Keywords
Voluntary interruptions of pregnancy, Abortion, Sexual and Reproductive Health, Socioeconomic factors, Spain.
Abstract
Introduction: The voluntary interruption of pregnancy (VIP) is a complex process, influenced both by health and psychosocial factors, which in turn affect the health and well-being of the women. The objective of this study is to describe the characteristics of repeat VIPs in Spain.
Methods: Cross-sectional study of the VIP episodes carried out at the request of the women themselves in Spain during 2018. The factors related to repeat VIPs are described according to the origin of the women, estimating the crude and adjusted prevalence odds ratio (OR).
Results: The highest rates of VIP occurred in women aged 20 to 24 years. The probability of a second VIP, both in Spanish women and those of foreign origin, increased with age, with the size of the population (> 50,000 inhabitants), and with dependent children.
Conclusions: According to the data from our study, knowing the factors related to the recurrence of voluntary interruptions of pregnancy allows us to draw up more effective and specific strategies for promoting safe and accessible sexual and reproductive health.
References
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[16] Rondón MB. Salud mental y aborto terapéutico. An Fac Med 2016;76(4):407-11. doi: 10.15381/anales.v76i4.11411.
[17] Danet Danet A. Experiencias emocionales en la interrupción voluntaria del embarazo. Gac Sanit 2020;35(4)361-73. doi: 10.1016/j.gaceta.2020.02.006.
[18] Wang MY, Zhang WH, Mu Y, Temmerman M, Li JK, Zheng A. Contraceptive practices among unmarried women in China, 1982-2017: systematic review and meta-analysis. Eur J Contracept Reprod Health Care 2019;24(1):54-60. doi: 10.1080/13625187.2018.1555641.
[19] Jacovetty EL, Clare CA, Squire MB, Kubal KP, Liou S, Inchiosa MA Jr. Clinical oversight and the avoidance of repeat induced abortion. Int J Gynaecol Obstet 2018;142(3):349-353. doi: 10.1002/ijgo.12543.
[20] Liu J, Wu S, Xu J, Temmerman M, Zhang WH; INPAC Group. Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces. Int J Environ Res Public Health 2019;16(5):794. doi: 10.3390/ijerph16050794.
[21] McCall SJ, Flett G, Okpo E, Bhattacharya S. Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data. J Fam Plann Reprod Health Care 2016;42(2):133-42. Doi: 10.1136/jfprhc-2014-101059
[22] Makleff S, Labandera A, Chiribao F, Friedman J, Cardenas R, Sa E, Baum SE. Experience obtaining legal abortion in Uruguay: knowledge, attitudes, and stigma among abortion clients. BMC Women’s Health 20199;19(1):155. Doi: 10.1186/s12905-019-0855-6
[23] Purcell C, Riddell J, Brown A, Cameron ST, Melville C, Flett G, Bhushan Y, McDaid L. Women's experiences of more than one termination of pregnancy within two years: a mixed-methods study. BJOG 2017;124(13):1983-1992. Doi: 10.1111/1471-0528.14940
[24] Vigoureux S. Epidemiology of induced abortion in France. J Gynecol Obstet Biol Reprod 2016;45(10):1462-1476. doi: 10.1016/j.jgyn.2016.09.024
[25] Jones RK, Singh S, Finer LB, Frohwirth LF. Repeat Abortion in the United States: Occasional Report (No. 29). New York. Guttmacher Institute, 2006. ISBN: 0-939253-92-5
[26] Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission. The Lancet, 2018;391(10140):2642-92. doi: 10.1016/S0140-6736(18)30293-9
[27] Sihvo S, Bajos N, Ducot B, Kaminski M. Women’s life cycle and abortion decision in unintended pregnancies. J Epidemiol Community Health, 2003; 57 (8): 601–605. doi: 10.1136/jech.57.8.601
[28] Bajos N, Prioux F, Moreau C. L’augmentation du recours répété à l’IVG en France: des enjeux contraceptifs au report de l’âge à la maternité. Revue d'Épidémiologie et de Santé Publique 2013; 61 (4):291-298. doi: 10.1016/j.respe.2013.04.001
[29] Rasch V, Gammeltoft T, Knudsen LB, Tobiassen C, Ginzel A, Kempf L. Induced abortion in Denmark: effect of socio-economic situation and country of birth. Eur J Public Health 2008;18(2):144-9. doi: 10.1093/eurpub/ckm112
[30] Bayefsky MJ, Bartz D, Watson KL. Abortion during the Covid-19 Pandemic - Ensuring Access to an Essential Health Service. N Engl J Med 2020;382(19):e47. doi: 10.1056/NEJMp2008006
[31] Dennis A, Manski R, Blanchard K. A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts. Women’s Health Issues 2015;25(5):463-9. doi: 10.1016/j.whi.2015.04.004
[32] Ostrach B, Cheyney M. Navigating Social and Institutional Obstacles: Low-Income Women Seeking Abortion. Qual Health Res 2014;24(7):1006-1017. doi: 10.1177/1049732314540218
[2] Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö,Beavin C, Kwok L, Alkema L. Unintended pregnancy and abortion by income, region, and the legal status of abortions: estimates from a comprehensive model for 1990-2019. Lancet Glob Health 2020;8(9):e1152-61. doi:10.1016/S2214-109X(20)30315-6.
[3] Ley Orgánica 9/1985, de reforma del artículo 471 del código penal. Boletín Oficial del Estado, núm. 166, de 12 de julio de 1985. Available at https://www.boe.es/boe/dias/1985/07/12/pdfs/A22041-22041.pdf
[4] Barroso García P, Lucena Méndez MA, Parrón Carreño T. Interrupción voluntaria del embarazo en mujeres de un distrito sanitario de Almería durante el período 1998-2002. Rev Esp Salud Pública 2005;79(4): 493-501. doi: 10.1590/S1135-57272005000400006
[5] Ley Orgánica 2/2010, de 3 de marzo, de salud sexual y reproductiva y de la interrupción voluntaria del embarazo. Boletín Oficial del Estado, núm. 55, de 4 de marzo de 2010. España. Available at: https://www.boe.es/buscar/pdf/2010/BOE-A-2010-3514-consolidado.pdf. Accessed on 03/05/2021.
[6] Ley Orgánica 10/1995, de 23 de noviembre, del Código Penal. Boletín Oficial del Estado, núm 281, de 24 de noviembre de 1995, artículos 144-146. España. Available at: https://www.boe.es/buscar/act.php?id=BOE-A-1995-25444&p=20210702&tn=0. Accesed on 03/05/2021.
[7] Dirección General de Salud Pública. Subdirección General de Promoción, Prevención y Calidad. Interrupción Voluntaria del Embarazo. Datos definitivos correspondientes al año 2018. Ministerio de Sanidad, Consumo y Bienestar Social. 2019. Available at: https://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/embarazo/docs/IVEs_anteriores/IVE_2018.pdf. Accesed on 03/05/2021.
[8] González de Chávez Fernández MA. El aborto: un abordaje bio-psico-social. Dilemata 2015; (17):1-21. Available at: https://www.dilemata.net/revista/index.php/dilemata/article/view/344 Accesed on 03/05/2021
[9] Zurriaga O, Martínez-Beneito MA, Galmés Truyols A, Torne MM, Bosch S, Bosser R, Portell Arbona M. Recourse to induced abortion in Spain: profiling of users and the influence of migrant populations. Gac Sanit. 2009;23(suppl 1):57–63. doi: 10.1016/j.gaceta.2009.09.012.
[10] Font-Ribera L, Pérez G, Salvador J, Borrell C. Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision. J of Urban Health 2008; 85(1):125-35. doi: 10.1007/s11524-007-9233-z.
[11] Llácer Gil de Ramales A, Morales Martín C, Castillo Rodríguez S, Mazarrasa Alvear L, Martínez Blanco ML. El aborto en las mujeres inmigrantes. Una perspectiva desde los profesionales sociosanitarios que atienden la demanda en Madrid. Index Enferm 2006;15(55):13-7. doi: 10.4321/S1132-12962006000300003
[12] Escobar-Ballesta M, García-Ramírez M, Albar-Marín MJ, Paloma V. Salud sexual y reproductiva en mujeres gitanas: el programa de planificación familiar del polígono Sur. Gac Sanit 2019;33(3):222-8. doi:10.1016/j.gaceta.2017.12.006.
[13] Orjuela M, Ronda E, Regidor E. Contribución de la inmigración al incremento de las interrupciones voluntarias del embarazo. Med Clínica 2009;133(6):213-6. doi: 10.1016/j.medcli.2008.10.064.
[14] Gemzell-Danielsson K, Cleeve A. Estimating abortion safety: advancements and challenges. The Lancet 2017;390(10110):2333-4. doi: 10.1016/S0140-6736(17)32135-9.
[15] Adesse L, Jannotti CB, Silva KS da, Fonseca VM. Aborto e estigma: uma análise da produção científica sobre a temática. Ciênc Saúde Colet 2016;21(12):3819-32. doi: 10.1590/1413-812320152112.07282015.
[16] Rondón MB. Salud mental y aborto terapéutico. An Fac Med 2016;76(4):407-11. doi: 10.15381/anales.v76i4.11411.
[17] Danet Danet A. Experiencias emocionales en la interrupción voluntaria del embarazo. Gac Sanit 2020;35(4)361-73. doi: 10.1016/j.gaceta.2020.02.006.
[18] Wang MY, Zhang WH, Mu Y, Temmerman M, Li JK, Zheng A. Contraceptive practices among unmarried women in China, 1982-2017: systematic review and meta-analysis. Eur J Contracept Reprod Health Care 2019;24(1):54-60. doi: 10.1080/13625187.2018.1555641.
[19] Jacovetty EL, Clare CA, Squire MB, Kubal KP, Liou S, Inchiosa MA Jr. Clinical oversight and the avoidance of repeat induced abortion. Int J Gynaecol Obstet 2018;142(3):349-353. doi: 10.1002/ijgo.12543.
[20] Liu J, Wu S, Xu J, Temmerman M, Zhang WH; INPAC Group. Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces. Int J Environ Res Public Health 2019;16(5):794. doi: 10.3390/ijerph16050794.
[21] McCall SJ, Flett G, Okpo E, Bhattacharya S. Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data. J Fam Plann Reprod Health Care 2016;42(2):133-42. Doi: 10.1136/jfprhc-2014-101059
[22] Makleff S, Labandera A, Chiribao F, Friedman J, Cardenas R, Sa E, Baum SE. Experience obtaining legal abortion in Uruguay: knowledge, attitudes, and stigma among abortion clients. BMC Women’s Health 20199;19(1):155. Doi: 10.1186/s12905-019-0855-6
[23] Purcell C, Riddell J, Brown A, Cameron ST, Melville C, Flett G, Bhushan Y, McDaid L. Women's experiences of more than one termination of pregnancy within two years: a mixed-methods study. BJOG 2017;124(13):1983-1992. Doi: 10.1111/1471-0528.14940
[24] Vigoureux S. Epidemiology of induced abortion in France. J Gynecol Obstet Biol Reprod 2016;45(10):1462-1476. doi: 10.1016/j.jgyn.2016.09.024
[25] Jones RK, Singh S, Finer LB, Frohwirth LF. Repeat Abortion in the United States: Occasional Report (No. 29). New York. Guttmacher Institute, 2006. ISBN: 0-939253-92-5
[26] Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission. The Lancet, 2018;391(10140):2642-92. doi: 10.1016/S0140-6736(18)30293-9
[27] Sihvo S, Bajos N, Ducot B, Kaminski M. Women’s life cycle and abortion decision in unintended pregnancies. J Epidemiol Community Health, 2003; 57 (8): 601–605. doi: 10.1136/jech.57.8.601
[28] Bajos N, Prioux F, Moreau C. L’augmentation du recours répété à l’IVG en France: des enjeux contraceptifs au report de l’âge à la maternité. Revue d'Épidémiologie et de Santé Publique 2013; 61 (4):291-298. doi: 10.1016/j.respe.2013.04.001
[29] Rasch V, Gammeltoft T, Knudsen LB, Tobiassen C, Ginzel A, Kempf L. Induced abortion in Denmark: effect of socio-economic situation and country of birth. Eur J Public Health 2008;18(2):144-9. doi: 10.1093/eurpub/ckm112
[30] Bayefsky MJ, Bartz D, Watson KL. Abortion during the Covid-19 Pandemic - Ensuring Access to an Essential Health Service. N Engl J Med 2020;382(19):e47. doi: 10.1056/NEJMp2008006
[31] Dennis A, Manski R, Blanchard K. A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts. Women’s Health Issues 2015;25(5):463-9. doi: 10.1016/j.whi.2015.04.004
[32] Ostrach B, Cheyney M. Navigating Social and Institutional Obstacles: Low-Income Women Seeking Abortion. Qual Health Res 2014;24(7):1006-1017. doi: 10.1177/1049732314540218