Repeat induced abortion – a matter of individual behaviour or societal factors? A cross-sectional study among Swedish women

Abstract

Even in a country with long established SRE and a public health policy to enhance sexual and reproductive health over a third of women requesting abortion have experienced one previously and the rate is maintained. Some specific factors are identified but, overall, a picture of vulnerability among women seeking repeat abortion stands out that needs to be considered in the prevention of unintended pregnancies.

Educational Inequalities in Repeat Abortion: A Longitudinal Register Study in Finland 1975–2010

“…These results add to the literature, since previous research on the topic has not used a high-quality large-scale dataset like the one in this study, and thus the results have been inconclusive. Some studies found an association between low socioeconomic position and higher likelihood of repeat abortion (Jones et al, 2006;Das et al, 2009;Väisänen & Jokela, 2010;Mentula et al, 2010;Makenzius et al, 2011), whereas others did not (Osler et al, 1997). Given that under-reporting of abortion is a common problem in all survey-based studies on abortion and that this problem is likely to be more severe for studies on repeat abortion, this paper provides a crucial addition to the reproductive health literature.…”

“…Cross-sectional studies have identified a positive association between low education and repeat abortion in the US (Jones et al, 2006), UK (Stone & Ingham, 2011) and Sweden (Makenzius et al, 2011), but not in Denmark (Osler et al, 1997). However, apart from one study (Jones et al, 2006), sample sizes were small (N = 150-798).…”

“…It was assumed that someone had at most compulsory education if there was no education level recorded in the dataset, because Statistics Finland does not give information for research purposes about people with less than upper secondary education due to ethical regulations. The other variables included in the analyses were time since previous abortion, parity, age, relationship status, place of residence (province and level of urbanization) and nativity (native Finn vs non-native), because previous studies have found these characteristics to be associated with repeat abortion (Osler et al, 1997;Jones et al, 2006;Heikinheimo et al, 2008;Niinimäki et al, 2009;Väisänen & Jokela, 2010;Makenzius et al, 2011).…”

“…None of these studies compared cohort trends or educational differences. Other characteristics commonly associated with higher incidence of repeat abortion include having children (Osler et al, 1997;Jones et al, 2006;Heikinheimo et al, 2008;Niinimäki et al, 2009;Väisänen & Jokela, 2010;Makenzius et al, 2011;Stone & Ingham, 2011;Rose et al, 2015), being unemployed (Das et al, 2009), not being married (Jones et al, 2006;Niinimäki et al, 2009;Väisänen & Jokela, 2010) and using barrier (Osler et al, 1997;Niinimäki et al, 2009) or oral contraceptives (Jones et al, 2006;Heikinheimo et al, 2008;Niinimäki et al, 2009) rather than long-acting reversible methods of contraception.…”

Induced Abortion - A Clinical Procedure Lined with Existential Attitudes and Needs among Women and Men, in Sweden

“…Men's role in sexual and reproductive health is not always clear. In some studies, men tend to refrain from responsibility in sexual and reproductive health issues [8,9], whereas, in other studies, men want to be involved [4,[10][11][12]. Even if male partners are happy with the woman's decision to have an induced abortion and have positive emotions post-abortion, abortion can sometimes be related to strong and paradoxical emotions in both women and men [4,13,14].…”