Disparities in Abortion Rates: a Public Health Approach

Overview

Journal Am J Public Health

Specialty Public Health

Date 2013 Aug 17

PMID 23948010

Citations 47

Authors

Christine Dehlendorf

Lisa H Harris

Tracy A Weitz

Affiliations

Soon will be listed here.

Abstract

Women of lower socioeconomic status and women of color in the United States have higher rates of abortion than women of higher socioeconomic status and White women. Opponents of abortion use these statistics to argue that abortion providers are exploiting women of color and low socioeconomic status, and thus, regulations are needed to protect women. This argument ignores the underlying causes of the disparities. As efforts to restrict abortion will have no effect on these underlying factors, and instead will only result in more women experiencing later abortions or having an unintended childbirth, they are likely to result in worsening health disparities. We provide a review of the causes of abortion disparities and argue for a multifaceted public health approach to address them.

Citing Articles

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US Abortion Bans and Infant Mortality.

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Weight and Procedural Abortion Complications: A Systematic Review.

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Making sense of the economics of abortion in the United States.

Weitz T Perspect Sex Reprod Health. 2024; 56(3):199-210.

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References

Finer L, Zolna M . Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011; 84(5):478-85. PMC: 3338192. DOI: 10.1016/j.contraception.2011.07.013. View

Cubbin C, Brindis C, Jain S, Santelli J, Braveman P . Neighborhood poverty, aspirations and expectations, and initiation of sex. J Adolesc Health. 2010; 47(4):399-406. DOI: 10.1016/j.jadohealth.2010.02.010. View

Santelli J . Medical accuracy in sexuality education: ideology and the scientific process. Am J Public Health. 2008; 98(10):1786-92. PMC: 2636467. DOI: 10.2105/AJPH.2007.119602. View

Henshaw S, Wallisch L . The Medicaid cutoff and abortion services for the poor. Fam Plann Perspect. 1984; 16(4):171-2, 177-80. View

Finer L, Frohwirth L, Dauphinee L, Singh S, Moore A . Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception. 2006; 74(4):334-44. DOI: 10.1016/j.contraception.2006.04.010. View

Abma J, Martinez G, Mosher W, Dawson B . Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002. Vital Health Stat 23. 2005; (24):1-48. View

Trussell J, Vaughan B . Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth. Fam Plann Perspect. 1999; 31(2):64-72, 93. View

Harris L . Stigma and abortion complications in the United States. Obstet Gynecol. 2012; 120(6):1472-4. DOI: 10.1097/aog.0b013e3182723d82. View

Martinez G, Copen C, Abma J . Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006-2010 national survey of family growth. Vital Health Stat 23. 2012; (31):1-35. View

10.

Borrero S, Abebe K, Dehlendorf C, Schwarz E, Creinin M, Nikolajski C . Racial variation in tubal sterilization rates: role of patient-level factors. Fertil Steril. 2010; 95(1):17-22. PMC: 2970690. DOI: 10.1016/j.fertnstert.2010.05.031. View

11.

Cox R, Zhang L, Zotti M, Graham J . Prenatal care utilization in Mississippi: racial disparities and implications for unfavorable birth outcomes. Matern Child Health J. 2009; 15(7):931-42. DOI: 10.1007/s10995-009-0542-6. View

12.

Dehlendorf C, Foster D, Thiel de Bocanegra H, Brindis C, Bradsberry M, Darney P . Race, ethnicity and differences in contraception among low-income women: methods received by Family PACT Clients, California, 2001-2007. Perspect Sex Reprod Health. 2011; 43(3):181-7. PMC: 3412526. DOI: 10.1363/4318111. View

13.

Thompson K, Speidel J, Saporta V, Waxman N, Harper C . Contraceptive policies affect post-abortion provision of long-acting reversible contraception. Contraception. 2010; 83(1):41-7. DOI: 10.1016/j.contraception.2010.06.008. View

14.

Crosby R, DiClemente R, Wingood G, Davies S, Harrington K . Adolescents' ambivalence about becoming pregnant predicts infrequent contraceptive use: a prospective analysis of nonpregnant African American females. Am J Obstet Gynecol. 2002; 186(2):251-2. DOI: 10.1067/mob.2002.120081. View

15.

Bartlett L, Berg C, Shulman H, Zane S, Green C, Whitehead S . Risk factors for legal induced abortion-related mortality in the United States. Obstet Gynecol. 2004; 103(4):729-37. DOI: 10.1097/01.AOG.0000116260.81570.60. View

16.

Moos M, Bartholomew N, Lohr K . Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda. Contraception. 2003; 67(2):115-32. DOI: 10.1016/s0010-7824(02)00472-9. View

17.

Halpern V, Lopez L, Grimes D, Gallo M . Strategies to improve adherence and acceptability of hormonal methods of contraception. Cochrane Database Syst Rev. 2011; (4):CD004317. DOI: 10.1002/14651858.CD004317.pub3. View

18.

Frost J, Darroch J . Factors associated with contraceptive choice and inconsistent method use, United States, 2004. Perspect Sex Reprod Health. 2008; 40(2):94-104. DOI: 10.1363/4009408. View

19.

Gaydos L, Neubert B, Hogue C, Kramer M, Yang Z . Racial disparities in contraceptive use between student and nonstudent populations. J Womens Health (Larchmt). 2010; 19(3):589-95. PMC: 6468939. DOI: 10.1089/jwh.2009.1385. View

20.

Jones R, Finer L . Who has second-trimester abortions in the United States?. Contraception. 2011; 85(6):544-51. DOI: 10.1016/j.contraception.2011.10.012. View