A Study of Reported
Therapeutic Abortions in North
Carolina
EMBRY M. HOWELL, MSPH
An analysis is presented of abortion statistics in North Carolina before and after reporting of therapeutic abortions became mandators.
History of the State Abortion Law and Abortion Reporting In 1967 the North Carolina legislature changed the state's abortion statute to allow hospital abortions in cases where the pregnancy endangered the mental or physical health of the woman, in cases where fetal indications existed, and in cases of rape or incest. Three physicians had to agree on the need for an abortion before the abortion could be performed. There was no provision in this law for reporting of abortions. However, the Committee on Maternal Health of the Medical Society of the State of North Carolina implemented a voluntary reporting system whereby hospitals were encouraged to report all abortions on a standard form. These forms were transmitted to the Public Health Statistics Section of the State Board of Health where they were coded, punclhed, and tabulated. In 1971 the abortion statute was changed to require only two physicians in agreement, to reduce residency requirements from 4 months to 30 days, and to require reporting of all abortions. Reporting became mandatory on May 19, 1971.
Time Trends A comparison of the data on reported therapeutic abortions since 1967 can be made using Table 1. The data At the time of this study, Ms. Howell was a student in the Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, North Carolina. She is currently with the Comprehensive Health Planning Council of Northern Virginia, 7245 Arlington Blvd., Falls Church, Virginia 22042. 480
AJPH MAY, 1975, Vol. 65, No. 5
for 1971 are divided into voluntary reporting (January to May) and mandatory reporting (June to December). The data collected before June, 1971, may be used only as a biased overview of the abortion situation because of the lack of mandatory reporting before that time. There is some basis for trusting percentage distributions, if not frequencies, as is discussed later in the comparison between voluntary and mandatory reporting for 1971. The reported abortion population has become younger each year, with the percentage under 20 increasing from 12.5 per cent in 1967 to 33.7 per cent in the mandatory reporting period, June to December, 1971. Correspondingly, the percentage aged 30 and over has decreased from 50.0 to 19.6 per cent. There has been an increase in the percentage of nonwhites receiving abortions, from 16.7 per cent in 1967 to 28.8 per cent in June to December, 1971. The percentage of reported abortions performed for psychiatric reasons has increased from 45.8 per cent in 1967 to 91.7 per cent in June to December, 1971. There has also been a shift in operational procedures during this period. In 1967 the majority (51.4 per cent) of abortions were performed by dilation and curettage. In June to December, 1971, only 21 per cent of abortions were performed by dilation and curettage and 43.2 per cent were performed by suction curettage. The percentages of hysterotomies and hysterectomies have gone down from 23.6 per cent and 16.6 per cent, respectively, to 3.3 per cent and 3.9 per cent. Hypertonic injection now accounts for 16.6 per cent of all operational procedures. The proportion of women receiving sterilization at the time of abortion has declined since 1967. In that year 56.9 per cent were sterilized. During June to December, 1971, only 11.7 per cent were sterilized.
TABLE 1-Time Trends in Reported Therapeutic Abortions, North Carolina, 1967-1971 1971
1967
Age of patient
Therapeutic Abortions in North
Carolina
EMBRY M. HOWELL, MSPH
An analysis is presented of abortion statistics in North Carolina before and after reporting of therapeutic abortions became mandators.
History of the State Abortion Law and Abortion Reporting In 1967 the North Carolina legislature changed the state's abortion statute to allow hospital abortions in cases where the pregnancy endangered the mental or physical health of the woman, in cases where fetal indications existed, and in cases of rape or incest. Three physicians had to agree on the need for an abortion before the abortion could be performed. There was no provision in this law for reporting of abortions. However, the Committee on Maternal Health of the Medical Society of the State of North Carolina implemented a voluntary reporting system whereby hospitals were encouraged to report all abortions on a standard form. These forms were transmitted to the Public Health Statistics Section of the State Board of Health where they were coded, punclhed, and tabulated. In 1971 the abortion statute was changed to require only two physicians in agreement, to reduce residency requirements from 4 months to 30 days, and to require reporting of all abortions. Reporting became mandatory on May 19, 1971.
Time Trends A comparison of the data on reported therapeutic abortions since 1967 can be made using Table 1. The data At the time of this study, Ms. Howell was a student in the Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, North Carolina. She is currently with the Comprehensive Health Planning Council of Northern Virginia, 7245 Arlington Blvd., Falls Church, Virginia 22042. 480
AJPH MAY, 1975, Vol. 65, No. 5
for 1971 are divided into voluntary reporting (January to May) and mandatory reporting (June to December). The data collected before June, 1971, may be used only as a biased overview of the abortion situation because of the lack of mandatory reporting before that time. There is some basis for trusting percentage distributions, if not frequencies, as is discussed later in the comparison between voluntary and mandatory reporting for 1971. The reported abortion population has become younger each year, with the percentage under 20 increasing from 12.5 per cent in 1967 to 33.7 per cent in the mandatory reporting period, June to December, 1971. Correspondingly, the percentage aged 30 and over has decreased from 50.0 to 19.6 per cent. There has been an increase in the percentage of nonwhites receiving abortions, from 16.7 per cent in 1967 to 28.8 per cent in June to December, 1971. The percentage of reported abortions performed for psychiatric reasons has increased from 45.8 per cent in 1967 to 91.7 per cent in June to December, 1971. There has also been a shift in operational procedures during this period. In 1967 the majority (51.4 per cent) of abortions were performed by dilation and curettage. In June to December, 1971, only 21 per cent of abortions were performed by dilation and curettage and 43.2 per cent were performed by suction curettage. The percentages of hysterotomies and hysterectomies have gone down from 23.6 per cent and 16.6 per cent, respectively, to 3.3 per cent and 3.9 per cent. Hypertonic injection now accounts for 16.6 per cent of all operational procedures. The proportion of women receiving sterilization at the time of abortion has declined since 1967. In that year 56.9 per cent were sterilized. During June to December, 1971, only 11.7 per cent were sterilized.
TABLE 1-Time Trends in Reported Therapeutic Abortions, North Carolina, 1967-1971 1971
1967
Age of patient
