Asymmetrical Information

This reminds me of the infamous "50,000 women a year are dying of anorexia" statistic that was published repeatedly in feminist journals and books until someone bothered to do the math and noted that it was off by a factor of at least 100. Naturally, the individuals who challenged it were called haters of women and the whole nine yards until the evidence was piled high for all to see, after which the purveyors of the lie melted into the woodwork to issue limp retractions or to simply change the subject.

Found on Google:
“The legalisation of abortion has almost no impact on the number of abortions performed. In some countries where abortions are illegal, in Latin America and eastern Europe, there are two to four times as many abortions (and higher mortality rates of women) as in Western European countries where abortions are free.” http://personal.nbnet.nb.ca/rosellam/family_planning.html

Is the increase in the rate of abortion in the US after 1973 the whole story – legalization drove demand? Or, should the rate as which abortions are sought in the US in the current timeframe be measured against nations whose laws do not permit legal access to abortion but are nations who have undergone similar cultural disruptions such as the diminished role of the church in society and the fragmentation of the extended family?

This is probably a misquote - it's not a percentage of total admissions, but of pregnancy-related admissions.

Link: Statistics on Emergency Department Visits (PDF)

Going through the link above, I find that roughly 10 million people are admitted to the hospital each year from the emergency room. Controlling that for population growth, we get a figure of roughly 7 million admissions in 1960 (perhaps that should be lower because of better ambulence technology; on the other hand, it could also be higher, because of worse medical care. We'll call it stat.) For women with botched abortions to be 42% of emergency room visits, then, we'd have to be seeing approximately 5 million botched abortions a year. Given that there were only about 30 million women in the relevant age cohort at any given time, none of us would have been born.

Megan, maybe it's lack of sleep, but I'm having trouble following your argument. I think the 42% number sounds way too high, but see if this analysis works.

The table on page 24 of Michael's cite shows 108 million Emergency Department (ED) visits in 2000, of which 13.4 million were admitted to the hospital.

Adjusting 13.4 million back to 1960 population (275 million in 2000, 181 million in 1960) gives us 8.8 million ED admits in 1960. If 42% of these are for botched abortions, then 3.7 million ED admits are abortion-related and 5.1 million are not. I don't see where you got your "approximately 5 million botched abortions a year" in the comment. But either way, that's an awful lot of abortions.

My 2000 NY Times Almanac (yeah, yeah, it's probably full of made-up data) says the 1960 population aged 18-44 was 63.3 million; assuming half were women, we've got around 32 million women. Slightly more than 10% of them would have to go to the hospital for a botched abortion each year to get the 3.7 million admits. By contrast, we can look at all other ED admits and see that less than 3% of the population as a whole would be admitted through the ED for all other causes. Yeah, that sounds pretty ridicuous, but it's not impossible.

Since the blurb also says that about 1 in 3 abortions was botched, there should be about 11 million abortions in 1960!! This means that one in three women of child-bearing years had an abortion in 1960, which also sounds pretty ridiculous. By contrast, my almanac says there were 586,760 abortions reported in 1972, rising to an (estimated) 1.22 million in 1996.

Now there's a statistic worth shouting about: legalizing abortion led to a 90% drop in abortions! If we think fewer than 1 in 3 abortions were botched, it gets even worse; if only 1 in 5 abortions were botched, then there should have been 18.5 million abortions in total in 1960.

The only real qualm I have with these numbers is the ED admits. My impression is that hospitals were much more likely to admit in 1960 than now; they were lots cheaper, much less advanced, and much more likely to keep people for observation. But again, upping the total number of ED admits for 1960 just makes the 42% number worse. 15 million ED admits would give us more than 6 million botched abortions, and at least 18 million abortions in toto.

Kimon, I can see how the statistic could get misquoted. But I wonder if saying "pregnancy-related" makes this a useful stat? I would think that most pregnancy admits go through Maternity and the regular admitting process, not through the ED. "Pregnancy-related ED admits" could be a very small number indeed, which would make the 42% simply a scare number.

I think I made it clear in my original post that I had not done independent research on the question. So I am very willing to concede that illegality may have led to a significant increase in the rate at which women seek abortion.

Still, why must -any- of such an increase be explained by the notion that under a legal regime men have more control over women's choices vis a vis abortion than they did prior to Roe? Note that I am not denying that some perhaps enormous proportion of the women who seek abortions these days do so in part because the men in their life influence them to do so. But wasn't that also the case before abortion was legal?

Also -

The 42% figure is clearly ludicrous if it is meant to describe a portion of all emergency room visits. But my understanding -- in part from talking to people who worked in emergancy rooms during the period -- is that an an enormous proportion of emergency gynecological care during the period leading up to Roe involved what you call "botched" abortions.

This is because, as I mentioned in my previous post, illegal abortion providers during that period were increasingly using methods that began an abortion that they -intended- to end up in the emergency room.

Again, this is not really my field, and I don't have the resources at hand to substantiate this, but my understanding is that the "botched" abortions that we're talking about were more sophisticated than the coathanger stories I was brought up with -- essentially dilation in a more or less sterile environment followed by a quick trip to the hospital, where they would more or less have to finish the procedure.

Yes, plenty of women went to Mexico, etc. Plenty of women had quiet abortions in their gynecologist's office. But many pre-Roe abortions were done in hospitals, either as emergency procedures or in situations where doctors had quota's of a certain amount of abortions that they could do for "medical reasons" without having to justify the procedure. Their should be some hard numbers on this out there, because it was all documented at the time by review boards, etc.

PJ -- the rate of non-abortion admissions should, medical technology aside, remain constant. The rate of abortion admissions should thus be 2/3 of the rate of non-abortion admissions to constitute 40% of the new, higher total.

"It's a miscite" is a much simpler explanation, isn't it?

It's entirely possible that it's a mis-cite by teh author, but the fact remains that I saw it in three separate places, all on prominent pro-choice websites. Bad facts must be rooted out regardless of intent.

PJ -- the rate of non-abortion admissions should, medical technology aside, remain constant. The rate of abortion admissions should thus be 2/3 of the rate of non-abortion admissions to constitute 40% of the new, higher total.

Sorry Megan, I missed that completely. So you're taking current ED admits, extrapolating back to 1960, and assuming that botched abortion admits need to be added in; ie, estimated 1960 ED admits were 7 million "normal" (extrapolated from 2000 data) and an additional ~5 million "botched abortion" admits (based on 42% number). In other words, you're assuming there are no botched abortion ED admits in 2000 (sounds reasonable to me).

The 42% figure is clearly ludicrous if it is meant to describe a portion of all emergency room visits.

Paul, I misread the stat in this same way, at first. It's not a percentage of ED visits (>100 million in 2000), it's a percentage of hospital admissions through the ED, which is much smaller (13.4 million in 2000). This means that you show up at the Emergency Dept entrance, they patch you up or whatever, and then you spend the night at the hospital, either for more ongoing care, follow-up, or monitoring. I used the phrase "ED admits" for short, sorry if that added to the confusion.

My all-time favorite such slip-up came in the introduction to a collection of vampire erotica. The editors assert, in a review of social status problems women have had, that in Victorian London (and perhaps Victorian Britain generally) there were one hundred prostitutes for every man. The slip-up is obvious, I just regarded it as hilariously telling that it passed through without being caught.

I'm sure that there are admits from the emergency room for abortion complications now; I just assumed, perhaps incorrectly, that they are likely to be trivial.

42% of emergency hospital admissions for gynecological reasons sounds reasonable. Or even for OBGYN - if normal deliveries aren't counted as "emergencies". There are very few gynecological conditions that require hospitalization and can't wait a few days.

In other words, probably an accurate statistic that was described inaccurately, and very, very misleadingly.

I somewhat doubt the "1/3 of all illegal abortions" statistic, though, unless there were another third who were treated in the emergency room an released without being admitted. In the 1950's, the simplest means of illegal abortion was also the safest for the patient: just send the woman to a hospital after creating a condition where the doctor would have to do an abortion for medical reasons. The technology was there to do abortions very safely, but an unlicensed practitioner would have a hard time explaining the possession of vacuum curettage equipment and a fully equipped sterile operating room. So they would get the hospital to use their equipment...

Umm, I don't think they had vacuum curettage equipment then. From what I've read, the method for all abortions, including legal ones, was an old fashioned D&C. Part of the reason that abortions had a lot of complications was that there was a very narrow window in which they could be done. They're safer now because the equipment is better. In fact, post-legalization, I've seen some people arguing that abortion got less safe, because the doctors who did them were less worried about the consequences of killing their patients; not until five or six years later, when vacuum curettage became available and authorities cracked down on marginal providers, did it get safer.

My impression is that hospitals were much more likely to admit in 1960 than now...

That's probably not accurate. While there are several reasons (those you stated and more) that admissions were more likely, there are also several reasons why they were not.

Admissions are more likely to day because:

1. The prevalence of malpractice/negligence suits suggests that admitting is safer when there is any doubt.

2. The laws on reimbursement, even for the uninsured, means the hospital will make money on the admission if the patient turns out to have no serious problems. Likewise, if the patient DOES have serious problems that are not immediately apparent, refer to Item 1 and the avoidance of an expensive lawsuit.

3. Medical equipment and technique are considerably more sophisticated these days, and thus can point out conditions that would have been overlooked 40 years ago. (And part of that is that blood tests that took days back then take minutes now.)

From the National Center for Health Statistics

Emergency Department Visits
(All figures are for U.S.)
Number of Visits Annually: 108,017,000 (2000)
Average Number of Visits per 100 Persons: 39.4 (2000)
Most Frequent Principal Reason for Visit: Stomach and Abdominal Pain (6.8) million visits, 2000)
Number of Injury-Related Visits Annually: 40.4 million (2000)
Percent of Urgent Visits Annually: 31.2 percent (2000)
Most Frequent Diagnostic/Screening Service Provided: Blood Pressure (75% of all visits in 2000)
Type of Drug Most Frequently Prescribed: Tylenol (10 million in 2000)

Obstetrical Procedures
(All figures are for U.S.)
Total number of Obstetrical Procedures Performed Annually: 6.2 million (2000)
Number of Episiotomies Performed Annually: 944,000 (2000)
Number of Artificial Rupture of Membrane Performed Annually: 944,000 (2000)
Source: Advance Data 329
Number of Cesarean Sections Performed Annually: 923,991 (2000)
Number of Electric Fetal Monitoring Procedures Performed Annually: 3,389,707 (2000)
Number of Amniocentesis Performed Annually: 96,698 (2000)
Number of Ultrasounds Performed Annually: 2,697,525 (2000)
Induced Labors Performed Annually: 800,448 (2000)

The quoted statistic cannot be correct

Wading Througha
"The legalisation of abortion has almost no impact on the number of abortions performed. In some countries where abortions are illegal, in Latin America and eastern Europe, there are two to four times as many abortions (and higher mortality rates of women) as in Western European countries where abortions are free."

This quotation is self-contradictory; it appears to claim that women are _much_ _more_ likely to get abortions when it's illegal. (A 'forbidden fruit' effect?) The quote is really a comparison of apples to oranges: western Europe to places where _contraceptives_ are illegal. Banning contraceptives does produce an increase in abortions, as seen by the high rate of legal abortions in Japan, where contraceptive pills were illegal till a few years ago.

(The Japanese Ministry of Health held up the Pill for decades with pretended quibbles about safety. They finally had to approve it after they cleared Viagra in less than six months.)

Regarding Rich Rostrom's argument that the abortion rate is higher in the absence of legal contraction...
We in Ireland have had the opposite experience. Up to about 25 years ago contraception was outlawed for everyone. Then it was permitted for married couples only and so on until today when condoms are everywhere. Meanwhile the number of abortions has increased more than ten-fold.
This happened because there was a seismic social upheaval : the sexually-conservative attitudes of the Catholic Church have been abandoned by the young so that today there is far more out-of-wedlock sexual activity (often in an advanced state of intoxication) than before. So even though there is far more contraceptive use it has not prevented an enormous increase in unintended conceptions (pardon the strange phraseology, I'm trying to describe the process in a morally-neutral way).
All of which shows that any argument on this subject has to look behind the statistics..

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