Reasons Why Women Have Induced Abortions: Evidence from 27 Countries. (RESEARCH NOTE).(Statistical Data Included)

Context: The immediate explanation that women often give for seeking induced abortion is that the pregnancy was unplanned or unwanted. However, the myriad social, economic and health circumstances that underile such explanations have not yet been fully explored.

Methods: Findings from 32 studies in 27 countries were used to examine the reasons that women give for having an abortion, regional patterns in these reasons and the relationship between such reasons and women's social and demographic characteristics. The data come from a range of sources, including nationally representative surveys, official government statistics, community-based studies and hospital- or clinic-based research.

Results: Worldwide, the most commonly reported reason women cite for having an abortion is to postpone or stop childbearing. The second most common reason--socioeconomic concerns-- includes disruption of education or employment; lack of support from the father; desire to provide schooling for existing children; and poverty, unemployment or inability to afford additional children. In addition, relationship problems with a husband or partner and a woman's perception that she is too young constitute other important categories of reasons. Women's characteristics are associated with their reasons for having an abortion: With few exceptions, older women and married women are the most likely to identify limiting childbearing as their main reason for abortion.

Conclusions: Reasons women give for why they seek abortion are often far more complex than simply not intending to become pregnant; the decision to have an abortion is usually motivated by more than one factor. While improved contraceptive use can help reduce unintended pregnancy and abortion, some abortions will remain difficult to prevent, because of limits to women's ability to determine and control all circumstances of their lives.

Although abortion occurs in every society, and a substantial proportion of pregnancies are resolved by abortion worldwide, there is little empirical research on why women obtain abortions. This lack of information is part of an overall scarcity of data on abortion. Legal, moral and ethical issues surrounding abortion make research on all aspects of abortion difficult to undertake, and also affect the quality of the information obtained. Collecting good information on reasons for abortion may be especially difficult, because it requires asking women to articulate the often complex and sensitive process that led to the decision.

Some might argue that we already know why a woman obtains an abortion--she does not want the pregnancy--and that we need look no further. However, while at one level almost all abortions result from unintended pregnancies, there can be many steps between acknowledging an unplanned pregnancy and having an abortion. Moreover, many women who have an unintended pregnancy either do not seriously consider having an abortion or do not consider it at all. Some will simply adjust to the pregnancy; for others, an initial desire to discontinue a pregnancy can change because they were either ambivalent themselves or because they acceded to the preferences of others. On the other hand, conditions that were either unknown or were less serious before conception may also change, so that a pregnancy wanted at the time of conception is no longer wanted later on. (1)

In addition, not all women who decide to seek an abortion will succeed in obtaining one. They may face personal and social barriers such as their husband's objections or community values that oppose abortion. In countries where safe abortion services are scarce, only affluent women who can afford the fees of a private doctor will obtain an abortion, along with poorer women who are so determined they are willing to risk their health and life in seeking out unsafe clandestine services.