THURSDAY, June 6, 2002 (HealthDayNews) -- Abortion rates and births to teen-age mothers have fallen but births by Caesarean section have sharply risen, according to new reports today from the U.S. government.
While births to teen mothers hit an all-time low last year, the number of mothers who delivered by C-section rose 7 percent between 2000 and 2001, according to a survey from the Centers for Disease Control and Prevention.
The rate of deliveries by C-section, which had fallen steadily between 1989 and 1996, has since gone up 17 percent, the CDC said. In 2001, almost one in four babies was delivered by C-section.
The agency also reported that the rate of women who delivered vaginally after having delivered by caesarean fell 20 percent between 2000 and 2001. A study published last month said that the death risk to the baby, while low, was higher among mothers who delivered vaginally after a previous C-section delivery.
The number of legal abortions in the United States fell 2 percent between 1997 and 1998, the last year for which abortion figures were available.
The CDC said the abortion ratio -- or the number per 1,000 live births -- was 274 in 1997 and 264 in 1998. Almost 60 percent of the procedures were performed in the first eight weeks of pregnancy, and 88 percent were performed in the first 12 weeks.
The 884,000-odd abortions, performed to terminate unwanted pregnancies or those with severe fetal defects, were about a quarter of the 3.9 million births in 1998. In 1995, officials said, 31 percent of pregnancies were unwanted.
The report does not include data from Alaska, New Hampshire, Oklahoma and California, and was adjusted to reflect this gap. [Including these states in 1997, the total number of abortions exceed 1.18 million]. Nor does it reflect the impact of the abortion pill RU-486, which won U.S. Food and Drug Administration approval in 2000.
Officials received reports of almost 4,900 non-surgical abortions in 1998, but fewer than half of the 48 jurisdictions surveyed provided such figures so the true number may have been higher.
Joy Herndon, a statistician for the CDC's National Center for Chronic Disease Prevention and Health Promotion and a co-author of the study, said abortion rates have been falling in this country for several years. But while the agency has a few explanations for the decrease, nothing is absolute.
One potential reason is that the last decade has seen a decline in births and pregnancies among teens, who are more likely than older women to seek abortions. Roughly one fifth of the procedures are performed in girls under 20, officials said.
Another reason for the reduction may be greater use of condoms and the availability of highly effective hormonal birth control, Herndon said. Changes in state laws that affect access to abortions may also play a role.
The report found 0.6 deaths per 100,000 legal procedures between 1993 and 1997. However, the number of women who died from abortions fell from 54 between 1988 and 1992 to 36 between 1993 and 1997, a 33 percent reduction.
That trend "shows not how dangerous it is but how safe it is," said Dr. Jeffrey Waldman, medical director of Planned Parenthood's Shasta-Diablo branch, in Concord, Calif. The vast majority of abortions occur early in pregnancy when they're safest, Waldman added.
Although it's too early to tell the impact of RU-486 (also known as Mifeprex) on abortion rates, Waldman said Planned Parenthood hasn't seen a surge in the procedure since the drug was approved.
"People are not going to be having abortions because there's a different method available to them," he said.
Meanwhile, the nation's teen birth rate dropped 5 percent between 2000 and 2001, marking the 10th straight year of decline and hitting a record low. The pregnancy rate for girls age 15 to 19 was 45.9 per 1,000 in 2001, off from 48.5 per 1,000 the previous year. The teen birth rate has plunged 26 percent since 1991.
The decline was greatest among 15-to-17-year-olds, for whom the number was down 8 percent between 2000 and 2001 -- and 35 percent since 1991. The number was also down 8 percent for blacks, among whom the rate has fallen 37 percent overall since 1991.
"This is an important milestone in our fight against teen pregnancy," Health and Human Services Secretary Tommy Thompson said in a statement today. "The research shows us that when teens postpone parenthood, they improve their lives and the lives of their children."
The Bush administration has urged American youth to delay sex until marriage and has been promoting abstinence-only sex education as a way to curb teen pregnancies and sexually transmitted diseases.
But Planned Parenthood's Waldman said that policy would have a "detrimental" effect on both the teen birth and abortion rates.
"It's a pretty bad situation if that was really the only program that was available" to youth in lieu of comprehensive sex education, he said.
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