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Published in: BMC Women's Health 1/2014

Open Access 01-12-2014 | Research article

Abortion trends from 1996 to 2011 in Estonia: special emphasis on repeat abortion

Authors: Made Laanpere, Inge Ringmets, Kai Part, Kärt Allvee, Piret Veerus, Helle Karro

Published in: BMC Women's Health | Issue 1/2014

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Abstract

Background

The study aimed to describe the overall and age-specific trends of induced abortions from 1996 to 2011 with an emphasis on socio-demographic characteristics and contraceptive use of women having had repeat abortions in Estonia.

Methods

Data were retrieved from the Estonian Medical Birth and Abortion Registry and Statistics Estonia. Total induced abortion numbers, rates, ratios and age-specific rates are presented for 1996–2011. The percentage change in the number of repeat abortions within selected socio-demographic subgroups, contraception use and distribution of induced abortions among Estonians and non-Estonians for the first, second, third, fourth and subsequent abortions were calculated for the periods 1996–2003 and 2004–2011.

Results

Observed trends over the 16-year study period indicated a considerable decline in induced abortions with a reduction in abortion rate of 57.1%, which was mainly attributed to younger cohorts. The percentage of women undergoing repeat abortions fell steadily from 63.8% during 1996–2003 to 58.0% during 2004–2011. The percentage of women undergoing repeat abortions significantly decreased over the 16 years within all selected socio-demographic subgroups except among women with low educational attainment and students. Within each time period, a greater percentage of non-Estonians than Estonians underwent repeat abortions and obtained third and subsequent abortions. Most women did not use any contraceptive method prior to their first or subsequent abortion.

Conclusion

A high percentage of women obtaining repeat abortions reflects a high historical abortion rate. If current trends continue, a rapid decline in repeat abortions may be predicted. To decrease the burden of sexual ill health, routine contraceptive counselling, as standard care in the abortion process, should be seriously addressed with an emphasis on those groups - non-Estonians, women with lower educational attainment, students and women with children - vulnerable with respect to repeat abortion.
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Literature
1.
go back to reference Henshaw KS: Induced abortion: a world review 1990. Int Fam Plann Persp. 1990, 16: 59-65. 10.2307/2133470.CrossRefPubMed Henshaw KS: Induced abortion: a world review 1990. Int Fam Plann Persp. 1990, 16: 59-65. 10.2307/2133470.CrossRefPubMed
3.
go back to reference Gissler M, Fronteira L, Jahn A, Karro H, Moreau C, Oliveira Da Silva M, Olsen J, Savona Ventura C, Temmermann M, Hemminiki E, the REPROSTAT group: Terminations of pregnancy in the European Union. BJOG. 2012, 119: 324-332. 10.1111/j.1471-0528.2011.03189.x.CrossRefPubMed Gissler M, Fronteira L, Jahn A, Karro H, Moreau C, Oliveira Da Silva M, Olsen J, Savona Ventura C, Temmermann M, Hemminiki E, the REPROSTAT group: Terminations of pregnancy in the European Union. BJOG. 2012, 119: 324-332. 10.1111/j.1471-0528.2011.03189.x.CrossRefPubMed
6.
go back to reference Heikinheimo O, Gissler M, Suhonen S: Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion. Contraception. 2008, 78: 149-154. 10.1016/j.contraception.2008.03.013.CrossRefPubMed Heikinheimo O, Gissler M, Suhonen S: Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion. Contraception. 2008, 78: 149-154. 10.1016/j.contraception.2008.03.013.CrossRefPubMed
8.
go back to reference Klemetti R, Gissler M, Niinimäki M, Hemminki E: Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Hum Reprod. 2012, 27: 3315-3320. 10.1093/humrep/des294.CrossRefPubMed Klemetti R, Gissler M, Niinimäki M, Hemminki E: Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Hum Reprod. 2012, 27: 3315-3320. 10.1093/humrep/des294.CrossRefPubMed
9.
go back to reference Shah PS, Zao J: Induced termination of pregnancy and low birth weight and preterm birth: a systematic review and meta-analysis. Br J Obstet Gynaecol. 2009, 116: 1425-1442. 10.1111/j.1471-0528.2009.02278.x.CrossRef Shah PS, Zao J: Induced termination of pregnancy and low birth weight and preterm birth: a systematic review and meta-analysis. Br J Obstet Gynaecol. 2009, 116: 1425-1442. 10.1111/j.1471-0528.2009.02278.x.CrossRef
10.
go back to reference Sedgh G, Singh S, Henshaw SK, Bankole A: Legal abortion worldwide in 2008: levels and recent trends. Perspect Sex Reprod Health. 2011, 43: 188-198. 10.1363/4318811.CrossRefPubMed Sedgh G, Singh S, Henshaw SK, Bankole A: Legal abortion worldwide in 2008: levels and recent trends. Perspect Sex Reprod Health. 2011, 43: 188-198. 10.1363/4318811.CrossRefPubMed
11.
go back to reference Temmerman M, Foster BL, Hannaford P, Cattaneo A, Olsen J, Bloemenkamp K, Jahn A, Oliveira da Silva M: Reproductive health indicators in the European Union: the Reprostat project. Eur J Obstet Gynecol Reprod Biol. 2006, 126: 3-10. 10.1016/j.ejogrb.2005.11.047.CrossRefPubMed Temmerman M, Foster BL, Hannaford P, Cattaneo A, Olsen J, Bloemenkamp K, Jahn A, Oliveira da Silva M: Reproductive health indicators in the European Union: the Reprostat project. Eur J Obstet Gynecol Reprod Biol. 2006, 126: 3-10. 10.1016/j.ejogrb.2005.11.047.CrossRefPubMed
12.
go back to reference Kivela J, Ketting E, Balttusen R: Cost analysis of school-based sexuality education programs in six countries. Cost Eff Resour Alloc. 2013, 11: 17-10.1186/1478-7547-11-17.CrossRefPubMedPubMedCentral Kivela J, Ketting E, Balttusen R: Cost analysis of school-based sexuality education programs in six countries. Cost Eff Resour Alloc. 2013, 11: 17-10.1186/1478-7547-11-17.CrossRefPubMedPubMedCentral
13.
go back to reference Haldre K, Part K, Ketting E: Youth sexual health improvement in Estonia, 1990–2009: The role of sexuality education and youth-friendly services. Eur J Contracept Reprod Health Care. 2012, 17: 351-356. 10.3109/13625187.2012.696751.CrossRefPubMed Haldre K, Part K, Ketting E: Youth sexual health improvement in Estonia, 1990–2009: The role of sexuality education and youth-friendly services. Eur J Contracept Reprod Health Care. 2012, 17: 351-356. 10.3109/13625187.2012.696751.CrossRefPubMed
18.
go back to reference Laanpere M, Rahu K, Part K, Dubikaytis T, Karro H: Ethnic differences in factors associated with the use of contraception among 20- to 44-year-old women in Estonia and St. Petersburg, Russia. Contraception. 2012, 86: 132-140. 10.1016/j.contraception.2011.11.021.CrossRefPubMed Laanpere M, Rahu K, Part K, Dubikaytis T, Karro H: Ethnic differences in factors associated with the use of contraception among 20- to 44-year-old women in Estonia and St. Petersburg, Russia. Contraception. 2012, 86: 132-140. 10.1016/j.contraception.2011.11.021.CrossRefPubMed
20.
go back to reference Tietze C, Jain AK: The mathematics of repeat abortion: explaining the increase. Stud Fam Plann. 1978, 9: 294-299. 10.2307/1965519.CrossRefPubMed Tietze C, Jain AK: The mathematics of repeat abortion: explaining the increase. Stud Fam Plann. 1978, 9: 294-299. 10.2307/1965519.CrossRefPubMed
21.
go back to reference Moreau C, Trussell J, Desfreres J, Bajos N: Patterns of contraceptive use before and after an abortion: results from a nationally representative survey of women undergoing an abortion in France. Contraception. 2010, 82: 337-344. 10.1016/j.contraception.2010.03.011.CrossRefPubMedPubMedCentral Moreau C, Trussell J, Desfreres J, Bajos N: Patterns of contraceptive use before and after an abortion: results from a nationally representative survey of women undergoing an abortion in France. Contraception. 2010, 82: 337-344. 10.1016/j.contraception.2010.03.011.CrossRefPubMedPubMedCentral
22.
go back to reference Rach V: Contraceptive failure-results from a study conducted among women with accepted and unaccepted pregnancies in Denmark. Contraception. 2002, 66: 109-116. 10.1016/S0010-7824(02)00325-6.CrossRef Rach V: Contraceptive failure-results from a study conducted among women with accepted and unaccepted pregnancies in Denmark. Contraception. 2002, 66: 109-116. 10.1016/S0010-7824(02)00325-6.CrossRef
23.
go back to reference Sydsjö A, Josefsson A, Bladh M, Sydsjö G: Trends in induced abortion among Nordic women aged 40–44 years. Reprod Health. 2011, 8: 23-10.1186/1742-4755-8-23.CrossRefPubMedPubMedCentral Sydsjö A, Josefsson A, Bladh M, Sydsjö G: Trends in induced abortion among Nordic women aged 40–44 years. Reprod Health. 2011, 8: 23-10.1186/1742-4755-8-23.CrossRefPubMedPubMedCentral
24.
go back to reference Prager SW, Steinauer JE, Greene Foster D, Darney PD, Drey EA: Risk factors for repeat elective abortion. Am J Obstet Gynecol. 2007, 197: 575-e1–e6CrossRefPubMed Prager SW, Steinauer JE, Greene Foster D, Darney PD, Drey EA: Risk factors for repeat elective abortion. Am J Obstet Gynecol. 2007, 197: 575-e1–e6CrossRefPubMed
25.
go back to reference Taylor D, Levi A, Simmonds K: Reframing unintended pregnancy prevention: a public health model. Contraception. 2010, 81: 363-366. 10.1016/j.contraception.2010.01.023.CrossRefPubMed Taylor D, Levi A, Simmonds K: Reframing unintended pregnancy prevention: a public health model. Contraception. 2010, 81: 363-366. 10.1016/j.contraception.2010.01.023.CrossRefPubMed
26.
go back to reference Moos M, Bartholomew N, Lohr K: Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda. Contraception. 2003, 67: 115-132. 10.1016/S0010-7824(02)00472-9.CrossRefPubMed Moos M, Bartholomew N, Lohr K: Counseling in the clinical setting to prevent unintended pregnancy: an evidence-based research agenda. Contraception. 2003, 67: 115-132. 10.1016/S0010-7824(02)00472-9.CrossRefPubMed
27.
go back to reference Schunmann C, Glasier A: Specialist contraceptive counseling and provision after termination of pregnancy improves uptake of longacting methods but does not prevent repeat abortion: a randomized trial. Hum Reprod. 2006, 21: 2296-2303. 10.1093/humrep/del168.CrossRefPubMed Schunmann C, Glasier A: Specialist contraceptive counseling and provision after termination of pregnancy improves uptake of longacting methods but does not prevent repeat abortion: a randomized trial. Hum Reprod. 2006, 21: 2296-2303. 10.1093/humrep/del168.CrossRefPubMed
29.
go back to reference Anderson BA, Katus K, Puur A, Silver BD: The Validity of Survey Responses on Abortion: Evidence from Estonia. Demography. 1994, 31: 115-132. 10.2307/2061911.CrossRefPubMed Anderson BA, Katus K, Puur A, Silver BD: The Validity of Survey Responses on Abortion: Evidence from Estonia. Demography. 1994, 31: 115-132. 10.2307/2061911.CrossRefPubMed
Metadata
Title
Abortion trends from 1996 to 2011 in Estonia: special emphasis on repeat abortion
Authors
Made Laanpere
Inge Ringmets
Kai Part
Kärt Allvee
Piret Veerus
Helle Karro
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2014
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-14-81

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