New Study Highlights Demographics of Women Who Have Abortions in 28 Low- and Middle-Income Countries

Demographic characteristics of women who obtain abortions vary widely by country and region, according to an article recently published in PLOS ONE, "Characteristics of Women Obtaining Induced Abortions in Selected Low- and Middle-Income Countries," by Guttmacher Institute researchers Dr. Sophia Chae and colleagues. Their work updates a previous study published in 1999 and measures characteristics such as abortion patients’ age, marital status, number of previous births, wealth, education, and urban or rural residence.

The researchers analyzed data collected from 2002 to 2014 in 28 low- and middle-income countries—five in Africa, 13 in Asia, eight in Europe, and two in Latin America and the Caribbean. Abortion is legally and severely restricted in approximately half of the countries studied, and in many others, safe abortion services are not easily accessible despite being legal.

"By identifying the characteristics of women who are most likely to have clandestine abortions—and who are therefore most at risk for experiencing complications—the findings can help target efforts to address unintended pregnancy and unsafe abortion among these groups," says Dr. Chae, senior research scientist at the Guttmacher Institute and lead author of the study.

Worldwide, there has been a shift over the past two decades in both the demographic composition of women of reproductive age and in access to reproductive health services. Girls are staying in school longer and more women are employed than in the past. The desire for smaller families and greater control over spacing births has also increased.

The study found that women aged 20–29 obtained a disproportionately high number of abortions in most low- and middle-income countries included in this review, based on the percentage of reproductive-age women in that age range in each country. Researchers also found a disproportionate share of abortions occurred among women aged 30–39 in the Asian and European countries studied. In some countries, a disproportionately high level of abortions was also found among women of high socioeconomic status—as measured by wealth status, educational attainment and urban residence.

However, researchers found wide variation among countries, and emphasize that the findings cannot be used to generalize across all low- and middle-income countries or geographic regions. For instance, in 11 of the 12 Asian countries in the study with applicable evidence, 73–85% of abortions occurred among women who had already had two or more children. Yet only one-third of abortions in Nepal occurred in this group.

"Notwithstanding some variations among countries and regions, one thing is clear: women from every social and demographic group have abortions—including in countries where abortion is highly restricted," says Dr. Gilda Sedgh, principal research scientist at the Guttmacher Institute and a coauthor of the study.

The researchers hope that policymakers and advocates will use their findings to better target efforts to reduce abortion-related injuries and deaths in developing countries, noting that 86% of all abortions worldwide occur in low- and middle-income countries. They recommend expanding contraceptive services, along with access to safe abortion services and postabortion care—interventions that will reduce unintended pregnancy and ameliorate the consequences of unsafe abortion.