Some sociologic and psychologic observations on abortion

Abstract The single, the white, the employed, the native American, the more highly educated woman was found significantly more frequently in the group who admitted induced abortion than among those who denied it. Women who felt a sense of economic pressure or shame, those who expressed no desire for a child, and those who had practiced contraception intensively howbeit ineffectively, were also significantly more frequent. Religious affiliation, age, prior gravidity, prior parity, previous abortions, number of living children, enjoyment of coitus, feeling for sexual partner, employment of the latter, childhood experience, emotional relation to parents and siblings, number of siblings, number of persons per room, concept of size of ideal family, although perhaps influential in individual cases, did not show statistically significant differences in the groups characterized by admission or denial of interference. The facts cited show that legal and religious disapproval mean little to the woman who is interested in limiting the size of her family. She uses such methods to prevent pregnancy as she and her partner know, and, when these fail, in many instances she takes drastic steps to rid herself of the fetus. The most obvious first step toward reducing the incidence of abortion would be to provide the woman, who has recently given proof of the seriousness of her desire to limit her family, with more reliable methods of contraception than those she has previously tried. There would be fewer abortions, both induced and spontaneous, if every postabortal patient were routinely advised to refrain from immediate pregnancy, instructed in the way of carrying out this advice and fitted with a pessary (provided she desired it and this method were suitable in her case) at her follow-up visit to the gynecologic clinic. Next in preference would be an intramural birth control clinic closely cooperating with the gynecologic and obstetric clinics. Since political and religious opposition render both of these plans unfeasible in many hospitals, the next best thing would be to offer every patient of this type a definite reference to the birth control clinic most convenient to her home. Popularization of the Aschheim-Zondek test and provision of this service at cost would reduce the incidence of “abortion” in the nonpregnant. Although greater access to contraceptive advice and early diagnosis in amenorrhea would cut down abortions to some extent, this is only a stopgap approach to the problem. The ultimate steps in the prevention of abortion are: 1. 1. Preferential community services to families with children. 2. 2. Maternity leave for employed women. 3. 3. Social and economic aid to unmarried pregnant women and responsible agencies to care for and place illegitimate children. 4. 4. Sex education at all levels correlated with instruction in child care and cultivation of an understanding of the values of parenthood. Many intelligent young people now enter upon life with the negative determination to avoid having too many children but without the positive inclination to have enough. The former position is easily acquired from observation of their elders and discussion among themselves; the latter requires systematic and intelligent presentation by competent teachers.