The
author
discusses
legalized
abortion
within
the
framework
of
contraceptive
services
and
emphasizes
its
value
in
population
control,
as
well
as
other
social
benefits.
The
Social
Effects
of
Legal
Abortion
Introduction
During
the
last
five
years
the
restrictive
State
laws
concerning
abortion
enacted
during
the
nineteenth
century
have
come
increasingly
under
scrutiny.
In
response
to
public
pressure,
15
State
legislatures
have
liberalized
their
abortion
laws.
The
principal
motivating
force
behind
the
drive
for
reform
of
the
abortion
laws
has
been
concern
for
the
wel-
fare
and
rights
of
women.
Proponents
of
the
reform
of
abor-
tion
laws
have
cogently
pointed
out
that
the
existing
laws
threaten
the
health
of
many
thousands
of
American
women
who
have
become
accidentally
and
unintentionally
preg-
nant,
by
forcing
them
either
to
bear
unwanted
children
or
to
seek
illegal
abortions.
For
the
woman
who
is
mentally
or
physically
ill,
poor,
or
already
overburdened
with
more
children
than
she
can
adequately
care
for,
the
birth
of
an
unwanted
child
can
be
disastrous.
By
contrast,
illegal
abor-
tion
can
be
life-threatening
and,
in
many
parts
of
the
country
has
become
a
leading
cause
of
maternal
mortality.1
Quite
apart
from
the
issue
of
welfare,
many
womens'
rights
groups
claim
that
the
decision
to
undergo
abortion
should
be
the
woman's
prerogative,
not
that
of
the
State,
and
have
insisted
that
the
law
should
allow
a
woman
to
terminate
an
unwanted
pregnancy
upon
request,
regardless
of
what
her
reasons
might
be
for
wanting
the
abortion.2
With
most
of
the
attention
of
abortion
reform
groups
focused
on
how
the
abortion
laws
affect
individual
women,
there
has
been
relatively
little
public
discussion
of
how
legalization
of
abortion
might
affect
society
as
a
whole.
Recent
research
in
the
fields
of
demography,
economics,
mental
health,
and
ecology
suggests
directly
and
indirectly
that
legalization
of
abortion
might
contribute
substantially
to
the
solution
of
a
wide
variety
of
serious
domestic
social
problems.
These
studies
indicate
that
the
effects
on
society
of
legalizing
abortion
might
be
far
greater
than
has
been
hitherto
recognized.
In
this
report,
I
review
some
of
this
recent
work
and
outline
what
appear
to
be
the
principal
social
benefits
that
would
result
from
legalizing
abortion.
Unwanted
Births
and
Abortion
A
recent
study
by
Bumpass
and
Westoff3
has
shown
that
despite
wide
availability
of
contraceptive
means,
ap-
proximately
22
per
cent
of
all
children
born
in
America
in
recent
years
were
unwanted
by
at
least
one
parent
at
the
time
of
conception;
17
per
cent
were
unwanted
by
both
parents.
These
findings
were
based
on
questionnaire
surveys
of
mothers
who
were
asked
whether
or
not
before
the
begin-
ning
of
their
last
pregnancy
they
and
their
husbands
had
re-
ally
wanted
another
child
sometime
in
the
future.
When
the
answer
was
negative,
the
last-born
child
was
considered
to
have
been
unwanted.
Bumpass
and
Westoff
point
out
that
the
actual
incidence
of
unwanted
children
is
probably
higher
than
22
per
cent
because
of
the
natural
reluctance
of
Richard
A.
Schwartz,
M.D.
parents
to
admit
to
not
having
wanted
all
of
their
children.
Converting
the
figure
of
22
per
cent
into
absolute
numbers,
during
the
year
1969,
800,000
births
of
a
total
of
3.6
million
can
be
said
to
have
been
not
wanted
by
at
least
one
parent.
The
incidence
of
unwanted
births
cannot
be
signifi-
cantly
reduced
by
reliance
solely
on
contraception,
without
having
legalized
abortion
as
a
backstop.
Reliable
methods
of
contraception
are
not
readily
available
to
many
women
of
childbearing
age;
many
women
are
erratic
in
their
use
of
contraception;
and,
in
addition,
currently
available
methods
of
contraception
are
less
than
100
per
cent
technically
de-
pendable.
There
are
two
large
groups
in
the
population
who
lack
access
to
effective
methods
of
contraception:
the
poor
and
the
young.
Planned
Parenthood-World
Population
es-
timates
that
of
5.4
million
medically
indigent
fertile
women
in
the
United
States
who
at
any
one
time
are
not
pregnant
or
seeking
to
become
pregnant,
only
14
per
cent
are
cur-
rently
being
served
by
subsidized
family
planning
pro-
grams4
In
the
United
States,
20
per
cent
of
brides
are
preg-
nant
at
the
time
of
their
marriage,
and
the
incidence
of
premarital
pregnancy
in
teenage
brides
is
at
least
40
per
cent.5
Despite
this
obvious
evidence
that
the
unmarried
young
are
in
need
of
birth
control
assistance,
our
culture
remains
unwilling
to
make
contraception
available
to
this
group,
presumably
out
of
fear
that
to
do
so
would
be
further
to
encourage
sexual
irresponsibility.
Most
methods
of
contraception
require
an
extremely
high
degree
of
reliability
and
consistency
in
their
use
in
order
to
be
effective.
Unfortunately
not
all
women
possess
the
intellectual
or
emotional
capacity
for
effective
practice
of
contraception
on
a
year-in,
year-out
basis.6
Because
women
are
fertile
for
approximately
20
to
25
per
cent
of
the
time
between
the
ages
of
12
and
45,
achieving
completely
successful
family
planning
over
a
reproductive
lifetime
leaves
little
room
for
human
error
or
carelessness.
Segal
and
Tietze7
have
estimated
a
3
per
cent
risk
of
pregnancy
from
one
unprotected
coitus.
Therefore,
even
if
every
one
of
the
25
million
fertile
women
in
America
used
a
100
per
cent
ef-
fective
contraception
method
except
for
one
unprotected
coitus
a
year,
there
would
still
be
750,000
accidental
preg-
nancies
annually
(3
per
cent
of
25
million
equals
750,000).
Even
if
the
problems
of
availability
and
human
depen-
dability
could
be
completely
""solved,"
technical
imperfec-
tions
of
existing
contraceptive
methods
present
another
bar-
rier
to
successful
family
planning.
The
two
most
effective
contraceptive
methods
currently
available
are
the
oral
pill
which
is
99
per
cent
reliable
(i.e.,
for
every
100
women
SOCIAL
EFFECTS
OF
LEGAL
ABORTION
1331
users,
one
pregnancy
per
year
will
occur),
and
the
IUD
which
is
approximately
97
per
cent
reliable.4
Hardin8
has
pointed
out
that
this
high
percentage
can
be
misleading.
Even
if
every
one
of
the
25
million
fertile
American
women
were
to
use
a
99
per
cent
reliable
method
like
the
oral
pill,
there
would
still
be
250,000
unwanted
births
a
year.
Although
considerable
research
is
currently
in
progress
in
the
field
of
contraception,
Djerassi,9
an
authori-
ty
in
this
field,
has
indicated
that
there
is
little
likelihood
of
a
significant
breakthrough
in
the
near
future,
especially
in
view
of
the
many
years
of
experimentation
required
to
es-
tablish
the
safety
of
any
new
pharmacologic
product.
Legalization
of
abortion
as
a
backstop
method
of
birth
control
offers
the
best
hope
of
bringing
about
a
signifi-
cant
reduction
in
the
incidence
of
unwanted
births,
and
in
fact
is
probably
the
only
feasible
way
that
this
can
be
achieved
in
a
reasonably
short
time.
Abortion
has
none
of
the
shortcomings
of
other
contraceptive
methods.
Abortion
is
not
97
or
99
per
cent
but
100
per
cent
effective.
Abortion
requires
no
foresight
or
planning
and
thus
can
give
even
the
most
careless
and
impulsive
woman
successful
control
over
her
reproduction.
Abortion
can
be
made
available
to
the
unmarried
young
without
seeming
to
grant
them
permission
to
be
sexually
active,
as
is
the
case
with
providing
con-
traception.
By
adding
legalized
abortion
to
our
present
ar-
mamentarium
of
imperfect
contraception,
a
nearly
fool-
proof
system
of
voluntary
family
planning
can
be
created
virtually
overnight.
The
experience
of
Romania
illustrates
how
great
can
be
the
impact
of
legalized
abortion
on
the
birth
rate.
In
1966,
with
abortion
legal,
the
birthrate
in
Romania
was
13.7
(per
1,000
population),
the
lowest
in
Europe.
Alarmed
by
the
declining
population,
the
leaders
of
the
country
outlawed
abortion
in
October
1966.
By
the
next
year
the
birthrate
jumped
to
38.4,
almost
a
threefold
increase.10
The
Environment
and
Abortion
Most
students
of
environmental
problems
agree
that
it
will
be
impossible
in
the
long
run
to
preserve
the
quality
of
the
environment
unless
population
growth
is
halted.
As
has
been
pointed
out
many
times,
the
earth
is
a
spaceship.
Our
supplies
of
agricultural
land,
fresh
water,
minerals,
and
air
are
limited.
If
we
cannot
adequately
provide
a
decent
diet
and
an
unpolluted
environment
for
the
3.5
billion
humans
now
alive,
it
is
unlikely
that
we
will
be
able
to
do
so
for
the
7
billion
predicted
by
the
year
2000,
just
28
years
away.
Furthermore,
as
our
population
grows
year
by
year,
and
with
it
our
industrial
and
agricultural
production,
there
is
a
steadily
increasing
threat
that
our
environment
will
become
so
badly
poisoned
by
pollutants
of
various
types
that
its
capacity
to
sustain
life
may
become
irreversibly
de-
stroyed.
11-13
Preserving
the
environment
will
require
more
than
merely
halting
population
growth
alone.
Direct
antipollu-
tion
activities
of
many
kinds
need
to
be
undertaken.
The
use
of
DDT
and
other
persistent
pesticides
will
have
to
be
dras-
tically
curtailed;
automobiles
and
factories
will
need
to
find
ways
of
decreasing
harmful
emissions;
our
currently
inade-
quate
system
of
sewage
disposal
must
be
overhauled;
safer
and
cleaner
ways
of
producing
electricity
must
be
found,
and
so
on.
All
of
these
programs
will
cost
enormous
sums
of
money
that
the
public
will
have
to
provide
in
the
form
of
higher
taxes
or
prices.
Citizen
opposition
both
to
higher
taxes
and
to
higher
prices
is
unfortunately
a
political
reality
that
imposes
severe
limitations
on
how
rapidly
antipollution
measures
can
be
implemented.
There
is
a
real
danger
that
the
rate
of
increase
in
pollution,
brought
about
by
popula-
tion
growth,
will
exceed
the
rate
of
increase
of
antipollution
efforts.
Without
stopping
population
growth,
we
might
well
end
up
spending
many
billions
of
dollars
a
year
on
pollution
control,
while
continuing
to
lose
ground
in
the
battle
to
save
the
environment.
Under
these
circumstances
the
search
for
effective
and
feasible
ways
of
reducing
the
birthrate
must
be
given
the
highest
possible
priority
in
any
rational
plan
for
coping
with
the
environmental
crisis.
Strategies
for
diminishing
the
birthrate
may
be
divided
into
two
broad
categories:
1)
family
planning-
programs
designed
to
prevent
unwanted
births;
and
2)
pop-
ulation
control-ways
of
decreasing
the
rate
of
wanted
births,
either
by
educating,
enticing
or
pressuring
people
to
want
fewer
births,
or
by
direct
coercion.
Which
of
these
two
approaches
offers
the
best
chance
of
substantially
lowering
the
birthrate?
Direct
popu-
lation
control
has
been
strongly
advocated
recently
by
many
prominent
demographers
and
ecologists.
1416
Citing
surveys
that
show
that
Americans
desire
an
average
of
3.4
children
per
family,
they
argue
that
family
planning
will
not
work
as
a
strategy
for
reducing
population
growth.
Since
the
average
number
of
children
per
family
must
be
reduced
to
2.2
to
stabilize
population,
allowing
families
to
have
the
number
of
children
they
want,
we
have
been
told,
is
a
formula
for
continued
population
growth
rather
than
halting
growth.
Advocates
of
population
control
have
ac-
cordingly
recommended
many
measures,
among
them
being
government-sponsored
educational
programs
aimed
at
con-
vincing
people
to
limit
their
families
to
two
children,
eliminating
tax
deductions
for
children
in
excess
of
two,
awarding
annual
payments
to
families
for
not
having
children,
and
increasing
opportunities
for
women
to
have
satisfying
careers
outside
the
home.
How
certain
can
we
be
that
these
direct
population
control
measures
are
necessary
to
control
overpopulation?
As
stated
above,
each
year
about
800,000
unwanted
infants
are
born
in
the
United
States.
Since
the
excess
of
births
over
deaths
in
the
United
States
in
recent
years
has
been
approx-
imately
1.5
million
annually,
prevention
alone
of
800,000
unwanted
births
would
decrease
the
rate
of
population
growth
by
more
than
half.
This
is
not
"zero
population
growth,"
but
it
is
considerably
closer
to
that
goal
than
one
would
gather
from
recent
pronouncements
by
the
more
rad-
ical
population
control
advocates
who,
in
my
opinion,
have
been
misled
by
relying
too
heavily
on
surveys
of
family-size
preference.
In
interpreting
these
surveys,
one
must
consider
that
a
newly
married
couple
may
say
that
they
want
three
or
four
children,
but
that
after
changing
diapers
for
several
years,
may
change
their
minds
and
decide
after
all
that
one
or
two
children
are
sufficient.
In
regard
to
feasibility,
population
control
compares
unfavorably
with
family planning.
The
problem
of
preventing
wanted
births
is
much
more
complicated
than
preventing
unwanted
births.
Changing
peoples'
motivation
on
a
mass
scale
is
extremely
difficult
in
a
democracy,
especially
one
with
a
long
tradition
of
respect
for
individual
freedom.
Until
our
over-population
problems
become
a
clear
and
present
danger
to
our
survival,
not
many
politi-
1332
AJPH
OCTOBER,
1972,
Vol.
62,
No.
10
cians
will
be
eager
to
propose
legislation
that
would
be
per-
ceived
as
giving
government
the
power
to
regulate
directly
the
number
of
children
a
family
may
have.
Legalization
of
abortion,
though,
contains
none
of
these
elements
of
gov-
ernment
intrusion
or
coercion,
and
is
therefore
far
more
likely
to
be
accepted
by
the
American
public,
despite
cur-
rent
opposition
from
church
and
other
groups.
Given
the
political
difficulties
of
adopting
direct
population
control
and
the
possibility
that
preventing
un-
wanted
births
alone
may
adequately
stabilize
population
growth,
it
would
appear
that
legalization
of
abortion
is
probably
the
single
most
effective
and
practical
measure
that
can
be
taken
to
lower
the
birthrate,
and,
by
doing
so,
preserve
the
environment
from
further
deterioration.
Poverty
and
Abortion
One
of
the
most
important
contributing
and
perpet-
uating
causes
of
poverty
in
the
United
States
is
the
high
in-
cidence
of
unwanted
children
born
into
poor
families.
Wes-
toff17
estimates
that
between
1960
and
1965
a
yearly
average
of
400,000
unwanted
children
were
born
to
the
poor,
40
per
cent
of
all
births
among
the
poor.
Although
motivational
factors
play
some
role
in
accounting
for
this
high
incidence,
the
principal
reason
for
the
failure
of
poor
people
effectively
to
control
their
reproduction
is
lack
of
access
to
adequate
medical
services
in
poverty
areas.
Surveys
repeatedly
have
shown
that
poor
couples
desire
the
same
number
of
children
as
do
families
who
are
not
poor.18
Enabling
the
poor
to
avoid
unwanted
births
would
profoundly
alleviate
the
overall
problem
of
poverty
in
the
United
States.
Since
approximately
40
per
cent
of
all
poor
persons
are
children,
making
it
possible
for
poor
couples
to
avoid
giving
birth
to
unwanted
children
would
lead
directly
to
a
sizable
reduction
in
the
total
number
of
poor
persons
in
the
population.
Sheppard19
has
pointed
out
that
if,
in
1964,
the
family
size
of
the
poor
had
been
identical
to
that
of
the
nonpoor,
there
would
have
been
6.5
million
fewer
children
living
in
poor
families,
a
19
per
cent
reduction
in
the
total
number
of
poor
persons
in
that
year.
Having
large
numbers
of
dependent
children
is
one
of
the
major
burdens
of
being
poor.
In
1966,
poor
adults
of
working
age
had
more
than
twice
as
many
children
to
provide
for
on
the
average
as
did
adults
with
adequate
in-
comes.20
If
poor
couples
had
fewer
children,
each
family
member
would
have
a
larger
share
of
the
family
income
and
consequently
an
improved
material
standard
of
living.
Since
the
official
definition
of
poverty
is
dependent
on
family
size
as
well
as
family
income,
many
poor
families
if
they
had
fewer
children
would
automatically
rise
above
the
poverty
level
without
any
change
in
the
size
of
the
breadwinner's
paycheck.
The
burden
of
trying
to
support
a
large
family
is
a
frequent
cause
of
alcoholism
and
desertion
among
low-in-
come
fathers.
Giving
poor
parents
better
control
over
their
reproduction
would
enable
more
families
to
remain
intact
and
would
decrease
the
numbers
of
mothers
with
dependent
children
to
be
forced
into
poverty
and
welfare
dependency.
With
fewer
children,
many
mothers
in
poor
families
would
have
increased
time
available
for
remunerative
work
outside
the
home.
The
additional
earnings
in
many
cases
would
raise
the
total
family
income
above
the
poverty
level.
Campbell20
estimates
that
16
per
cent
of
all
births
among
the
poor
are
illegitimate.
For
a
poor
girl
the
birth
of
an
illegitimate
child
frequently
leads
to
dropping
out
of
school,
to
diminished
chances
of
eventually
forming
a
stable
marriage,
and
to
becoming
trapped
in
the
cycle
of
poverty
and
welfare
dependency.
There
is
little
doubt,
therefore,
that
prevention
of
unwanted
births
would
have
a
remarkably
beneficial
impact
upon
the
problem
of
poverty
in
a
number
of
ways.
By
the
relatively
simple
measure
of
legalizing
abortion,
a
substan-
tial
percentage
of
unwanted
births
could
be
prevented,
as
I
have
shown
earlier.
As
a
strategy
for
reducing
the
incidence
of
poverty,
prevention
of
unwanted
births
compares
favorably
in
terms
of
effectiveness
and
feasibility
with
the
three
most
com-
monly
proposed
alternative
antipoverty
approaches:
educa-
tion,
creation
of
government
jobs,
and
direct
money
payments
to
the
poor.
Despite
the
enormous
sums
spent
on
special
educa-
tion
programs
for
the
poor
(such
as
Head
Start,
Upward
Bound,
Job
Corps),
these
programs
have
had
little
impact
on
the
actual
incidence
of
poverty.
Education
can
equip
a
person
to
compete
successfully
for
an
existing
job,
but
it
cannot
increase
the
total
number
of
well-paying
jobs.
How-
ever
much
being
educated
may
improve
the
economic
status
of
the
individual
in
competition
with
other
individu-
als,
it
cannot
raise
the
economic
status
of
the
group
as
a
whole.
This
can
only
be
achieved
by
increasing
the
total
number
of
jobs
and
(or)
the
salaries
of
existing
jobs.
Asian
and
South
American
countries
are
full
of
highly
educated
college
graduates
who
cannot
find
employment
in
the
stag-
nant
economies
of
those
countries.
Even
in
the
United
States,
many
with
degrees
of
doctor
of
philosophy
are
having
difficulty
in
finding
suitable
employment
because
of
the
present
economic
recession.
Providing
government
jobs
at
public
expense
for
the
unemployed
is
not
so
feasible
a
solution
to
the
poverty
problem
as
might
appear
at
first
glance.
As
Moynihan21
has
pointed
out,
being
employed
does
not
automatically
raise
one's
income
above
poverty
level.
There
are
at
present
22
million
male
workers
in
the
United
States
employed
at
full-
time
jobs
whose
annual
earnings
are
less
than
$5,500.
Alleviating
the
poverty
of
the
unemployed
and
working
poor
by
a
government
job-creation
and
job-subsidization
program
would
be
extremely
expensive,
and
therefore
un-
likely
to
be
acceptable
to
the
American
taxpayers.
More-
over,
such
a
program
would
be
in
opposition
to
the
federal
government's
principal
strategy
for
controlling
inflation:
i.e.,
deliberate
economic
slowdown,
with
a
consequent
increase
in
the
rate
of
unemployment.
A
large
segment
of
the
poor
are
unemployable,
ei-
ther
because
they
are
sick,
elderly,
minor
children,
or
mothers
of
preschool
children.
Creating
jobs
would
have
no
relevance
to
alleviating
the
poverty
of
these
groups.
Raising
their
income
can
be
accomplished
only
by
giving
them
money.
Here
again
the
cost
of
a
meaningful
program
is
pro-
hibitive.
Moynihan21
has
stated
that
raising
the
income
of
all
families
in
the
United
States
to
the
modest
level
of
$5,500
per
year
would
cost
$60
billion
annually,
more
than
the
entire
current
budget
of
the
Department
of
Health,
Edu-
cation,
and
Welfare.
The
likelihood
that
any
such
measure
will
be
enacted
by
Congress
in
the
foreseeable
future
is
vir-
tually
nil.
Now
that
several
years
have
elapsed
since
President
SOCIAL
EFFECTS
OF
LEGAL
ABORTION
1333
Johnson's
announcement
of
the
War
on
Poverty,
it
has
become
increasingly
apparent
that
ending
poverty
will
be
extraordinarily
difficult
for
the
reasons
I
have
outlined
above,
as
well
as
others.
Helping
the
poor
to
avoid
un-
wanted
births
would
appear
to
be
one
of
the
most
effective
and
feasible
antipoverty
strategies.
Since
legalization
of
abortion
is
the
most
effective
way
to
reduce
the
incidence
of
unwanted
births,
legalization
of
abortion
may
well
be
the
single
most
effective
and
feasible
step
that
can be
taken
to
reduce
the
incidence
of
poverty
in
America.
Behavioral
Disorders
and
Abortion
Severe
disorders
of
behavior,
e.g.,
mental
illness,
criminality,
drug
addiction,
and
alcoholism,
are
among
the
most
serious
social
problems
in
America.
These
disorders
wreck
many
lives,
inflict
widespread
suffering
on
families,
and
impose
enormous
cost
on
the
public
which
must
provide
the
necessary
police,
courts,
prisons,
reformatories,
mental
hospitals,
clinics,
and
social
agencies
to
restrain
and
to rehabilitate
disturbed
individuals.
Despite
massive
and
expensive
efforts
to
deal
with
these
severe
problems,
they
seem
to
grow
worse
year
by
year.
Crime
and
drug
addiction
in
particular
have
recently
grown
to
such
menacing
propor-
tions
that
they
seriously
threaten
the
very
future
of
urban
society
in
the
United
States.
Considerable
research
has
been
done
in
regard
to
the
causes
of
behavioral
disorders
during
the
last
50
years,
resulting
in fairly
widespread
agreement
among
behavioral
scientists
that
the
most
important
causal
influence
on
per-
sonality
development
and
behavior
patterns
in
adulthood
is
the
quality
of
care
given
to
children
during
their
formative
years,
especially
from
age
I
year
through
5
years.
If
a
child
is
raised
in
an
atmosphere
of
love
and
affection,
coupled
with
reasonable
and
consistent
discipline
and
guidance,
this
usually
confers
life-long
immunity
against
developing
seriously
disordered
behavior.
By
contrast,
a
background
of
parental
rejection,
neglect,
and
lack
of
guidance
and
dis-
cipline
is
almost
invariable
in
the
life
histories
of
persons
with
disturbed
behavior.22-25
The
reason
that
most
programs
that
aim
to
prevent,
treat,
or
rehabilitate
the
emotionally
and
behaviorally
dis-
turbed
are
so
unsuccessful
is
that
they
fail
to
counteract
these
deleterious
childhood
influences.
Psychotherapy,
counseling,
reeducation,
and
other
corrective
efforts,
in-
volving
a
few
hours
or
even
several
hundred
hours
of
con-
tact
with
professional
helpers,
simply
do
not
create
suf-
ficient
leverage
to
offset
the
crippling
impact
of
living
day
in,
day
out,
year
after
year
in
a
disturbed
and
hostile
home
environment
during
the
formative
years
of
childhood.
Fur-
thermore,
trained
manpower
to
provide
intensive
coun-
seling
services
is
not
available
in
anywhere
nearly
sufficient
numbers.26
Thus,
there
is
little
hope
of
bringing
the
current
epidemic
of
severe
behavioral
disorders
under
control
unless
ways
can
be
found
of
increasing
the
percentage
of
children
who
receive
adequate
upbringing.
Unfortunately,
there
is
little
that
can
be
done
to
in-
fluence
parents
to
do
a
better
job
of
raising
their
children.
Removing
children
from
inadequate
homes
has
also
proved
unsatisfactory
as
an
overall
solution,
because
all
too
often,
no
better
environment
can
be
found
in
which
to
place
the
child
than
the
one
from
which
he
was
removed.
The
most
promising
method
for
improving
the
quality
of
child
care
in
the
United
States
is
to
ensure
that
no
woman
is
forced
to
bear
an
unwanted
child.
Each
year,
among
the
800,000
women
who
bear
unwanted
children,
many
undoubtedly
are
able
to
provide
adequate
care
for
their
children,
but
just
as
certainly,
many
thousands
are
unable
or
not
motivated
to
do
so.
Common
sense
tells
us
that
a
wanted
child
has
a
much
better
chance
of
receiving
an
adequate
upbringing
than
an
unwanted
child,
and
considerable
research
evidence
exists
to
support
this
assumption.
In
a
follow-up
study
of
120
children
born
after
their
mothers
had
applied
for
thera-
peutic
abortion
but
had
been
refused,
Forssman
and
Thuwe27
found
that
by
the
age
of
21
years,
a
higher
per-
centage
of
these
children
than
that
in
a
control
group
had
required
psychiatric
treatment,
had
engaged
in
crirhe,
had
been
arrested
for
drunkenness,
and
required
more
public
as-
sistance.
In
reviewing
several
studies
of
the
relationship
be-
tween
birth
order
and
incidence
of
mental
disorder,
128
found
that
there
was
a
higher
incidence
of
mental
disorder
among
offspring
in
the
last
half
of
the
birth
order
in
large
families
as
compared
to
the
first
half
of
the
birth
order.
Since
it
has
been
shown
that
the
lower
in
the
birth
order
a
child
is,
the
more
likely
he
is
to
have
been
unwanted,
these
findings
were
interpreted
as
showing
a
causal
relationship
between
unwantedness
and
subsequent
development
of
mental
illness.
Studies29
of
the
battered
child
syndrome
have
revealed
a
high
incidence
of
premarital
conception,
un-
wanted
pregnancy,
illegitimacy,
and
forced
marriage
among
abusive
parents.
In
view
of
the
crucial
importance
to
the
welfare
of
society
that
all
children
receive
adequate
parental
care,
our
present
policy
of
each
year
forcing
800,000
American
women
to
bear
unwanted
children
must
be
regarded
as
a
dangerous
anachronism.
Since
legalization
of
abortion
is
the
most
feasible
way
to
ensure
that
a
high
proportion
of
children
born
are
wanted,
legalization
of
abortion
is
proba-
bly
the
single
most
effective
measure
that
can
be
taken
to
improve
the
quality
of
child
care
in
the
United
States,
and,
by
so
doing,
decrease
the
incidence
of
severe
behavioral
disorders.
Social
Costs
of
Legalizing
Abortion
Legalization
of
abortion
lacks
many
of
the
serious
drawbacks
that
often
prevent
worthwhile
social
reform
measures
from
being
adopted
by
the
public.
Most
proposals
for
improving
society
require
the
expenditure
of
large
sums
of
money,
the
creation
of
new
government
bureaucracies,
increased
government
regulation
of
private
life,
or
whole-
sale
change
in
public
attitudes.
Legalization
of
abortion
would
require
none
of
these
actions.
The
experience
in
other
countries
has
shown
that
after
a
period
of
adjustment,
the
demands
for
abortion
can
be
met
adequately
by
existing
medical
facilities
without
requiring
creation
of
new
clinics
or
hospitals
at
public
ex-
pense.
Since
repeal
of
abortion
laws
would
not
require
ei-
ther
women
or
physicians
to
participate
in
abortions
if
they
chose
not
to,
such
a
change
in
the
law
would
not
infringe
in
any
way
on
individual
freedoms.
On
the
question
of
public
attitudes,
roughly
half
of
the
population
now
supports
the
principle
of
leaving
the
1334
AJPH
OCTOBER,
1972,
Vol.
62,
No.
10
decision
for
abortion
in
the
hands
of
the
woman
and
her
physician.
A
Harris
poli30
taken
in
June,
1970,
shows
40
per
cent
of
respondents
favoring
abortion
on
request,
with
10
per
cent
undecided.
Another
Harris
poll31
reported
one
year
earlier
showed
63
per
cent
agreeing
that"
.
. .
the
abor-
tion
decision
should
not
be
a
matter
of
law
at
all
but
left
up
to
the
woman
and
her
physician."
In
line
with
these
poll
results,
State
legislatures
in
New
York,
Hawaii,
and
Alaska
have
enacted
new
laws
allowing
abortion
on
request
up
to
the
middle
of
pregnancy,
and
the
voters
of
the
State
of
Washington
approved
by
referendum
a
similar
law
on
November
3,
1970.
With
public
opinion
so
equally
divided,
however,
changing
the
abortion
laws
in
the
rest
of
the
fifty
states
through
legislative
action
could
take
many
years.
Fortu-
nately,
there
is
another
way
to
achieve
repeal
not
dependent
on
producing
change
in
public
opinion,
i.e.,
via
court
ac-
tion.
Several
state
and
federal
courts
have
ruled
existing
abortion
laws
to
be
unconstitutional
on
several
grounds,
the
most
important
of
which
is
that
the
abortion
laws
infringe
upon
the
right
of
marital
privacy.
The
United
States
Supreme
Court
is
expected
to
rule
on
appeals
from
the
lower
courts
in
the
near
future,
and
if
they
uphold
these
decisions,
restrictive
abortion
laws
in
all
fifty
states
could
immediately
be
struck
down
without
any
further
efforts
to
influence
public
opinion.
Opponents
of
abortion
argue
that
severe
social
costs
will
result
from
legalization
of
abortion
in
the
form
of
erosion
of
important
moral
values
such
as
the
sanctity
of
human
life
and
traditional
sexual
morality.
They
have
expressed
fears
that
if
abortion
is
permitted
this
could
lead
to
acceptance
of
infanticide
and
other
forms
of
murder,
and
could
also
lead
to
an
increase
in
sexual
promiscuity
since
all
fears
of
becoming
illegitimately
pregnant
will
have
been
removed.
Most
thoughtful
students
of
the
abortion
problem
reject
these
claims,
finding
them
to
be
lacking
in
supportive
evidence.
Certainly
the
experience
of
liberalized
abortion
laws
in
Sweden,
Japan,
and
the
East
European
Bloc
nations
has
provided
little
basis
for
regarding
the
abortion
prohibi-
tion
as
playing
an
important
role
in
preserving
moral
val-
ues.
Conclusions
In
much
of
the
current
debate
on
the
abortion
issue,
the
fact
that
abortion
is
a
highly
effective
method
of
birth
control
has
received
little
emphasis.
Since
the
introduction
of
the
newer
medical
methods
of
contraception
(oral
pill,
IUD)
it
has
become
widely,
but
erroneously,
assumed
that
effective
family
planning
has
become
a
reality
in
America.
Analysis
of
the
limitations
of
our
current
system
of
con-
traceptive
services
reveals
that
the
present
high
rate
of
un-
wanted
births
(800,000
per
year)
probably
cannot
be
signifi-
cantly
reduced
by
reliance
on
contraception
alone.
Legalization
of
abortion
is
the
only
feasible
way
that
we
can
approach
the
traditional
family
planning
goal
of
"every
child
a
wanted
child"
in
the
foreseeable
future.
If,
by
legalization
of
abortion,
a
high
proportion
of
the
800,000
unwanted
births
now
occurring
annually
can
be
prevented,
this
would
make
legalizing
abortion
one
of
the
most
useful
and
effective
social
reform
measures
available
in
our
society.
Among
social
benefits
that
would
result
from
prevention
of
800,000
unwanted
births
each
year
are:
1)
decrease
in
the
U.S.
birthrate
by
more
than
50
per
cent,
2)
substantial
slowing
of
the
rate
of
environmental
deterio-
ration,
allowing
antipollution
technology
to
begin
to
catch
up
with
unmet
needs,
3)
significant
decrease
in
the
in-
cidence
of
poverty,
4)
improvement
in
the
quality
of
child
care,
leading
to
decrease
in
the
potential
incidence
of
crimi-
nality,
psychosis,
drug
addiction,
alcoholism,
and
other
severe
disorders
of
behavior.
These
social
benefits
can
be
achieved
without
the
excessive
costs that
doom
most
desirable
social
reform
measures
to
the
political
graveyard.
Legalization
of
abor-
tion
would
not
cost
enormous
sums
of
taxpayers'
money,
would
not
require
an
increase
in
government
bureaucracy
or
regulation
of
private
life,
and
would
not
require
massive
change
in
public
attitudes.
Possibly
there
is
no
social
measure
with
a
higher
benefit-to-cost
ratio
than
legalization
of
abortion,
and
therefore
none
more
qualified
to
be
given
number
one
pri-
ority
on
the
agenda
of
needed
domestic
social
reforms.
References
1.
Guttmacher,
A.
F.
Induced
abortion.
NYJ
Med.
63:2334-2335,
1963.
2.
Kimmey,
J.
The
abortion
argument:
what
it's
not
about.
Barnard
Alumnae,
Vol.
XIX,
No.
1
(Fall
1969)
3.
Bumpass,
L.
and
Westoff,
C.
F.
The
"perfect
contraceptive"
population.
Science
169:1177-1182,
1970.
4.
Harkavy,
O.;
Jaffe,
F.
S;
and
Wishik,
S.M.
Family
planning
and
public
policy:
who
is
misleading
whom?
Science
165:367-373,
1969.
5.
Guttmacher,
A.
F.
How
can
we
best
combat
illegitimacy?
Medical
Aspects
of
Human
Sexuality,
March
1969,
pp.
48-61.
6.
Ziegler,
F.
J.;
Rodgers,
D.
A.,
Kriegsman,
S.
A.,
and
Martin,
P.
L.
Ovula-
tion
suppressors,
psychological
functioning
and
marital
adjustment.
JAMA
204:849-853,
1968.
7.
Segal,
S.
J.
and
Tietze,
C.
Contraceptive
technology:
current
and
prospective
methods.
Reports
on
Population/Family
Planning,
Popula-
tion
Council.
October,
1969.
8.
Hardin,
G.
The
history
and
future
of
birth
control.
Perspectives
in
Biol.
and
Med.
10:1-18,
1966.
9.
Djerassi,
C.
Birth
control
after
1984.
Science
169:941-951,
1970.
10.
Tietze,
C.
and
Lewit,
S.
Abortion.
Sci.
Amer.
220:21-27,
1969.
11.
Ehrlich,
P.
R.
and
Ehrlich,
A.
H.
Population,
Resources,
Environment:
Issues
in
Human
Ecology.
San
Francisco:
W.
H.
Freeman,
1970.
12.
Cole,
L.
C.
Can
the
world
be
saved?
Bio
Science
18:679-684,
1968.
13.
Borgstrom,
G.
The
Hungry
Planet.
New
York:
Collier
Books,
1967.
14.
Ehrlich,
P.
R.
The
Population
Bomb.
New
York:
Ballantine
Books,
1968.
15.
Blake,
J.
Population
policy
for
Americans:
is
the
government
being
misled?
Science
164:522-529,
1969.
16.
Davis,
K.
Population
policy:
will
current
programs
succeed?
Science
158:730-739,
1967.
17.
Westoff,
C.
F.
The
extent
of
unwanted
fertility
in
the
U.S.
Mimeograph
of
paper
read
at
annual
meeting
of
Planned
Parenthood-World
Popula-
tion,
October
28,
1%9.
18.
Jaffe,
F.
S.
Family
planning
and
poverty.
J.
of
Marriage
and
the
Family
26:467-470,
1964.
19.
Sheppard,
H.
L.
Effects
of
Family
Planning
on
Poverty
in
the
United
States.
Kalamazoo,
Michigan:
The
W.
E.
Upjohn
Institute
for
Employment
Research,
1967.
20.
Campbell,
A.
A.
The
role
of
family
planning
in
the
reduction
of
poverty.
J.
of
Marriage
and
the
Family
30:236-245,
1968.
21.
Moynihan,
D.
P.
An
exchange
of
views:
Nixon's
family
assistance
bill.
New
Republic,
July
19,
1970,
p
31-33.
22.
Bowlby,
J.
Maternal
Care
and
Mental
Health.
Geneva,
World
Health
Or-
ganization,
1954.
23.
Glueck,
S.
and
Glueck,
E.
Unravelling
Juvenile
Delinquency.
New
York:
The
Commonwealth
Fund,
1950.
24.
Saul,
L.
J.
and
Wenar,
S.
Early
influences
on
development
and
disorders
of
personality.
The
Psychoanalytic
Quarterly
34:327-389,
1965.
25.
Menninger,
K.
The
Vital
Balance.
New
York:
The
Viking
Press,
1963.
26.
Albee,
G.
W.
Models,
myths,
and
manpower.
Ment.
Hyg
52:168-180,
1968.
27.
Forssman,
H.
and
Thuwe,
I.
One
hundred
and
twenty
children
born
after
application
for
therapeutic
abortion
refused.
Acta
Psychiat.
Scand.
42:71-
88,
1966.
28.
Schwartz,
R.
A.
The
role
of
family
planning
in
the
primary
prevention
of
mental
illness.
Am.
J.
Psychiat.
125:1711-1718,
1969.
29.
Zalba,
S.
R.
The
abused
child:
A
survey
of
the
problem.
Social
Work
11:3-16,
1966.
30.
Harris
Survey,
Cleveland
Plain
Dealer,
June
22,
1970,
p.
13-A.
31.
Time
Magazine,
June
6,
1969,
p.
27.
Dr.
Schwartz
is
affiliated
with
the
Department
of
Psychiatry,
The
Cleveland
Clinic
Foundation,
2020
East
93rd
St.,
Cleveland,
Ohio
44106.
This
paper
was
submitted
for
publication
in
April,
1971.
SOCIAL
EFFECTS
OF
LEGAL
ABORTION
1335
