Abortion: the continuing controversy

While most countries of the world practice abortion, government policy, medical opinion, private opinion and actual practice vary widely. Although mortality from legal abortions is quite low, complications rise sharply after 12 gestational weeks. No conclusive proof shows adverse postabortion psychological effects. Romania, Japan and the Soviet Union experienced declining birth rates when abortion was made available and New York City saw a decline in illegitimacy of approximately 12% from 1970 to 1971. Throughout the world abortion laws vary from restrictive to moderate to permissive. Where laws are restrictive, as in France and Latin America, illegal abortions are estimated in the millions. The controversy over abortion centers around the arguments of what constitutes a human life, and the rights of the fetus versus the right of a woman to control her reproductive life. A review of state abortion laws as of August 1972 shows pressure on state legislatures to change existing laws. The future of abortion depends upon technological advances in fertility control, development of substitutes like menstral extraction, prostaglandins and reversible sterilization. Development of these techniques will take time. At present only through education and improved delivery of contraceptives can dependence on abortion as a method of fertility control be eased. Citizen education in the United States, both sex education and education for responsbile parenthood, is in a poor state according to the Commission on Population Growth and the American Future. If recourse to abortion is to be moderated, it is the next generation of parents who will have to be educated.     

Legal abortion and fertility in Maryland, 1960–1971

In the brief period between 1967 and 1971 about one-third of the state legislatures passed abortion reform bills, and in states such as Maryland the number of legal abortions soared. Maryland with its good reporting system for legal abortions, as well as its demographic representativeness, appears to offer an ideal "test situation" for assessing the impact on fertility of the new liberalization. Data on live births and reported induced abortions to residents of the state have been compiled and analyzed in an effort to interpret the recent changes in birth rates. Variables examined include maternal age, birth order, race, and legitimacy.Since 1968, Maryland, along with higher than national average abortion ratios, has experienced a rate of decline in fertility greater than that for the nation. In addition, most of the age and parity groups with high abortion ratios show fertility declines greater than those for groups not using abortion as extensively, Nevertheless, because a number of different factors simultaneously influence fertility, it is hazardous to make accurate cause-and-effect statements on the relationship of any single one of these to the observed change.     

Welfare generosity, pregnancies and abortions among unmarried AFDC recipients

Even before the 1996 overhaul of the U.S. welfare system, a number of states had ended the practice of paying extra benefits to families who have additional children while receiving welfare. Proponents believe that this reform can reduce births to recipients, however many worry that it may encourage women to obtain abortions. Using a sample of unmarried AFDC recipients from the NLSY, we estimate a bivariate probit model of pregnancy and, conditional on becoming pregnant, the probability of abortion. Our results lend some support for the proposition that reducing incremental AFDC benefits will decrease pregnancies without increasing abortions. Received: 16 April 1998/Accepted: 11 March 1999     

Family planning practice and women's fertility decision-making power

This paper investigates the effects of family planning practice on fertility decision-making power in South Korea. The log-linear analysis of the 1981 survey data by the Institute of Population and Health Services Research, Yonsei University, Seoul, Korea, shows that those urban and rural women who practice family planning or have experienced abortion exercise greater influence on a couple's fertility decision making than those who do not practice family planning or who have had no abortion experience. In addition, there is the interactive effect of abortion experience and contraceptive use on fertility decision making among urban women. This finding is significant because regardless of how birth control is available within a society, birth control use enhances women's decision making power where fertility is concerned.     

选择与限制:生育过程中的终止妊娠措施——基于规范和实践层面的价值权衡

终止妊娠问题在规范层面一是作为对于违反计划生育规定生育子女的行为所采取的纠正措施之一而存在的;二是对基于非医学需要性别鉴定/选择的终止妊娠的禁止,但存在当事人终止妊娠的动机难以确定、控制性别比例的初衷难以实现、对符合生育条件的妇女与不符合生育条件的妇女区别对待、缺乏设定行政许可的上位法依据等问题。在实践层面上,选择性别的终止妊娠未得到真正禁止。规范与实践层面问题背后的出路在于厘清问题所涉及到的权利冲突,并对其进行价值权衡。     

Abortion in amsterdam

Abstract Mortality from abortion is low in the Netherlands to-day, and approximately equal to mortality at delivery. Calculations suggest that about 4,000 abortions occur in Amsterdam every year, of which about 2,100 are induced. The abortion rate shows a very gradual decline after the Second World War. An investigation of the social background of women with induced abortion showed no relationship between occupational group and the incidence of abortion, but a strong negative correlation between religion and abortion. Abortion was more common among women with disturbed relationships in their own or parental families. Induced abortion usually occurred in pregnancies resulting from failure of contraception; these failures were caused not by lack of knowledge of good contraceptives, but by ineffective practice of contraception. The inability to use contraceptive methods in an effective way is related to a lack of communication between the two partners, and to a negative attitude of the women towards sex. An attempt has been made to formulate a theory of the causes of induced abortion among the women interviewed in Amsterdam.     

Evolution of fertility and mortality

Historical and current fertility trends in both Quebec and Canada as a whole are surveyed. While fertility among French Canadians was higher than that in neighboring provinces until the mid-20th century, in 1968 Quebec's crude birthrate was the lowest in Canada, and in 1972 it was 13.8 vs. 15.9 (the national birthrate). This reversal is explained in terms of the demographic transition theory, the declining influence of organized religion, and new opportunities for social mobility for minority groups. The birthrate throughout Canada is also declining. Although recent cohort studies are incomplete because women have not yet finished their reproductive years, it appears that completed family size will be lower than at any time in Canadian history. The period total fertility rate indicates an average family size of 1.8 children in 1976, but it is unclear whether this represents an actual reduction in family size or the postponement of childbearing. The sharpest fertility decline has been among women aged 35-49, but peak fertility rates have shifted from the 20-24 age group to those aged 25-29. Fertility is negatively related to education, and the lowest fertility is found among the intermediate income groups. Since the 1969 lifting of the ban on contraceptive sales and advertising, family planning activities have been stepped up. Also removed was the total ban on abortion. In 1975 there were 14.9 therapeutic abortions per 100 live births, but it has been charged that abortion standards are being applied inequitably from hospital to hospital.     

Effects on pregnancy outcomes of changes in the North Carolina State Abortion Fund

Extending work of Cook et al. (1999, 1996), this paper examines abortion funding cutoffs for poor women in North Carolina, a unique setting allowing for a strong quasi-experimental design. Using vital registration data and additional administrative data from North Carolina, we decompose program effects on the abortion/birth ratio into two components: coverage (i.e., the proportion of all abortions that are state funded) and substitutability (the proportion of state funded abortions that would have been births in the absence of the state program). We show that both components are crucial for understanding the effects of fund cutoffs and that both components vary by age and by race. We offer explanations for these differences. Overall, we conclude that: the North Carolina State Abortion Fund (SAF) had powerful and pervasive effects: i.e., the SAF cutoffs reduced abortions and increased births.     

Repeat abortion

A reanalysis of the repeat abortion experience of New York City residents during July 1, 1970 to June 30, 1972 is undertaken on the basis of a probability model that generates repeat abortion ratios as a function of assumptions about fecundity, contraceptive efficiency, and exposure lengths. Tested are three hypotheses put forward by Daily et al. in a 1973 analysis: (i) the low repeat abortion ratio of .0245 is attributable in part to underreporting of registered induced abortions as repeat ones; (ii) a major part of the rise in repeat abortion ratios, from virtually zero to six percent over four consecutive six-month intervals, is explainable in terms of the rising volume of exposure time to risk of repeat abortion relative to the stream of initial abortions; and (iii) the higher abortion ratios of women in their twenties compared to those of older or younger women is ascribable to “differences in fecundity and intercourse frequency.” Support is found for the first two hypotheses, and a mixed outcome for the third.     

Sex‐Selective Abortions in India

Provisional estimates from the 2001 census of India, which showed unusually high sex ratios for young children, have sparked renewed concern about the growing use of sex‐selective abortions to satisfy parental preferences for sons. According to the 1998–99 National Family Health Survey (NFHS‐2), in recent years the sex ratio at birth in India has been abnormally high (107–121 males per 100 females) in 16 of India's 26 states. Data from NFHS‐2 on abortions, sex ratios at birth, son preference, and the use of ultrasound and amniocentesis during pregnancy present compelling evidence of the extensive use of sex‐selective abortions, particularly in Gujarat, Haryana, and Punjab. The authors estimate that in the late 1990s more than 100,000 sex‐selective abortions of female fetuses were being performed annually in India. Recent efforts to expand and enforce government regulations against this practice may have some effect, but they are not likely to be completely successful without changes in the societal conditions that foster son preference.     

High Sex Ratios at Birth in the Caucasus: Modern Technology to Satisfy Old Desires

During the 1990s, the sex ratio at birth increased considerably and simultaneously in the three independent Caucasian countries, Armenia, Azerbaijan, and Georgia. At the end of the first decade of the twenty‐first century, levels remain abnormally high in Armenia and Azerbaijan (above 114 male births per 100 female births) and show erratic trends in Georgia. Analyzing data from demographic surveys carried out around 2005, we confirm the persistence of high sex ratios in these three countries and document significant differences in fertility intentions and behavior according to the sex of the previous child or children that constitute evidence of the practice of sex‐selective abortion. These countries combine societal features and medical systems that make this phenomenon possible: son preference in a context of low fertility and the possibility of prenatal sex selection given easy access to ultrasound screening and induced abortion. Why high sex ratios are observed only in these three countries of the sub‐region remains, however, an open question.     

Prenatal Sex Determination and Sex‐Selective Abortion in Rural Central China

This study analyzes the practice of prenatal sex selection in rural central China. It examines the prevalence and determinants of prenatal sex determination by ultrasound scanning and subsequent sex‐selective abortion. The data are derived from a survey of 820 married women aged 20–44 and from in‐depth interviews with rural women and men, village leaders, family planning managers, and health providers, conducted by the author in one county in central China in 2000. Prenatal sex determination was a widespread practice, especially for second and higher‐order pregnancies. Sex‐selective abortion was prevalent and order of pregnancy, sex of fetus, and sex of previous children were major determinants of the practice. A female fetus representing a high‐order pregnancy in a family with one or more daughters was the most likely to be aborted. Awareness among rural families that in the population at large a future marriage squeeze was likely did not diminish the demand for sex‐selective abortion.     

An Increase in the Sex Ratio of Births to India‐born Mothers in England and Wales: Evidence for Sex‐Selective Abortion

Male preference in many Asian cultures results in discriminatory practices against females, including neglect and infanticide. This preference, together with the availability of prenatal sex determination and sex‐selective abortion, has led to an increase in sex ratios at birth in China, India, and South Korea. The resulting expected gender imbalances raise ethical, demographic, and social concerns. We analyzed birth statistics to see whether similar trends are apparent among births to foreign‐born mothers in England and Wales. Before 1990, sex ratios at birth were consistently nearly one point lower (104) for the three major Asian groups in Britain compared with mothers born in Western countries. This is inconsistent with previous suggestions that Asian populations have a higher “natural” sex ratio at birth. In the birth statistics since 1990, we find a four‐point increase in the sex ratio at birth for mothers born in India, attributable particularly to an increase at higher birth orders, mirroring findings reported for India. This suggests that sex‐selective abortion is occurring among mothers born in India and living in Britain. By contrast, no significant increase was observed for Pakistan‐born and Bangladesh‐born mothers, among whom male preference also exists. It seems that male preference in different cultures does not necessarily lead to sex‐selective abortion.     

Shortage of girls in China today

China has the most severe shortage of girls compared to boys of any country in the world today, as documented by China's surveys and censuses up to 2000. This article evaluates data on sex ratios in China since before the founding of the People's Republic, and shows that the relative dearth of girls has become more extreme during the last two decades, and that the problem is real and not merely due to undercounting of girls. Daughters are lost primarily through sex-selective abortion, secondly through excess female infant mortality, and thirdly through neglect or mistreatment of girls up to age three, in cities as well as rural areas. Until recently, the dearth of girls was confined to second or higher-order births, but now couples in some provinces are using sex-selective abortions for first births. Maps show the geographical concentration of life-threatening discrimination against girls and its spread over time. Son preference, low fertility and technology combine to cause the loss of daughters in China today and compulsory family planning and the one-child policy exacerbate the problem. The discussion includes what the People's Republic of China has done to ameliorate life-threatening discrimination against girls and what further steps might be taken to improve the situation.     

Women’s sex preferences in the United States: 1970 to 1975

This analysis examines the potential effect of sex preselection technology in the United States. The results suggest that controlling the sex of offspring is not the desire of most American women; that if it were employed, there would be a significant increase in sons as first-born and daughters as second children; that the overall sex ratio would be little changed from that occurring naturally except at very low fertility levels with universal use of such technology; and that fertility is only minimally influenced by gender preferences.     

Mother's education and effect of son preference on fertility in Matlab,Bangladesh

This analysis follows earlier research that hypothesized and substantiated that, in a society with strong son preference, its effect on fertility would be conditional on the level of contraceptive use. Present analysis of the prospective fertility experience of 22,819 women of reproductive age during 3.5 years in Matlab, Bangladesh, shows that this effect is higher among mothers with postprimary schooling versus those with primary or no education. The higher effect conforms with the known positive relationship of contraceptive use with maternal schooling. However, this increase when contrasted with the idea that education promotes modern values, including gender equality, suggests that education in Matlab, with its traditional slant, is not resistant to son preference. In a poor, traditional society with low status for women, schooling alone is not enough to motivate women to abandon low esteem for daughters though schooling promotes child survival. But if preference for smaller family size increases, promoted by education including such modern values as gender equality, then sex preference, although it cannot be completely removed, will have minimal effect on fertility as in most developed countries.Abbreviations DSS demographic surveillance system - ICDDR,B International Centre for Diarrhoeal Disease Research, Bangladesh - MCH-FP maternal/child health and family planning - SPEF sex preference effect on fertility     

The Implementation of Preferences for Male Offspring

Over the past quarter century the sex ratio at birth (SRB) has risen above natural levels in a number of countries, mostly in Asia. This rise has been made possible in populations with strong son preference by the increasing availability of safe, effective, and inexpensive technologies to determine the sex of a fetus and to end unwanted pregnancies. This article documents levels and trends in the sex ratio at birth, in preferences for male offspring (using information on desired number of girls and boys), and in the implementation of these preferences. DHS surveys from 61 countries in Africa, Asia, and Latin America and for Indian states are the main source of data. A comparison of desired with actual SRBs finds large gaps in most populations, implying a substantial pent‐up demand for male offspring and the technology to implement this preference. Two types of actions to implement preferences are considered: the practice of contraception to stop childbearing after the desired number of sons has been born and the use of sex‐selective abortion to avoid female births. The second part of the article discusses factors that could influence the SRB, including the promotion of gender equality, and the implications of these factors for future trends.     

韩国出生性别比失衡的公共治理及对中国的启示

韩国出生性别比呈现先上升后下降的态势,韩国出生性别比偏高的直接原因是性别选择流、引产,而传统文化是根源性的原因,韩国性别失衡带来一系列社会后果,影响了韩国的社会稳定;韩国政府出台了一系列旨在维护女童权益、反对歧视女性、提高女性地位的法律法规;韩国的公民社会也作出了许多有益的尝试,通过公共治理,出生性别比出现显著下降,而且女性地位得到较大提升;韩国性别比失衡问题的治理对中国解决相关人口问题有着重要的借鉴意义。     

Second Births and the Second Shift: A Research Note on Gender Equity and Fertility

In a set of propositions on fertility transition, Peter McDonald recently proposed that the decline from replacement‐level fertility to low fertility is associated with a combination of high levels of gender equity in individual‐oriented institutions, such as education and market employment, and low levels of gender equity in the family and family‐oriented institutions. Similarly, the “second shift,” or the share of domestic work performed by formally employed women, forms a critical piece of current cross‐national explanations for low fertility. Building on this scholarship, the authors explore whether there is empirical evidence at the individual level for a relationship between gender equity at home, as indicated by the division of housework among working couples with one child, and the transition to a second birth. Results, based on a sample of US couples, indicate a U‐shaped relationship between gender equity and fertility. Both the most modern and the most traditional housework arrangements are positively associated with fertility. This empirical test elaborates the family‐fertility relationship and underscores the need to incorporate family context, including gender equity, into explanations for fertility change.     

Eastern Europe: pronatalist policies and private behavior

Fertility trends in the 9 Eastern European socialist countries (Albania, Bulgaria, Czechoslovakia, German Democratic Republic, Hungary, Poland, Romania, USSR, Yugoslavia) are reviewed. Official policy in all these countries but Yugoslavia is explicitly pronatalist to varying degrees. Attention is directed to the following areas: similarities and differences; fertility trends (historical trends, post World War 2 trends, and family size); abortion trends (abortion legislation history, current legislation, abortion data, impact on birth rates, abortion seekers, health risks, and psychological aftereffects); contraceptive availability and practice; pronatal economic incentives (impact on fertility); women's position; and marriage, divorce, and sexual attitudes. The fact that fertility was generally higher in the Eastern European socialist countries than in Western Europe in the mid-1970s is credited to pronatalist measures undertaken when fertility fell or threatened to fall below replacement level (2.1 births/woman) after abortion was liberalized in all countries but Albania, following the lead of the USSR in 1955. Fertility increased where access to abortion was again restricted (mildly in Bulgaria, Czechoslovakia, and Hungary at various times, and severely in Romania in 1966) and/or economic incentives such as birth grants, paid maternity leave, family and child care allowances, and low interest loans to newlyweds were substantially increased (Bulgaria, Czechoslovakia, Hungary, and Poland to some extent, in the late 1960s and early 1970s, and the German Democratic Republic in 1976). Subsequent declines in Bulgaria, Czechoslovakia, Hungary, and Romania suggest that policy induced increases in fertility are short-lived. Couples respond to abortion restrictions by practicing more efficient contraception or resorting to illegal abortion. It is evident that the region's low birth rate is realized mainly with abortion, for withdrawal remains the primary contraceptive method in all countries but Hungary and the German Democratic Republic. It seems that cash incentives have advanced the timing of 1st and 2nd births without substantially increasing the 3rd births required to keep national fertility above replacement level. Demographic factors alone will most likely keep birth rates low in several Eastern European countries during the 1980s and the 1990s. Due to the low birth rates in the 1960s, there will be fewer women in the prime childbearing ages of 20-29 in at least Poland, Czechoslovakia, Bulgaria, and Hungary. It becomes clear that policy efforts to influence private reproductive behavior can only be moderately successful if the living conditions are such that women are determined not to have more than 1 or 2 children.