Academic journal article International Perspectives on Sexual and Reproductive Health

Legal Abortion Levels and Trends by Woman's Age at Termination

Academic journal article International Perspectives on Sexual and Reproductive Health

Legal Abortion Levels and Trends by Woman's Age at Termination

Article excerpt

CONTEXT: Assessments of abortion levels and trends by women's age at termination can be used to monitor trends in unintended pregnancy by age and can inform relevant programs and policies.

METHODS: Legal abortion incidence data were compiled from national statistical offices and nationally representative surveys of more than 40 countries where legal abortion is generally available. Age-specific abortion rates and percentage distributions of abortions by age were computed, and trends since 1996 and 2003 were examined. Subregional and regional estimates were developed for geographic areas where the majority of the population was represented by the data.

RESULTS: The median year for the most recent estimates of abortions by woman's age was 2009. Adolescents accounted for a smaller share of abortions than their share of the population in the majority of eligible countries with data. In most countries, the highest age-specific abortion rates and proportions of abortions were among women aged 20-29. Since 1996, adolescent abortion rates have increased the most in Belgium, the Netherlands and Scotland (22-42%), and have decreased the most in Estonia, Hungary, Iceland, Slovakia and Slovenia (40-55%). The proportion of abortions obtained by adolescents was higher in North America (18%) than in Europe overall (11%), although the proportion in Northern Europe (18%) was the same as that in North America.

CONCLUSIONS: Higher abortion rates in particular age-groups probably reflect higher-than-average levels of unmet need for contraception or difficulty using methods consistently and effectively, and a stronger desire to avoid childbearing. Each of the patterns observed has implications for service and information needs within countries. International Perspectives on Sexual and Reproductive Health, 2012, 38(3):143-153, doi: 10.1363/3814372

Worldwide, the incidence of induced abortion has remained steady in recent years after declining in the 1990s and early 2000s. (1) The same is not true, however, for each individual country for which information on abortion trends is available: In many, the incidence of abortion has continued to decline, and in a few, it has risen. (2)

Abortion levels and trends can also vary within countries, across subgroups of women. (3) Documentation of abortion incidence is unavailable in most countries with highly restrictive abortion laws, and quantitative information on the characteristics of women who have abortions in such countries--including their age, marital status and parity--is even more scarce. However, abortion data collection systems are in place in most countries with liberal abortion laws. The information obtained about women having abortions differs across these countries; age is perhaps the most commonly recorded characteristic.

Groups of women with disproportionately high abortion rates likely have an exceptionally difficult time avoiding unintended pregnancies or a greater motivation to terminate such pregnancies. In many societies, young unmarried women who are sexually active might have a particularly difficult time avoiding unintended pregnancies, because fear of the stigma attached to nonmarital sexual activity can inhibit them from obtaining contraceptive services and from using methods correctly and consistently. In addition, young women may find it. difficult to negotiate contraceptive use with their partners. Unplanned births among adolescents and young adults can carry high opportunity costs--sometimes forcing them to curtail their schooling and, thus, adversely affecting their future employment prospects and sometimes compromising their ability to establish stable partnerships. (4), (5) On the other hand, sexual activity is less prevalent among adolescents than among women in their 20s; in settings where sexual activity is low among adolescents, abortion rates might also be low. (6)

Other factors that could influence the age patterns of abortion include age at marriage, desired fertility and fecundity. …

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