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

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.

摘要

目的：研究后续流产的社会相关因素是否随流产次数的不同而不同。

方法：利用弗兰德斯流产中心的匿名病历(2010-2019年), 使用离散时间风险模型来检测女性生育阶段的个人流产经历是否具有不同的社会关联。

结果：总体而言, 二十多岁、外国血统、单身、未受过高等教育、无薪酬、有孩子、没有(一直且无差错)使用避孕措施并曾通过药物流产的女性, 后续流产的可能性较高。虽然单身女性和处于社会经济弱势地位的女性更有可能进行第二次或第三次流产, 但当流产次数更多时, 这种差异不再存在。与流产次数无关, 多次流产的风险在有移民背景的女性中更加明显。采用避孕措施与第四或更多次数的流产无关。

结论：利用离散时间风险模型, 我们揭示了女性生育阶段中的个人流产经历。通过分别研究不同次数的后续流产, 我们提供了与其他欧洲研究相比更详细的风险因素的理解。社会相关因素因次数不同而不同：第二次或第三次流产的女性会出现一定的特征, 但当流产次数更多时, 这种特征消失。这一结论使临床医生和政策制定者能够更好地了解经历后续流产的女性, 并提供最适合她们需求的服务。

Keywords:

• More than one abortion
• discrete time-hazard models
• subsequent abortions
• repeat abortions

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Abortions due to medical conditions that might harm the mother or foetus are performed in hospitals. For all other abortions, women are referred to an abortion centre.