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[Welfare] - State Social Welfare Board - Unplanned Parenthood, April 1974 (2 of 2)
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118565144
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[Welfare] - State Social Welfare Board - Unplanned Parenthood, April 1974 (2 of 2)
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Ronald Reagan's Governor's Papers of the Press Unit
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Ronald Reagan Presidential Library Digital Library Collections This is a PDF of a folder from our textual collections. Collection: Reagan, Ronald: Gubernatorial Papers, 1966-74: Press Unit Folder Title: [Welfare] - State Social Welfare Board - Unplanned Parenthood, April 1974 (2 of 2) Box: P39 To see more digitized collections visit: https://reaganlibrary.gov/archives/digital-library To see all Ronald Reagan Presidential Library inventories visit: https://reaganlibrary.gov/document-collection Contact a reference archivist at: [email protected] Citation Guidelines: https://reaganlibrary.gov/citing National Archives Catalogue: https://catalog.archives.gov/ parental consent is necessary before medical care can be provided to a minor; otherwise the care constitutes an unauthorized touching - the tort or wrong against the person called battery. But there have always been exceptions to this rule. Harriet Pilpel and Nancy Wechsler review these exceptions in their two excellent articles on this subject in Family Planning Perspectives, Spring 1969 and July 1971. Since many of us fall into the trap of saying that parental consent is always necessary before medical care can be provided to a minor, let me review the exceptions: - in cases of emergency (one might view lack of contraception for a sexually active minor as an emergency) - when the minor is emancipated, which is a question of fact (e.g., married, in the armed forces, living away from home, self-supporting) - in cases of parental neglect (one might view refusal or failure of parents to consent to contraception for a sexually active minor as parental neglect) - when the minor is a 'mature' minor, the procedure is for the benefit of the minor, and the minor can understand its nature and consequences (increasingly the emerging doctrine of the mature minor is being recognized by courts in varying circumstances). (Legal Aspects of Access to Family Planning Services) There is a clear intent on the part of some family planning agencies and clinics to subvert the long-standing rule of law relating to parental consent. The only argument that can be made in support of this position is that "the end justifies the means". This attitude is always dangerous, but it is especially so when a third party is interjected into the relationship between the child and his parents. Family planning information and counseling may be given to a minor without the parent's consent or knowledge; however, upon the state permitting such an intrusion into parental authority the state then assumes the responsibility to assure that those persons providing such informational and counseling services are sufficiently trained in accordance with statewide standards established by the Department of Health. A minor child is permitted to obtain contraceptive devices from trained medical personnel without obtaining parental consent upon such medical practitioner determining that there is a likellhood of conception unless such device is provided. A minor child may obtain prescriptive contraceptives provided they are prescribed by a licensed doctor, if he finds the prescription is necessary to prevent conception. The use of prescriptive contraceptives may continue subject to the parent's right to modify or terminate such course of treatment. Ideally, parents should take responsibility for initiating ongoing discussion of this very sensitive and important subject with their children. This lost opportunity on the part of parents and the information void, from the standpoint of the children, is being partially filled by family planning clinics. -76- What is clear is that in recent years there has been a substantial increase in the availability of birth control information to children and adults alike. This service is provided through a vast number of public and private agencies funded through the use of donated funds and tax funds. It is also clear that this information resource will continue to undergo significant expansion in the coming years. A further aid to expansion is the fact that under the new Social Service Regulations published by the United States Department of Health, Education, and Welfare in May 1973, family planning (birth control) is one of those services which is mandated and will receive more favorable funding consideration. The Board supports the broad availability of birth control information services to adults as well as children under certain circumstances. In this context, however, the Board is concerned about two important points. First, there are Insufficient standards or guidelines to define and assure the provision of quality services in all types of public and private birth control information programs. Most responsible public and private agencies have established their own independent guides and standards; however, such a fragmented approach does not provide adequate protection to the public. The California State Department of Health, as the appropriate state agency, should develop guidelines and standards for birth control services and take the necessary steps to ensure that these requirements are met by providers of birth control services throughout the state. The second major problem in the viewpoint of the Board is the fact that there are essentially no qualifications which individuals providing birth control information services are required to meet. This state and/or its political subdivisions licenses doctors, teachers, psychologists, contractors and barbers as well as a host of other professional individuals and craftsmen, many of whom are engaged in activities having far less significant social im- pact than do those persons involved in disseminating birth control information. Many individuals currently providing birth control information services are highly qualified professional persons who have adequate background and training to provide such services. It is the Board's contention, however, that the significant and rapid growth in the family planning field has resulted in a substantial number of people with notably little background or experience being placed in the position of providing such services. There is a need to establish some basic qualifications in terms of education, experience or training which the Individual purveyors of family planning services would have to meet. The California Business and Professions Code Section 17800 et seq. governs the licensing of persons engaged in marriage, family or child counseling. A legal interpretation of this section reveals that the provisions do not apply to persons engaged in providing family planning services. It is the Board's viewpoint that this section of the Business and Professions Code should be amended to provide for licensing of family planning practitioners and that the basic qualifications as suggeste above, when met, should represent a prerequisite for state licensing. -77- D. Psychological Vulnerability in Birth Control Earlier sections of this report have primarily dealt with the dissemination of birth control information to children and the importance of this factor as it relates to their protection, especially during the time of the child's awakening sexuality. In fact, there are a number of circumstances and stages which occur during the individual's lifetime which have been found to have a significant affect on the individual's motivation with respect to birth control protection. Dr. Miller has reported on his research of women who were seeking a therapeutic abortion. He was interested in determining why these women got pregnant, their subsequent behavior (request for abortion) indicating that the pregnancy was rejected and they did not want to have the baby. He identified a number of situations and circumstances which resulted in psychologically vulnerable stages in the life of the fertile woman which affected her motivation to properly utilize birth control tech- niques and devices. These stages of vulnerability as identified by Dr. Miller are as follows: 1. During early adolescence, a. when fecundity is absent or low, but increasing, and as a consequence, contraceptive diligence is infrequently developed. 11. At the start of the sexual career, a. at the time of the first few intercourses, for which there is typically no contraceptive preparation; b. during the six months afterwards, until the woman recognizes and acknowledges the beginning of her sexual career. 111. In relation to a stable sexual partner, a. while the relationship is in the stage of development, before a stable sexual and contraceptive pattern has been established; b. during conflict or separation, when patterns of communication and cooperation are disrupted and the sense of interpersonal loss may be acute; C. after breakup with the partner with whom a particular sexual and contraceptive pattern have been established; (1) when situationally reexposed to the old partner, but without access to the previous contraceptive method; (2) when exposed to new partners with different sexual and contraceptive styles. IV. After geographic mobility, a. when there are major changes in social fields such that sexual contraceptive norms and opportunities change; -78- (1) after moving away from home and family; (2) after moving to a new socio-cultural area. V. In relation to marriage, a. just before or just after, a contraceptive diligence is relaxed; b. during conflict or separation; C. after separation or divorce. VI. After each pregnancy, a. during the postpartum period, when there is subfecundity, altered sexual activity and, often, the use of interim contraceptive methods; b. when a new level of contraceptive diligence is required as a result of the demand brought about by a new baby. VII. In relation to the end of child bearing, a. when the decision to stop having children is being dealt with. VIII. During menopause, a. when fecundity is decreasing and as a consequence, contraceptive diligence is waning. A significant part of the activity and resources of public and private family planning agencies is directed toward providing birth control information to teen-agers. The youthful age groups have been identified as a target group within which there is a significant need for these services. The Board generally concurs with this viewpoint; however, it suggested that such agencies need to recognize other factors which affect conception vul- nerability and to broaden their program to include these target groups as well. It is suggested that the kinds of research summarized above, can serve to identify such other target groups which should be Included in the expanded programs. E. The Moral Issue in Family Planning Another major issue in agency rendered family planning services is the method of presentation of the material. Basic to this issue is the concern that the simple presentation of cold factual information to the child without some moral frame of reference a possibility which can more easily arise in a clinical environment than in a parent-child relationship will represent nothing more than a "how-to-do-it" approach. There are those family planning advocates who tend to deny that they have a responsibility beyond simply providing information and permitting the child to make his own choices. -79- This attitude is similar to providing a young person with the knowledge required to fire a rifle without acquainting him with safety measures and the legal and moral implications of injuring another person or taking a human life. It is a question that has been much debated, but never resolved. Family planning agencies must come to grips with this issue now in order for their credibility to be accepted by the public. Since these agencies are injecting themselves into a subject matter which has a very deep and lasting social and family significance, they must go far beyond the mere providing of cold clinical information. Consider one comment on the related subject of sex education: "If indeed, a person by understanding what I like to call education for human sexuality rather than just sex education, goes ahead and engages in sexual activity, is this harmful? We have never been able to find any kind of proof that if we remove the telltale symptoms, such as pregnancy and venereal disease, that sexual activity is harmful. If there is no venereal disease, because we are so educated that we know how to prevent it, if we have no pregnancies, because we are also educated to prevent pregnancy, what indeed is the harm of sexuality?" This statement is not only simplistic, but it is inconsistent with family attitudes upon which our social norms are based. The attitude expressed in the above few sentences represents the nub of the problem associated with providing birth control and sex information to minors. A common feature of relatively new and rapidly developing social programs is that they tend to draw together those individuals who are prone to express what they view as the advanced thinking of the profession. While the Board certainly favors creative thinking and innovation, it suggests that in the area of birth control, especially as related to minors, the public expression of extreme viewpoints does a disservice to the profession as a whole, par- ticularly in such a sensitive area as birth control. It is suggested that one way in which the public and private family planning agencies can encourage greater acceptance of their service would be to recruit the membership of their policy making boards from among interested citizens and concerned parents residing in their service area. With citizen input into their policies, such agencies might better reflect community attitudes on sexuality, particularly in the area of service to teens. F. Other Considerations in the Delivery of Birth Control Services At the present time, birth control services are provided throughout the State of California by a host of public and private agencies on a drop-in basis. In spite of the fact that such services have reached vast numbers of people in this state, those persons served thus far represent only a small part of the target or vulnerable groups which need such family planning services. -80- Family planning services should also be offered on a voluntary basis to other target groups who do not now have these services generally available to them. For example, reference is made to the number of women who are residents in public and private medical and psychiatric hospitals and in county and state penal facilities. In many instances, the contraceptive program used by women are seriously disrupted when they enter such institutions are either on a temporary or longer term basis. Their release and return to normal family relationships without adequate provision for birth control information and resumption of their contraceptive program makes them par- ticularly vulnerable. Early efforts to provide family planning services, particularly to women incarcerated in county and state penal institutions have met with much success. Some progressive county jails have permitted the development of voluntary family planning programs operated by local volunteers and the acceptance of these programs by female inmates has been enthusiastic. Another example of such an Innovative approach on a broader scale is a highly regarded family planning program directed toward young men functioning within California Youth Authority facilities. The significance of these kinds of programs points out the need for public and private family planning agencies to develop approaches for bringing these services to men and women who are facing a time of high vulnerability. Another important concern relates to the role and responsibility of the welfare system for providing information and referral services to their clients needing family planning services. At present, family planning services to current, former and potential recipients of welfare in California are provided by local health departments under a contract between the State Department of Benefit Payments and the State Department of Health. Local welfare staff has responsibility for providing information and referral services and local agencies outside the welfare department are responsible for providing the birth control services. Too often, local welfare staff members have not received sufficient training and experience in family planning services to feel comfortable in raising this issue with their recipient-clients. In too many instances, information and referral services to a family planning resource means simply providing the recipient with the name, address and telephone number of the service agency. The same kinds of motivational problems exist with respect to the woman making her way to the family planning agency as exists in the woman using birth control information and devices once they have been provided. Welfare staff needs to be sufficiently informed and trained about family planning considerations so they will be able to speak comfortably about this subject and further consideration must be given to follow-up activities to ensure that the recipient actually reaches the family planning agency to which she has been referred. Motivating the individual to recognize the need for birth control services and effectively utilizing such services remains a significant problem. Motivational considerations require that the presentation of birth control -81- Information must go far beyond the mere presentation of factual clinical data. The entire conception process must be explained in sufficient detail and understood so that the recipient of these services, male or female, will have a clear concept of his vulnerability and need for protection. There is ample research to demonstrate that, for the most part, conceptions of unwanted pregnancies result more from human failing than from ineffectiveness of a particular birth control device or method. For example, in the Board's two-county survey of 259 paternity cases (Appendix 6i), 46% of the mothers had received some type of training in birth control and a larger percent had an awareness of the subject matter. However, 88% of the mothers in these cases falled to use any protective device or method during the period of conception. Effective pregnancy prevention requires planning and self-discipline. Many young girls are reluctant to consider consciously the possibility of inter- course in advance and, consequently, do not take adequate precautions. Unfortunately, the female has had to assume major responsibility for guarding against conception due to the relative ease and increased use of the pill. In the minds of many males, they are relatively free of responsibility. They tend to relate the use of the condom more to venereal disease prevention than to pregnancy prevention. As stated earlier, when researchers asked a group of young unwed fathers why they had not used this form of protection, the usual response was, "She's not that kind of a girl." This attitude places an unequal and an unfair burden on the woman. Birth control services have the potential of resulting in great public good. The broad and effective dissemination of this information can help childless couples with their problems; can assist other couples in determining the number and spacing of the children they will have; and assist others, particularly teen-agers, by providing protective information as a means of preventing conception outside of marriage. There are many serious unresolved problems connected with the providing of these services, and there continues to be a heated controversy over many of the issues. Although the proposals suggested herein by the State Social Welfare Board do not purport to address themselves to all of the problems, the Board suggests that the adoption of these principles and recommendations will represent significant progress toward the development of a rational public policy on this sensitive matter. -82- VIII. ABORTION In 1971 the State Social Welfare Board was requested by James Hall, Secretary of the California Human Relations Agency, to make a study of abortion. Therefore, testimony on the subject and its possible impact on society was sought at the public hearings on illegitimacy. This section deals with information gleaned from the hearings, related extensive research, and observations gained from both. Abortion is the termination of pregnancy via expulsion of the fetus or an embryo from the uterus. There are two types of abortion: spontaneous, commonly referred to as miscarriage, and induced. Between 10 and 15 percent of all pregnancies end in spontaneous abortion. Over 116,000 legally induced abortions were performed in California in 1971. The terms legal and therapeutic are used interchangeably in this report to describe certain induced abortions. This specific type of induced abortion is the subject of this section. A. Philosophical and Historical Perspective As was stated in the earlier section on family planning, legal abortions became more socially acceptable as a result of the merging of previously divergent viewpoints with respect to women's rights, population control, the problem of illegal abortions, and the attitudes of certain segments of the medical profession. This was not an easy transition. The passage of legal abortion acts in states across the country did not occur without heated debate and the subsequent court decisions related to these statutes served to spark additional dialogue. The fact that California enacted its Therapeutic Abortion Act on November 8, 1967, has not quelled the debate in this state. Essentially, the pro-abortionists defended the act and sought further liberalization based upon their protestations that every child should be a wanted child; that parents should be able to determine the number of children and the spacing of their children; and, it is the right of every woman to determine whether or not she will bear children. Birth control techniques and devices had come into increased use. However, not all of these proved to be totally effective and most require planning and self-discipline which tend to be inconsistent with the timing and emotional nature of sexual relations. "Abortion, then, appeared as the surgically certain way of eliminating accidents, the completely effective way of preventing unwanted children. Through abortion, the individual's control of the consequences of his sexual freedom was affirmed." The Morality of Abortion In discussing this "backstop" concept of abortion, Dr. Kingsley Davis has stated: "In current thinking, legalized abortion is also often regarded as a preventive measure. In my view, it is likely, at least in the short run, to be more effective than stepped- up contraceptive programs in reducing the number of children with inadequate parents. Since sexual intercourse is an ephemeral -83- activity engaged in under many kinds of situations and under varying degrees of emotional rationality, it is not always compatible with a systematic utilitarian use of contraception. Further, the best contraceptives from the standpoint of female health (the condom and spermicidal jellies) are not necessarily the best from the standpoint of birth control. Abortion, on the other hand, is a back-up measure that can be used when, for whatever reason, unwanted pregnancy has ensued. There is plenty of time to seek objective advice and to make a careful decision. If the girl has taken a chance and lost, abortion allows her to avoid the full penalty of having an unwanted child." This "backstop" concept, cited by Davis and others, is held as justification for aborting the unwanted child and, in many cases, has replaced the former practice of giving life to the child and then placing it in an adoptive home where it is wanted. Antiabortionists plead for the right to life of the fetus and express concern about the moral and social consequences to the individual and members of a society which legitimize pregnancy termination on a wholesale and "demand" basis. In support of their argument that the fetus is an unborn child endowed with life, they point out that the fetus has a heartbeat within 18 to 25 days; has human brain waves within six weeks; moves within six weeks; and, breathes within 12 weeks. The debate continues to rage at both the state and national level, and there is every reason to believe that it will continue into the future. A constitutional amendment banning most abortions has been proposed by a member of Congress. The proposal in effect defines life as beginning at the moment of conception, a position which is disputed in medical circles and among abortion advocates. Also, on this particular subject, welfare laws and regulations have coped with an issue which has, so far, been sidestepped by law makers and social planners. As soon as a female welfare recipient has a verified pregnancy, her grant may be increased to account for the additional "person" (the unborn child). This factor suggests that two realities must be faced: That life begins at the time of conception and that abortion is, in fact, the taking of a life. With this in mind, more rational decisions should be made with respect to public policy on the important question of abortion. It is clear that societies in western civilization have long demonstrated a moral, social, legal and religious abhorrence toward abortion. Generally, the only recent exception to prohibiting abortions was in those cases when the procedure was necessary to save the life of the expectant mother. The exception has now become the rule, changes have been made in abortion statutes tending to overlook moral, legal and religious considerations and without a basis of facts on social consequences, good or bad. It was in the midst of this controversy and debate that the California Legislature enacted the California Therapeutic Abortion Act which became Section 25950, et seq., of the Health and Safety Code. The particular provisions of these sections, the court decisions affecting them, the particular applications and misapplications of this law will be the subject of this section. -84- B. Statistical Perspective The year 1968 was the first year of full implementation of California's Therapeutic Abortion Act. In that year, there were 5,018 abortions performed under the provisions of this act and within four years, this number had increased 23-fold to more than 116,000 therapeutic abortions in the year 1971. The increasing number of abortions performed each of the four years is shown in the following chart. Therapeutic Abortions Performed in California 1968 5,018 1969 15,339 1970 65,369 1971 116,749 Appendix 10 describes some of the selected characteristics of the women having abortions in California during the years 1968 through 1971. Some of the significant characteristics shown in Appendix 10 are the fact that over half the women receiving abortions in 1971 had never been married. Over 31 percent of the abortions performed in that year were performed on women under the age of 20 years. Ninety percent of the abortions performed in 1971 were performed in private hospitals as opposed to county medical facilities, and more than 30 percent of these surgical procedures were paid for at public expense. Another significant feature is the increased representation of black women in the population receiving abortions from 7.2 percent of the total in 1968 to 13.7 percent of the total in 1971. Of the 116,749 abortions performed in the year 1971, 104,844 were performed on women who were residents of the State of California. The startling fact is that over 1,100 of these abortion procedures were performed on young girls between the ages of 10 and 14 years. These children are included in the 31 percent of the abortions performed in California in 1971 on girls age 19 and under. The following chart reflects the numbers of abortions performed in the various age groups. Therapeutic Abortions Performed in California in 1971 By Age Groups Age Groups Number 10-14 years of age 1,166 15-19 31,806 20-24 35,988 25-34 27,940 35-44 7,944 -85- As stated in the section "Dimensions of the Illegitimacy Problem", there seems little doubt that the increased use of therapeutic abortions in California has had an effect on illegitimate births. For example, of the 65,529 abortions performed under California's law in 1970, 48,205 were performed for unmarried women (never married, widowed, divorced or separated). Further, Berkov and Sklar point out certain parallels between the characteristics of mothers of illegitimate children and those who receive abortions. In 1971, the age group between 20 and 24 had the largest drop in the illegitimate birth rate. This age group also had the highest therapeutic abortion rate in 1970. C. Relationship of Therapeutic Abortions to Illegal Abortions A significant feature of the increased number of legal therapeutic abortions in California is its estimated effect on illegal abortions. For obvious reasons, the number of illegal abortions performed in California at any given time is not known. However, a recent study of both spontaneous and illegal abortions in urban North Carolina indicates that in the 18 to 44 age group, it was estimated that the proportion of white women having induced abortions was 13.9 per 1,000 and the proportion of nonwhite women was 68.1 per 1,000. The Board expresses a note of caution on the applicability of this data to California, especially in view of the sparcity of other research information. The California Department of Public Health has applied these rates to the number of California women ages 15 to 44, and estimated there were over 80,000 illegal abortions in the state in 1967. Thus, it was not until 1971 that therapeutic procedures exceeded the previous level of illegal abortions. From 1968 through 1970, it appeared that therapeutic abortions were replacing illegal ones. This indicates that despite the increases in therapeutic procedures, the rate of total induced abortions (illegal plus therapeutic) did not really change until 1971 when the rate for therapeutic abortions was greater than that estimated for illegal procedures in 1967. Public attitudes about illegal abortions as reflected in the various California legal codes are quite clear. For example, Business and Professions Code Section 601 provides that advertising for producing or facilitating an abortion is a felony. Business and Professions Code Section 2377, provides that aiding or abetting or attempting or agreeing or offering to procure a criminal abortion constitutes unprofessional conduct by a physician. Under Section 2761, a nurse may be the subject of disciplinary action for being involved in a criminal abortion. The license of a vocational nurse may be suspended or revoked for similar conduct under Section 2878. Similar action can be taken against a psychiatric technician under Section 4521. Penal Code Section 187-a defines murder as the unlawful killing of a human being or a fetus with malice aforethought, but further qualifies the definition of murder involving a fetus so as to be consistent with the provisions of the California Therapeutic Abortion Act. Several other sections of the Penal Code describe the punishment for soliciting the use of or supplying chemicals and/or instruments designed for the purpose of inducing a miscarriage. From this, it can be seen that public policy took a clear and opposing view of criminal abortions. -86- D. The Therapeutic Abortion Act in Practice California's Therapeutic Abortion Act was passed in November 1967. Essentially it provides that the holder of a Physician's and Surgeon's Certificate may perform an abortion if each of the following requirements is met: 1. The abortion is performed in a hospital accredited by the Joint Commission on Accreditation of Hospitals. 2. The abortion is approved in advance by a committee of the medical staff which is established and maintained according to the standards of the Joint Commission and if such committee consists of no more than three licensed physicians, the unanimous consent of all committee members is required to approve the abortion. 3. The committee of the medical staff finds that one or more of the following conditions exist: a. There is substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother; b. The pregnancy resulted from rape or incest. The law also provides that the above-described committee must consist of not less than two licensed physicians, but three are required if the pregnancy is to be terminated after the thirteenth week and in no event shall the termination be approved after the twentieth week of pregnancy. The California Department of Public Health estimates that prior to 1967, there were fewer than 600 legal abortions per year performed in all California hospitals. It is presumed that most of these abortions were performed because of the danger to the mother's physical health and relatively few were performed following rape or incest. Only four years later, in 1971, the number of therapeutic abortions performed in this state jumped to 116,749. It is estimated that an excess of 90 percent of these abortions were performed under Health and Safety Code Section 25951 (c) (1) holding that the continuance of the pregnancy would gravely impair the mental health of the mother. The term "mental health" as used in Health and Safety Code Section 25951 is defined in Section 25954 and means "mental illness to the extent that the woman is dangerous to herself or to the person or property of others or in need of supervision or restraint. This definition appears to be even more stringent than that contained in Welfare and Institutions Code Section 5150. This section describes the individual's psychiatric condition in circumstances when she may be involuntarily detained for evaluation and treatment. That definition reads "When any person as a result of mental disorder, is a danger to others, or to himself, or gravely disabled, The enactment of California's Therapeutic Abortion Act opened the door and from that time on, relatively little attention was paid to the specific requirements of the statute by a number of large-scale abortion facilities in the state. -87- In many facilities, the pregnant woman simply makes written application for an abortion, indicating that unless the abortion is approved her mental health will be impaired and the abortion is approved solely on the basis of the unverified written application. The law specifically requires the establishment of a committee structure maintained in accordance with standards promulgated by the Joint Commission on Accreditation of Hospitals. An accreditation surveyed by the Joint Commission involves a detailed study of the administrative and medical- psychiatric practices in each accredited institution. California's law has been in effect for six years and it is curious that the Joint Commission has not publicly raised questions about the informal functioning of the Therapeutic Abortion Committee in a large number of public and private facilities across the state. The California State Department of Public Health reports that in 1970, 17 hospitals, each performing over 1,000 abortions, accounted for over 27,000, or 42 percent of the total 65,369 procedures. In 1971, the number of institutions performing more than 1,000 abortions each increased to 22 and they did more than half (51 percent) of the 116,749 abortions that year. The distribution of therapeutic abortions among medical facilities in this state is quite interesting. Appendix 11 reflects the number of therapeutic abortions reported by county and individual hospitals throughout California in 1971, as well as the abortions performed in these facilities, other than those in Los Angeles County, in the first quarter of 1972. This information reveals that reports on therapeutic abortions performed were received from 351 public and private hospitals in 48 counties. It is interesting, however, to note that four hospitals in Los Angeles County (Avalon Memorial, Los Angeles- University of Southern California, Parkwood, and San Vincente) accounted for over 29,000 abortions which represented 25 percent of the total abortions performed in the State of California in the year 1971. In its Report to the 1972 California Assembly on the Effects of Therapeutic Abortion Law on the Medical Profession, Patient-Doctor Relationships, Relationships Between the Medical Profession and General Public, the California Department of Public Health stated on Page 2: "Within the medical community, therapeutic abortions have changed from a rare operation in 1967 to the most common surgical procedure in the state in 1971. As mentioned earlier, in relation to the subject of family planning or birth control, a whole new medical industry has been created with significant fiscal ramifications. The average cost of a therapeutic abortion is $250 Applying this amount to the 116,749 abortions in 1971 reveals that the fees for this service totaled almost $30 million during that year, approximately 40 percent of which was reimbursed by public tax-supported medical care programs. Misapplication or misuse of the California Therapeutic Abortion Statutes is not restricted to the abortion procedure itself, but rather includes other aspects as well. The same problems identified earlier with respect to birth control also exist in relation to abortion counseling, but are considered to be more serious because of the possible consequences. There are no statewide guidelines which require that individuals or agencies meet certain standards of quality for the service they perform, nor are -88- there requirements that the individuals performing pregnancy counseling and referral services must meet certain qualifications in terms of their education and experience. Obviously for the protection of pregnant women, standards of service and educational and experience criteria must be established by a responsible agency of state government and then enforced on a uniform statewide basis. At one of its public hearings, the Board received testimony from Stewart Knight who alleged that there exists in the State of California the practice of referral payments between pregnancy counselors and medical centers which provide abortion services. The magnitude of this particular problem is unknown, but the possibilities could be substantial considering the number of therapeutic abortions performed in California. In that 40 percent of the abortions performed in this state are financed through Medi-Cal funds, the improper expenditure of public funds also raises serious questions. As a part of the effort to develop standards for quality service and minimum qualifications for individuals engaged in pregnancy counseling, legislation should also be enacted to prohibit the soliciting or payment of a fee for referral to an abortion service. The Board is concerned about the apparent conflict of interest involved in such a situation in which implications of such counseling and referral services may exert influence on the emotional young women to seek an abortion. In the face of the turmoil and emotional debate the United States Supreme Court, in a seven to two decision, overruled all state laws that prohibit or restrict the woman's right to obtain an abortion during her first three months of pregnancy. An analysis of the key features of the ruling are as follows: 1. For the first three months of pregnancy, the decision to have an abortion lies with the woman and her doctor, and the state's interest in her welfare is not "compelling enough" to warrant any interference. 2. In the second trimester of pregnancy, a state may regulate the abortion procedure in ways that are reasonably related to maternal health, such as licensing and regulating the persons and facilities involved. 3. For the last ten weeks of pregnancy, the period during which the fetus is judged capable of surviving if born, any state may prohibit abortion, if it wishes, except where it may be necessary to preserve the life or health of the mother. The California State Supreme Court in December 1972 threw out all requirements for abortions in California except that they be performed by licensed physicians in accredited hospitals before 20 weeks of pregnancy. The U. S. Supreme Court decision went beyond this and threw out all requirements in the first trimester (12 weeks) except that the abortion be performed by a licensed physician. Further, the decision provides for abortion up to 24 weeks as compared with California's 20-week restriction. -89- The force and effect of both the California Supreme Court decision and the United States Supreme Court Decision on this state was not that significant. Essentially, what the courts have done was to simply legitimize a practice which already existed in California resulting from the misuse of this state's therapeutic abortion statutes. Even the United States Supreme Court decision of January 22, 1973 and a February 26 denial of petitions for rehearings by Texas and Georgia failed to settle the social issue or quell the debate. By the end of February at least nine states had introduced legislation that would bring their laws into conformity with the decision and an equal number were working on new legislation. One state legislature which had acted by that time, the State of Virginia, rejected a bill that would have brought its law into line with what the court said. In more than a dozen states, attorneys general or local courts have declared existing abortion laws null and void, but in at least five states legal or judicial authorities have supported the old restrictive laws. However, despite actions of the court, various efforts are being made to nullify the recent Supreme Court decision: 1. A constitutional amendment was introduced in Congress which would call for legal protection of life from the moment of conception. 2. Another proposed constitutional amendment was introduced in Congress to give states the unqualified right to make their own abortion laws. 3. Several state legislatures have introduced (and one state passed) resolutions to endorse a federal constitutional amendment to supersede the Supreme Court decision. E. The Process and Procedures There has been a rapid growth of pregnancy counseling services since the Therapeutic Abortion Act became effective. Preliminary survey data from the California State Department of Health indicates about half the women obtaining abortions in 1971 used counseling services. The effect of such services tends to limit the physician's role to a medical assessment of the patient and the application of his technical skills. Pregnancy counseling and, in particular, abortion counseling represents a new and unique service. The Department has identified 110 pregnancy counseling agencies in California. The following kinds of organizations are providing these services: Planned Parenthood-World Population, county health and welfare departments, The Children's Home Society, University Hospital and Health Services, free clinics, Community Crisis Centers, Women's Liberation, Zero Population Growth, and the Association to Repeal Abortion Laws. Private individuals are also offering pregnancy counseling services. The Board has previously expressed its viewpoint on the need for criteria to assure quality service and the establishment of qualifications for individuals providing pregnancy counseling services. -90- The pregnancy counseling agency is acting as an intermediary between the patient and the doctor. There is no specific legal authority for this practice. After the patient makes the decision as to whether or not the pregnancy will be continued, she is referred to the appropriate medical resource for either prenatal care or therapeutic abortion. The exchange of information about pregnancy alternatives, assessment of emotional needs, and even the institution of follow-up, if any, is carried out largely by the counseling service. The role of the physician is limited to the physical assessment of his patient and implementing the medical procedures whether it be abortion, prenatal care, or contraception. The Board has also expressed its position that such pregnancy counseling agencies should be prohibited by statute from soliciting or collecting a fee for their service from the medical practitioner or the medical facility to which the client is referred. Essentially, at the time the pregnant woman reaches the doctor or hospital, her decision has already been made with respect to the abortion. It is interesting that pregnant women seeking a therapeutic abortion tend to use medical facilities other than those that they would use for normal procedures. Although there has been a marked increase in the number of therapeutic abortions, with over 300 hospitals in California reporting one or more procedures. For example, in 1970, 24,000 abortions, nearly 40 percent of the total, were performed in only 17 hospitals and these same 17 hospitals accounted for less than seven percent of all total births. These figures make it clear that many women are not obtaining abortions in the same hospitals in which they receive their obstetric care. The above information also implies that a greater number of women are not seeking abortions from the physician usually providing them obstetric or general medical care. It is not known if this situation stems basically from the patient's desire for anonymity, from a reluctance of many obstetricians and general practitioners to perform abortions, or whether it's simply a function of patients going to the place where services are available. It is clear that therapeutic abortions are frequently obtained in a manner distinct from all other medical surgical services even though as pointed out earlier abortions have become the most common medical procedure in this state. Assuming that the pregnant woman visits an accredited medical facility which provides an active therapeutic abortion program and her pregnancy is in the first trimester (12 weeks), the entire procedure can be completed in four to five hours including a one-hour counseling session. Some facilities conduct their preabortion counseling sessions in a group setting with from three to five abortion patients in attendance. Generally, the "counselor" is a nonprofessional from the peer group who devotes a substantial part of the counseling hour to a discussion of the specifics of the medical procedure and to birth control techniques which the patients may have used in the past and which they plan to use in the future. Considering the fact that half of the women attending have had no prior counseling, such sessions are completely inadequate in comparison to general psychiatric or medical practice, and, when witnessed, completely destroy the illusion that the decision to abort is arrived at in a -91- considered, confidential, doctor-patient conference. The "counseling" session becomes an emotionally-charged experience with each of the women generally offering information about the circumstances which brought her to this point. This hour-session is virtually the last opportunity the woman has to change her mind, and it is also the key point at which the staff has an opportunity to identify the woman who is insecure in her decision. If the woman's pregnancy is 12 weeks or less, the abortion is normally performed by use of a vacuum aspirator. The placenta is drawn out of the uterus through suction created by an electric pump. Major facilities performing these services advertise that patients flying into metropolitan areas can easily be admitted by 11 a.m. and be released from the hospital in order to make plane connections home that evening. Women whose pregnancies are more advanced than the first trimester generally are required to rely on the "amnio" method of abortion. This is a more extensive procedure than that described above and requires at least an overnight stay in the hospital. Essentially, a saline solution is injected through the abdominal wall into the uterus and this process induces labor in much the same fashion as normal childbirth. The cost of this procedure is substantially higher than the aspiration method and there is also an increased risk. Compared to the extensive prenatal and postnatal laboratory and diagnostic testing now common in normal childbirth, some facilities seem lax in this regard. There is generally little, if any, medical follow-up, expecially since a substantial number of women do not live in close proximity to the medical facility they use for abortion services. Some facilities advertise no charge for medical complications, but from the patient's standpoint, this is normally impractical. These factors combine to cloud the whole issue of specifically what kinds of medical and psychiatric complications do, in fact, result from abortions. It also becomes impossible to determine resultant death rates with any precision. F. The Consequences There is the potential for deep individual and social significance connected with a society's headlong rush into liberalized abortion. One is forced to wonder how much consideration was given to these factors in the development of legislation. It would also appear that lawmakers and the courts have gone beyond what the majority of people will support with respect to abortion. Davis reports that seven opinion studies taken since 1962 showed only 33 percent of the public believes there should be no legal restraints on abortions. The latest survey taken in late 1972 indicates that ten percent opposed any legal abortion, 19 percent opposed if an expected child was deformed, 55 opposed for financial reasons, and 67 percent opposed abortions on women who just didn't want more children. The specific effect of abortions on individuals is relatively unclear at this point in time. Most studies involve a relatively small sample of women and the inability of the medical-psychiatric profession to accurately measure cause and effect is a very real problem. Another -92- compounding element is the fact that a substantial number of women go elsewhere for abortions and are, therefore, very difficult to follow for study purposes. Having obtained her abortion in a metropolitan area, major and minor complications are most likely seen by the family physician near the patient's home and as a result are not reported to the abortion facility. Dr. Robert Pasnaugh reports the viewpoint that most normal women were found to react to abortions with mild feelings of depression without serious after-effects. Most women who were psychiatrically ill were found to respond with improved mental attitudes. Some were found to respond with increased symptoms. No study has been able to determine in advance which women will react adversely to pregnancy and which to abortion. He states that at present, there is no evidence to suggest that the risk of psychiatric complications in induced abortions constitutes a contraindication to the procedure in either normal or psychiatrically ill women. He does, however, propose three specific steps that should be taken to reduce the risk of psychiatric complications: (1) there should be routine psychiatric consultation; (2) psychiatric evaluation should be requested if patient exhibits symptoms of major psychiatric illness, history of postpartum psychosis, exhibits ambivalence or is passively compliant; and, (3) all patients should be seen in routine follow-up visits. Although the evidence is unclear, there are studies which identify guilt reactions and lowered self-esteem following abortion. Perhaps the most ambitious study and certainly one which involved a substantial sample is one conducted by the Joint Program for the Study of Abortions (JPSA). This study was based on a total of 72,988 abortions performed from July 1, 1970 to June 30, 1971 as reported by 66 institutions participating in the JPSA study sponsored by the Population Council. The JPSA study also noted that abortions were performed on 164 women who were not pregnant. It is suggested that this document should receive careful consideration as it represents a significant contribution toward assessing postabortion medical complications. Some of the conclusions reached by JPSA with respect to medical complications are as follows: 1. The incidence of early medical complications, including minor complaints, during the first trimester of pregnancy was on the order of one in twenty abortions; the incidence of major complications as defined in the report, was one in two hundred abortions. 2. The risk to health associated with abortions was three to four times as high in the second trimester of pregnancy as in the first trimester. 3. Complication rates were higher for abortions performed at six weeks gestation or less than at seven to ten weeks gestation, especially for major complications. However, the major complication rates were far lower for the earliest abortions than for abortions in the second trimester. -93- The above study should represent a significant contribution to assessing postabortion medical complications and it is suggested that this document should receive careful consideration. It is extremely doubtful that any amount of statistical data received through studies will ever totally erase the atmosphere of emotion which surrounds the subject at the present time. It can only be hoped that through proper counseling and education men, women, boys and girls will come to realize the burden of responsibility they place upon themselves and society with the creation of unwanted pregnancies. -94- IX. APPENDICES Appendix 1 State Social Welfare Board Analysis of Mail Preliminary Position Statement on Illegitimacy Published March 1972 A total of 139 letters were received by the State Social Welfare Board following publication of its preliminary position statement on the subject of illegitimacy. Every letter received a personal reply and in instances where the writer seemed to be reacting to a news report only, a copy of the statement accompanied the letter. Writers were urged to study the problem and then to suggest alternatives. In only two cases did the Board receive follow-up letters containing alternative suggestions. Persons requesting a copy of the statement 44 Persons expressing a position on the statement 95 139 Positions Expressed Of the 95 writers who expressed a position, those who supported the Board's position were as likely to react emotionally as were those who opposed the position: Support of the Board's position 51 53% Opposed to the Board's position 44 47% 95 100% Basis for Criticism A number of writers opposed to the Board's position simply reacted on an emotional level and did not propose alternative solutions. There were 83 critical responses contained in the 44 letters of opposition. The breakdown of these responses is as follows: Interference with mother's rights 32 39% Excessive governmental power 25 30% Illegitimacy not criteria for inadequacy 10 12% Unconstitutional 9 11% Motivated by cost savings 5 6% Insufficient adoptive homes 1 1% Will not promote greater use of Civil Code Section 232 1 1% 83 100% Alternative Proposals Generally, writers making suggestions were inclined to propose more than one. Most of the following 95 suggestions came from writers who opposed the Board's position. 1. Increased emphasis on family planning and expand 17 18% availability of contraceptive devices. 2. Increased emphasis on education for family life 13 14% and responsibility. -95- 3. Provide for sterilization on males and females 10 10% and consider bonus for voluntary sterilization. 4. Liberalize abortion laws and broaden the avail- 7 7% ability of information on this subject. 5. Enforce the support obligation of the father. 7 7% 6. Give recognition to social changes which condone 7 7% other family life styles. 7. Find some means of getting at the inadequate or 5 5% unfit parents who are married. 8. Provide more social services during and following 4 4% the pregnancy. 9. Provide child care so young mothers can complete 4 4% education and obtain training. 10. No increase in grant following birth of certain 4 4% number of illegitimate children (usually two). 11. Develop program to assist the young mother to 3 3% complete her education. 12. Increase the grant level to improve mother's 3 3% ability to provide good home for child. 13. Evaluate grandparents' home for suitability to avoid 3 3% repeating mistakes they may have made before insist- ing that the young mother remain in their home. 14. Provide for financial responsibility on the part 3 3% of the grandparents of one/both unwed parents. 15. Provide equal job opportunities for women. 2 2% 16. Use income tax incentives to limit the number 2 2% of births. 17. Provide for state-run institutions as alternatives 1 1% to unfit or inadequate parents. - 95 97% -96- Appendix 2 Survey Opinion Questions Following is a summary of responses to survey opinion questions reported in Illegitimacy: Law and Social Policy, by Harry D. Krause, Bobbs-Merrill Co., Inc., App. B, PP 307-322. Refer to the text for a breakdown of responses by character- istics of the respondents and for information on the conduct of the survey and drawing of the sample. 1. Do you agree or disagree that in general, the illegitimate child should have the same legal relationship (rights and duties) with its mother that a legitimate child has with its mother? Don't Know or Number Agree Disagree No Opinion Total of Cases 95% 3% 2% 100% 2,031 2. Which one of these statements best reflects your opinion? a. The father of an illegitimate child should have no legally recognized and enforceable responsibilities to his illegitimate child. b. An illegitimate child should be entitled to the same amount of support as a legitimate child. C. An illegitimate child should not be in as good a position as a legitimate child, but it should be entitled to receive enough support from its father to take care of its basic needs. Number ail b. i Total of Cases 4% 78% 18% 100% 2,031 3. Which one of these statements best reflects your opinion? a. Unless the father leaves a will in which he specifically gives his illegitimate child an inheritance, the illegitimate child should have no right to inherit from its father. b. If the father does not leave a will, the illegitimate child should inherit from its father the same inheritance to which the child would be entitled if it were of legitimate birth. C. If the father does not leave a will, the illegitimate child should inherit from its father enough to cover support needs until the child is able to go to work and earn its own living. Number of b. il Total of Cases 5% 64% 31% 100% 2,031 -97- 4. If the father is fit, willing, and paying adequate support, and if a family court considers this in the best interests of the child, the father of an illegitimate child should be allowed to visit his child periodically, even if the mother objects. Don't Know or Number Agree Disagree No Opinion Total of Cases 82% 14% 4% 100% 2,031 5. The illegitimate child should have the same rights involving the payment of benefits for the death or disability of the father (for example, workman's compensation) as a child of legitimate birth. Don't Know or Number Agree Disagree No Opinion Total of Cases 87% 9% 4% 100% 2,031 6. In each case of an illegitimate birth, appropriate legal authorities should investigate the fitness of the mother to bring up the child and if the mother is considered unfit, should ask the courts to determine whether the child should be given into foster care or into adoption. Don't Know or Number Agree Disagree No Opinion Total of Cases 86% 10% 4% 100% 2,031 7. Unless the child is given up for adoption by its mother, appropriate legal authorities should investigate the identity of the father in each case of an illegitimate birth and should ask the court to hold the father responsible for his child. Don't Know or Number Agree Disagree No Opinion Total of Cases 86% 10% 4% 100% 2,031 Do you agree or disagree with the following statements? 8. If the father cannot be found or cannot contribute to the support of his illegitimate child, the welfare authorities should give the mother (if she is a fit person) enough money to make a decent home for her illegitimate child. 9. The discrimination imposed by our law on the illegitimate child is an effective way to discourage sexual intercourse between unmarried persons. -98- 10. Making fathers financially responsible for their illegitimate children would seem to be a more effective way to discourage promiscuous sexual intercourse than imposing no obligation or a limited support obligation on fathers of illegitimate children. Don't Know or Agree Disagree/No Opinion Question 8 79% 21% Question 9 20% 80% Question 10 75% 25% 11. The law should not disadvantage the illegitimate child for the misdeed of its parents that brought it into the world. Do you agree or disagree? Don't Know or Number Agree Disagree No Opinion Total of Cases 96% 3% 1% 100% 2,031 12. Fathers and mothers of illegitimate children should be punished by the criminal law for bringing them into the world. Do you agree or disagree? Don't Know or Number Agree Disagree No Opinion Total of Cases 20% 70% 10% 100% 2,031 -99- Appendix 3 NUMBER OF LIVE BIRTHS BY LEGITIMACY STATUS RACE OF MOTHER AND AGE OF MOTHER CALIFORNIA 1966 - 1972 LEGITIMACY ALL RACES WHITE BLACK- STATUS AND YEAR All All All Ages 15-19 20-24 25-34 35+ Ages 15-19 20-24 25-34 35+ Ages 15-19 20-24 25-34 35+ Illegitimate 1972 40,171 17,499 12,806 7,917 1,277 26,821 11,243 8,620 5,644 950 12,420 5,928 3,865 2,044 297 1971 39,912 16,726 13,222 7,887 1,419 26,522 10,685 8,930 5,514 1,041 12,450 5,738 3,950 2,145 341 1970 45,593 18,888 15,615 8,793 1,676 31,052 12,345 10,996 6,187 1,222 13,602 6,231 4,277 2,396 404 1969a/ 42,085 17,348 14,557 8,009 1,600 29,371 11,517 10,742 5,683 1,156 11,924 5,537 3,571 2,120 406 1968a/ 38,053 15,587 13,110 7,177 1,614 27,141 10,597 9,963 5,143 1,162 10,393 4,818 2,972 1,905 416 1967 35,215 14,440 11,658 6,841 1,740 24,987 9,636 8,943 4,873 1,262 9,750 4,630 2,590 1,839 429 1966 31,804 12,819 10,303 6,582 1,627 22,204 8,531 7,712 4,582 1,167 9,124 4,138 2,450 1,860 418 Legitimate 1972 266,204 34,830 97,833 118,362 14,991 239,217 32,075 88,890 105,264 12,821 14,450 2,134 5,630 5,785 883 1971 289,914 36,989 111,955 123,422 17,410 260,919 33,954 101,919 109,935 14,987 16,595 2,404 6,569 6,470 1,142 1970 -100- 317,059 42,125 121,668 133,234 19,863 286,116 38,597 111,107 119,122 17,144 18,531 2,842 7,206 7,158 1,311 1969a/ 310,822 41,406 118,842 129,442 20,978 280,823 37,498 108,765 116,232 18,228 18,700 3,209 7,104 6,970 1,381 1968a/ 301,168 42,135 115,476 121,488 21,923 272,618 38,129 106,248 108,953 19,193 18,113 3,375 6,667 6,680 1,351 1967 301,369 44,168 114,939 117,963 24,165 272,862 40,048 105,784 105,642 21,282 18,746 3,568 6,770 6,862 1,523 1966 305,819 46,698 112,520 119,869 26,610 276,287 42,587 103,274 106,867 23,465 19,723 3,647 6,910 7,458 1,690 All Live Births 1972 306,375 52,329 110,638 126,279 16,268 266,038 43,318 97,510 110,908 13,771 26,870 8,062 9,495 7,829 1,130 1971 329,826 53,715 125,177 131,309 18,829 287,441 44,639 110,849 115,449 16,028 29,045 8,142 10,519 8,615 1,483 1970 362,652 61,013 137,283 142,027 21,539 317,168 50,942 122,103 125,309 18,366 32,133 9,073 11,483 9,554 1,715 1969 352,907 58,754 133,399 137,451 22,578 310,194 49,015 119,507 121,915 19,384 30,624 8,746 10,675 9,090 1,787 1968 339,221 57,722 128,586 128,665 23,537 299,759 48,726 116,211 114,096 20,355 28,506 8,193 9,639 8,585 1,767 1967 336,584 58,608 126,597 124,804 25,905 297,849 49,684 114,727 110,515 22,544 28,496 8,198 9,360 8,701 1,952 1966 337,623 59,517 122,823 126,451 28,237 298,491 51,118 110,986 111,449 24,632 28,847 7,785 9,360 9,318 2,108 1/ For 1966-1969, births by race of mother were estimated from births by race of child using 1970 ratios. Prior to 1970, California births were classified by race of child only. Since 1970, they have been classified by race of mother, race of father and race of child. a/ Figures for illegitimate and legitimate births adjusted for comparability with coding rules applied for 1966-67 and 1970-71. Note: Totals Include births to mothers under age 15 and of unknown age. Source: State of California, Department of Public Health, Birth Records. Appendix 4 ESTIMATED BIRTH RATES BY LEGITIMACY STATUS, RACE OF MOTHER, AND AGE OF MOTHER: CALIFORNIA RESIDENTS, 1966-1972 Type of All Races Whitea Blacka Birth Rate and Year 15-44 15-19 20-24 25-34 35-44c/ 15-44b/ 15-19 20-24 25-34 35-44c/ 15-44b/ 15-19 20-24 25-34 35-44c1 Illegitimate 1972 22.0 20.7 31.3 23.5 5.4 17.4 15.3 24.9 20.7 5.0 65.4 85.5 101.6 42.7 8.5 1971 22.6 20.4 32.8 25.4 6.1 17.7 14.9 26.2 21.9 5.5 69.1 87.6 106.3 49.2 10.0 1970 27.0 24.1 41.3 29.9 7.2 21.6 17.9 34.2 26.0 6.4 80.1 102.0 123.5 58.5 12.2 1969 26.0 22.8 41.6 28.9 7.0 21.2 17.1 36.1 25.1 6.1 74.5 95.9 112.2 55.6 12.6 1968 24.6 21.1 41.0 27.8 7.1 20.4 16.2 36.5 24.2 6.2 69.2 88.8 102.6 54.0 13.2 1967 23.8 20.0 40.3 28.2 7.7 19.6 15.0 36.1 24.5 6.7 69.2 90.1 99.4 56.2 14.0 1966 22.5 18.2 40.4 28.8 7.3 18.1 13.5 35.2 24.2 6.3 69.2 84.8 107.5 60.8 14.1 Legitimate 1972 98.4 333.8 194.2 102.8 15.9 99.2 342.2 195.5 102.8 15.3 92.3 286.4 192.3 83.9 17.4 1971 109.5 354.7 220.3 114.1 18.3 110.2 364.2 221.3 114.0 17.7 109.7 330.2 223.2 101.0 22.6 1970 122.1 409.6 247.9 127.6 20.7 122.8 418.1 249.5 127.4 20.0 126.4 405.2 254.4 117.0 26.2 1969 120.1 390.8 248.2 126.6 21.4 120.6 392.7 249.9 127.0 20.7 128.9 449.5 255.8 117.3 27.2 1968 117.7 388.9 249.8 122.6 22.0 118.1 388.9 252.3 122.6 21.3 127.4 473.9 248.4 117.0 26.5 1967 119.1 399.2 259.3 122.5 23.8 119.1 395.6 261.7 122.0 23.1 134.4 495.0 263.0 124.6 29.6 1966 122.4 410.6 272.9 127.0 25.8 121.9 410.6 274.6 125.7 25.1 144.5 504.8 287.8 139.4 32.7 All Live Births 1972 67.6 55.2 121.2 84.9 13.8 67.3 52.2 121.8 85.6 13.4 77.5 105.0 141.1 67.0 13.8 1971 74.7 58.2 137.4 94.3 15.9 74.3 55.1 138.4 94.9 15.4 87.6 111.8 157.9 80.0 17.6 1970 84.6 68.8 158.0 106.1 18.1 84.1 65.1 159.3 106.8 17.5 101.6 133.2 182.4 93.6 20.6 1969 83.9 67.6 161.1 105.8 18.6 83.5 63.7 163.1 106.8 18.1 100.4 134.8 179.1 93.1 21.5 1968 82.7 68.2 164.4 103.0 19.2 82.4 64.6 167.5 103.6 18.7 97.5 133.4 172.7 92.9 21.4 1967 83.9 70.5 172.8 103.6 20.9 83.5 66.7 176.0 103.8 20.4 101.6 139.9 180.7 99.1 23.8 1966 86.3 72.7 184.1 107.9 22.5 85.5 69.5 186.5 107.2 21.9 107.5 139.0 200.0 110.8 26.0 NOTE: Rates are per 1,000 unmarried (illegitimate), married (legitimate), and total women. Unmarried women are those single, widowed, divorced, or separated. a/For 1966-1969, births by race of mother (numerators for rates) were estimated from births by race of child using 1970 ratios. Prior to 1970, California births were classified by race of child only. Since 1970, they have been classified by race of mother, race of father, and race of child. b/Rates computed by relating total births, regardless of age of mother, to estimated number of women aged 15-44. c/Rates computed by relating births to mothers aged 35 and over to estimated number of women aged 35-44. Source: State of California, Department of Public Health, Birth Records; State of California, Department of Finance, population estimates prepared December 1971 and November 1972; 1970 Census of Population, General Population Characteristics, California, Tables 19, 22; 1960 Census of Population, Vol. 1, Part 6, Table 105 and Subject Reports PC(2)-1C, Table 19. Appendix 5 Illegitimate Birth Rates by Rank Order for 46 Countries Number of Illegitimate Births per 1000 Unmarried Women 15-44 Latest Year Rank Order Country Date Rate 1 Guinea 1955 209.9 2 Angola 1960 209.4 3 El Salvador 1961 206.6 4 Venezuela 1961 190.3 5 Jamaica 1960 189.5 6 Honduras 1961 185.1 7 Panama 1960 170.4 8 Ecuador 1962 136.3 9 Peru 1961 125.8 10 Mexico 1960 112.6 11 Puerto Rico 1960 78.4 12 Iceland 1950 76.7 13 Colombia 1951 60.3 14 Congo, D.R. 1957 49.4 15 Chile 1960 48.3 16 Argentina 1947 26.4 17 Yugoslavia 1961 26.0 18 Austria 1951 25.4 19 Bulgaria 1956 24.9 20 New Zealand 1961 24.1 21 United States 1965 23.5 22 Portugal 1960 22.2 23 England and Wales 1964 20.2 24 Sweden 1960 19.7 25 Canada 1961 17.9 26 Australia 1961 17.8 27 China-Taiwan 1956 17.7 28 Denmark 1960 17.1 29 Poland 1960 15.3 30 France 1962 14.5 31 West Germany 1961 13.0 32 Hungary 1960 12.4 33 Norway 1960 9.2 34 Finland 1960 8.5 35 Ryukuy Islands 1960 8.2 36 Switzerland 1950 7.2 37 Belgium 1947 5.4 38 Spain 1960 4.9 39 Italy 1961 4.2 40 Albania 1955 3.6 41 Ireland 1951 3.6 42 Netherlands 1960 3.6 43 Greece 1961 2.2 44 Philippines 1960 1.9 45 Japan 1964 1.6 46 Israel 1961 1.3 Sources: Computations from the number of births by legitimacy and total births, numbers of unmarried women 15-44, from the United Nations, Demographic Yearbook, 1959, 1962, 1963 and 1965. -102- Appendix 6a Characteristics of Persons Involved in Welfare Paternity Actions Based on 259 Interviews in Two Counties, August 1972 Column one describes the characteristics of persons involved in cases in which the district attorney made a decision to proceed with the action. Column two are those cases in which the district attorney decided not to proceed. Column three represents a combined total of both types of cases. 1. Of the 259 cases interviewed, a decision was Prosecutable Combined made to proceed with the paternity action in Yes No Total 162 (62%) of the cases. The mother, or # % # % # % expectant mother, was asked to indicate if she could identify the putative father. Yes 162 100 81 84 243 94 No 0 0 16 16 16 6 2. The present residence of the putative father was indicated by the mother to be: In county 115 71 22 23 137 52 -103- In state 28 17 7 7 35 14 Out of state 10 6 42 43 52 20 Unknown 9 6 26 27 35 14 3. The present living arrangement of the mother in these cases is as follows: Parents/Relative 76 47 28 29 104 40 Alone 55 34 48 50 103 40 Friends 21 13 15 15 36 14 Husband 3 12 6 6 9 3 Common-law husband 7 4 0 0 7 3 Appendix 6b 4. The education level of the mother and Prosecutable Combined putative father were determined to be: Yes No Total Mother: # % # % # % Less than 8 years 1 1 10 10 11 4 8 through 11 years 98 60 37 38 135 52 High school graduate 45 28 37 38 82 32 Some college 15 9 11 12 26 10 College graduate 3 2 2 2 5 2 Father: Less than 8 years 3 2 6 6 9 3 8 through 11 years 78 48 21 22 99 38 High school graduate 45 28 30 31 75 29 Some college 23 14 10 10 33 13 College graduate 4 2 0 0 4 2 -104- Unknown 9 6 30 31 39 15 5. The present age of the mother and putative father is as follows: Mother: Under 15 0 0 0 0 0 0 15-17 31 19 5 5 36 14 18-19 45 28 19 20 64 25 20-24 59 37 35 36 94 37 25-29 15 9 17 18 32 12 30-34 9 6 15 15 24 9 35 and over 2 1 6 6 8 3 Appendix 6c Prosecutable Combined Yes No Total # % # % # % Father: Under 15 0 0 0 0 0 0 15-17 18 11 1 1 19 7 18-19 17 10 7 7 24 9 20-24 70 44 28 30 98 37 25-29 29 18 24 25 53 20 30-34 16 10 12 12 28 10 35 and over 12 7 11 11 33 12 -105- Unknown 0 0 14 14 14 5 6. At the time of conception, the age spread of the mother and putative father was as follows: Mother: Under 15 4 2 1 1 5 2 15-17 58 37 15 16 73 28 18-19 39 24 26 27 65 25 20-24 49 30 39 40 88 34 25-29 10 6 11 11 21 8 30-34 2 1 5 5 7 3 35 and over 0 0 0 0 0 0 Appendix 6d Prosecutable Combined Yes No Total # % # % # % Father: Under 15 0 0 0 0 0 0 15-17 27 17 6 6 33 13 18-19 25 15 15 16 40 15 20-24 64 39 34 35 98 38 25-29 32 20 21 22 53 20 30-34 13 8 5 5 18 7 35 and over 1 I 3 3 4 2 -106- Unknown 0 0 13 13 13 5 7. The present marital status of the mother and putative father is as follows: Mother: Never married 101 63 43 44 144 56 Married to another 17 10 21 22 38 15 Divorced from putative father 2 1 0 0 2 1 Divorced from another 20 12 14 14 34 13 Separated from putative father 11 7 2 2 13 5 Separated from another 11 7 16 17 27 10 Widowed 0 0 1 1 1 0 Appendix 6e Prosecutable Combined Yes No Total # % # % # % Father: Never married 86 53 32 34 118 45 Married to another 18 11 11 11 29 11 Divorced from mother 2 1 0 0 2 1 Divorced from another 23 14 7 7 30 12 Separated from mother 11 7 2 2 13 5 Separated from another 9 6 2 2 11 4 Widower 1 1 I 1 2 1 -107- 8. Unknown 12 7 42 43 54 21 At the time of conception, the marital status of the mother and putative father was as follows: Mother: Never married 123 79 65 67 188 73 Married to another 12 7 10 10 22 8 Divorced from putative father 0 0 0 0 0 0 Divorced from another 15 9 13 14 28 11 Separated from putative father 2 1 0 0 2 1 Separated from another 10 6 8 8 18 7 Widowed 0 0 1 1 1 0 Appendix 6f Prosecutable Combined Yes No Total # % # % # % Father: Never married 100 61 54 56 154 59 Married to another 14 9 7 7 21 8 Divorced from mother 0 0 0 0 0 0 Divorced from another 20 12 8 8 28 11 Separated from mother 2 1 0 0 2 1 Separated from another 14 9 2 2 16 6 Widowed I 1 1 1 2 1 Unknown 11 7 25 26 36 14 9. Based on the knowledge of the mother, the putative father's present occupation is: Professional 7 4 1 1 8 3 -108- # Proprietor, manager 0 0 0 0 0 0 Clerical 4 2 2 2 6 2 Craftsman 9 6 1 1 10 4 Armed Forces 5 3 7 7 12 5 Operatives 29 18 12 12 41 16 Farm laborer 1 1 0 0 1 0 Service worker 6 4 2 2 8 3 Household worker 0 0 0 0 0 0 Unskilled worker 36 22 18 19 54 22 Retired 0 0 0 0 0 0 Unemployed 25 15 6 6 31 12 Student 19 12 3 3 22 8 Unknown 21 13 45 47 66 25 Appendix 6g Prosecutable Combined 10. Also based upon the knowledge of the mother, Yes No Total the putative father's present monthly income is: # old # % # % None 43 26 7 7 50 19 Under $200 5 3 1 1 6 2 $200 399 17 11 4 4 21 8 $400 - 599 12 7 5 5 17 7 $600 - 799 17 11 1 1 18 7 $800 - 999 4 2 0 0 4 2 $1000 - 1199 1 I 1 I 2 1 $1200 1399 0 0 0 0 0 0 $1400 1599 0 0 I 1 1 0 $1600 and over 0 0 0 0 0 o Unknown 63 39 77 80 140 54 11. At the time of the interviews, there were Combined 169 other children in the custody of the Prosecutable Nonprosecutable Total -109- mothers, 65 (38%) of whom were born out of wedlock. Distribution by family size and Legitimate: legitimacy status is as follows: Families with 1 child 24 25 49 Families with 2 children 9 6 15 Families with 3 children 0 5 5 Families with 4 children 1 0 1 Families with 6+ children I 0 1 Illegitimate: Families with 1 child 26 12 38 Families with 2 children 4 5 9 Families with 3 children 1 0 1 Families with 6+ children 1 0 1 Appendix 6h Combined 12. An effort was made to determine what had been Prosecutable Nonprosecutable Total the outcome of any earlier conception, if any, involving this mother and this, or any other, putative father, in addition to the 169 legitimate and illegitimate children presently in the custody of this mother. There had been at least 39 other conceptions, the outcome of which was as follows: This putative father - 3 0 3 placed for adoption By another father - placed 1 9 10 for adoption This putative father - aborted 4 1 5 By another father - aborted 11 10 21 13. The putative fathers represented in this group of 259 cases had 171 children among them. Distribution by family size and legitimacy status is as follows: Legitimate - with this mother: Cases with 1 child 2 2 4 -110- Cases with 3 children 0 1 1 Illegitimate - with this mother: Cases with 1 child 11 4 15 Children by another mother: Cases with 1 child 23 10 33 Cases with 2 children 19 4 23 Cases with 3 children 6 2 8 Cases with 4 children 2 0 2 Cases with 5 children 2 2 4 Cases with 6+ children 3 0 3 Appendix 6i Prosecutable Combined 14. We attempted to determine the living Yes No Total arrangment of the two parties at the # % # % # % time of conception: Lived together during conception 44 27 17 18 61 24 Did not live together during conception 118 73 80 82 198 76 15. We attempted to learn the level of knowledge on the part of the mother with respect to birth control techniques. Forty-six percent of the mothers had received some type of birth control training, although many more had some knowledge of the subject: Formal training 18 11 8 8 26 10 Home training 7 4 3 3 10 4 Informal training 56 35 27 28 83 32 -111- None 81 50 59 61 140 54 16. Although 46 percent of the mothers had some type of birth control training, and an additional percentage had an awareness of the subject and techniques, 88 percent of the mothers used no form of contraception during the period of conception: Yes 23 14 9 9 32 12 No 139 86 88 91 227 88 Appendix 6j Prosecutable Combined 17. Within the 259 cases, expectant mothers most Yes No Total often (83%) told the putative father of the # % # % # % pregnancy. This percentage was higher (95%) among those 162 cases in which the district attorney decided to proceed with a paternity action. The question of whether or not the father was told of the pregnancy was answered as follows: Yes 154 95 62 64 216 83 No 8 5 35 36 43 17 18. Putative fathers most often admitted paternity to the mother or to another person, or both. Of the 354 responses in the 259 cases, only 11% denied paternity and in 6% of the cases the mother was not aware of the admission or denial by the father. Admitted to mother 143 56 45 42 188 53 Admitted to another 94 37 12 11 106 30 -112- Denied paternity 7 3 31 28 38 11 Unknown 11 4 21 19 22 6 19. Although the father admitted paternity in an overwhelming number of cases, this fact did not appreciably influence the financial arrangements for the birth of the 259 children. In these cases 82% were delivered, or to be delivered, under the Medi-Cal program. Medi-Cal delivery 138 85 74 76 212 82 Non-Medi-Cal delivery 24 15 23 24 47 18 Appendix 6k Prosecutable Combined 20. Some of the fathers did assist the mother in Yes No Total limited ways. However, again, 75% of the # % # % # % fathers assumed no part of the financial burden: Paid any medical expenses 14 9 3 3 17 7 Made cash contributions 12 7 2 2 14 5 Made in-kind contribution 27 17 7 7 34 13 None 109 67 85 88 194 75 Combined 21. We sought to determine if before or after Prosecutable Nonprosecutable Total delivery the mother received any type of abortion, adoption or birth control counseling. Of the 259 mothers, 187 had received none (112 prosecutable cases + 75 nonprosecutable cases). of the 72 mothers who had received counseling, the following -113- agencies were involved: Welfare 8 9 17 Public Health 19 9 28 Probation 2 0 2 Private social agency 10 2 12 Private family planning 11 2 13 22. Mothers sometimes received counseling on more than one subject. The 72 mothers had a total of counseling contacts spread among the three subjects as follows: Abortion 21 5 26 Adoption 12 9 21 Birth control 33 15 48 Appendix 61 23. In 97 of the 259 cases, the district attorney determined that prosecution of the paternity action was not feasible. This decision was based on the following primary reasons: Reason Number Percent Incarceration of father 3 3 Death of father 0 0 Disability of father I 1 Absence of father from state 37 38 Too many potential fathers 29 30 Incomplete evidence 17 18 Absolute marital presumption (child of -114- legal husband) 3 3 Mother refused to cooperate 1 1 Child nearing age of emancipation 2 2 Child has limited life expectancy 1 1 Application for public assistance withdrawn 1 1 Mother is an illegal alien 2 2 TOTAL 97 100% Appendix 7 TABLE 32. AFDC FAMILIES, BY NUMBER OF ILLEGITIMATE CHILDREN, 1971 NUMBER OF ILLEGITIMATE RECIPIENT CHILDREN CENSUS DIVISION TOTAL 1 2 3 4 5 6 OR MORE AND STATE FAMILIES NONE CHILD CHILDREN CHILDREN CHILDREN CHILDREN CHILDREN TOTAL: NUMBER 2523900 1426000 559600 262400 129600 71700 37300 37300 PERCENT 100.0 56.5 22.2 10.4 5.1 2.8 1.5 1.5 CENSUS DIVISION: Education, and Welfare Publication No. (SRS) 72-03756. Source: Findings of the 1971 AFDC Study, Part I, U.S. Department of Health, NEW ENGLAND 134000 66.7 21.3 7.2 2.4 0.9 0.9 0.6 MIDDLE ATLANTIC 560100 51.8 21.9 12.1 6.7 4.1 1.5 1.9 EAST NORTH CENTRAL 363500 51.9 23.9 12.2 5.6 2.8 1.9 1.7 WEST NORTH CENTRAL 136600 63.1 20.2 8.2 3.4 2.4 1.4 1.2 SOUTH ATLANTIC 321800 48.0 24.1 13.5 7.3 3.7 1.9 1.6 EAST SOUTH CENTRAL 161900 48.7 25.0 12.4 5.9 3.4 2.2 2.5 WEST SOUTH CENTRAL 183000 51.0 21.4 12.5 6.7 3.7 2.2 2.6 MOUNTAIN 87600 66.4 21.0 6.3 3.1 1.5 1.0 0.7 PACIFIC 517000 65.3 21.9 6.9 3.0 1.5 0.8 0.6 -115- SELECTED STATES: ALABAMA 42600 43.2 27.2 12.9 6.3 4.2 3.1 3.1 CALIFORNIA 440000 63.3 22.7 7.4 3.2 1.8 0.9 0.7 FLORDIA 70200 47.7 22.6 13.8 8.7 3.7 1.1 2.3 GEORGIA 75100 47.3 27.2 14.0 6.3 2.8 1.5 1.1 ILLINOIS 120300 44.9 22.8 15.4 7.5 4.1 2.7 2.7 KENTUCKY 37600 64.4 20.2 8.8 2.7 1.9 0.5 1.6 LOUISIANA 54100 43.4 19.0 13.7 8.1 6.1 3.7 5.9 MARYLAND 40900 39.4 24.0 18.6 7.6 4.6 3.7 2.2 MASSACHUSETTS 72300 67.9 21.2 7.3 1.7 0.8 0.6 0.6 MICHIGAN 94700 55.2 25.1 10.2 4.5 2.5 1.1 1.3 MISSISSIPPI 34600 38.7 25.4 15.0 9.0 4.6 3.2 4.0 MISSOURI 48500 53.6 20.0 10.5 6.6 4.1 2.7 2.5 NEW JERSEY 86200 48.7 23.9 12.6 7.0 3.8 1.5 2.4 NEW YORK 332600 49.0 22.6 12.8 7.2 4.7 1.8 1.9 NORTH CAROLINA 39200 50.3 24.0 11.7 6.1 4.1 2.6 1.3 OHIO 91500 55.5 23.3 11.8 4.7 2.0 1.6 1.1 PENNSYLVANIA 141300 60.3 18.9 9.9 5.4 3.0 0.9 1.6 TENNESSEE 47100 48.6 26.5 12.7 5.7 3.0 1.9 1.5 TEXAS 84000 52.7 22.7 12.5 6.9 2.1 1.9 1.1 WASHINGTON 42500 76.9 17.4 3.1 1.9 0.2 0.2 0.2 PUERTO RICO 57800 84.8 9.0 3.6 0.9 0.9 0.2 0.7 Appendix 8 Questions Planned Parenthood speakers must be able to answer. Also questions that pregnancy counselors say, "If the girl had known the answer she probably wouldn't be pregnant." 1. How soon can a pregnancy be determined by a urine test or pelvic exam? By urine test, 5-7 days after a missed period. By a pelvic, after six weeks. 2. Why does a female become pregnant when withdrawal is the method of contra- ception used? Often there are sperm down in the penis before the male ejaculates. 3. Can a female become pregnant if there is no penetration? Yes - Sperm are mobile and can travel up the entire length of the vagina. 4. If a female has been raped, had unexpected intercourse or had a condom break and is fearful of this resulting in pregnancy, what can be done for her? Take the "morning after pill" which can only be prescribed by a physician. 5. Is it possible for conception to occur during a menstrual period? Yes 6. How soon after delivery, miscarriage or abortion can a new pregnancy occur? 2 - 3 weeks. 7. Why do some young girls who have had sexual relations for 3 or 4 years after puberty without using any form of birth control find themselves pregnant when they are in their teens? They have not ovulated regularly. 8. How does the pill compare in numbers of fatalities to pregnancy? Pregnancy is about 15 times more dangerous than the pill. 9. At what age of the mother are birth defects most likely to occur? Early teens and after 35. -116- Page Two Questions (Continued) 10. Name the symptoms of German measles. Fine rash, swollen glands behind the ears and symptoms similar to a cold. 11. When does a girl become old enough to have an abortion without her parents' consent? At any age that she becomes pregnant. 12. What, if any, responsibilities are involved when a minor fathers a child? Legally, the boy's parents are financially responsible until the boy is 18; after 18 he is responsible. 13. At what age can a girl get contraceptives without parental consent if she might become a welfare recipient? Age 15 and above. -117- Appendix 9 AGE AT ONSET OF MENSTRUATION PAST 100 YEARS 17.5 17.0 16.5 16.0 15.5 Y 15.0 E A R 14.5 S 14.0 13.5 13.0 USA 12.5 12.5 1850 1870 1890 1910 1930 1950 1960 = Norway Menstrual Disorders & Sterility - 1959 Mazer & Israel Gynecology Text it Finland = Sweden = USA -118- Appendix 10 PERCENT DISTRIBUTION OF SELECTED CHARACTERISTICS OF WOMEN HAVING ABORTION California, 1968-1971 YEAR CHARACTERISTIC 1968 1969 1970 1971 Total: Number 5,018 15,339 665,369a/ 116,749a/ Percent 100.0 100.0 100.0 100.0 Ethnic Group White 89.1 85.8 81.5 80.0 Black 7.2 9.5 11.8 13.7 Other and Not Reported 3.6 4.7 6.7 6.3 Marital Status Married 30.1 25.2 25.4 26.3 Never Married 53.0 57.5 55.0 51.0 Other and Not Reported 16.9 17.2 19.6 22.7 Pregnancy Number 1 51.4 54.5 49.0 47.8 2-3 23.4 24.2 26.8 30.1 4 or More 23.9 20.6 18.4 19.3 Not Reported 1.4 0.8 5.8 2.8 Age Under 20 Years 29.1 31.6 31.7 31.4 20-29 44.4 47.3 49.5 50.9 30-39 21.6 17.8 15.5 15.5 40 and Over 4.7 3.1 2.4 2.2 Not Reported 0.2 0.2 0.9 0.1 Source of Payment Medi-Cal 7.8 19.5 35.8 38.5 Other and Unknown 92.2 80.5 64.2 61.5 Type of Hospital County 10.5 14.1 9.4 10.0 Private and Other 89.5 84.9 90.6 90.0 a/: Number of therapeutic abortions adjusted for late reports. Note: Percents calculated independently and may not add to 100. Source: State of California, Department of Public Health, Bureau of Maternal and Child Health, Therapeutic Abortion Reports. -119- Appendix 11 THERAPEUTIC ABORTIONS REPORTED BY COUNTY AND INDIVIDUAL HOSPITAL California, 1971, January-March 1972 HOSPITAL NUMBER REPORTED. 1971 January-March, 1972 Alameda 7,638 2,142 Alameda Hospital 189 50 2070 Clinton Avenue, Alameda Albany Hospital 1A/ 0 1247 Marin Avenue, Albany Alta Bates Community Hospital 879 160 Webster & Regent, Berkeley Civic Center Hospital 2,623 911 390 & 420 Fortieth, Oakland Doctors Hospital of San Leandro 98 14 13855 East 14th Street, San Leandro Eden Hospital 88 22 20103 Lake Chabot Road, Castro Valley Herrick Memorial Hospital 422 117 2001 Dwight Way, Berkeley Highland General Hospital 181 44 1411 East 31st Street, Oakland Kaiser Foundation Hospital 266 73 27400 Hesperian Boulevard, Hayward Kaiser Foundation Hospital 857 194 280 West MacArthur Boulevard, Oakland Laurel Grove Hospital 573 69 19933 Lake Chabot Road, Castro Valley Levine Hospital 163 24 1030 Levine Court, Hayward Memorial Hospital of San Leandro 627 282 2800 Benedict Drive, San Leandro Oak Knoll Naval Hospital 0 -- 8750 Mountain Boulevard, Oakland Oakland Hospital 43 31 2648 East 14th Street, Oakland Peralta Hospital 50 8 450 - 30th Street, Oakland Providence Hospital 0 0 3012 Summit Street, Oakland Samuel Merritt Hospital 269 80 Hawthorne & Webster, Oakland St. Rose Hospital 0 0 27200 Calaroga Avenue, Hayward Valley Memorial Hospital 111 26 1111 Stanley Boulevard, Livermore Washington Hospital 198 37 2000 Mowry Avenue, Fremont I/ Reports received as of September 12, 1972. A/ Incomplete reporting. Estimates made from reports received. Source: State of California, Department of Health. -120- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Amador 1 -- Amador Hospital 1 0 810 Court Street, Jackson Butte 98 38 Feather River Hospital 1 1 5974 Pentz Road, Paradise Medical Center Hospital of Oroville 45 22 2767 Olive Highway, Oroville N T Enloe Memorial Hospital 52 15 West 5th Esplanade, Chico Calaveras 2 -- Mark Twain Hospital 2 0 El Dorado and Pope, San Andreas Colusa 12 5 Colusa Memorial Hospital 12 5 119 East Webster Street, Colusa Contra Costa 1,845 399 Brookside Hospital 266 38 Vale Road and San Pablo, San Pablo Concord Community Hospital 133 22 2540 East Street, Concord Contra Costa County Hospital 799 166 2500 Alhambra Avenue, Martinez Doctors Hospital of Pinole 40 28 2151 Appian Way, Pinole John Muir Memorial Hospital 120 24 1601 Ygnacio Valley Road, Walnut Creek Kaiser Foundation Hospital 388 85 1425 South Main Street, Walnut Creek Martinez Community Hospital 2 0 20 Allen Street, Martinez Pittsburg Community Hospital 40 25 550 School Street, Pittsburg Richmond Hospital 57 11 23rd and Gaynor Avenue, Richmond El Dorado 63 25 Barton Memorial Hospital 9 3 4th and South Streets, Tahoe Valley El Dorado Community Hospital 9 2 935 Spring Street, Placerville Marshall Hospital 45 20 Marshall Way, Placerville -121- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Fresno 983 275 Clovis Memorial Hospital 74 14 88 Norte DeWitt, Clovis Coalinga District Hospital 6 1 Sunset and Washington, Coalinga Fresno Community Hospital 202 53 Fresno and R Streets, Fresno Valley Medical Center 701 207 445 South Cedar Avenue, Fresno Humboldt 265 64 General Hospital 83A/ 22 Harris and H Streets, Eureka Humboldt Medical Center 182A/ 37 2200 Harrison Avenue, Eureka Trinity Hospital 0 5 14th and C Street, Arcata Imperial 54 22 El Centro Community Hospital 54 22 Ross at Imperial, E1 Centro Inyo 36 11 Northern Inyo Hospital 25 10 150 Pioneer Lane, Bishop Southern Inyo Hospital 11 1 501 East Locust, Lone Pine Kern 622 175 Greater Bakersfield Memorial Hospital 332 84 420 - 34th Street, Bakersfield Kern County General Hospital 146 39 1830 Flower Street, Bakersfield North Kern - South Tulare Hospital 0 1 1330 Jefferson, Delano Physicians Hospital 13 5 901 Olive Drive, Bakersfield Ridgecrest Community Hospital 45 14 1081 North China Lake, Ridgecrest San Joaquin Community Hospital 82 31 2628 Eye Street, Bakersfield USAF Hospital 4 1 Edwards AFB, Edwards A/ Incomplete reporting. Estimates made from reports received. -122- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Kings 5 4 Corcoran District Hospital 3 4 1310 Hanna Avenue, Corcoran Hanford Community Hospital 2A/ 0 450 Greenfield Way, Hanford Lake 3 2 Lakeside Community Hospital 3 2 Lakeshore Drive, Lakeport Lassen 27 6 Lassen Memorial Hospital 27 6 HSP Lane and West Street, Susanville C/ Marin 487 109 Marin General Hospital 211 39 250 Bon Air Road, San Rafael Novato General Hospital 16A/ 7 Hill and Canyon Roads, Novato Ross General Hospital 260 63 1160 Sir Francis Drake, Ross Mendocino 2 3 Mendocino State Hospital 1 0 Talmadge Ukiah General Hospital 1 3 564 South Dora Street, Ukiah Merced 14 3 Merced General Hospital 3 0 290 East 15th Street, Merced USAF Hospital 11A/ 2 Castle Air Force Base, Merced West Side Community District Hospital 0 1 151 South Highway 33, Newman Mono 6 3 Mono General Hospital 6 3 Twin Lakes Road, Bridgeport A/ Incomplete reporting. Estimates made from reports received. C/ Los Angeles County, see page 133. -123- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Monterey 970 227 Alisal Community Hospital 17A/ 4 333 North Sanborn Road, Salinas Community Hospital Monterey Pennisula 146 89 Pacific Grove Carmel Highway, Carmel General Hospital of Monterey County 39A/ 7 Natividad Road, Salinas George L. Mee Memorial Hospital 15 7 300 Canal Street, King City Monterey Hospital Limited 477 58 576 Hartnell Street, Monterey Salinas Valley Memorial Hospital 132 51 450 East Romie Lane, Salinas US Army Registrar's Division 144A/ 11 Medical Records, Fort Ord Napa : 1 St. Helena Sanitarium and Hospital 0 1 Sanitarium Road, Sanitarium Nevada 32 19 Tahoe Forest Hospital 32 19 Tahoe Drive and Pine Street, Truckee Orange 3,015 862 Anaheim General Hospital 54 77 3350 West Ball Road, Anaheim Anaheim Memorial Hospital 4 0 1111 West La Palma, Anaheim Beach Community Hospital 5 2 5742 Beach Boulevard, Buena Park Chapman General Hospital 48A/ 36 2601 East Chapman Avenue, Orange Costa Mesa Memorial Hospital 1 : 301 Victoria Street, Costa Mesa Doctors Hospital of Santa Ana 15 20 1901 College Avenue, Santa Ana Fullerton Community Hospital 125 35 100 East Valley View, Fullerton Garden Park General Hospital 307 30 9922 Gilbert Street, Anaheim Hoag Memorial Hospital 321 76 301 Newport Boulevard, Newport Beach Huntington Intercommunity Hospital 6A/ 5 17772 Beach Boulevard, Huntington Beach A/ Incomplete reporting. Estimates made from reports received. -124- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Orange (Continued) Lincoln Community Hospital 381 226 6850 Lincoln Avenue, Buena Park Los Alamitos General Hospital 19 38 3751 Katella Avenue, Los Alamitos Martin Luther Hospital 28 10 1825 West Romneya Drive, Anaheim Orange County Medical Center 890 151 101 Manchester, Orange Palm Harbor General Hospital 113A 45 12860 Palm Street, Garden Grove Riverview Hospital 52 37 1901 North Fairview Street, Santa Ana Santa Ana Community Hospital 365 8 600 East Washington, Santa Ana South Coast Community Hospital 132 28 31872 Coast Highway, South Laguna Stanton Community Hospital 23 7 7770 Katella Avenue, Stanton West Anaheim Community Hospital 118 29 3033 West Orange Avenue, Anaheim Westminster Community Hospital 8 2 200 Hospital Circle, Westminster Placer 46 15 Auburn Faith Hospital 3A/ 2 Highway 49 & Education, Auburn Roseville Community Hospital 43 13 333 Sunrise Avenue, Roseville Plumas 90 16 Plumas District Hospital 90 16 Meadow Valley Road, Quincy Riverside 1,456 390 Circle City Hospital 31 11 730 Old Magnolia, Corona Corona Community Hospital 2 0 812 South Washburn Street, Corona Desert Hospital 186 49 1151 North V Miraleste, Palm Springs Hemet Valley Hospital 19 5 1116 East Latham Street, Hemet Indio Community Hospital 59 13 47-111 Monroe Street, Indo A/ Incomplete reporting. Estimates made from reports received. -125- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Riverside (Continued) Knollwood Hospital 14 9 5900 Brockton Avenue, Riverside Palo Verde Hospital 30 B/ 250 North First Street, Blythe Parkview Community Hospital 346 99 3865 Jackson Street, Riverside Riverside Community Hospital 183 45 4445 Magnolia Avenue, Riverside Riverside GH University Medical Center 496 127 9851 Magnolia Avenue, Riverside San Gorgonio Pass Memorial Hospital 10 2 600 North Highland Spr, Banning US Air Force Hospital 78 30 March AF Base, Riverside Valley Memorial Hospital 2 0 82 - 485 Miles Avenue, Indio Sacramento 4,202 1,153 American River Hospital 1,079 271 4747 Engle Road, Carmichael Community Memorial Hospital 117 233 2251 Hawthorne Street, Sacramento Kaiser Foundation Hospital 371 146 2025 Morse Avenue, Sacramento Sacramento Medical Center 865 172 2315 Stockton Boulevard, Sacramento Sutter Memorial Hospital 1,724 323 52nd and F Streets, Sacramento Twin Lakes Community Hospital 21 2 223 Fargo Way, Folsom US Air Force Hospital 9 5 Mather AF Base, Sacramento Woodside Community Hospital 16 1 3201 Del Paso Boulevard, North Sacramento San Bernardino 4,232 4,089 Hi Desert Memorial Hospital 2 3 8515 Cholla Avenue, Yucca Valley Kaiser Foundation Hospital 258 89 9961 Sierra Avenue, Fontana Loma Linda University Hospital 24 3 11234 Anderson, Loma Linda Montclair Memorial Hospital 3,103 3,620 5050 San Bernardino, Montclair Ontario Community Hospital 16 4 550 North Monterey, Ontario B/ No report received -126- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 San Bernardino (Continued) Redlands Community Hospital 58 19 350 Terracina Boulevard, Redlands San Antonio Community Hospital 447 179 999 San Bernardino, Upland San Bernardino County General Hospital 160 131 780 East Gilbert Street, San Bernardino San Bernardino Community Hospital 163 41 1500 West 17th Street, San Bernardino US Air Force Hospital 0 George AF Base, Victorville San Diego 5,829 1,290 Bay General Hospital 98 61 435 H Street, Chula Vista Childrens Hospital 14 0 8001 Frost Street, San Diego Clairemont General Hospital 923 250 5255 Mount Etna Drive, San Diego Community Hospital of Chula Vista 2 0 553 F Street, Chula Vista Donald N. Sharp Memorial Community Hospital 2,589 577 7901 Frost Street, San Diego Fallbrook Hospital 16 1 624 East Elder Street, Fallbrook Grossmont Hospital 195 37 5555 Grossmont, La Mesa Kaiser Foundation Hospital - La Mesa 256 91 8010 Parkway Drive, La Mesa Oceanside Community Hospital 184 51 1100 Fifth Street, Oceanside Palomar Memorial Hospital 71 20 550 East Grand Avenue, Escondido Paradise Valley Hospital 362 29 2400 East 4th Street, National City Scripps Memorial Hospital 152 21 9888 Genesee Avenue, La Jolla Tri City Hospital 14 5 4002 Vista Way, Oceanside University Hospital of San Diego Center 838 120 225 West Dickinson, San Diego US Naval Hospital 47 9 Camp Pendleton, Oceanside US Naval Hospital 68 18 Park Boulevard, Balboa Park 1/ Reports received as of September 12, 1972. -127- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 San Francisco 11,052 3,335 Childrens Hospital of San Francisco 1,081 245 3700 California Street, San Francisco Chinese Hospital 49 10 835 Jackson Street, San Francisco French Hospital 828 172 4131 Geary Boulevard, San Francisco Golden Gate Community Hospital 648 745 1065 Sutter Street, San Francisco Hahnemann Hospital 62 17 3773 Sacramento, San Francisco Harkness Community Hospital & Medical Center 4A/ 8 1400 Fell Street, San Francisco Kaiser Foundation Hospital 1,032 257 2425 Geary Boulevard, San Francisco Letterman General Hospital 135 16 Presidio of San Francisco, San Francisco Mount Zion Hospital 632A/ 116 1600 Divisadero Street, San Francisco Presbyterian Hospital Pacific Medical Center 477A/ B/ Clay & Webster, San Francisco San Francisco Eye & Ear 2,689A/ 1,096 1801 Bush Street, San Francisco San Francisco General Hospital 456 125 1001 Potrero Avenue, San Francisco St. Francis Memorial Hospital 815 159 900 Hyde Street, San Francisco St. Lukes Hospital 499 170 1580 Valencia, San Francisco UC San Francisco Medical Center 1,377 139 3rd and Parnassus, San Francisco Unity Hospital 268A! 60 2356 Sutter Street, San Francisco San Joaquin 767 226 Dameron Hospital 411 147 525 West Acacia, Stockton Lodi Community Hospital 43 5 800 South Lower Sacramento, Lodi Lodi Memorial Hospital 32 16 975 South Fairmont Avenue, Lodi Manteca Hospital 7 2 300 Cottage Avenue, Manteca Oak Park Community Hospital of North Ca 7 I 2510 North California, Stockton San Joaquin General Hospital 265 54 Hospital Lane Highway 50, French Camp Stockton State Hospital 2 1 510 East Magnolia, Stockton A/ Incomplete reporting. Estimates made from reports received. B/ No report received. -128- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 San Luis Obispo 411 116 San Luis Obispo General Hospital 314 90 2180 Johnson Street, San Luis Obispo Sierra Vista Hospital 97 26 1010 Murray Street, San Luis Obispo San Mateo 1,633 403 Church of St. Matthew Mills Memorial Hospital 202 48 100 South San Mateo Drive, San Mateo H. D. Chope Community Hospital 895 246 222 West 39th Avenue, San Mateo Kaiser Foundation Hospital 65 34 1150 Veterans Boulevard, Redwood City Peninsula Hospital & Medical Center 320 52 1783 E1 Camino RL, Burlingame Sequoia Hospital 151 23 Whipple & Alameda, Redwood City Santa Barbara 604 93 Goleta Valley Community Hospital 20 9 351 South Patterson, Santa Barbara Lompoc District Hospital 16 3 508 East Hickory, Lompoc Register Office (MSR) 54A/ 16 USAF Hospital, Vandenberg AFB Santa Barbara Cottage Hospital 328 25 320 West Pueblo, Santa Barbara Santa Barbara County General Hospital 117 16 P.O. Box 3650, Santa Barbara Santa Ynez Valley Hospital 57 13 700 Alamo Pintado, Solvang Valley Community Hospital 12 11 505 East Plaza Drive, Santa Maria Santa Clara 5,047 1,270 Campbell Community Hospital 8 10 1650 Winchester, Campbell Community Hospital Los Gatos Sar 482 156 815 Pollard, Los Gatos El Camino Hospital 892 224 2500 Grant Road, Mountain View Kaiser Foundation Hospital 639 170 900 Kiely Drive, Santa Clara A/ Incomplete reporting. Estimates made from reports received. -129- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Santa Clara (Continued) San Jose Hospital & Health Center B/ 227 - 675 East Santa Clara, San Jose Santa Clara Valley Medical Center 300A/ 43 751 South Bascom Avenue, San Jose Stanford University Hospital 1,307 192 300 Pasteur Drive, Palo Alto The Good Samaritan Hospital 1,023 182 15825 Samaritan Drive, San Jose The Park Alameda Hospital 354 49 976 Lenzen Avenue, San Jose Wheeler Hospital 42 17 651 - 6th Street, Gilroy Santa Cruz 2 3 Watsonville Community Hospital 2 3 Green Valley Holohan, Watsonville Shasta 11 -- Memorial Hospital of Redding 11 0 East & Butte Streets, Redding Siskiyou 50 6 Mount Shasta Community Hospital 22 6 203 Eugene Street, Mount Shasta Siskiyou General Hospital 28A/ 818 South Main Street, Yreka Solano 767 234 Broadway Hospital 428 123 525 Oregon Street, Vallejo David Grant USAF Hospital 204A/ 54 Travis AF Base, Fairfield Intercommunity Memorial Hospital 40 29 1800 Pennsylvania, Fairfield Kaiser Foundation Health & Rehabilitation Center 93 28 2600 Alameda Street, Vallejo Vallejo General Hospital 2 0 510 Los Cerritos, Vallejo A/ Incomplete reporting. Estimates made from reports received. B/ No report received. -130- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Sonoma 857 246 Community Hospital of Sonoma County 439 90 3325 Chanate Road, Santa Rosa Hillcrest Hospital 115 34 Hayes Street & El Rose, Petaluma Palm Drive Hospital 15 2 501 Petaluma Avenue, Sebastopol Santa Rosa General Hospital 138 97 465 A Street, Santa Rosa Sonoma Valley District Hospital 146 23 347 Andrieux Street, Sonoma Warrack Medical Center Hospital 4 0 2457 Summerfield Road, Santa Rosa Stanislaus 602 105 Doctors Hospital of Modesto 34 22 333 West Orangeburg A, Modesto Emanuel Hospital 18 7 825 Delbon Avenue, Turlock Memorial Hospital Stanislaus County 12 3 P.O. Box 942, Modesto Modesto City Hospital 16 28 730 - 17th Street, Modesto Scenic General Hospital 520 43 830 Scenic Drive, Modesto Turlock Community Hospital 2 2 222 South Thor Street, Turlock Sutter 121 28 Fremont Hospital 70 28 970 Plumas Street, Yuba City Sutter County General Hospital 51 B / 1965 Live Oak Boulevard, Yuba City Tulare 133 38 Alta Local Hospital 2 0 500 Adelaide Way, Dinuba Kaweah Delta District Hospital 56 17 400 West Mineral King, Visalia Lindsay District Hospital 2 0 City Park, Lindsay Tulare County General Hospital 1 0 1062 South K Street, Tulare Tulare District Hospital 72 21 869 Cherry Avenue, Tulare B/ No report received. -131- NUMBER REPORTED HOSPITAL 1971 January-March, 1972 Tuolumne 4 1 Sierra Hospital 3 I 179 South Fairview Lane, Sonora Tuolumne General Hospital I 0 101 East Hospital Road, Sonora Ventura 787 168 Community Memorial Hospital S Buenaventura 155 35 2800 Loma Vista Road, Ventura General Hospital Ventura County 513 93 3291 Loma Vista Road, Ventura Los Robles Hospital 61 17 215 West Janss Road, Thousand Oaks Ojai Valley Community Hospital 25 4 1306 Maricopa Highway, Ojai Oxnard Community Hospital 32 19 540 South H Street, Oxnard Simi Valley Adventist Hospital I 0 2975 Sycamore Drive, Simi Yolo 253 46 Davis Community Hospital 119 30 Road 31 & Road 99, Davis Woodland Memorial Hospital 93 16 1325 Cottonwood Street, Woodland Yuba 69 26 Rideout Memorial Hospital 69 26 726 Fourth Street, Marysville -132- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Alhambra Community Hospital 5 206 South Garfield Ave. Alahambra Antelope Valley District Hospital 90 1600 West Avenue J Lancaster Avalon Memorial Hospital 10,021 5862 South Avalon Boulevard Los Angeles Bay Harbor Hospital 11 1437 West Lomita Boulevard Harbor City Behrens Memorial Hospital 89 446 Piedmont Avenue Glendale Bel Air Memorial Hospital 2,515 2311 Roseomare Road Bel Air Bella Vista Community Hospital 3,640 5425 East Pomona Los Angeles Bellflower Community Hospital 46 9542 East Artesia Bellflower Belvedere Hospital 4A/ 127 South Utah Street Los Angeles Beverly Glen Hospital 162A/ 10361 West Pico Boulevard Los Angeles Beverly Hills Doctors Hospital 770 10390 Santa Monica Los Angeles A/ Incomplete reporting. Estimates made from reports received. -133- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Beverly Hospital 61 309 West Beverly Boulevard Montebello Bon Air Hospital 86 250 West 120th Street Los Angeles Broadway Community Hospital 577 9500 South Broadway Los Angeles Burbank Community Hospital 173 466 East Olive Avenue Burbank Canoga Park Hospital 934 20800 Sherman Way Canoga Park Carson Intercommunity Hospital 324 23621 South Main Carson Cedars Lebanon Hospital 1,251 4833 Fountain Avenue Los Angeles Centinela Valley Community Hospital 531 555 East Hardy Street Inglewood City of Hope 2 1500 East Duarte Duarte City View Hospital 24 3711 Baldwin Street Los Angeles Community Hospital North Hollywood 1,541 6421 Coldwater Canyon North Hollywood Community Hospital of San Gabriel 7 218 South Santa Anita San Gabriel -134- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Community Hospital of Gardena 51 1246 West 155th Street Gardena Community Hospital of Huntington Park 148 2623 East Slausen Huntington Park Community Hospital of Los Angeles 4 4081 East Olympic Boulevard Los Angeles Compton Phys. & Surg. Hospital 16A/ 4200 East Compton Compton Doctors Hospital 1,755 325 West Jefferson Los Angeles Dominguez Valley Hospital 50 3100 South Susana Road Compton Downey Community Hospital 2 11500 Brookshire Downey Encino Hospital 15A/ 16237 Ventura Boulevard Encino Fox Hills Community 151A/ 5525 West Slausen Avenue Los Angeles Gardena Medical Center Hospital 117 2315 West Compton Boulevard Gardena Garfield Hospital 139 123 Hilliard Monterey Park A/ Incomplete reporting. Estimates made from reports received. -135- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Glendale Adventist Hospital 47 1509 Wilson Terrace Glendale Glendale Community Hospital 25 800 South Adams Street Glendale Granada Hills Community Hospital 232 10445 Balboa Granada Hills Hartland Hospital 157 14148 East Francisqto Baldwin Park Hawthorne Community Hospital 111 11711 Grevillea Avenue Hawthorne Hollywood Pres. HP 01msted 12 1322 North Vermont Los Angeles Holly Park Hospital 90A/ 2501 West El Segundo Hawthorne Hollywood Community Hospital 142 6245 De Longpre Hollywood Hospital of Good Samaritan 49A/ 1212 Shatto Street Los Angeles Huntington Memorial Hospital 217 100 Congress Street Pasadena Imperial Hospital 9 11222 Inglewood Inglewood A/ Incomplete reporting. Estimates made from reports received. -136- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Inter Community Hospital 62 275 West College Street Covina Inter-Valley Community Hospital 10 21704 West Soledad Court Saugus John Wesley Co. Hospital 946 2826 South Hope Street Los Angeles Kaiser Foundation Hospital 489 9400 East Rosecrans Bellflower Kaiser Foundation Hospital 1,316 4867 Sunset Boulevard Los Angeles Kaiser Foundation Hospital 369 13652 Cantara Street Panarama City Kaiser Foundation Hospital 407 1100 West Pacific Coast Highway Harbor City Los Angeles County - Harbor 278 1000 West Carson Street Torrance Los Angeles County - Olive View 2 14445 Olive View Drive Sylmar Los Angeles County - U.S.C. Medical Center 6,184 1200 West State Street Los Angeles La Mirada Community Hospital 73 14900 East Imperial Highway La Mirada A/ Incomplete reporting. Estimates made from reports received. -137- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Lincoln Hospital 2 443 South Soto Street Los Angeles Long Beach Community Hospital 739 1720 Termino Avenue Long Beach Los Altos Hospital 369 3340 Los Coyotes Long Beach Memorial Hospital of Glendale 91 1420 South Central Glendale Memorial Hospital of Hawthorne 140 13300 South Hawthorne Hawthorne Memorial Hospital of Long Beach 842 2801 Atlantic Avenue Long Beach Memorial Hospital of Panorama City 260A! 14850 Roscoe Boulevard Panorama City Memorial Hospital of Southern California 103 13828 Hughes Avenue Culver City Memorial Hospital of Gardena 186 1145 Redondo Beach Gardena Methodist Hospital of Southern California 206 300 West Huntington Arcadia Midvalley Community 109 7533 Van Nuys Boulevard Van Nuys A/ Incomplete reporting. Estimates made from reports received. -138- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Midway Hospital 12 5925 San Vicente Los Angeles Mission Hospital 2 3111 East Florence Huntington Park Monte Sano Hospital 14 2834 Glendale Boulevard Los Angeles Morningside Hospital 727 8711 South Harvard Boulevard Los Angeles Mt. Sinai Hospital and Clinic 71A/ 8720 Beverly Boulevard Los Angeles North Glendale Hospital 12 1401 West Glenoaks Glendale Northridge Hospital Foundation 149A/ 183 Roscoe Boulevard Northridge Norwalk Community Hospital 19 13222 Bloomfield Norwalk Pacific Glen Hospital 816 712 South Pacific Avenue Glendale Pacific Hospital of Long Beach 158 2776 Pacific Avenue Long Beach Pacoima Memorial Lutheran Hospital 372 11600 Eldridge Avenue Pacoima A/ Incomplete reporting. Estimates made from reports received. -139- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed Palmdale General 6 1212 East Avenue South Palmdale Park View Hospital 34A/ 1021 North Hoover Street Los Angeles Parkwood Community Hospital 6,906 7011 Shoup Avenue Canoga Park Pasadena Community Hospital 3 1845 North Fair Oaks Pasadena Pico Rivera Community Hospital 45 5216 South Rosemead Pico Rivera Pioneer Hospital 64 17831 South Pioneer Artesia Pomona Valley Community Hospital 263 1798 North Garey Avenue Pomona Presbyterian Intercommunity Hospital 116A/ 12401 East Washington Whittier Rancho Los Amigos 2 7601 Imperial Highway Downey Rio Hondo Memorial Hospital 289 8300 Telegraph Road Downey San Fernando Hospital 1 732 Mott Street San Fernando A/ Incomplete reporting. Estimates made from reports received. -140- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed San Gabriel Valley Hospital 28 115 East Broadway San Gabriel San Pedro and Peninsula Hospital 61 1305 West 6th Street San Pedro San Vicente Hospital 6,524 6000 San Vicente Los Angeles Santa Monica Hospital Medical Center 104 1225 - 15th Street Santa Monica Sherman Oaks Community Hospital 13 4929 Van Nuys Boulevard Sherman Oaks South Bay Hospital 211 514 North Prospect Avenue Redondo Beach Southeast Doctors Hospital 432 5900 Pine Avenue Maywood St. Michaels 120 1845 Pacific Coast Highway Hermosa Beach Studebaker Community Hospital 1 13100 South Studebaker Norwalk Suburban Hospital, Inc. 2 3164 Southern Avenue South Gate Temple Hospital 191 235 North Hoover Los Angeles -141- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed The California Hospital 201 1414 South Hope Street Los Angeles Torrance Memorial 345 1425 Engracia Torrance U.C.L.A. Medical Center 144 10833 Le Conte Los Angeles University Hospital 28 3787 South Vermont Los Angeles Valley Hospital 15 14500 Sherman Circle Van Nuys Valley Doctors 1,897 12629 Riverside Drive North Hollywood Valley Presbyterian 405 15107 Van Owen Street Van Nuys Viewpark Community Hospital 9 5035 Coliseum Street Los Angeles Washington Hospital 119 12101 West Washington Los Angeles West Hills Hospital 19 23023 Sherman Way Canoga Park West Park Hospital 78 22141 Roscoe Boulevard Canoga Park -142- THERAPEUTIC ABORTIONS REPORTED BY INDIVIDUAL HOSPITAL LOS ANGELES COUNTY, 1971 Number Hospital Performed West Valley Community Hospital Fd. 827 5333 Balboa Boulevard Encino Westside Hospital 6 910 South Fairfax Avenue Los Angeles White Memorial Medical Center 73 1720 Brooklyn Avenue Los Angeles Whittier Hospital 4 15151 Janine Drive Whittier Woodruff Community Hospital 90 3800 Woodruff Avenue Long Beach -143- Appendix 12 STATE OF CALIFORNIA STATEWIDE ADOPTIONS Fiscal 55-56 through Fiscal 70-71 Total Public and Total Relinquish- Relinquishment Adoptions Private Relinquish- Independent ment and Indepen- Stepparent Fiscal Year Public Private ment Adoptions Adoptions dent Adoptions Adoptions 1955-56 1243 914 2157 4101 6258 3276 1956-57 1271 1147 2418 4214 6632 3644 1957-58 1326 1144 2470 4265 6735 3524 1958-59 1436 1216 2652 4552 7204 3870 1959-60 1758 1508 3266 4994 8260 3862 1960-61 2135 1506 3641 4872 8513 3911 1961-62 2669 1659 4328 4827 9155 4362 1962-63 3207 1531 4738 4890 9628 4605 -144- 1963-64 3832 1739 5571 4912* 10483 5019 1964-65 4611 1729 6340 4772 11112 5002 1965-66 5059 1951 7010 4683 11693 5639 1966-67 5410 2200 7610 4370 11980 6453 1967-68 6055 2337 8392 3995 12387* 6369 1968-69 6301 2366 8667* 3390 12057 6433 1969-70 5718 2037 7755 3115 10870 5951 1970-71 4121 1438 5559 2603 8162 7088 * Peak year followed by decrease. Source: State of California, Department of Benefit Payments. PROTECTIVE SERVICES FOR ILLEGITIMATE CHILDREN DOH LEGITIMATE COUNTY WELFARE ADOPTION VITAL BIRTH DEPARTMENT, STATISTICS ILLEGITIMATE PROTECTIVE SERVICES PATERNITY ENDANGERED OR CHILD NOT ADEQUATE HOME POTENTIALLY ENDANGERED ENDANGERED CHILD FOSTER CARE PROTECTIVE SERVICES WORKER INTERVIEW AND RECOMMENDATIONS -145- PROTECTIVE SERVICES BOARD HEARING FAMILY LAW COURT Appendix 13 ESTABLISHMENT OF PATERNITY AND NOTIFICATION OF INTERESTED FATHER FATHER SIGNS ADOPTION COUNTY NOTICE BIRTH VITAL WELFARE TO FATHER CERTIFICATE STATISTICS DEPARTMENT IF REQUIRED FOSTER CARE FATHER FAILS TO SIGN GUARDIANSHIP MONITOR FOR 1 YEAR AFTER BIRTH REQUEST FATHER FOR UNLOCATED NOTICE AFFIDAVIT PATERNITY OF DISPUTED PATERNITY -146- SIGNATURE BY AFFIDAVIT REFER TO DISTRICT ATTORNEY FOR PATERNITY ACTION Appendix 14 NONPATERNITY PATERNITY LEGITIMATION X. REFERENCES AFDC Characteristics January 1973; Frank Din, Unpublished State Department of Social Welfare Report Associated Press Report; Sacramento Bee, January 30, 1973 Birth Records; State of California; Department of Health Boys in Fatherless Homes; Herzog and Sudia, U.S. DHEW, Office of Child Development, Publication 72-33 (reprinted 1971) California Department of Finance; Financial and Economic Research Bureau, Population Studies Unit Elizabeth K. Canfield, Consultant, Student Health Center, San Fernando Valley State College, Moderating Panel on "A Critique on Sex and Health Education in the Public Schools", Meeting of the California Interagency Council on Family Planning, Los Angeles, June 9, 1972 Children; September-October 1968; Children's Bureau, Office of Child Development, U.S. DHEW; Fatherless Homes; Herzog and Sudia; Vol. 15, No. 5 Judith Blake Davis, Professor of Demography, University of California, Berkeley, U.P.I., dispatch, Sacramento Bee, February 6, 1973 Kingsley Davis, Ford Professor of Sociology and Comparative Studies; Chairman, International Population and Urban Research; University of California, Berkeley; testimony before the State Social Welfare Board, July 28, 1972 Early Medical Complications of Legal Abortions; Studies in Family Planning; Publication of the Population Council; Vol. 3, No. 6, June 1972 The Effects of Legal Abortion on Legitimate and Illegitimate Birth Rates: The California Experience; June Sklar and Beth Berkov, University of California Reprint No. 436, November 1973 80 Unmarried Mothers Who Kept Their Babies; Helen R. Wright, Ph. D., State of California, Department of Social Welfare, May 1965 Estimate of Induced Abortions in Urban North Carolina; J. R. Abernathy, B. G. Greenberg, and D. G. Harvitz; Demography, 7 (1970) Facts of Life in California - 1972-1973; Public Education and Research Committee of California, Berkeley, California Facts of Life in California - 1973; Public Education Research Committee of California, May 10, 1973 Frances Feldman, Professor of Social Work, University of Southern California; Chairman, Advisory Committee on Family and Children's Services, Los Angeles County in testimony before State Social Welfare Board, November 16, 1972 -147- Fifth Annual Report on the Implementation of the California Therapeutic Abortion Act; California Department of Public Health, Bureau of Maternal and Child Health Fifth Annual Report on the Implementation of the California Therapeutic Abortion Act; State of California, Department of Public Health, Report to the 1972 Legislature Final Report of the Task Force on Absent Parent Child Support; State Social Welfare Board; January 1971 Findings of the 1971 AFDC Study; Part I, U.S. DHEW, Publication No. (SRS) 72-03756 Alan F. Guttmacher, M.D., President, Planned Parenthood-World Population, Newsletter No. 61, June 15, 1972 Shirley Hartley, Ph. D., Department of Sociology, California State University, Hayward; testimony before the State Social Welfare Board, July 28, 1972 How They Fared in Adoption; Benson Jaffee and David Fanshel; from Foreward by Joseph H. Reid, Executive Director, Child Welfare League of America, Columbia University Press, New York and London, 1970 Nancy Humpreys, President, National Association of Social Workers, Los Angeles Chapter; testimony before the State Social Welfare Board, Long Beach, June 23, 1972 Illegitimacy: Law and Social Policy; Harry D. Krause; Bobbs-Merrill Illegitimacy Recidivism Among AFDC Clients; Barbara B. Griswald, Kermit Wiltse, Robert Roberts; In Unmarried Parenthood, Clues to Agency and Community Action; National Council on Illegitimacy, New York, 1967 Illegitimate Births in California 1966-67; State of California, Department of Public Health; March 1971 Infant and Perinatal Mortality in Scotland; National Center for Health Statistics, Series 3 No. 5; Vital and Health Statistics: Analytic Series; November 1966 An Interim Report on Fertility and Abortion in California; Beth Berkov and June Sklar; International Population and Urban Research; University of California, Berkeley; June 1972 International Comparison of Perinatal and Infant Mortality; National Center for Health Statistics, Series 3 No. 6; Vital and Health Statistics: Analytical Series, March 1967 The Juvenile Unwed Father; Robert E. Perkins and Ellis S. Grayson Stuart W. Knight, Attorney at Law; testimony before the State Social Welfare Board, November 16, 1972 -148- Legal Aspects of Access to Family Planning Services; Ruth Roemer, J.D., Associate Researcher in Health Law, Institute of Government and Public Affairs University of California, Los Angeles; Presented in "Sex and the Law", Western Regional Conference, Planned Parenthood - World Population, Pasadena, April 7, 1972 Memorandum; Public Education Research Committee of California, No. 1, Febraury 26, 1973 Memorandum; Public Education Research Committee of California, No. 2, April 3, 1973 Warren B. Miller, M.D., Department of Psychiatry, Stanford Unviersity, Psychologically Vulnerable Stages in Women Leading to Unwanted Pregnancies; California Interagency Council on Family Planning Meeting The Morality of Abortion; John T. Noonan, Jr., Harvard Press, 1970 National Natality and Infant Mortality Surveys: 1964-66; National Center for Health Statistics, Vital Statistics Report; Vol. 20, No. 5, August 2, 1971 Mrs. Doanld A. Nielsen, Executive Director, Florence Crittenton Services in Key Notes from the Florence Crittenton Service, December 1972 1970 Census Data for Health Planning; State of California, Department of Public Health, Vol. 2, Table 9, Birth Records and Therapeutic Abortion Reports Robert 0. Pasnau, M.D., Reviews, Obstetrics and Gynecology; Vol. 40, No. 2, August 1972 Position Statement Issue: Illegitimacy; State Social Welfare Board; March 1972 Report on Child Welfare Services in California; State Social Welfare Board; July 1969 Report on Foster Care: Children Waiting; State Social Welfare Board; September 1972 Report to the California Assembly Pursuant to House Resolution No. 44; 1971 State of California, Department of Public Health Report to the 1972 California Assembly Pursuant to House Resolution No. 44; State of California Human Relations Agency, Department of Public Health Right to Life; Greater Cincinnati, pamphlet Senate Documents; Vol. 13, 60th Congress, ED.S. Sex Code of California; Public Education and Research Committee of California, 1973 -149- A Statistical Analysis of Teen-age and Young Adult Patients Receiving Family Planning Services from OEO and U.S. DHEW Funded Grantees in Region IX During Calendar Year 1971; by Neil Bodine, presented to OEO Workshop, California Interagency Council on Family Planning, Asilomar, July 5, 1972 Gary G. Stewart, M.D., Cathedral Hill Medical Center, San Francisco, in testimony before the State Social Welfare Board, November 16, 1972 Student-Parent Reaction Panel; Proceedings of the Council Meeting, California Interagency Council on Family Planning; June 9, 1972 The Unmarried Father; Reuben Pannor, Fred Massarik, Byron Evans, Springer Publishing Company, Inc., 1971 Unmarried Mothers; Clark E. Vincent, The Free Press of Glencoe, Inc. 1961 Vital Statistics; Marriages and Divorces; California Department of Public Health, August 1972, No. 10, Table vs 72-024 Vital Statistics of the United States; 1967, VII, Mortality, Part A, U.S. DHEW Welfare Myths vs. Facts; U.S. DHEW; November 15, 1971; Congressional Record - Senate What Do you Want Your Children to Learn About Sex; Eric W. Johnson; California Interagency Council on Family Planning Newsletter; Vol. 4, No. 1; Reprinted from Parents Magazine Who Insures the Child's Right to Health?; Helen E. Boardman, ACSW, RSW; Child Welfare League of America, Inc.; July 1963 -150-