Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014

摘要

Objectives. To assess the prevalence of abortion among population groups and changes in rates between 2008 and 2014. Methods. We used secondary data from the Abortion Patient Survey, the American Community Survey, and the National Survey of Family Growth to estimate abortion rates. We used information from the Abortion Patient Survey to estimate the lifetime incidence of abortion. Results. Between 2008 and 2014, the abortion rate declined 25%, from 19.4 to 14.6 per 1000 women aged 15 to 44 years. The abortion rate for adolescents aged 15 to 19 years declined 46%, the largest of any group. Abortion rates declined for all racial and ethnic groups but were larger for non-White women than for non-Hispanic White women. Although the abortion rate decreased 26% for women with incomes less than 100% of the federal poverty level, this population had the highest abortion rate of all the groups examined: 36.6. If the 2014 age-specific abortion rates prevail, 24% of women aged 15 to 44 years in that year will have an abortion by age 45 years. Conclusions. The decline in abortion was not uniform across all population groups. Abortion is a common medical procedure and an important component of public health. 1,2 In 2014, 926?190 abortions were performed in the United States; the abortion rate was 14.6 abortions per 1000 women aged 15 to 44 years, meaning that in that year 1.5% of women of reproductive age had an abortion. 3 In 2008, it was estimated that 30% of women aged 15 to 44 years would have an abortion by age 45 years if the prevailing rate continued, 4 and this figure is often used to demonstrate the commonality of abortion. 2,5 However, the abortion rate has declined substantially since that time—14% between 2011 and 2014 alone 3 —and it is likely that the estimate of the lifetime incidence of abortion has also declined. In addition to fewer women having abortions, the characteristics of the women who obtained them has changed. In 2014, 49% of abortion patients had family incomes below 100% of the federal poverty level, a significant increase from 42% in 2008. 6 Adolescents accounted for a significantly smaller share of abortion patients: 12% in 2014 compared with 18% in 2008. Low-income and younger women have traditionally been at increased risk for unintended pregnancy and, in turn, abortion. Changes in the prevalence of abortion for these and other groups, as measured by the abortion rate, could inform strategies to reduce disparities in access to family planning services and other types of reproductive health care. We combined information on abortion rates and the characteristics of women who have abortions to determine if declines in abortion were experienced by all populations of women. Specifically, we estimated abortion rates in 2014 according to age, income, race and ethnicity, and other characteristics, and we also examined changes in population rates since 2008, the last year these measures were generated. Finally, we provide an updated estimate of the lifetime incidence of abortion.