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

Abstract

Introduction: We 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.

Methods: We 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.

Results: Overall, 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.

Conclusion: Legal first-trimester abortion services in Mexico can help prevent first births in adolescents, especially students.

Keywords: abortion; adolescent; family planning services; induced; reproductive behavior; reproductive rights.

Figure 1

Preventing first births (nulliparous women) or limiting births (parous women) by age group. Mexico ILE programme, n=47 398; p<0.001 (excluding 64 women whose age was missing).

Figure 2

Adjusted probabilities of using abortion to prevent (vs limit) a birth by age group and occupation. Mexico ILE programme, n=46 526. The model also controls for year, state and clusters on clinical site (excluding 936 women whose age or education were missing).