Abstract
Federal government policy in the United States lacks uniformity, as is indicated by the fact that the Dept. of Defense permits the performance of abortion for medical and mental health reasons, the Office of Economic Opportunity states that no project funds may be used for any surgical procedure intended to result in abortion, and the Dept. of Health, Education and Welfare has no policy concerning abortion in its programs but that abortion is a reimbursable expense under Title XIX Medicaid payments in enrolled states. This ambiguity of the federal government is considered a reflection of the complexity of the issue and the lack of clear consensus concerning abortion among the American public. Factors that federal family planning officials must consider are: 1) the ethical and moral considerations that confront the individual citizen making a private decusion about abortion; 2) legal and constitutional issues, such as that of discrimination in the availability of abortion services on economic grounds; and 3) the relationship of abortion to public service needs and public health considerations, given that 1/4-1/5 of pregnancies in the United States end in legal or illegal abortion. Clandestine abortion constitutes a significant health problem, accounting for a significant proportion of maternal mortality, especially among the poor (the 1967 rate of reported mortality due to abortion with sepsis being 7 times greater for nonwhites than whites). The Office of Economic Opportunity in reassessing its current policy needs to ascertain the standards of medical care, cost projections, and logistics of providing abortion services. It is recommended that abortion services be combined with serious efforts to provide effective subsequent contraception, as abortion as an exclusive method of birth control would cost up to $2000 per year while the provision of high quality family planning services is $60-$80 per woman per year.
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