. 2000, October 1998-December 1999, [http://www.health.state.mn.us/divs/chs/abrpt99.pdf]; July 2001, January-December 2000, [http://www.health.state.mn.us/divs/chs/abrpt00.pdf]; July 2002, January-December 2001, [http://www.health.state.mn.us/divs/chs/abrpt01.pdf]; July 2003, January-December 2002, [http://www.health.state.mn.us/divs/chs/abrpt/abrpt02.pdf]; July 2004, January-December 2003, [http://www.health.state.mn.us/divs/chs/abrpt/2003abrpt.pdf]; July 2005, January-December 2004, [http://www.health.state.mn.us/divs/chs/abrpt/2004abrpt.pdf]; July 2006, January-December 2005, MDH, on line [http://www.health.state.mn.us/divs/chs/abrpt/2005abrpt.pdf]; July 2007, January-December 2006, [http://www.health.state.mn.us/divs/chs/abrpt/2006abrpt.pdf]; July 2008, January-December 2007, [http://www.health.state.mn.us/divs/chs/abrpt/2007abrpt.pdf].
23. Nebraska Health and Human Services System, Nebraska Health and Human Services System, on line: March 2001, "Nebraska 2000 Statistical Report of Abortions," [http://www.hhs.state.ne.us/ced/]; March 2002, "Nebraska 2001 Statistical Report of Abortions," [http://www.hhs.state.ne.us/ced/ABORTION2001RPT.pdf]; March 2003, "Nebraska 2002 Statistical Report of Abortion," [http://www.hhs.state.ne.us/srd/2002Abortion.pdf]; 22 March 2004, "Nebraska 2003 Statistical Report of Abortion," [http://www.hhs.state.ne.us/srd/2003Abortion.pdf]; 6 April 2005, "Nebraska 2004 Statistical Report of Abortion," [http://www.hhs.state.ne.us/srd/abortion-report2004.pdf]; April 2006, "Nebraska 2005 Statistical Report of Abortions," [http://www.hhs.state.ne.us/srd/ABORTION2005RPT.PDF]; 18 Jan. 2008, "Nebraska 2006 Statistical Report of Abortions," [http://www.hhs.state.ne.us/srd/ABORTION2006RPT.PDF]; Oct. 2008, "Nebraska 2007 Statistical Report of Abortions," 2008, Nebraska Health and Human Services System, on line [http://www.hhs.state.ne.us/srd/ABORTION2007RPT.PDF].
24. South Dakota Department of Health, South Dakota Department of Health, on line: 2004, "Induced Abortion," [http://www.state.sd.us/doh/Stats/10-InducedAbortion.pdf]; 2005, "Induced Abortion," [http://www.state.sd.us/doh/Stats/2004VitalStats/Abortion.pdf]; 2006, "Induced Abortion," [http://www.state.sd.us/doh/Stats/2005VitalStats/Abortion.pdf]; 2007, "Induced Abortion," [http://doh.sd.gov/Statistics/2006Vital/Abortion.pdf].
25. Utah Department of Health, Utah Department of Health, on line: 1997, "Utah's Vital Statistics, Abortions, 1996," [http://health.utah.gov/vitalrecords/pub_vs/96abrpub.pdf]; 1998, "Utah's Vital Statistics, Abortions, 1997," [http://health.utah.gov/vitalrecords/pub_vs/]; 1999, "Utah's Vital Statistics, Abortions, 1998," [http://health.utah.gov/vitalrecords/pub_vs/]; 2000, "Utah's Vital Statistics, Abortions, 1999," [http://health.utah.gov/vitalrecords/pub_vs/]; 30 Jan. 2002, "Utah's Vital Statistics, Abortions, 2000," [http://health.utah.gov/vitalrecords/pub_vs/ia00/00abor.pdf]; 2003, "Utah's Vital Statistics, Abortions, 2001," [http://health.utah.gov/vitalrecords/pub_vs/]; 20 Dec. 2004, "Utah's Vital Statistics, Abortions, 2002 and 2003," [http://health.utah.gov/vitalrecords/pub_vs/ia03/03a.pdf]; 2006, "Utah's Vital Statistics, Abortions, 2004," [http://health.utah.gov/vitalrecords/pub_vs/]; 16 Feb. 2007, "Utah's Vital Statistics, Abortions, 2005," [http://health.utah.gov/vitalrecords/pub_vs/ia05/05a.pdf]; Jan. 2008, "Utah's Vital Statistics, Abortions, 2006," [http://health.utah.gov/vitalrecords/pub_vs/ia06/06a.pdf].
26. Henshaw, Stanley K., and Kathryn Kost, Aug. 2008, "Trends in the characteristics of women obtaining abortions, 1974 to 2004," Alan Guttmacher Institute, on line [http://www.guttmacher.org/pubs/2008/09/18/Report_Trends_Women_Obtaining_Abortions.pdf].
27. Based on compiled figures by Johnston, W. R., "Abortion Statistics," 2008, Johnston's Archive, on line [http://www.johnstonsarchive.net/policy/abortion/]; figures are compiled from CDC's MMWR and NVSR and respective state health departments.
28. Smith, Chris, and Bart Stupak, 26 Sept. 2008, letter to Michael Leavitt, Secretary of Health and Human Services, on line [].
29. Kansas Department of Health and Environment, Kansas Department of Health and Environment, on line: 29 March 1999, "Abortions in Kansas 1998, Preliminary Report," [http://www.kdheks.gov/hci/98itop1.pdf]; 24 March 2000, "Abortions in Kansas 1999, Preliminary Report," [http://www.kdheks.gov/hci/99itop1.pdf]; March 2006, "Abortions in Kansas 2005, Preliminary Report," [http://www.kdheks.gov/hci/05itop1.pdf]; March 2008, "Abortions in Kansas 2007, Preliminary Report," [http://www.kdheks.gov/hci/07itop1.pdf].
30. Gianelli, D. M., 3 March 1997, "Abortion rights leader urges end to 'half truths'," American Medical News, pp. 3-4, 55-56; Statement of representative Charles T. Canady (R-Fla), 27 March 1996, Congressional Record; Sprang, M. LeRoy, and Mark G. Neerhof, 1998, "Rationale for banning abortions late in pregnancy," Journal of the American Medical Association, 280:744-747.
31. National Right to Life, 1996, "For what reasons are partial-birth abortions usually performed?," NRLC, on line [http://www.nrlc.org/abortion/pba/pbafact10.html]; Statement of representative Charles T. Canady (R-Fla), 27 March 1996, Congressional Record; Sprang, M. LeRoy, and Mark G. Neerhof, 1998, "Rationale for banning abortions late in pregnancy," Journal of the American Medical Association, 280:744-747.
32. Statement of representative Charles T. Canady (R-Fla), 27 March 1996, Congressional Record.
33. National Right to Life, 1996, "For what reasons are partial-birth abortions usually performed?," NRLC, on line [http://www.nrlc.org/abortion/pba/pbafact10.html].
34. Johnston, W. R., 19 April 2007, "Data on 'partial-birth' abortion in the United States," Johnston's Archive, on line [http://www.johnstonsarchive.net/policy/abortion/pba.html].

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© 2003, 2005, 2006, 2008 by Wm. Robert Johnston.
Last modified 9 October 2008.
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