ratio reaching a maximum of almost 1,400 abortions per 1,000 live births in 1964.

In Czechoslovakia, legalization of abortion for nonmedical reasons in 1957 was preceded by almost two years of public discussion. Moderate increases in the abortion rate in 1956-1957 reflect the changing attitude of the medical profession. Promulgation of a new and liberalized abortion law in December 1957 was followed by an eightfold rise in legal abortions in the next year. The rise continued at a decelerating pace until 1961, when the total reached a peak of 94,300 followed by a decline to less than 71,000 in 1963-1964, obviously in response to restrictions imposed in 1962. This drop was followed by another rise to 102,800 in 1969, exceeding the peak of 1961, and another decline to 91,300 in 1972.

Data for Romania are fragmentary. According to reports in the literature that could not be traced to an official source, 112,100 legal abortions were performed in 1958, the first full year after elective abortion was legalized, and 219,100 were performed in 1959 (71). After a lapse of several years, during which no statistics were released, the Romanian Communist Party announced a total of 1,115,000 abortions for 1965, corresponding to an abortion rate of more than 250 per 1,000 women of reproductive age and a ratio of more than 4,000 abortions per 1,000 live births (92), suggesting a low level of contraceptive use. It is not clear whether the reported total included incomplete abortions admitted to hospitals; however, the number of such cases could not have exceeded 100,000, or one-tenth of the total. For 1967, a report of 51,700 legal abortions was found in the files of the World Health Organization, but all reports for later years (64) apparently include all abortions, legally induced or admitted to hospitals for aftercare following a spontaneous or an illegal abortion.

The USSR published some sta

tistics during the 1920s and 1930s, but they were not for the entire country. Although it has been reported that abortion statistics are currently compiled in the USSR, none have been published officially for more than three decades. The figures shown in Table 1 are based on a set of abortion ratios per 1,000 births and a crude abortion rate per 1,000 population, respectively. As in the case of Romania, it is not certain whether these data refer to the entire population of the USSR, nor whether they are limited to legal abortions, excluding women admitted to hospitals for aftercare or for complications of abortion. All that can be deduced from these and other fragmentary data is that the incidence of abortion in the USSR has been very high in recent years.

EAST AND SOUTHEAST ASIA

In Japan, Article 14 of the Eugenic Protection Law of 1948 permits termination of pregnancy in a woman "whose health may be affected seriously by continuation of pregnancy or by delivery from the physical or economic viewpoint" (77, p. 68). The interpretation of this paragraph by the medical profession and by the authorities has been tantamount to making abortion available on request. As shown in Table 1 the reported number of legal abortions and the abortion rate and ratio reached their peaks in 1955/ 1956. From then to 1967, the number of abortions declined by 36 percent, the abortion rate per 1,000 women of reproductive age, by 48 percent, and the abortion ratio per 1,000 live births, by 45 percent. Since 1967, changes have been minor.

Because the variation among the prefectures of Japan in the levels of abortion rates and ratios is far greater than could be explained by differences in the level of urbanization and other socioeconomic factors, Japanese scholars have argued that the reporting of legal abortions by physicians performing them is grossly incomplete in many

TABLE 5 Legal abortion rates and rate indices by age of woman at termination: Selected areas and years (continued)

places and, hence, for Japan as a whole (79). According to an estimate by Muramatsu, also shown in Table 1, it is possible that two out of three legal abortions escape registration, that the completeness of reporting has declined from 1955 to 1965, and that the number of abortions during this period was twice as large as the number of births (78).

Table 2 presents data on the lifetime experience with induced abortion obtained in a survey of a sample of the general population conducted in 1971 by the Population Problems Research Council of the Mainichi Newspapers (69). About one-tenth of the respondents did not answer any of the questions relating to their experience with abortion. It appears reasonable to assume that some of the women who failed to answer questions on abortion had in fact had abortions and that the average number of abortions among the nonrespondents and the respondents reporting abortions was the same. The fact that after correction for underreporting, the mean number of abortions and the abortion ratio per 1,000 live births reported by the older women in the survey were of the same order of magnitude as the corresponding figures derived from the number of abortions reported by physicians is probably a coincidence.

In Korea, the incidence of abortion increased rapidly during the 1960s. The data shown for Korea in Tables 1 and 3, based on a survey of 6,300 women conducted in 1971 (50), are believed to be among the most complete data on experience with induced abortion obtained so far by direct questioning. Abortion was illegal during the years covered by the survey but was easily available because of the relaxed attitude of the medical profession. Furthermore, two-thirds of the respondents did not know that the procedure was illegal. In 1973 legislation was adopted authorizing termination of pregnancy on medical, eugenic, and jurídical grounds (66A).

England and Wales

(Residents)

1968

1969

1970

In Taiwan, abortion remains illegal but physicians appear to be performing abortions readily. Direct questioning in a series of surveys produced substantially smaller percentages of women reporting induced abortion than in Korea, but one recent survey, using the randomized response technique (Table 2) suggests a level of incidence equal to, if not higher than, that in Korea (19, 20). Singapore liberalized its abortion law in 1969, permitting termination of pregnancy on medical and social grounds (96). The number of legal abortions performed under this law has increased from year to year but was still quite modest in 1972. It is believed that illegal abortion has made a major contribution to the recent decline of the birth rate in Singapore and in Hong Kong.

79

126

888

43

74

126

49

87

144

34

54

59

62

67

64

64

59

49

39

59

61

74

countries of south central Asia. For India, an estimate of four million illegal abortions per year has been quoted, corresponding to an abortion ratio of 170 per 1,000 live births (43). Because the birth rate is high, the abortion rate should be in the vicinity of 35 per 1,000 women aged 15-44 years. In 1971, India adopted an abortion statute patterned after the British Abortion Act of 1967 with the important addition that, in the case of a married woman, a pregnancy resulting from contraceptive failure "may be presumed to constitute a grave injury to the mental health of the woman" (57, p. 966). Implementation of the new statute has been