Legal Abortion Levels and Trends By Woman’s Age at Termination

Abstract

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. 2Abortion 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. 6Other factors that could influence the age patterns of abortion include age at marriage, desired fertility and fecundity. The average age at marriage has been increasing in many countries, 7,8 and the risk of unintended pregnancy and abortion among sexually active women in their 20s may also be increasing. Women who are reaching the end of their reproductive years, are sexually active and fecund, and have completed their desired family size are also at risk of unintended pregnancy and abortion. The most recent prior assessments of abortion incidence across age-groups of women are for the mid-1990s and for 2003; 3,9 however, patterns in age-specific abortion levels in many countries may have changed since then.

Modeling the fertility impact of the proximate determinants: Time for a tune-up

“…In developed countries with reasonably accurate abortion statistics, abortion rates by age have an inverted U graph-shape, with peak rates between ages 20 and 29 (Sedgh et al 2012a). For present purposes it will be assumed that the countries included in this paper also have an inverted U graph-shape.…”

Social Inequalities in Teenage Fertility Outcomes: Childbearing and Abortion Trends of Three Birth Cohorts In Finland

“…Between 1976 and 1999, teenage fertility rates in all Nordic countries decreased by more than 50%; during the same time period, abortion rates declined by approximately 40% in Finland and Denmark, and by 20–25% in Norway and Sweden . However, a higher proportion of all abortions were performed for teenagers in Finland than in all other Nordic countries except for Iceland (in the late 1990s and early 2000s, around 20%, compared with approximately 15% in Denmark, Norway and Sweden), which may indicate higher sexual activity or more inconsistent contraceptive use among Finnish teenagers than among teenagers in other Nordic countries.…”

Impact of a pay-for-performance scheme for long-acting reversible contraceptive (LARC) advice on contraceptive uptake and abortion in British primary care: An interrupted time series study

“…Unintended pregnancies make up an estimated 44% of all pregnancies worldwide, nearly 60% of these end in abortions [ 1 ], and up to half of unintended pregnancies are due to incorrect or inconsistent use of contraception [ 2 , 3 ]. Britain has among the highest teenage abortion rates in Europe [ 4 , 5 ]; together, these suggest significant room for improvement in contraceptive programmes in Britain and worldwide [ 6 ].…”