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Studies Suggesting That Induced Abortion May Increase the Feminization of Poverty
by Thomas W. Strahan, J.D.

The term "feminization of poverty" was first used by Diana Pearce when she observed that poverty seemed to be becoming more and more focused as a female problem. The phrase refers to the dramatic change in the composition of the poverty population in the United States in recent decades. Pearce noted that in 1976 almost two-thirds of the poor over 16 years of age were women and that this measure was growing, indicating that "it is women who account for an increasingly large portion of the economically disadvantaged."[1]

Until the 1960s, most poor families had husbands or other men present. Between 1969 and 1978, however, the number of poor families composed either of male only or husband and wife families dropped from 3.2 million to 2.6 million. During that same period, the number of poor families headed by women with minor children increased by one-third, from 1.8 to 2.7 million.[2]

This trend continued in the 1980s. In 1983, roughly one-half of all poor families were headed by women, up from 36% in the early 1970s.[3] The poverty rate for female-headed households is almost three times that of male-headed households and nearly five times that of husband and wife families. [4]

This trend appears even more strongly in the African-American community than in the population as a whole. During the 1970s, the number of black families in poverty who were maintained by men declined by 35%, while the number maintained by women increased by 62%. In the course of one decade, female-headed families increased from one-half to three-fourths of poor black families.[5]

This increased feminization of poverty coincides remarkably closely to the period of increasingly legalized abortion. Arguments have been made that the availability of abortion should help avoid this trend, because job loss due to childbirth would be avoided, as would the burdens of child care which so clearly contribute to povertization. The fact that the pattern has worsened precisely during the period when there was an upsurge in abortions suggests that, at the very least, abortion has been an inadequate solution to this poverty trend.

The causes of the feminization of poverty are varied and complex, as are any solutions.[6] However, experience suggests that, contrary to the above expectations, abortion may instead actually be a contributing factor. Through an increase in broken relationships, psychological difficulties, and substance abuse, a practice which is done exclusively on women may put them at greater economic disadvantage.

The Rapid Rise of Repeat Abortions
In 1973, it was estimated that only about 12% of induced abortions in the United States were repeat abortions -- that is, abortions done on women who had had at least one previous abortion. By 1980 the national repeat rate had risen to about 33%, and by 1983 it had reached nearly 40%.[7] One study in 1987 found that, of 9,480 women having abortions at roughly one hundred clinics across the United States, 42.9% were undergoing at least their second. Of the estimated 1.5 million U.S. abortions performed that year, an estimated 643,500 were repeat abortions.[8]

In a report on the incidence of abortion in 1988, the United States National Center for Health Statistics reported on 297,251 women who had induced abortions in 14 states. Among these women 39.6% of the white women and 53.0% of the black women were repeating abortion. For all groups, 44.1% were repeating abortion with 27.0% having a second abortion, 10.7% having a third abortion and 6.4% having a fourth abortion or more. Two out of three of the black women aged 25 years or older had repeated abortion and about one out of two of the white women had repeated abortion. Teenagers also had high repeat abortion rates as 22.5% of white teenagers aged 18-19 were repeating abortion while 35.5% of black teenagers aged 18-19 were repeating abortion.[9]

The abortion rate is much higher among the population of women who have already had at least one abortion. A 1984 study of 31,000 teenagers in New York City found that those who had experienced one induced abortion were approximately four to six times more likely to terminate a current pregnancy than teenagers with no previous abortions.[10] A California study of 404 teenagers who had had abortions and whose medical records were watched for a five-year period found that 38% had repeat abortions. Eighteen percent, almost one in five, had two abortions in one year.[11]

Researchers have found that the socioeconomic status of women tends to deteriorate as abortion is repeated. In one study at Yale Medical School, researchers reviewed the records of the abortion clinic at Yale-New Haven Hospital of 886 women having a first or repeat abortion at the clinic during 1974-75. It was determined that women having first abortions were similar both in age (22.7 versus 24.0) and in years of completed education (11.8 years versus 12.1 years) to those having repeat abortions. Women in the repeat abortion group were significantly more likely to be divorced (11.9% versus 6.1%), less likely to be a student (15.7% versus 27.7%), and more likely to be a welfare recipient (38.2% versus 25.8%). Among black women 55.6% of the first abortion group were on welfare versus 65.6% of those having repeat abortions. The respective figures for white women on welfare were 12.3% for first-abortion women and 19.3% for repeat abortions. Among those repeating abortion, an average of approximately two years had elapsed since the previous abortion, but 42% had repeated abortions within the last 12 months. Women on welfare were found to be particularly likely to engage in unprotected sexual intercourse and appeared to remain susceptible to repeat abortion.[12]

If unprotected sexual intercourse and "unwanted" pregnancy by women on welfare is considered undesirable, undergoing an induced abortion only heightens the problems. As will be presented below, a number of studies have shown that despite contraceptive knowledge, women will repeat abortion due to depression over prior personal losses, increased frequency of sexual activity, masochism, replacement pregnancies following abortion, compulsive re-enactment and other reasons.

Broken Relationships
Various studies have shown a weakening of social bonds (particularly with male partners) as abortion is increasingly utilized. As women have repeat abortions, their communications with others tend to break down. They tend more often to make the decision to abort by themselves. They are less likely to be happily married and tend to have more difficulty than other women in getting along with others. A Yale University study of 345 women at a New York abortion clinic found that women who have repeat abortions are in less stable social situations and have relationships of shorter duration than women who seek abortions for the first time.[13] The study also found that women having first abortions were generally more concerned with ethical issues, worry over the procedure itself, and the possibility of complications than were the women having repeat abortions. A Los Angeles study also found that women repeating abortion were significantly more likely to be single or living without a spouse and to have less stable relationships with their partners compared to women seeking abortion for the first time.[14] A study at the University of Pennsylvania found that repeat-abortion patients had more difficulty in getting along with others and evidenced significantly higher distress scores on interpersonal sensitivity, paranoid ideation, phobic anxiety, and sleep disturbance than women undergoing abortion for the first time.[15]

The trend for women who have abortions to undergo a deterioration of personal relationships, particularly with male partners, is of considerable importance economically. In the United States, for example, the median income of families in 1992 where there was a female householder with an absent husband was $18,587 compared to $42,140 for a married couple living together. Among non-family households, those headed by a female householder had a median income of only $14,438. Among households with children under 18 years of age, only 4.2% had an annual income of $10,000 or less if the children lived with both parents, compared to 42.7% if the children lived with the mother only. Households headed by women with children under 18 years of age are twice as likely to be rented rather than owned. In contrast, where both parents are living in the household the property is about three times more likely to be owned rather than rented.[16]

One of the many ways abortion can increase the likelihood of welfare status is by breaking up an existing relationship with a male partner. Evidence from a number of studies shows this to be the case. For example, in a study of 344 post-abortive women at the Akron Pregnancy Services Center in Akron, Ohio, during 1988-93, 49% reported that their relationship with the father of the unborn child ended soon after their abortion. Approximately six years after their abortion, only 22% were married, and 67% remained single.[17] Another study of women in a post-abortion support group at the Medical College of Ohio found that only 7 of the 66 women who had abortions while single eventually married the father.[18] Another study found that only 19.3% of women who had undergone an abortion were living with the father in the years following the abortion.[19]

Abortion can also have a definite adverse effect on existing marriages which may lead to separation or divorce.[20] This has been illustrated in the medical literature and elsewhere [21]. It has shown up in the psychological sequelae of abortions performed for genetic reasons[22] and in works dealing with recovery steps after abortion.[23]

The fact that the abortion also means that there is not a child whose care requires expense does not necessarily change the situation, because replacement pregnancies are common. A study of Chicago adolescents, for example, demonstrated a tendency to conceive again shortly after an induced abortion, miscarriage or other loss of a fetus or infant.[24]

Psychological Difficulties
The psychological stability required to work one's way out of an impoverished state is also impaired by abortion, especially repeated abortions. Evidence of denial and isolation is frequently observed among women who repeat abortion. By way of illustration, one researcher who favors the legality of abortion described an interview with a 16-year-old who said she had just had her second abortion, although her Planned Parenthood counselor said it was her fourth: "This abortion doesn't make me feel sad, I feel good. . . . There are no complications and Medicaid pays for it. . . . Being Catholic doesn't bother me at all. But I don't confess it. I'm scared of what the priest would say. I wish I could tell my mother. But she would be so angry."[25] This girl believes she is in charge of her own behavior, but denial and impaired communication with important people in her life are obvious problems.

Masochism or self-punishment has been identified as a factor in repeat abortions; from that same researcher comes the case of a professional who had undergone three abortions. "I hated myself. I felt abandoned and lost. . . . And I felt guilty about killing something. I couldn't get it out of my head that I'd just killed a baby."[26] A 30-year-old single woman recalled: "I was totally irresponsible about birth control. It was like I was just wanting to be punished. . . . I didn't go out to do it, but I didn't do anything not to make it happen."[27] These illustrative cases do not come from an anti-abortion bias, since the researcher reporting them is of the opposite opinion.

Emotional or psychological conflicts increase as abortion is repeated. A study at the Medical College of Ohio found that women reporting multiple abortions had more often considered suicide and showed more indication of borderline personality pathology and depression. Half had sought psychotherapy.[28] A study of Danish women who had been admitted to a psychiatric institution during 1973-75 found that the percentage of psychiatric admissions increased with the number of self-reported past abortions but did not increase with an increasing number of childbirths.[29].

A Finnish study compared women who were able to contracept with women repeating abortion and found that repeaters were lower in self-esteem, more impulsive, less realistic, more unstable, and had less emotional balance and less capacity for integrated personal relationships. Women who repeated abortion were less likely to have a relationship of five years or longer with their current male partner. Partners of repeaters took less responsibility for contraception even though the women left them with greater responsibility in this respect. Solidarity with the partner was weaker in those repeating abortion, even though the women felt greater admiration for their partners. This study found no statistically significant differences between women aborting for the first time and women repeating abortion as to amount of education, level of vocational training, or the women's satisfaction with their own education. There was no significant income difference between the women in the two groups. However, in the case of men living with the women in a common household, net household income was highest in the single abortion group. The level of housing conditions was poorer in the repeat abortion group, and these women were more commonly dissatisfied with their living environment in general. The authors concluded that women who repeat abortion had poorer competence to build the socioeconomic framework of their lives.[30]

A Danish study of 50 women undergoing abortion for the first time compared with 50 women aborting for the second time found that those in the latter group were significantly less likely to report they were living with a partner (33% versus 57%). Those aborting for the second time were also more likely to report being unemployed (16% versus 6%).[31]

Women who repeat abortions tend to have increasing health problems and evidence a trend toward personality disintegration as abortion is increasingly repeated. The pattern of abortions appears to increase the likelihood of a need for public assistance. In a study of patients entering Boston Hospital for Women during 1976-78, 19.9% of the women with no prior abortions were welfare recipients compared with 26% of the women with one prior abortion and 27% for the women with two or more prior abortions.[32]

The well-documented fact that lower-income people are more likely to be philosophically opposed to abortion than those of higher income also means that those who do abort are emotionally harder hit. A study by researcher Larry Peppers of Clemons University on a group of women who had abortions at an Atlanta hospital found that those who had abortions for financial reasons were among the group with the highest post-abortion grief reactions.[33]

Substance Abuse
The women with a history of abortion also had increasingly higher smoking levels as the number of prior abortions increased. Of women with no abortion history, 31.7% smoked. That compares with 40.3% for one prior abortion, and 51.7% for two or more prior abortions.[34] A study conducted by researchers at the Fred Hutchinson Cancer Research Center and the Department of Epidemiology at the University of Washington among 6,541 white women living in Washington state in 1984-87 found that 18% of the women smoked during pregnancy where there was no history of abortion, compared to 28.1% (one abortion), 31.0% (two prior abortions), 29.8% (three prior abortions), and 41.6% (four prior abortions).[35]

The increasing smoking rates among women as abortion is repeated has other possible side effects that would not ordinarily be assumed. Studies have shown that smokers are less likely than non-smokers to use contraceptives or plan a pregnancy.[36] In a study of college students at the University of Arizona in 1973, it was found that smokers manifested more psychosomatic symptoms than non-smokers and also had a higher level of anxiety, more guilt proneness, more unrealistic fantasy content, less self-control over internal processes, and more nervous tension.[37] This could mean that smoking exacerbates these problems, but it is more likely to mean that people with these problems are more inclined to smoke.

As with any statisitical analysis, these facts must take into account the direction of causation. Does abortion increase the desire to smoke, or is it that people who smoke are more likely to have repeat abortions? While definitive answers are being sought, it has at least been found that women in a state of bereavement following a loss will tend to increase smoking.[38] People tend to smoke to relieve stress or emotional upsets. Female heavy smokers have been found to be more depressed or neurotic than non-smokers.[39] In addition, women who smoke during pregnancy will tend to have increased rates of practicing child abuse compared with women who do not smoke during that time.[40]

More troubling for an analysis of what causes increased poverty in women would be abuse of alcohol and illicit drugs. Despite the report of the World Health Organization in 1975 that women who have undergone induced abortion tend to consume alcohol more than the general population,[41] there has been no systematic study of the problem. However, based on various studies and anecdotal reports, it appears that the elevated use of alcohol as well as other drugs stems, in large part, from the effects of the abortion experience itself.

Anecdotal reports of women who have aborted indicate that subsequent drug or alcohol abuse may be an attempt to overcome nightmares or insomnia, or to reduce grief reactions or repress the abortion experience itself.[42] Surveys of women who suffer from post-abortion trauma show that many fall into alcohol or drug abuse after their abortions. In a 1987 study of 252 members of Women Exploited by Abortion (women who would be select for regarding their abortion experience negatively), nearly one-third stated they drank more heavily following their abortion, 15% described themselves as becoming alcoholics, and 40% said that after their abortions they began to use or increased their use of drugs.[43] In a 1985 study of 30 women who reported stress from their abortion experience, 18 (60%) reported increased alcohol use following their abortion. The majority stated that their first heavy drug and alcohol use occurred in conjunction with stress related to the abortion.[44] In a study of 68 women in a Minnesota post-abortion support group sponsored by a religious ministry, 37% acknowledged that they frequently used alcohol and 21% acknowledged that they frequently used drugs. Of the women who used alcohol, 48% said they began drinking after the abortion experience. Of the women who used drugs, 42.9% said they started using them after their abortion experience.[45] A survey of 344 post-abortal women at Akron Pregnancy Services from 1988-93 found that 17% reported drug/alcohol abuse as a psychological complaint following their abortion.[46]

A 1980-81 study of 706 young women, average age 24.3, found that about 9 years after an initial contact in public high schools in New York State , the current use of illicit drugs, other than marijuana, was 6 times more likely when the woman had one or more prior abortions and much less likely when associated with postmarital birth (0.14).[47]

Random studies show elevated rates of substance abuse in post-abortion women. A 1990 random questionnaire survey of women throughout the United States aged 24-44 that included reproductive history as well as history of substance abuse found that 34% of those women reporting a prior abortion also reported substance abuse, compared with only 12% for non-aborted women.[48]

A 1981 random survey of 917 women throughout the United States found that 13% of the women who reported prior abortions were heavy drinkers, while those who abstained from alcohol reported an abortion rate of only 4%. Among women in general, only 6% were heavy drinkers, and had more health and social problems than light drinkers, abstainers or women in general. Heavy drinkers more often had memory lapses while drinking (36% versus 10% of all women drinkers) and more often suffered mental depression (19% versus 3% for abstainers). Driving while intoxicated was a problem for 45% of the heavy drinkers but only 17% of all women drinkers said they had driven while feeling drunk or high at least once in the preceding year. Heavy drinkers were likely to report belligerence after drinking. In the preceding year, 34% had started fights with their husbands or partners while drinking, and 11% had started fights with people outside the family. Sexual relations outside of marriage were more prevalent among heavy drinkers. Heavy drinkers were more likely to have had sexual relations before marriage (53%) than women who completely abstained from alcohol (21%).[49]

A study of women seen at a detoxification center found that those classified as problem drinkers or secondary alcoholics were likely to have experienced abortion in the same year as an alcohol-related health or social problem. Two-thirds of the women reported drinking alone and drinking in bars at least once a week. Secondary alcoholics were prone to binge drinking (81%), physical fights (64%), blackouts (88%), hospitalization (55%), divorce or separation (41%), charges of driving while intoxicated (33%), auto accidents (33%), and job loss (41%). Problem drinkers also had binges (40%), blackouts (54%), physical fights (32%), a charge of driving while intoxicated (9%), or had lost a job (9%).[50]

Other studies have found that women's abortion experiences and related substance abuse can directly affect the health of their future children. Women who have had abortions are more likely to use alcohol or drugs during subsequent pregnancies, pregnancies intended to be carried to term, than women who have had other pregnancy outcomes. A 1981 Scottish study of pregnant women found that those with prior abortions had higher levels of alcohol consumption during pregnancy than women with prior stillbirth, spontaneous abortions (miscarriages), or who previously had given birth to a handicapped child.[51]

A California study of 12,000 pregnant women in 1975-77 found that among those with two or more prior abortions, virtually all (98.5%) consumed up to 3 ounces of alcohol per day throughout the entire nine months of their pregnancy.[52] Women who used drugs such as cocaine, heroin, or methamphetamine during pregnancy have been found to have a higher incidence of prior abortions, and particularly repeat abortions, compared to women who did not use these drugs during pregnancy. A 1984 Boston City Hospital study among inner-city women enrolled for prenatal care found that 19% of those who reported two abortions used cocaine, while only 9% of those who did not use cocaine had had two abortions; that is, cocaine users were twice as likely to have had two abortions. They were three times as likely to report having three or more abortions than those who were not using cocaine; 9% of cocaine users reported having had three abortions, while only 3% of those not using cocaine reported that many.[53]

In a study of maternal drug use in San Diego, women who used cocaine and/or methamphetamine averaged 1.7 abortions compared with 1.2 abortions for non-drug-using controls. Women who used heroin or methadone had an average of 2.4 prior abortions. Where infants were exposed to both heroin and either methamphetamine or cocaine, the mothers averaged 2.7 abortions. These infants in the last group had the highest rate of prematurity, significantly poorer growth, small birth weight, and fetal distress compared with controls.[54]

A study of alcohol, marijuana, tobacco, and cocaine use of pregnant women aged 13-19 at Boston City Hospital found that drug users were twice as likely to have a history of prior elective abortion compared to non-users (33.0% versus 16.3%). The pregnant adolescent drug users were also significantly more likely to report more negative life events and violence during pregnancy. Two out of three adolescent drug users were receiving Medicaid.[55] Illicit drug use was five times more likely to occur among pregnant white teenagers where there was a prior history of abortion, according to findings reported in the National Longitudinal Survey of Youth.[56]

The detrimental economic effects of substance abuse range from job loss, health problems, and increased violence. Women who are heavy drinkers have a high rate of divorce and separation as well as job loss, which can also undermine economic well-being.[57]

Alcohol and drug abuse following induced abortion has a potential increased risk for women in a variety of health and social aspects. Alcohol impairs the immune system and puts a woman at risk for a variety of diseases. Social deterioration may occur due to sexual dysfunction, increased violence, hospitalization, job loss, increased isolation, self-destructive behavior, and poverty status. Maternal health and the well-being of offspring may be impaired due to alcohol or drug use during subsequent pregnancies, including low birth weight, miscarriages, fetal alcohol syndrome, congenital malformation or perinatal mortality.[58] Additionally, subsequent children may have greater learning difficulties.[59] The connection of all these problems to a greater feminization of poverty requires little imagination.

Cause and Effect
The many studies that show a correlation between abortion, especially repeated abortions, and a reduction in women's economic well-being do not, for the most part, prove a clear causation. While anecdotal evidence may support the contention that abortion increases the breakup of relationships, psychological difficulties, and substance abuse, the argument can be and has been made that the causation is in the other direction. Those women inclined toward multiple abortions are also inclined to have these problems. More precisely, the same thing that is causing these women to have these problems may also be causing the multiple abortions. It is not that the abortions cause the difficulties, but that problems with unhealthy sexual relations with men, domestic violence, and similar challenges may cause both the abortions and the subsequent problems that are correlated with them. This argument is frequently used by abortion counselors and promoters.

However, another causal factor must be taken into account: to what extent does the ready accessibility of abortion cause the problems of exploitational sexual attitudes and self-righteous denials of responsibility by men? To what extent does the presence of the abortion clinic itself exacerbate the problems that cause both the abortions and the subsequent psychological difficulties?

In any event, the very least that can be said from this evidence is that repeated abortion is not therapeutic. The repeated utilization of abortion does not appear to lead to economic prosperity or social well-being. The argument that abortion accessibility is necessary to help eradicate poverty cannot be maintained in the face of the evidence.

More probably, the practice of abortion is leading to greater impoverishment of women. Abortion is a practice aimed at women, and therefore any impoverishing effects as described above would disproportionately impact on women. When we know that current trends involve a "feminization of poverty," any possible factor that exacerbates the problem should be examined. There is ample evidence to suggest that the widespread use of abortion is such a factor, which should, despite political ideologies, receive greater scrutiny.

1. Diana Pearce, "The Feminization of Poverty: Women, Work, and Welfare," Urban and Social Change Review (February, 1978): 30.

2. Arthur Blaustein, The American Promise (New Brunswick: Transaction Books, 1982), p. 8.

3. Diana Pearce, "The Feminization of Ghetto Poverty," Society 21 (Nov./Dec. 1983): 70.

4. United States Department of Commerce, Bureau of the Census, "Money Income and Poverty Status of Families and Persons in the United States: 1983," (Washington D.C.: Current Population Reports, Series P-60, no. 145, 1985).

5. Pearce 1983, p. 70.

6. See, for example, Emily M. Northrop, "The Feminization of Poverty: The Demographic Factor And the Composition of Economic Growth," Journal of Economic Issues, 24, no. 1 (March 1990): 145.

7. Christopher Tietze, "Repeat Abortions -- Why More?" Family Planning Perspectives 10(5): 286 (Sept./Oct.1978); Henshaw, "Characteristics of U.S. Women Having Abortions, 1982-1983," Family Planning Perspectives 19, no. 1 (1987): 5.

8. Stanley K. Henshaw and Jane Silverman, "The Characteristics and Prior Contraceptive Use of U.S. Abortion Patients," Family Planning Perspectives 20, no. 4 (July/Aug. 1988): 158.

9. Kenneth D. Kochanek, "Induced Termination of Pregnancy: Reporting States, 1988," Monthly Vital Statistics Report 39, no. 12 (30 April 30 1991): 1-31.

10. Theodore Joyce, "The Social and Economic Correlates of Pregnancy Resolution Among Adolescents in New York City: A Multivariate Analysis," American Journal of Public Health 78, no. 6 (June 1988): 626.

11. Rena Bobrowsky, "Incidence of Repeated Abortion, Second Trimester Abortion, Contraceptive Use, and Illness within a Teenage Population," Ph.D. Thesis, University of Southern California (1986).

12. Mary Jo Shepard and Michael B. Bracken, "Contraceptive Practice and Repeat Induced Abortion: An Epidemiological Investigation," Journal of Biosocial Science 11 (1979): 289-302.

13. Michael B. Bracken and Stanislav K. Kasl, "First and Repeat Abortions: A Study of Decision-Making and Delay," Journal of Biosocial Science 7 (1975): 374-491.

14. See note 11.

15. Ellen Freeman, "Emotional Distress Patterns among Women Having First or Repeat Abortions," Obstetrics and Gynecology 55, no. 5 (May, 1980): 630.

16. Statistical Abstracts of the United States (U.S. Department of Commerce, Bureau of the Census, 1994).

17. Lee Ellen Gsellman, "Physical and Psychological Injury in Women Following Abortion: Akron Pregnancy Services Survey," Association for Interdisciplinary Research Newsletter 5, no. 4 (Sept./Oct. 1993): 1-8.

18. Kathleen N. Franco, Marijo B. Tamburrino, Nancy B. Campbell, "Psychological Profile of Dysphoric Women Post-Abortion," Journal of the American Medical Women's Association 44, no. 113 (1989).

19. Gail B. Williams, "Induced Elective Abortion and Perinatal Grief," Ph.D. Thesis, New York University (1991).

20. See, for example, Christopher R. Moore, "Husband Mourns Outcome of Wife's Painful Decision," American Medical News (14 October 1991): 24

21. See, for example, Thomas Strahan, "Portraits of Post-Abortive Fathers Devastated by the Abortion Experience," Association for Interdisciplinary Research Newsletter 7, no. 3 (Nov./Dec. 1991): 1-8.

22. Bruce D. Blumberg, Mitchell S. Golbus, and Karl H. Hanson, "The Psychological Sequelae of Abortion Performed for a Genetic Indication," American Journal of Obstetrics and Gynecology 122, no. 7 (1 August 1975): 799.

23. Jeannette Vought, Post-Abortion Trauma: 9 Steps to Recovery (Grand Rapids, Mich.: Zondervan), pp. 131-43.

24. Nancy Heller Horowitz, "Adolescent Mourning Reactions to Infant and Fetal Loss," Social Casework (November, 1978): 551-59.

25. Linda Francke, The Ambivalence of Abortion (New York: Randon House, 1978), pp. 190-91.

26. Ibid., p. 61.

27. Ibid., p. 65.

28. See note 18.

29. Ronald K. Somers, "Risk of Admission to Psychiatric Institutions Among Danish Women Who Experienced Induced Abortions," Ph.D. Thesis, University of California, Los Angeles (1979).

30. Pirkko Niemela, Paivi Lehtinen, and Lauri Rauramo, "The First Abortion--And the Last? A Study of the Personality Factors Underlying the Repeated Failure of Contraception," International Journal of Gynaecology and Obstetrics, 19 (1981): 193.

31. Mogens Osler, Janine M. Morgall, Birgitte Jensen, and Merete Osler, "Repeat Abortion in Denmark," Danish Medical Bulletin 39, no. 1 (February 1992): 89.

32. Ann A. Levin, Stephen C. Schoenbaum, Richard R. Monson, Phillip G. Stubblefield, and Kenneth J. Ryan, "Association of Induced Abortion with Subsequent Pregnancy Loss," Journal of the American Medical Association 243, no. 24 (27 June 1980): 2495.

33. Larry G. Peppers, "Grief and Elective Abortion: Implications for the Counselor," in Kenneth J. Doka, Disenfranchised Grief, Recognizing Hidden Sorrow, (Lexington, Mass.: Lexington Books, 1989), pp. 135-46.

34. See note 32.

35. Margaret T. Mandelson, Christopher B. Maden, and Janet R. Daling, "Low Birth Weight in Relation to Multiple Induced Abortions," American Journal of Public Health 82, no. 3 (March, 1992): 391.

36. J. Yerushalmy, "The Relationship of Parents' Cigarette Smoking to the Outcome of Pregnancy," American Journal of Epidemiology 93, no. 6 (1971): 443.

37. Richard W. Coan, "Personality Variables Associated with Cigarette Smoking," Journal of Personality and Social Psychology 26, no. 1 (1973): 86-104.

38. C. Murray Parkes and R. J. Brown, "Health after Bereavement: A Controlled Study," Psychosomatic Medicine 34 (1972): 449-461.

39. D. Schubert, "Personality Implications of Cigarette Smoking among College Students," Journal of Consulting Psychology 23 (1959): 276; W.E. Walters, "Smoking and Neuroticism," British Journal of Preventative and Social Medicine 25 (1971): 162.

40. J. Cheesare, J. Pascoe, and E. Baugh, "Smoking During Pregnancy and Child Maltreatment: Is There an Association?" International Journal for Biosocial Research 8, no. 1 (1986): 37-42

41. Susan Harlap and Michael Davies, "Characteristics of Pregnant Women Reporting Previous Induced Abortions," Bulletin of the World Health Organization, 52, (1975): 49; "Gestation, Birth-Weight and Spontaneous Abortion in Pregnancy after Induced Abortion: Report of the Collaborative Study by the World Health Organization Task Force on Sequelae of Abortion," The Lancet (20 January 1975), pp. 142-45.

42. David Reardon, Aborted Women: Silent No More (Westchester, Illinois: Crossway Books, 1987). See, for example, pp. 79 and 146.

43. Ibid.

44. Anne Speckhard, "Psycho-Social Stress Following Abortion," Ph.D. Thesis, University of Minnesota (1985).

45. Vought, pp. 111-112

46. See note 17.

47. Kazuo Yamaguchi and Denise B. Kandel, "Drug Use and Other Determinants of Premarital Pregnancy and Its Outcome: A Dynamic Analysis of Competing Life Events," Journal of Marriage and the Family 49 (May 1987): 257.

48. David Reardon, "Preliminary Results of the Elliot Institute's 1990 Abortion Survey," Elliot Institute for Social Science Research (Springfield, Ill., 1990).

49. Albert D. Klassen and Sharon C. Wilsnack, "Sexual Experience and Drinking Among Women in a U.S. National Survey," Archives of Sexual Behavior 15 (5) 1986: 363; Wilsnack, Wilsnack and Klassen, "Women's Drinking and Drinking Patterns from a 1981 National Survey," American Journal of Public Health 74, no. 11 (Nov. 1984): 1231.

50. Elizabeth R. Morrissey and Mark A. Schuckit, "Stressful Life Events and Alcohol Problems among Women Seen at a Detoxification Center," Journal of Studies on Alcohol 39, no. 9 (1978): 1559.

51. Moria Plant, Women, Drinking and Pregnancy (London: Tavistock Publications, 1985), pp. 59-69

52. Jan W. Kuzman and David G. Kissinger, "Patterns of Alcohol and Cigarette Use in Pregnancy," Neurobehavioral Toxicology and Terotology 3 (1981): 211.

53. Deborah A. Frank, Barry Zuckerman, and Hortensia Amaro, "Cocaine Use during Pregnancy: Prevalence and Correlates," Pediatrics 82, no. 6 (Dec. 1988): 888-95.

54. Amy S. Oro and Suzanne D. Dixon, "Perinatal Cocaine and Methamphetamine Exposure: Maternal and Neonatal Correlates," Journal of Pediatrics 111 (1987): 571.

55. Hortensia Amaro, Barry Zuckerman, and Howard Cabral, "Drug Use among Adolescent Mothers," Pediatrics 84, no. 1 (July 1989): 144.

56. Barbara Mensch and Denise B. Kandel, "Drug Use as a Risk Factor for Premarital Teen Pregnancy and Abortion in a National Sample of Young White Women," Demography 29, no. 3 (Aug. 1992): 409.

57. See note 50.

58. "Surgeon General's Advisory on Alcohol and Pregnancy," Food and Drug Administration Drug Bulletin, Department of Health and Human Services, 11, no. 2 (1981).

59. Lucille Newman and Stephen L. Buka, "Every Child a Learner: Reducing Risks of Learning Impairment during Pregnancy and Infancy," Education Commission of the States, Denver, Col. (1990).

Originally printed in Feminism and Non-Violence Studies Journal, Vol. 1, Issue 3, Summer 1995. Reprinted with permission.