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New evidence on induced abortion in Tehran, Iran: Rates, causes, and changes
Abstract
Introduction: Awareness of the incidence of abortion in Iran is essential to promoting maternal health. Therefore, it is of paramount importance to estimate the rate of induced abortion. The present study aimed to investigate the rate, causes, and changes associated with induced abortion during 2009-2014. Methods: This survey was conducted using the abortion data collected from two fertility surveys preformed in 2009 and 2014 on a respective sample of 2,934 and 3,012 married women aged 15-49 years in Tehran, Iran. The incidence of abortion was estimated based on the age-specific abortion rate, general abortion rate, total abortion rate, and abortion ratio Results: During 2009-2014, total abortion rate reduced from 0.16 to 0.14 cases per woman, while the general abortion rate decreased from 5.5 to 4.4 cases per 1,000 women, and the annual rate of abortion declined from 11,500 to 11,400 cases. Assuming the estimated abortion rate in Tehran as a national average rate, it is estimated that approximately 101,000 abortions are performed in Iran annually. Moreover, about 9% of known pregnancies are reported to be terminated in Tehran. Mean age at abortion is 33.5±6.3 years, and the rate of induced abortion is comparatively higher among the women with academic education, proper employment, favorable socioeconomic status, and low religious tendencies, as well as the migrants of urban areas and those with no or one living child. The proportion of abortions for non-medical reasons was found to increase from 69% in 2009 to 82% in 2014. In addition, half of the induced abortions were due to withdrawal failure; however, only one-third of the women with withdrawal failure switched to modern contraceptives after abortion. Conclusion: According to the results, the high prevalence of induced abortions in Iran highlights the need for effective family planning services and counseling in order to prevent unintended pregnancies among women. © 2018, Mashhad University of Medical Sciences. All rights reserved.
... Regarding the relationship between individual characteristics and the number and type of abortion undertaken, the results of our study showed that the number of abortions undertaken increased with age. Similar findings have been reported elsewhere [50,51]. No statistically significant relationship was observed between education level and abortion. ...
... No statistically significant relationship was observed between education level and abortion. Yet this has not been found to be the case elsewhere in Iran, where the highest frequency of intentional abortion was previously found in those with a higher level of education [51]. According to the illegality of abortion in Iran, the frequency of abortion is higher in those with higher income [51]. ...
... Yet this has not been found to be the case elsewhere in Iran, where the highest frequency of intentional abortion was previously found in those with a higher level of education [51]. According to the illegality of abortion in Iran, the frequency of abortion is higher in those with higher income [51]. Future changes in the law may permit safer abortions worldwide. ...
Background and Aim
By creating an international emergency, the COVID-19 pandemic may have led to compromised reproductive health care, including family planning services, and thus increased unintended pregnancies and unsafe abortions. This study was conducted to compare methods of contraception, abortion, and unintended pregnancies in those served by the health centers of Babol city in Iran, both before and during the COVID-19 pandemic.
Methods
A cross-sectional study was conducted including 425 participants registered to the health centers of Babol city, Mazandaran province, Iran. Using a multi-stage method, 6 urban health centers and 10 rural centers were selected for inclusion. Proportional allocation method was used for sampling those who met the inclusion criteria. A questionnaire was used to collect data in relation to individual characteristics and reproductive behaviors via 6 questions focused upon methods and preparation of contraception, number and type of abortions, and number and causes of unintended pregnancy from July to November 2021. The data were analyzed using SPSS software version 26. Significance level was considered to be p < 0.05 in all tests.
Results
Most participants aged between 20 and 29 years old had a diploma level of education, were housewives and lived in the city. Prior to the pandemic, 32.0% used modern contraceptive methods and 31.6% used these during the pandemic. No change in the combination of contraceptive methods used was observed between these two periods. Approximately two-thirds used the withdrawal method in both periods. The majority of participants in both periods purchased their contraceptives from a pharmacy. Unintended pregnancy increased from 20.4% prior to the pandemic to 25.4% during the pandemic. Abortions increased from 19.1% prior to the pandemic to 20.9% during the pandemic, although these findings were not found to be statistically significant. Contraceptive methods had a statistically significant relationship with age, education, spouse’s education, spouse’s occupation, and place of residence. The number of unintended pregnancies had a significant relationship with age, the educational level of both participants and their spouses and socio-economic status, and the number of abortions had a statistically significant relationship with the age and education level of the spouse (p > 0.05).
Conclusion
Despite there being no change in contraceptive methods compared to the pre-pandemic period, an increase in the number of unintended pregnancies, abortions and illegal abortions was observed. This may be indicative of an unmet need for family planning services during the COVID-19 pandemic.
... Concerning internal studies, the research conducted by Erfani et al. on the general population showed that from 2010 to 2015, the rate of intentional abortion decreased from 5.5 to 4.4 per 1,000 women. The annual number of abortions also reduced from 11,500 to 11,400 [43]. ...
Purpose
In addition to estimating the prevalence of intentional abortion in Iranian female sex workers (FSWs), this study identified related factors using the data of a national study.
Methods
This cross-sectional study utilizes the third round of integrated bio-behavioral surveillance-III data in Iranian FSWs in December 2019 and August 2020, and 1515 Participants were selected in 8 geographically diverse cities in Iran. Logistic regression was performed using unweighted analysis to identify factors associated with intentional abortion. Stata software (version 14), respondent-driven sampling analyses, and R (version 4.1.2) was used for data analysis.
Results
From 1390 participants with valid responses to the abortion question, 598 (37.3%; 95% CI: 32.43, 42.11%) reported intentional abortion during their life. According to the age groups, the highest prevalence of abortion was in the age group of 31 to 40 years (42.60%). In the multivariate logistic regression model, the marital status (divorced women (AOR = 2.05, 95% CI: 1.29, 3.27), concubines (AOR = 1.78, 95% CI: 1.02, 3.11)), work experience in brothels (AOR = 1.39, 95% CI: 1.04, 1.84), the type of sex (AOR = 2.75, 95% CI: 1.35, 5.58), the history of sexual violence (AOR = 1.54, 95% CI: 1.19, 2.01), and alcohol consumption (AOR = 1.53, 95% CI: 1.18, 2.01) were significantly associated with a history of intentional abortion.
Conclusion
Intentional abortion’s prevalence among Iranian FSWs has been much higher than that of the general female population in Iran, which is an alarming issue in the public health of this group and needs more effective interventions. In addition, alcohol consumption, working in a brothel, and being divorced are essential factors in increasing abortions among sex workers.
The Kurds are the fourth-largest ethnic group in the Middle East, divided between five countries. Despite political and geographical segregation, they share a common culture and history, leading to the belief that they possess similar attitudes. We investigated abortion attitudes among 1473 Kurds in Iraq and Iran using WVS data during 2000–2020. Results revealed an overall increase in positive attitudes towards abortion, though scores remained below average. Initially, the differences were negligible, but divergence occurred in 2020. Cultural factors and higher education had the most significant impact on attitudes. Iraqi Kurds consistently scored higher, and the differences were particularly significant in 2020. These findings confirmed the impact of macrostructures on attitudes. Iraqi Kurdistan’s secular federal government facilitates legal abortion under medical conditions. Conversely, Iranian Kurdistan is under the domination of a centralized Islamic government that has restricted all types of abortion, resulting in a more restrictive abortion attitude.
Objective: The aim of this study was to investigate the fertility indicators in Iran.
Methods: This was a cross-sectional study and included Iranian women of reproductive-age. The data were collected using a questionnaire and analyzed using SPSS18.
Results: In all 10547 women included in the study. The mean live birth was 1.96 and it was increased as age of both women and husbands were increased; and it was decreased as age at marriage, age at birth of the first child, and education were increased. Live birth was more in low-income women and in rural areas. The frequency of stillbirth was 4.8% and increased as age of both women and husbands were increased. The stillbirth decreased as age at marriage, the age at birth of the first child, and education were increased. There was no relationship between stillbirth and women’s occupation, occupation of husbands, and religion. The stillbirth was more in low-income women and in rural areas. The frequency of abortion was 18.2% and increased with age of women, age of husbands, and age at birth of the first child. Abortion decreased with increased age at marriage and education. Abortion was more common in low-income women. Abortion had no relationship with women’s occupation, religion, and urban/rural residency. The frequency of the cesarean section was 42.1%. Cesarean increased with increased age of women and husbands, age at marriage, age at birth of the first child, and education. Delivery by cesarean had no relationship with occupation of husbands. The cesarean decreased with decreased income and was higher in urban areas.
Conclusion: Investigating the trend of fertility indicators can play important role in identifying problems, planning for required services, and optimal allocation of resources. The findings from this study will complement the information that is needed by policy-makers.
Keywords: Fertility, Live birth, Stillbirth, Abortion, Cesarean section, Iran
Introduction: Current data on changes in contraceptive use is required to prevent unintended pregnancies. This study aims to study trends, and patterns of contraceptive use from 2000 to 2014.
Methods: This survey research uses data from three fertility surveys conducted in 2000, 2009, and 2014 respectively among representative samples of 1396, 2,934 and 3012 married women aged 15-49 living in the capital city of Tehran. The prevalence of contraceptive methods was estimated according to women’s socio-economic and demographic characteristics.
Results: In 2014, 82% of women used contraceptive methods (48% modern methods, and 34% traditional methods). Withdrawal (33%) and condoms (21%) had the highest prevalence, compared with female sterilization (9%), IUD (7%) and Pills (7%). Over 2000-2014, the use of withdrawal and condoms increased by 69% and 20%, respectively. In contrast, the prevalence of female sterilization, pills, male sterilization, and IUD decreased respectively by 20%, 42%, 45% and 51% over the same period. The use of withdrawal method increased with women’s age. Withdrawal and condom were used by 67% of contraceptive users, who mostly hold higher education levels, were employed, and lived in upper residential districts. In contrast, users of modern methods, namely sterilizations, IUD and pills, mostly hold lower levels of education and income, were unemployed, lived in the lower residential districts, and had two or more children.
Conclusion: The increasing prevalence of withdrawal and condom signifies a need for provision of effective family planning education and counseling to prevent unintended pregnancy.
Introduction: Current data on changes in contraceptive use is required to prevent
unintended pregnancies. This study aims to study trends, and patterns of
contraceptive use from 2000 to 2014.
Methods: This survey research uses data from three fertility surveys conducted
in 2000, 2009, and 2014 respectively among representative samples of 1396, 2,934
and 3012 married women aged 15-49 living in the capital city of Tehran. The
prevalence of contraceptive methods was estimated according to women’s socioeconomic
and demographic characteristics.
Results: In 2014, 82% of women used contraceptive methods (48% modern
methods, and 34% traditional methods). Withdrawal (33%) and condoms (21%) had
the highest prevalence, compared with female sterilization (9%), IUD (7%) and Pills
(7%). Over 2000-2014, the use of withdrawal and condoms increased by 69% and
20%, respectively. In contrast, the prevalence of female sterilization, pills, male
sterilization, and IUD decreased respectively by 20%, 42%, 45% and 51% over the
same period. The use of withdrawal method increased with women’s age.
Withdrawal and condom were used by 67% of contraceptive users, who mostly hold
higher education levels, were employed, and lived in upper residential districts. In
contrast, users of modern methods, namely sterilizations, IUD and pills, mostly hold
lower levels of education and income, were unemployed, lived in the lower
residential districts, and had two or more children.
Conclusion: The increasing prevalence of withdrawal and condom signifies a
need for provision of effective family planning education and counseling to prevent
unintended pregnancy.
Background:
Information about the incidence of induced abortion is needed to motivate and inform efforts to help women avoid unintended pregnancies and to monitor progress toward that end. We estimate subregional, regional, and global levels and trends in abortion incidence for 1990 to 2014, and abortion rates in subgroups of women. We use the results to estimate the proportion of pregnancies that end in abortion and examine whether abortion rates vary in countries grouped by the legal status of abortion.
Methods:
We requested abortion data from government agencies and compiled data from international sources and nationally representative studies. With data for 1069 country-years, we estimated incidence using a Bayesian hierarchical time series model whereby the overall abortion rate is a function of the modelled rates in subgroups of women of reproductive age defined by their marital status and contraceptive need and use, and the sizes of these subgroups.
Findings:
We estimated that 35 abortions (90% uncertainty interval [UI] 33 to 44) occurred annually per 1000 women aged 15-44 years worldwide in 2010-14, which was 5 points less than 40 (39-48) in 1990-94 (90% UI for decline -11 to 0). Because of population growth, the annual number of abortions worldwide increased by 5.9 million (90% UI -1.3 to 15.4), from 50.4 million in 1990-94 (48.6 to 59.9) to 56.3 million (52.4 to 70.0) in 2010-14. In the developed world, the abortion rate declined 19 points (-26 to -14), from 46 (41 to 59) to 27 (24 to 37). In the developing world, we found a non-significant 2 point decline (90% UI -9 to 4) in the rate from 39 (37 to 47) to 37 (34 to 46). Some 25% (90% UI 23 to 29) of pregnancies ended in abortion in 2010-14. Globally, 73% (90% UI 59 to 82) of abortions were obtained by married women in 2010-14 compared with 27% (18 to 41) obtained by unmarried women. We did not observe an association between the abortion rates for 2010-14 and the grounds under which abortion is legally allowed.
Interpretation:
Abortion rates have declined significantly since 1990 in the developed world but not in the developing world. Ensuring access to sexual and reproductive health care could help millions of women avoid unintended pregnancies and ensure access to safe abortion.
Funding:
UK Government, Dutch Ministry of Foreign Affairs, Norwegian Agency for Development Cooperation, The David and Lucile Packard Foundation, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction.
Context: The immediate explanation that women often give for seeking induced abortion is that the pregnancy was unplanned or unwanted. However, the myriad social, economic and health circumstances that underlie such explanations have not yet been fully explored. Methods: Findings from 32 studies in 27 countries were used to examine the reasons that women give for having an abortion, regional patterns in these reasons and the relationship between such reasons and women's social and demographic characteristics. The data come from a range of sources, including nationally representative surveys, official government statistics, commu- nity-based studies and hospital- or clinic-based research. Results: Worldwide, the most commonly reported reason women cite for having an abortion is to postpone or stop childbearing. The second most common reason-socioeconomic concerns- includes disruption of education or employment; lack of support from the father; desire to pro- vide schooling for existing children; and poverty, unemployment or inability to afford additional children. In addition, relationship problems with a husband or partner and a woman's percep- tion that she is too young constitute other important categories of reasons. Women's charac- teristics are associated with their reasons for having an abortion: With few exceptions, older women and married women are the most likely to identify limiting childbearing as their main rea- son for abortion. Conclusions: Reasons women give for why they seek abortion are often far more complex than simply not intending to become pregnant; the decision to have an abortion is usually motivated by more than one factor. While improved contraceptive use can help reduce unintended preg- nancy and abortion, some abortions will remain difficult to prevent, because of limits to women's ability to determine and control all circumstances of their lives.
Abortions are of major public health concern in developing countries. In settings in which abortion is highly prohibited, the direct interview is not a reliable method to estimate the abortion rate. The indirect estimation methods to measure the rate of abortion might overcome this dilemma; They are practical methods to estimate the size of the hidden group who do not agree to participate in a direct interview.
The aim of this study was to explore the practicality of an indirect method for estimating the abortion rate , Known as Network Scale-up, and to provide an estimate about the episode of abortion with and without medical indications (AWMI+ and AWMI-) in Iran.
This cross-sectional study was conducted in 31 provinces of Iran in 2012. A random sample between 200 and 1000 was selected in each province by the multistage sampling method that 75% of the data were collected from the capital and 25% from one main city. We selected samples from urban people more than 18 years old (12960) and we asked them about the number of abortion in women they knew who had experienced the medical and non-medical abortions in the past year. A range for the transparency factor was estimated based on the expert opinion.
The range of the transparency factors for AWMI+ and AWOMI- were 0.43-0.75 and 0.2-0.34, respectively. Regarding the AWMI+, our minimum and maximum estimations (per 1000 pregnancies) were 70.54 and 116.9, respectively. The corresponding figures for AWMI- were 93.18, and 148.7.
The frequency rates for AWMI+ and AWMI- were relatively high. Therefore, the system has to address to this hidden problem using the appropriate preventive policies.
Abortion is severely restricted in Iran, and many women with an unwanted pregnancy resort to clandes-tine, unsafe abortions. Accurate information on abortion incidence is needed to assess the extent to which women ?experience unwanted pregnancies and to allocate resources for contraceptive services.
Data for analysis came from 2,934 married women aged 15-49 who completed the 2009 Tehran Survey of Fertility. Estimated abortion rates and proportions of known pregnancies that end in abortion were calculated for all women and for demographic and socioeconomic subgroups, and descriptive data were used to examine women's contraceptive use and reasons for having an abortion.
Annually, married women in Tehran have about 11,500 abortions. In the year before the survey, the estimated total abortion rate was 0.16 abortions per woman, and the annual general abortion rate was 5.5 abortions per 1,000 women; the general abortion rate peaked at 11.7 abortions among those aged 30-34. An estimated 8.7 of every 100 known pregnancies ended in abortion. The abortion rate was elevated among women who were employed or had high levels of income or education, as well as among those who reported a low level of religiosity, had two children or wanted no more. Fertility-related and socioeconomic reasons were cited by seven in 10 women who obtained an abortion. More than two-thirds of pregnancies that were terminated resulted from method failures among women who had used withdrawal, the pill or a condom.
Estimated abortion rates and their correlates can help policymakers and program planners identify subgroups of women who are in particular need of services and counseling to prevent unwanted pregnancy.
Iran has experienced a dramatic decline in fertility in recent decades, but limited access to legal abortion continues to lead many women whose pregnancies are unwanted or mistimed to undergo clandestine, unsafe abortions. No official data on the abortion rate in Iran have been collected, however. This study uses the 2000 Iran Demographic and Health Survey to estimate the abortion rate for the country as a whole and for specific regions, and to explore the role of contraceptive use and religiosity in explaining regional variations in abortion rates. We estimate the total abortion rate for the country to be 0.26 abortions per married woman, and the annual general abortion rate to be 7.5 abortions per 1,000 married women aged 15-49. We find that the negative effect of modern contraceptive use on the abortion rate is 51 percent greater than the negative effect of religiosity, and we highlight the implications of these findings for policies on reproductive health and family
Introduction: Prediction of pregnancy complications and its prevention are the most important strategy for reducing morbidity and mortality rates in the fetus and the mother. This study was conducted with aim to determine the prevalence of high-risk pregnancies in pregnant women of Sonqor city. Methods: This descriptive study was conducted using data related to 3157 cases of pregnant women referring to health bases of pregnant mothers in Sonqor city in 2011. Data recorded in the booklets of maternal care included the data of pregnancy, previous pregnancies and underlying diseases of mother. To describe data, the mean and standard deviation for quantitative variables and frequency percentage for qualitative variables were used. Data were analyzed by SPSS software (version 20) and chi-square test. PResults: Among a total of 3157 pregnant mothers, 1256 mothers (39.8%) had high risk pregnancy. Urinary tract infection (5.8%), history of abortion (4.02%), maternal age over 35 age (3.8%) and under 18 years (2.7%), poor weight gain (2/41%), anemia (2.38%), decreased fetal movements (2.34%), placenta previa (2.31%) and high blood pressure (1.74%) were the most common causes of high risk pregnancy. Frequency distribution of the causes of high-risk pregnancy had significant difference in age groups of pregnant women based on gravidity (P=0.001). Conclusion: The most important risk factors in pregnant women of Sonqor city included urinary tract infection (5.8%), history of abortion (4.02%), age over 35 years (3.8%) and younger than 18 years (2.7%). Prevalence of placenta previa was higher than other studies, but the prevalence of gestational diabetes and hypertension was lower than the results of other studies. © 2015, Mashhad University of Medical Sciences. All rights reserved.
Introduction: Unwanted pregnancy is one of the major health problems which can cause serious health problems for mother and neonate and also, lead to high costs for health system. This study was performed with the aim to determine the prevalence of unwanted pregnancy and some related factors among pregnant women referred to health centers in Sanandaj. Methods: This descriptive- analytic study was performed on 1070 pregnant women referred to Sanandaj health centers in 2011. The data collection tools were the questionnaire consisting of questions about demographic characteristics and information about contraception method before pregnancy, contraception failure and type of pregnancy. Data was analyzed using SPSS software (version 16) and chi- square test. PResults: the results of this study showed that %25.1 of pregnancies were unwanted which 20.4% was related to women, 8.6% related to husbands, and %71 related to both. There was statistic significance difference between unwanted pregnancy and contraceptive failure method (P= 0.001), sufficient monthly income (P = 0.001), emotional relationship with husband (P = 0.001), mother's age (P=0.009), parity (P=0.001), occupation of mother (P=0.018), and employment of husband (P= 0.020). Conclusion: It seems that we can reduce the rate of unwanted pregnancies by increasing women's knowledge about contraceptive methods and men participation in reproductive health program. © 2015, Mashhad University of Medical Sciences. All rights reserved.
Context: Abortion levels may differ between subgroups of women because of variations in the level of unintended pregnancy and in the likelihood that women will choose abortion if they become pregnant unintentionally. Understanding differentials in levels of abortion according to women's characteristics can shed light on the circumstances surrounding the reasons leading to abortion. Methods: Data from government statistics, nationally representative sample surveys and subnational sources are used to estimate percentage distributions of abortions and abortion rates and ratios by selected characteristics of women, particularly age at abortion, marital status and parity. Comparisons are made within and across countries. Results: Women aged 40 and older generally obtain the lowest proportion of abortions (10% or fewer in most countries). Although adolescents account for a high proportion of abortions in some countries (for example, 33% in Cuba and 22% in Scotland), they do not obtain a disproportionate share of procedures. In general, abortion rates by women's age show an inverted U-shaped pattern. Abortion ratios by age, however, show two patterns: a U shape and a monotonic increase with age. In more than half of the countries studied, married women obtain a larger proportion of abortions than unmarried women. However, once pregnant, unmarried women are more likely than married women to choose abortion. More than half of abortions are obtained by women with at least one child. Some variations exist in these patterns by region. Conclusions: Women's characteristics influence their likelihood of terminating unintended pregnancies. However, within all demographic and socioeconomic subgroups, some women will obtain an abortion when faced with an unintended pregnancy.
Introduction:
The aims of this descriptive study were to determine the prevalence of illegal induced abortion among participants, the factors that influence decision making to have an abortion, and the health consequences of abortion in Iran.
Methods:
Women who attended health centers or an antenatal clinic in Iran were interviewed to complete a questionnaire.
Results:
Among the 2705 participants, 17% had experienced at least 1 illegal induced abortion. Education level, family income, religion, ethnicity, number of children, and age at marriage are associated with having an induced abortion. One-third of abortions (33%) were performed by nonmedical providers. The desire to stop or postpone childbearing and family economic problems were the most common reasons for having an abortion. Most women (84%) experienced a complication of abortion that required hospitalization.
Discussion:
Strategies to prevent abortion complications are needed and could include training midwives and general physicians to perform abortions and promoting the availability of post-abortion care.
This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used in this analysis links the abortion rate to its direct determinants, including couples' reproductive preferences, the prevalence and effectiveness of contraceptive practice to implement these preferences, and the probability of undergoing an abortion to avoid an unintended birth when a contraceptive fails or is not used. An assessment of the tradeoff between contraception and abortion yields estimates of the decline in the total abortion rate that would result from an illustrative increase of 10 percentage points in prevalence. This effect varies among societies, primarily because the tendency to obtain an abortion after an unintended pregnancy varies. For example, in a population with an abortion probability of 0.5, a 10 percentage-point increase in prevalence would avert approximately 0.45 abortions per woman, assuming contraception is 95 percent effective. If all unintended pregnancies were aborted, this effect would be three times larger. Eliminating all unintended pregnancies and subsequent abortions would require a rise in contraceptive prevalence to the level at which all fecund women who do not wish to become pregnant practice contraception that is 100 percent effective. A procedure is provided for estimating this "perfect" level of contraceptive prevalence.
Legal abortions are authorized medical procedures, and as such, they are or can be recorded at the health facility where they are performed. The incidence of illegal, often unsafe, induced abortion has to be estimated, however. In the literature, no fewer than eight methods have been used to estimate the frequency of induced abortion: the "illegal abortion provider survey," the "complications statistics" approach, the "mortality statistics" approach, self-reporting techniques, prospective studies, the "residual" method, anonymous third party reports, and experts' estimates. This article describes the methodological requirements of each of these methods and discusses their biases. Empirical records for each method are reviewed, with particular attention paid to the contexts in which the method has been employed successfully. Finally, the choice of an appropriate method of estimation is discussed, depending on the context in which it is to be applied and on the goal of the estimation effort.
Underreporting of induced abortions in surveys is widespread, both in countries where the procedure is illegal or highly restricted and in those where it is legal. In this study, we find that fewer than one half of induced abortions performed in the United States in 1997-2001 (47 percent) were reported by women during face-to-face interviews in the 2002 National Survey of Family Growth (NSFG). Hispanic and black women and those with low income were among the least likely to report their experience of abortion. Women were also less likely to report abortions that occurred when they were in their 20s. Second-trimester abortions were more likely to be reported than first-trimester terminations. The levels of recent spontaneous abortion reported in the 2002 NSFG were consistent with the accumulated body of clinical research, although substantially more lifetime pregnancy losses were reported on self-administered surveys than in face-to-face interviews. Subsequent research should explore strategies to improve information collected on abortion, and, in the interim, research involving pregnancy outcomes should be adjusted for unreported induced abortions.
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