Academic journal article International Family Planning Perspectives

Estimates of Induced Abortion in Mexico: What's Changed between 1990 and 2006?

Academic journal article International Family Planning Perspectives

Estimates of Induced Abortion in Mexico: What's Changed between 1990 and 2006?

Article excerpt

CONTEXT: In Mexico, where abortion remains largely illegal and clandestine, reliable data on induced abortion and related morbidity are critical for informing policies and programs. The only available national estimate of abortion is for 1990, and demographic and socioeconomic changes since then have likely affected abortion incidence.

METHODS: This study used official statistics on women treated for abortion-related complications in public hospitals In 2006 and data from a survey of informed health professionals. Indirect estimation techniques were used to calculate national and regional abortion measures, which were compared with 1990 estimates.

RESULTS: In 2006, an estimated 150,000 women were treated for induced abortion complications in public-sector hospitals, and one in every 5.8 women having an induced abortion were estimated to have received such treatment. The estimated total number of induced abortions in 2006 was 875,000, and the abortion rate was 33 per 1,000 women aged 15-44. Between 1990 and 2006, the abortion rate increased by 33% (from a rate of 25). The severity of morbidity due to unsafe abortion declined (as seen in shorter hospital stays), but the annual rate of hospitalization did not--it was 5.4 per 1,000 women in 1990 and 5.7 in 2006. The abortion rate was similar to the national average in three regions (34-36), but substantially lower in one (25 in the South/East region).

CONCLUSIONS: Clandestine abortion continues to negatively affect women's health in Mexico. Recommended responses include broadening the legal criteria for abortion throughout Mexico, improving contraceptive and postabortion services, and expanding training in the provision of safe abortion, including medical abortion.

International Family Planning Perspectives, 2008,34(4): 158-168

A critical challenge in the global effort to reduce maternal mortality is the persistence of unsafe abortion, which accounts for 13% of pregnancy-related deaths worldwide. (1) The World Health Organization defines unsafe abortion as a procedure to terminate an unintended pregnancy that is performed by an individual who lacks adequate skills or that occurs in conditions that do not meet basic medical standards, or both. (2) Unsafe abortion has significant negative effects on women, families, public health systems and society worldwide (3), (4) and in Mexico (5-7)-yet it is almost entirely preventable.

Unsafe abortion is often the only option available to women who wish to terminate a pregnancy in countries where abortion is illegal or legally restricted, or where significant access barriers exist. Latin America and the Caribbean have some of the world's most restrictive abortion laws, yet an estimated 4.1 million abortions occur each year in this region, almost all of them unsafe. (8) In Guatemala, where abortion is legal only to save the woman's life, the estimated annual abortion rate is 24 per 1,000 women aged 15-49, and approximately 30% of all women having induced abortions are hospitalized for treatment of complications. (9) In Mexico, complications from unsafe abortion are the fifth leading cause of leading cause of maternal mortality (accounting for 6-8% of pregnancy-related deaths); given the underreporting of maternal deaths in general and abortion deaths in particular, this proportion could be larger. (10), (11)

Estimates of the incidence of unsafe abortion are critical for quantifying the scope of the problem and for informing policy change, (12) yet there is little reliable information on trends in abortion incidence. In countries such as Mexico, where abortion is highly legally restricted, collecting accurate data is a formidable challenge, particularly given the limitations of face-to-face surveys and other direct measurement approaches. Although some national surveys have included abortion questions in pregnancy histories, the use of face-to-face interviews is likely to result in high levels of underreporting because of the stigma attached to abortion. …

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