Recurrent voluntary termination of pregnancy. Prevalence study and exploration of associated factors. Antioquia, Colombia, 2015 – 2021
DOI:
https://doi.org/10.18597/rcog.4018Keywords:
Legal abortion, induced abortion, contraception, sexual and reproductive rightsAbstract
Objectives: To describe the prevalence of recurrent voluntary termination of pregnancy (VTP) and to explore associated factors.
Materials and methods: Descriptive, cross-sectional cohort study which included women seen between 2015 and 2021 in five sites of an institution located in the Department of Antioquia which promotes sexual and reproductive health (SRH) care in Colombia. Measured variables included sociodemographics, SRH, recurrent performance of VTP, type of procedure used in the first VTP and contraception method selected afterwards. The prevalence of global and yearly recurrent abortion period is presented. Associated factors were explored using a multivariate analysis. The research committee of the institution approved the study.
Results: In total, 20,423 women were included. The prevalence of recurrent VTP was 4.07% (n = 831) during the entire period, ranging between 2.3 and 6% over the 7 years. The most commonly used method for recurrent VTP was pharmacological induction (48.50%). After the first VTP, 69.81% of women used contraceptive methods classified as “very effective” according to the World Health Organization. The risk factors identified as being associated with recurrent VTP included being part of the state-subsidized health insurance system (adjusted odds ratio [aOR] = 1.35; 95 % CI:1.05-1.72) and having had two or more pregnancies (aOR = 1.23; 95% CI: 1.06 - 1.44). Protective factors were identified and included out-of-pocket payment for VTP service (aOR = 0.71; 95% CI: 0.61-0.82), a history of late VTP (aOR = 0.30; 95% CI: 0.11-0.81), and the selection of a subdermal implant for contraception following the first abortion (sOR = 0.64; 95% CI: 0.49 – 0.83).
Conclusions: It is possible that the prevalence of recurrent VTP is increasing. Prospective studies are required in order to determine whether there is a growing trend and to verify potential association hypotheses derived from this work.
Author Biographies
Laura Andrea González-Pérez, Universidad EIA, Medellín (Colombia).
Profamilia (Asociación Probienestar de la Familia Colombiana), docente de cátedra en la Universidad EIA, Medellín (Colombia).
Freddy Andrés Barrios Arroyave, Institución Universitaria Visión de Las Américas, Medellín (Colombia).
Grupo de Investigación en Salud y Comunidad (GISCO), Institución Universitaria Visión de Las Américas, Medellín (Colombia).
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