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Trends in the method and gestational age of abortion in high-income countries
  1. Anna Popinchalk1,
  2. Gilda Sedgh2
  1. 1 Guttmacher Institute, New York, New York, USA
  2. 2 Guttmacher Institute, New York, New York, USA
  1. Correspondence to Anna Popinchalk, Guttmacher Institute, New York NY 10038, USA; apopinchalk{at}guttmacher.org

Abstract

Background Examining the distribution of abortions by method of abortion and gestational age at time of termination provides insight about the options women may have to terminate their pregnancies. Comparing these distributions across countries and over time is an important step toward understanding the factors that can drive these distributions, including regulations and practices related to the provision of abortion services, and women’s preferences and needs.

Methods We sought official statistics on gestational age and method of abortion for all high-income countries with liberal abortion laws. For the 24 high-income countries with available data, we calculated percentage distributions of abortions by gestational age of pregnancy and method of abortion for 2017 or the most recent year for which data were available, and assessed trends in the preceding 10 years whenever possible.

Results Medication (or medical) abortion accounts for at least half of all abortions in the majority of countries. In the majority of countries over 90% of all abortions were completed before 13 weeks, and more than two-thirds of abortions occurred before the first 9 weeks of gestation. Over the past 10 years there has been an increase in both the proportion of abortions that were medication abortions and the proportion that were obtained before 9 weeks gestation.

Conclusions These findings highlight changes in abortion provision in the past decade. More research is needed to understand whether the observed distributions are a function of women’s preferences or of barriers to the timing and type of care they would prefer.

  • abortion

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsrh-2018-200149

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    Footnotes

    • Contributors Both authors contributed to the conceptualisation of the paper. Drawing on methodologies from earlier papers by GS and colleagues, AP conducted data collection and analysis. Both authors developed the outline of the paper, and AP wrote the first draft. Both authors reviewed and substantively edited subsequent drafts.

    • Funding This work was made possible by UK Aid from the UK Government and the Dutch Ministry of Foreign Affairs. The views expressed are those of the authors and do not necessarily reflect the positions and policies of the donors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.

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