Repeat induced abortion – a matter of individual behaviour or societal factors? A cross-sectional study among Swedish women

ABSTRACT

Background Almost 40% of all induced abortions in Sweden are repeat abortions; little is known about the risk factors.

Objective To investigate differences between women who had a first-time abortion and those with repeat abortion, and to identify factors associated with repeat abortion.

Methods A questionnaire was answered by 798 abortion-seeking women in Sweden during 2009. A regression model was used to assess risk factors for repeat abortions.

Results In the age range 20–49 years, 41% of women had experienced at least one previous abortion. Risk factors for repeat abortion were parity (OR 2.57), lack of emotional support (OR 2.09), unemployment or sick leave (OR 1.65), tobacco use (OR 1.56), and low educational level (OR 1.5). Some women (n = 55) considered economic support and work opportunities could have enabled them to continue the pregnancy. Increased Sex and Relationship Education (SRE), easy access to high-quality contraception and counselling, were suggested (n = 86) as interventions for preventing unintended pregnancies.

Conclusions Even in a country with long established SRE and a public health policy to enhance sexual and reproductive health over a third of women requesting abortion have experienced one previously and the rate is maintained. Some specific factors are identified but, overall, a picture of vulnerability among women seeking repeat abortion stands out that needs to be considered in the prevention of unintended pregnancies.

KEYWORDS:

• Women
• Abortion
• Repeat abortion
• Risk factors
• Socioeconomics

ACKNOWLEDGEMENTS

The study was funded by grants from the European Society of Contraception and Reproductive Health (Project no 90147/11794), Uppsala-Örebro Regional Research Council, Uppsala County Council (RFR-81551), the Family Planning Fund at Uppsala University Hospital, Uppsala University, Sweden, and the Swedish National Institute of Public Health.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.