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Abortion surveillance -- United States, 2013
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Details:
  • Corporate Authors:
    National Center for Chronic Disease Prevention and Health Promotion (U.S.). Division of Reproductive Health.
  • Pubmed ID:
    27880751
  • Series:
    MMWR. Surveillance summaries : Morbidity and mortality weekly report. Surveillance summaries ; v. 65, no. SS-12
  • Document Type:
  • Description:
    Table I. Provisional cases of selected infrequently reported notifiable diseases (<1,000 cases reported during the preceding year) — United States, week ending November 12, 2016 (45th week) -- Figure I. Selected notifiable disease reports, United States, comparison of provisional 4-week totals November 12, 2016, with historical data -- Table II Provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding year), and selected low frequency diseases, United States and U.S. territories, weeks ending November 12, 2016, and November 14, 2015 (45th week) -- Table III. Number of deaths from pneumonia and influenza and all deaths, by U.S. Department of Health and Human Services region and state, for the week ending October 29, 2016, as of November 16, 2016.

    Problem/Condition: Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States.

    Period Covered: 2013.

    Description of System: Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2013, data were received from 49 reporting areas. For trend analysis, abortion data were evaluated from 47 areas that reported data every year during 2004–2013. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births).

    Results: A total of 664,435 abortions were reported to CDC for 2013. Of these abortions, 98.2% were from the 47 reporting areas that provided data every year during 2004–2013. Among these 47 reporting areas, the abortion rate for 2013 was 12.5 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 200 abortions per 1,000 live births. From 2012 to 2013, the total number, rate, and ratio of reported abortions decreased 5%. From 2004 to 2013, the total number, rate, and ratio of reported abortions decreased 20%, 21%, and 17%, respectively. In 2013, all three measures reached their lowest level for the entire period of analysis (2004–2013).

    In 2013 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates; women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates. In 2013, women aged 20–24 and 25–29 years accounted for 32.7% and 25.9% of all abortions, respectively, and had abortion rates of 21.8 and 18.2 abortions per 1,000 women aged 20–24 and 25–29 years, respectively. In contrast, women aged 30–34, 35–39, and ≥40 years accounted for 16.8%, 9.2%, and 3.6% of all abortions, respectively, and had abortion rates of 11.8, 7.0, and 2.5 abortions per 1,000 women aged 30–34 years, 35–39 years, and ≥40 years, respectively. During 2004–2013, the decrease in abortion rates among adult women aged 20–39 years ranged from 8% to 27% across these age groups, whereas the abortion rate was stable for women aged ≥40 years.

    In 2013, adolescents aged <15 and 15–19 years accounted for 0.3% and 11.4% of all abortions, respectively, and had abortion rates of 0.6 and 8.2 abortions per 1,000 adolescents aged <15 and 15–19 years, respectively. From 2004 to 2013, the percentage of abortions accounted for by adolescents aged 15–19 years decreased 31% and their abortion rate decreased 46%. 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 2013 and throughout the entire period of analysis were highest among adolescents and lowest among women aged 30–39 years. Abortion ratios decreased from 2004 to 2013 for women in all age groups, except for adolescents aged <15 years.

    In 2013, the majority (66.0%) of abortions were performed by ≤8 weeks’ gestation, and nearly all (91.6%) were performed by ≤13 weeks’ gestation. Few abortions were performed between 14 and 20 weeks’ gestation (7.1%) or at ≥21 weeks’ gestation (1.3%). From 2004 to 2013, the percentage of all abortions performed at ≤13 weeks’ gestation remained consistently high (≥91.5%) and among those performed at ≤13 weeks’ gestation, the percentage performed at ≤6 weeks’ gestation increased 16%.

    In 2013, among the 43 reporting areas that included medical (nonsurgical) abortion on their reporting form, a total of 67.9% of abortions were performed by curettage at ≤13 weeks’ gestation, 22.2% were performed by early medical abortion (a nonsurgical abortion at ≤8 weeks’ gestation), and 8.6% were performed by curettage at >13 weeks’ gestation; all other methods were uncommon. Among abortions performed at ≤8 weeks’ gestation that were eligible for early medical abortion on the basis of gestational age, 32.8% were completed by this method. From 2012 to 2013, the percentage of abortions reported as early medical abortions increased 5%.

    Deaths of women associated with complications from abortion for 2013 are being investigated as part of CDC’s Pregnancy Mortality Surveillance System. In 2012, the most recent year for which data were available, four women were identified to have died as a result of complications from known legal induced abortion. No reported deaths were associated with known illegal induced abortion.

    Interpretation: Among the 47 areas that reported data every year during 2004–2013, the decreases in the total number, rate, and ratio of reported abortions that occurred during 2009–2012 continued from 2012 to 2013, resulting in historic lows for all three measures of abortion.

    Public Health Action: The data in this report can help program planners and policymakers identify groups of women with highest rates of abortion. Unintended pregnancy is the major contributor to abortion. Increasing access to and use of contraception, including the most effective methods, can reduce unintended pregnancies and further reduce the number of abortions performed in the United States.

    Suggested citation for this article: Jatlaoui TC, Ewing A, Mandel MG, et al. Abortion Surveillance — United States, 2013. MMWR Surveill Summ 2016;65(No. SS-12):1–44. DOI: http://dx.doi.org/10.15585/mmwr.ss6512a1.

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