If you have any questions, feel free to ask on my ask site: http://fyseq.tumblr.com/ask, though check out http://fuckyeahsexeducation.tumblr.com/FAQ!
The Anatomy of an Unsafe Abortion
FYSE: I’ve seen this making the rounds around tumblr! Very interesting read.
The term “teens” refers to 15–19-year-olds, unless otherwise specified.
[All of these statistics are cis-centric, unfortunately.]
Sexual Activity and Marriage Among Teens:
- When American teens have sex for the first time, is it typically with a significant other or a more casual acquaintance? Seven in 10 female teens and more than five in 10 male teens report that their first sexual experience was with a steady partner, while 16% of females and 28% of males report a first sexual experience with someone whom they had just met or who was just a friend.
- What is known about the age at first sex among female teens in developing regions? In Latin America and the Caribbean, more than four in 10 sexually active female teens have had sex by their 18th birthday. In Sub-Saharan Africa, six in 10 female teens have had sex by that age.
- Are teen marriage rates similar throughout the developing world? No. The poorer the country or region in the developing world, the greater the chances are that female teens are married. [13,50] An estimated four in 10 women aged 15–19 living in low-income countries in Sub-Saharan Africa, South Central and Southeast Asia, and Latin America and the Caribbean are married, compared with slightly more than one in 10 in upper-middle– and high-income countries in these regions.
Contraceptive Use Among Teens:
- Do American teens typically use a contraceptive method the first time they have sex? How about the most recent time they had sex? The majority of U.S. teens use a contraceptive method the first time they have sex (78% of females and 85% of males). Among teens who are already sexually active, more than eight in 10 female teens and nine in 10 male teens reported using a method the last time they had sex.
- Which contraceptive method is most commonly used by American teens? The male condom is the most common contraceptive method used at first sex, as well as at most recent sex. Almost seven in 10 U.S. females and eight in 10 males used condoms the first time they had sex, and more than five in 10 female teens and almost eight in 10 male teens used it the last time they had sex.
- How do American teens’ sexual behaviors compare with those of European teens? Teens in the United States and Europe have similar levels of sexual activity. However, European teens are more likely to use contraceptives and to use more effective contraceptive methods; therefore, they have substantially lower pregnancy rates than U.S. teens.
- Do teens in developing regions have adequate access to contraceptives? No. Fewer than one-third of married female teens who want to avoid pregnancy use modern contraceptive methods. Among unmarried teens who want to avoid pregnancy, almost seven out of 10 in South Central and Southeast Asia and in Sub-Saharan Africa, and almost half in Latin America, do not use modern contraceptive methods.[13,50]
- Do any U.S. states give minors confidential access to contraceptive services? Half of states explicitly allow minors to obtain contraceptive services without a parent’s involvement or interpret the absence of a law in favor of minors’ access. The remaining states allow access to contraceptive services without parental involvement only for certain groups of minors, such as married teens.
- What impact could U.S. parental involvement laws have on minors’ contraceptive use? While parental involvement can be helpful for some minors, others will remain sexually active but will not seek contraceptive services if they are required to tell their parents, which puts them at increased risk for unintended pregnancy and sexually transmitted infections.
- Do sexually active teens in the United States have a need for publicly funded contraceptive services? Some five million U.S. teens are in need of publicly funded contraceptive services and supplies. They represent about 30% of all U.S. women with such a need. Many sexually active teens need publicly funded contraceptive services so that they can obtain confidential care without having to depend on their family’s resources or their private insurance.
Pregnancy and Births Among Teens:
- What is the teen pregnancy rate in the United States? Overall, about 70 pregnancies occur for every 1,000 female teens. However, when only female teens who have ever had sex, the pregnancy rate is much higher, about 150 per 1,000.
- Is there a difference in teen pregnancy rates between older and younger teens in the United States? Yes. Two-thirds of all U.S. teen pregnancies occur among 18–19-year-olds. The pregnancy rate for younger teens is almost 40 per 1,000 women aged 15–17, while the rate for teens aged 18–19 is nearly 120 per 1,000 women.
- Does the teen pregnancy rate vary by race in the United States? Yes. The U.S. pregnancy rate for both black and Hispanic teens (126 and 127 per 1,000 women aged 15–19, respectively) is almost three times that of non-Hispanic white teens (44 per 1,000).
- Do teen fatherhood rates vary by race in the United States? Yes. The U.S. rate of fatherhood among black men aged 15–19 (34 per 1,000) is more than twice that among white men (15 per 1,000).
- What proportion of American teen pregnancies are unintended? Of the approximately 750,000 pregnancies that occur among teens every year, more than 80% are unintended. Teens account for almost one-fifth of all unintended pregnancies. [Prolonged Eye Contact comment: one more reason to make emergency contraception available to younger teenagers over the counter without a prescription.]
- Is the rate of unintended pregnancy among American teens higher or lower than that among older women? Calculations of the unintended pregnancy rate typically include all women, whether or not they are sexually active. While most older women are sexually active, many teens are not, so the rate among teens is often understated. The unintended pregnancy rate among sexually active teens only is more than twice the rate among all women.
- How many unintended pregnancies occur each year among teens in developing countries? Each year, there are more than six million unintended pregnancies among teens in South Central and Southeast Asia, Sub-Saharan Africa, and Latin America and the Caribbean.
- What are the outcomes of U.S. teen pregnancies? The majority (nearly 60%) of U.S. teen pregnancies end in birth, while 27% end in abortion and the remainder end in miscarriage.
- Which countries have the most teen births? Worldwide, half of all teen births each year occur in just seven countries: Bangladesh, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Nigeria and the United States.
Abortion Among Teens:
- What proportion of all U.S. abortions occur among teens? Just 17% of all U.S. abortions are obtained by teenagers. Teens aged 18–19 account for 11% of all abortions and 15–17-year-olds account for 6%; teens younger than age 15 account for another 0.4%. Teens aged 18–19 obtain two out of three teen abortions.
- What is the abortion rate among American teens? There are 19 abortions for every 1,000 women aged 15–19 in the United States. The abortion rate is higher than average for black and Hispanic teens (44 and 24 per 1,000 women aged 15–19, respectively) and lower than average for non-Hispanic whites (11 per 1,000).
- What proportion of all unsafe abortions in the developing world occur among teens? Teens account for 14% of all unsafe abortions that occur in the developing world. The number of teens in the developing world who have legal and safe abortions is unknown.
- Does obtaining an abortion have an impact on U.S. teens’ mental health? Studies of U.S. teens who have had an abortion show that this group is not at higher risk for depression or low self-esteem than teens who carry their pregnancy to term. Similarly, studies indicate a lack of negative mental health effect of abortion among adult women.
- Do many states have laws requiring parental involvement in teens’ abortions? The majority of states have laws that require parents to consent to or be notified of a teen’s decision to have an abortion, but only a few require both parental notification and consent. A handful of states do not require any parental involvement. 
- What is the effect of laws requiring parental involvement in teens’ abortions? Laws requiring parental involvement in minors’ abortions appear to do little to reduce teen abortion or pregnancy rates. These laws do, however, force some teens to navigate complicated judicial bypass systems to obtain waivers, or to seek abortions in a state without such requirements. These barriers delay access to the procedure, reducing safety and resulting in later, more costly abortions.
Sexually Transmitted Infections (STIs) Among Teens:
- How does the incidence of sexually transmitted infections (STIs) among young people in the United States compare with that among older adults? Even though young people aged 15–24 represent only about 25% of sexually active Americans, they account for nearly half of all new STIs annually. Every year, roughly nine million new STIs occur among U.S. teens and young adults. Rates among U.S. teens are much higher than rates among teens in Canada and Western Europe.
- Do many states give minors access to STI services without parental involvement? All 50 states and the District of Columbia give minors access to services related to sexually transmitted infections without parental involvement, although more than 10 states require that a minor be of a certain age (generally 12 or 14) to do so.
Sources of Information About Sex:
- Who do American teens trust the most for information on sex? American teens rank parents, peers and the media as important sources of sexual health information.
- Do U.S. states require that formal sex education curricula be medically accurate? Only a handful of states require that the information presented in sex education classes be medically accurate and factual (14 states, as of October 2011).
- What subjects are usually included in formal U.S. sex education curricula? Virtually all teens receive formal instruction about STIs, and more than eight in 10 receive instruction on abstinence. However, about one-third of teens do not receive any instruction about contraception.
- Do U.S. teens who receive abstinence education also receive information about birth control? Not always. About one in four teens (23% of females and 28% of males) receive abstinence education without receiving any formal instruction about birth control.
- Worldwide, do teens get comprehensive sex education in schools or other formal settings? Most often they do not. Teens in many parts of the world do not get comprehensive sex education. Many also report feeling shy about obtaining information and contraception from formal settings, particularly in countries where some influential groups believe that such education encourages sexual promiscuity.
- What impact does comprehensive sex education have on teen sexual behavior worldwide? Comprehensive sex education, which includes information on both contraception and abstinence, often results in delayed sexual activity, lower frequency of sex and fewer sexual partners. This type of sex education can also increase condom or contraceptive use and reduce risky sexual behaviors. Receiving comprehensive sex education does not lead teens to have sex earlier.
- What impact does abstinence-only sex education have on teens? A review of 13 commonly used abstinence-only curricula found that 11 had incorrect, misleading or distorted information. Some abstinence-only programs have been shown to deter contraceptive use among sexually active teens, increasing their risk of pregnancy and STIs. Moreover, there is no strong evidence that abstinence-only programs influence teens to delay sexual activity, to have fewer sexual partners or, if already sexually active, to become abstinent.
[These statistics are entirely cis-centric, unfortunately.]
- How many abortions occur each year worldwide? More than 40 million abortions are performed worldwide each year. More than 85% of all abortions occur in developing countries.
- Are women in developed countries more likely to have an abortion than women in developing countries? A woman’s likelihood of having an abortion is similar whether she lives in a developed or developing country. Each year, there are 24 abortions per 1,000 women aged 15–44 in developed countries, compared with 29 per 1,000 in developing countries. At the regional level, the lowest abortion rate in the world is in Western Europe (12 per 1,000), and the highest is in Eastern Europe (43 per 1,000).
- How many abortions occur each year in the United States? There were roughly 1.2 million abortions performed in 2008, and the abortion rate was 20 per 1,000 women aged 15–44. Put differently, about 2% of American women aged 15–44 had an abortion that year.
- How does the U.S. rate of abortion compare with the worldwide rate? Worldwide, there are about 28 abortions for every 1,000 women of childbearing age (15–44). In the United States, there are about 20 abortions per 1,000 women.
- How likely is it that a U.S. woman will obtain an abortion in her lifetime? Barring any changes in the U.S. abortion rate (as of 2008), 30% of women will have an abortion by age 45; 25% of women will have an abortion by age 30; and 8% by age 20.
- Is abortion becoming more or less common in the United States? Less common. The overall U.S. abortion rate declined steadily between 1980 and 2005. However, between 2005 and 2008 that overall decline stagnated, while rates increased among poor women.
- How many abortions occurred before the procedure became legal throughout the United States in 1973? Estimates of the annual number of illegal abortions in the 1950s and 1960s range from 200,000 to 1.2 million. Because the procedure was illegal under most circumstances in most states, women had few options aside from a dangerous, clandestine procedure. As late as 1965, illegal abortions accounted for an estimated 201 deaths in the United States—17% of all officially reported pregnancy-related deaths that year.
Safety of Abortion:
- How safe is abortion? When performed under proper medical conditions by trained personnel in a hygienic setting, abortion is an extremely safe procedure. Fewer than 1% of all U.S. abortion patients experience a major complication and the risk of death associated with abortion is 10 times as low as that associated with childbirth. (34) However, when the procedure is performed by an unskilled person, or in an environment not conducive to safe medical circumstances, it is considered unsafe. The risk of death associated with unsafe abortion worldwide is 30 deaths per 100,000 live births.
- Are most abortions safe or unsafe? Almost half of all abortions that occur worldwide—about 22 million in 2008—are unsafe. Between 2003 and 2008, the global unsafe abortion rate remained unchanged at 14 per 1,000 women aged 15–44 years. The highest rate of unsafe procedures—36 per 1,000 women—was in Eastern and Middle Africa.
- How does the rate of unsafe abortion in developing regions compare with the rate in developed regions? The rate of unsafe abortion in developing regions is 16 times that in developed regions. Unsafe abortions are rare in developed regions because the procedure is widely legal and therefore likely to be performed under safe conditions; in developing regions, where abortion is largely illegal, more than half of all abortions are unsafe.
- How harmful is unsafe abortion? Complications from unsafe abortion account for an estimated 13% of maternal deaths worldwide, some 47,000 annually. An estimated five million women are hospitalized each year for treatment of abortion-related complications.
- How many abortion-related deaths are there in the United States each year? In 2007, six women in the United States were reported to have died as a result of abortion complications.
- Does abortion lead to mental health problems for women? For two decades, the highest quality scientific evidence available has led to the conclusion that having an abortion does not cause mental health problems for most women. A woman’s mental health before she faces an unwanted pregnancy is the best indicator of her likely mental health after an abortion. 
Medication Abortion In The United States:
- What is medication abortion? Medication abortion, an alternative to surgical abortion, involves the administration of two drugs, mifepristone and misoprostol, to terminate the pregnancy. Medication abortion is an option only in the first nine weeks of pregnancy.
- How common is medication abortion in the United States? Medication abortion has become an integral part of U.S. abortion care. In 2008, medication abortion accounted for slightly more than one-quarter of all abortions performed before nine weeks’ gestation.
- How many U.S. providers offer medication abortion? In 2008, almost six in 10 U.S. abortion providers (more than 1,060 facilities), provided medication abortions. At least 9% of providers offered only medication abortion services.
- Has medication abortion expanded access to abortion in the United States? Because it does not involve surgery, medication abortion has the potential to make abortion services more accessible, particularly in areas without a surgical abortion provider. But research suggests that although use of mifepristone has become widespread and has contributed to the shift toward earlier abortions, its use has not yet substantially improved U.S. women’s geographic access to abortion services.
Characteristics of U.S. Women Having Abortions:
- How old are most women who obtain abortions in the United States? More than half of American women obtaining abortions are in their 20s. Women aged 20–24 have the highest abortion rate of any age-group (40 abortions per 1,000 women).
- How many U.S. women obtaining abortions are already mothers? Six in 10 American women having an abortion already have a child, and more than three in 10 already have two or more children.
- What proportion of U.S. women obtaining abortions are religious? More than seven in 10 U.S. women obtaining an abortion report a religious affiliation (37% protestant, 28% Catholic and 7% other), and 25% attend religious services at least once a month. The abortion rate for protestant women is 15 per 1,000 women, while Catholic women have a slightly higher rate, 22 per 1,000.
- What is the racial or ethnic background of U.S. women who have abortions? No racial or ethnic group makes up a majority of women having abortions: 36% are non-Hispanic white, 30% are non-Hispanic black, 25% are Hispanic and 9% are women of other races.
- Which racial or ethnic groups are most likely to have abortions in the United States? Non-Hispanic black and Hispanic women have higher rates of abortion (40 and 29 per 1,000 women aged 15–44, respectively) than non-Hispanic white women do (12 per 1,000). The higher rates reflect the fact that black and Hispanic women have high unintended pregnancy rates (91 and 82 per 1,000 women, respectively), compared with non-Hispanic white women (36 per 1,000 women).
- What proportion of abortions in the United States are among poor women? Women with family incomes below the federal poverty level ($18,530 for a family of three) account for more than 40% of all abortions. They also have one of the country’s highest abortion rates (52 per 1,000 women). In contrast, higher-income women (with family incomes at or above 200% of the poverty line) have a rate of nine abortions per 1,000, which is about half the national rate.
- Why do women in the United States have abortions? Most women identify multiple reasons for having an abortion: Three-fourths cite concerns for or responsibility to other individuals, including children; three-fourths say they cannot afford a child; three-fourths say that having a baby would interfere with work, school or the ability to care for dependents; and half say they do not want to be a single parent or are having problems with their husband or partner. The reasons U.S. women give for having an abortion reflect their understanding of the responsibilities of parenthood and family life.
- In which regions of the United States are women most likely to have an abortion? In 2008, the abortion rate was highest in the Northeast (27 abortions per 1,000 women), followed by the West, the South and the Midwest (22, 18 and 14 per 1,000, respectively).
- How many abortions in the United States occur in the second trimester? In the United States, only about one in 10 abortions occur in the second trimester. More than nine in 10 occur in the first 12 weeks of pregnancy and more than six in 10 occur in the first eight weeks. The availability of medication abortion and new techniques that allow surgical abortions to be performed earlier in pregnancy are likely to reinforce the trend toward earlier abortions.
Cost of Abortion Services In The United States:
- What is the average cost of a first-trimester abortion in the United States? In 2009, the median charge for a surgical abortion at 10 weeks’ gestation was $470; but since most U.S. women obtain abortions at facilities with lower charges, the average amount paid was $451. The median cost for a medication abortion was $490 and women paid an average of $483.
- How do U.S. women pay for their abortion procedures? In 2008, just one-third of privately insured U.S. women having abortions used that coverage to pay for their procedures; it is not clear how many of their plans offered full or partial coverage for abortion, or how many women were deterred from using their coverage because of concerns about confidentiality. Among women having abortions that year, methods of payment included paid out of pocket 9 almost 60%), private insurance (12%), and Medicaid (20%; almost all of whom lived in the few states that use their own funds to cover medically necessary abortions).
Abortion Providers In The United States:
- Where are abortions performed? Abortions are performed at clinics, hospitals and physicians’ offices. The vast majority of U.S. abortions (about 94%) are performed at clinics.
- Is the number of abortion providers in the United States increasing or decreasing? The number of U.S. abortion providers decreased 38% between its peak, in 1982, and 2005. In 2008, however, there were 1,793 providers, about the same number as in 2005.
- Is it difficult for women in the United States to reach a provider? Some 87% of U.S. counties do not have an abortion provider and 35% of women aged 15–44 live in those counties. The proportions are lower in the Northeast (53% and 18%) and the West (74% and 13%). In 2005, nonhospital providers estimated that while more than seven in 10 women traveled less than 50 miles to access abortion services, nearly two in 10 traveled 50–100 miles and almost one in 10 traveled more than 100 miles.
- Are U.S. abortion clinics primarily located in black communities? No. Despite claims by antiabortion activists that most U.S. abortion clinics are located in black neighborhoods in order to target black women, fewer than one in 10 abortion clinics are actually located in predominantly black communities. 
- What proportion of U.S. abortion providers experience harassment, and what types of harassment do they experience? In 2008, nearly nine in 10 abortion clinics in the United States experienced at least one form of harassment. Levels of harassment were particularly high in the Midwest (85%) and the South (75%). Overall, picketing was the most common harassment, reported by 87% of clinics
- Why do the Guttmacher Institute’s U.S. abortion data differ from those compiled by the U.S. Centers for Disease Control and Prevention (CDC)? Guttmacher’s abortion provider data are gathered through a national census of all known facilities that provide abortions in the United States, an effort the Institute has undertaken since 1973. The CDC compiles data on U.S. abortion procedures it receives from state departments of health; there are a few states that do not collect or report data on abortion procedures at all. Therefore, Guttmacher’s data on abortion are considered more complete.
Legal Restrictions On Abortion:
- Does making abortion illegal make it less common? No. The criminalization of abortion does not eliminate the procedure; instead it forces women to turn to unskilled providers who work in clandestine, unsafe conditions, thus increasing their risk of injury and death. Many developing countries have highly restrictive laws, but also high abortion rates. While the legal restrictions in these countries do not lessen the incidence of abortion, they greatly increase the risk to women. The risk of death resulting from abortion in developing regions is almost 60 times that in developed regions.
- What proportion of the world’s women live in countries with highly restrictive abortion laws? As of 2008, some 40% of women of childbearing age (15–44 years) live in countries with highly restrictive laws (i.e., prohibiting abortion altogether, or allowing it only to save a woman’s life or to protect her physical or mental health).
- What is Roe v. Wade? Roe v. Wade is the 1973 Supreme Court decision that recognized that a woman’s right to privacy includes her right to decide, in consultation with her physician, whether to continue her pregnancy. Roe also established that after the fetus is viable (that is, able to live outside the woman’s body, with or without artificial aid), states may restrict or ban abortions entirely, except when necessary to protect the woman’s life or health.
- What is the Hyde Amendment? First implemented in 1977, the Hyde Amendment prevents federal Medicaid funds from being used to pay for abortion except in cases of rape or incest, or to save the life of the mother. However, states may use their own funds to cover the cost of abortion services for women on Medicaid; as of October 2011, 17 states currently do so in at least some circumstances.
- How does the Hyde Amendment affect low-income women’s access to abortion in the United States? Approximately one-third of women obtaining abortions have Medicaid health care coverage, but many cannot use it to pay for their abortion procedures. Women who have to pay for an abortion out of pocket may be forced to delay the procedure to raise the necessary funds, increasing both the cost and health risks associated with a later procedure. Many women must divert money meant for rent, child care, utility bills and food to pay for abortion care. Moreover, some women who are unable to obtain funding for abortions are forced to carry the pregnancy to term.
- How do states restrict abortion access? States adopt many types of laws to restrict abortion access. The most common restrictions on abortion are parental involvement requirements for minors, state-mandated counseling and waiting periods, and limitations on public funding and private insurance. All abortion laws enacted by states must include an exception to protect the woman’s life and health. The vast majority of states have such laws in place.