What are the social correlates of subsequent abortions in Flanders, Belgium?

Eur J Contracept Reprod Health Care. 2020 Oct;25(5):387-393. doi: 10.1080/13625187.2020.1792877. Epub 2020 Jul 20.

Abstract

Objective: To study whether the social correlates of subsequent abortions vary depending on the order of the abortion. Methodology: Drawing upon the Flemish abortion centres' anonymized patient records (2010-2019), discrete-time hazard models were used to examine whether individual abortion experiences across women's reproductive life course have different social correlates.

Results: Overall, women who were in their twenties, of foreign origin, single, had non-tertiary education, were not in paid employment, had children, did not (consistently and without errors) use contraception and had a previous abortion through medication, had an elevated probability to experience subsequent abortions. While single women and women with a vulnerable socioeconomic status were more likely to have a second or third abortion, this difference is no longer prevalent when considering higher-order abortions. The hazard for higher-order abortions was more pronounced in women with a migration background, regardless of the order considered. Contraceptive use was unrelated to fourth or higher-order abortions.

Conclusion: Using discrete-time hazard models, we unpack individual abortion experiences across women's reproductive life courses. By studying the transitions into different orders of subsequent abortions separately, we provide a more detailed understanding of risk factors compared to other European studies. The social correlates vary by the order considered: A certain profile emerges for women who have a second or third abortion, but disintegrates when considering higher-order abortions. This knowledge enables clinicians and policymakers to better understand women who experience subsequent abortions and to tailor services best suited to their needs.

Keywords: More than one abortion; discrete time-hazard models; repeat abortions; subsequent abortions.

MeSH terms

  • Abortion, Induced / psychology
  • Abortion, Induced / statistics & numerical data*
  • Adolescent
  • Adult
  • Belgium
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data
  • Female
  • Humans
  • Marital Status
  • Parity
  • Pregnancy
  • Proportional Hazards Models
  • Social Factors
  • Young Adult