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Impact of a Permissive Abortion Statute on Community Health Care

From the Department of Obstetrics and Gynecology of the Mount Sinai School of Medicine, The Mount Sinai Hospital and the City Hospital Center at Elmhurst, New York, New York

Abstract

Between July 1, 1970, and June 30, 1972, 3542 first-trimester and 876 second-trimester pregnancies were terminated at City Hospital Center, Elmhurst, New York. The present rate of abortion is 1009 per 1000 deliveries. No maternal mortality occurred in this series. Maternal early morbidity rates have been 4.7% for first trimester and 15.1% for second trimester abortions. Salutory changes have been noted in other health care services. The incidence of delivery without prenatal care has decreased by 44.4%; of immature delivery, by 23.1%; of premature delivery, by 16.5%; and the corrected perinatal mortality rate, by 29.2%. Antepartum clinic utilization increased. There has been significant elimination from the child-bearing population of certain categories of "high risk" obstetric patients—the very young, the elderly, the unmarried, and the emotionally disturbed. The spontaneous abortion rate has decreased by 52.2%, and "septic" abortions have been almost entirely eliminated. Benefits observed in other aspects of health care are: pregnancy testing and counseling; gynecologic cancer detection and cytologic screening; venereal disease screening; sickle cell trait/disease screening; and detection of intercurrent medical, surgical, gynecologic and psychosocial problems. The abortion program has served the community not only by the solution of immediate health crises, but as a major portal of entry into a comprehensive health care program.