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. 2022 Jan;48(e1):e81-e87.
doi: 10.1136/bmjsrh-2021-201079. Epub 2021 Jul 28.

Travelling for abortion services in Mexico 2016-2019: community-level contexts of Mexico City public abortion clients

Laura E Jacobson  1 , Biani Saavedra-Avendano  2 , Evelyn Fuentes-Rivera  3 , Raffaela Schiavon  4 , Blair G Darney  5
Affiliations

Travelling for abortion services in Mexico 2016-2019: community-level contexts of Mexico City public abortion clients

Laura E Jacobson et al. BMJ Sex Reprod Health. 2022 Jan.

Abstract

Objective: To describe the community context of women who travel to access Mexico City's public sector abortion programme and identify factors associated with travelling from highly marginalised settings.

Methods: We used data from the Interrupción Legal de Embarazo (ILE) programme (2016-2019) and identified all abortion clients who travelled from outside Mexico City. We merged in contextual information at the municipality level and used descriptive statistics to describe ILE clients' individual characteristics and municipalities on several measures of vulnerability. We also compared municipalities that ILE clients travelled from with those where no one travelled from. We used logistic regression to identify factors associated with travelling to access ILE services from highly marginalised versus less marginalised municipalities.

Results: Our sample included 21 629 ILE clients who travelled to Mexico City from 491 municipalities within all 31 states outside Mexico City. The majority of clients travelled from the least marginalised (81.9%) and most populated (over 100 000 inhabitants; 91.3%) municipalities. Most (91.2%) ILE clients came from municipalities with adolescent fertility rates in the bottom three quintiles. Clients with a primary or secondary education (vs high school or more) and those from a municipality with a high adolescent fertility rate (top two quintiles) had higher odds of travelling from a highly marginalised (vs less) municipality (adjusted odds ratio (aOR) 1.46, 95% CI 1.35 to 1.58 and aOR 1.89, 95% CI 1.68 to 2.12, respectively).

Conclusion: ILE clients travel from geographically and socioeconomically diverse communities. There is an unmet need for legal abortion across Mexico.

Keywords: abortion; health services accessibility; health services research; induced.

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Conflict of interest statement

Competing interests: BGD receives research support from Merck.

Figures

Figure 1
Figure 1
Characteristics of municipalities that ILE clients traveled from versus other Mexican municipalities.
Figure 2
Figure 2
ILE Client Count by Municipality, (Mexico 2016-2019).
See this image and copyright information in PMC

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