Preventing first births among adolescents in Mexico City’s public abortion programme

Abstract

IntroductionWe examined parity and age among women seeking an abortion in Mexico City’s public first-trimester abortion programme, Interrupcion Legal de Embarazo (ILE). We hypothesised that younger women, especially students, used abortion to prevent first births while older women used abortion to limit births.MethodsWe used clinical data from a sample of 47 462 women who had an abortion between 2007 and 2016 and classified them as nulliparous or parous according to previous births prior to the abortion. We used logistic regression to identify sociodemographic and clinical factors associated with using abortion to prevent a first birth (nulliparous) versus limiting births (parous) and calculated absolute multivariable predicted probabilities.ResultsOverall, 41% of abortions were in nulliparous women seeking to prevent a first birth, and 59% were in women who already had one or more children. The adjusted probability of using abortion to prevent a first birth was 80.4% (95% CI 78.3 to 82.4) for women aged 12–17 years and 54.3% (95% CI 51.6 to 57.0) for women aged 18–24 years. Adolescents (aged 12–17 years) who were employed or students had nearly 90% adjusted probability of using abortion to prevent a first birth (employed 87.8%, 95% CI 82.9 to 92.8; students 88.5%, 95% CI 82.9 to 94.1). At all ages, employed women and students had higher probabilities of using abortion to prevent a first birth compared with unemployed women and women who work in the home.ConclusionLegal first-trimester abortion services in Mexico can help prevent first births in adolescents, especially students.

Association of maternal age 35 years and over and prenatal care utilization, preterm birth, and low birth weight, Mexico 2008–2019

“…9 In Mexico, some evidence suggests that younger generations of Mexican women are delaying first births. 10,11 Births to women aged 35 years and over also represent higher-order births; so, births to older women include both those who delay childbearing and those who have multiple births. Socioeconomic conditions may be different for older women with multiple children compared with older nulliparous women.…”

“…Countries in the Latin American region have also reported increases in maternal age at birth over the last several decades 9 . In Mexico, some evidence suggests that younger generations of Mexican women are delaying first births 10,11 . Births to women aged 35 years and over also represent higher‐order births; so, births to older women include both those who delay childbearing and those who have multiple births.…”