Incidence of Abortion Among Adolescents, Worldwide: Levels and Recent Trends

Session: Improving Access and Quality of Safe Abortion Services: Global Lessons and Questions

Presenter: Ann Starrs, Guttmacher Institute
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Background: Teen abortion and pregnancy have been the topic of much research, policy and program discussion, and debate. Obtaining solid evidence can help monitor progress in meeting adolescents’ need for sexual and reproductive health information and services.

Methodology: We examine abortion incidence among adolescents (15-to-19 years old) in all countries for which recent information could be obtained. We present estimates primarily for 2011 and assess trends in these rates since the mid-1990s. Information was obtained from countries’ vital statistics reports, the United Nations Statistics Division, or other published estimates. A literature review on adolescent abortion services in developing regions was also conducted.

Results: Since the mid-1990s adolescent abortion rates have declined in most developed countries with reliable trend data.  Among countries with complete abortion records, the highest adolescent abortion rate was in England and Wales (20 per 1,000 females), and Sweden (20), with the lowest in Switzerland (5). In half of these countries the proportion of pregnancies that ended in abortion ranged from 35-55%. In Mexico and the countries in Sub-Saharan Africa, where abortion is largely illegal, the adolescent abortion rate ranged from 11 in Ethiopia to 44 in Mexico, and rates tended to higher than in countries with liberal abortion laws. The proportion of teen pregnancies ending in abortion ranged from 9% in Ethiopia to 24% in Mexico. In developing countries cost and privacy are two of the biggest barriers adolescents face to accessing abortion care. Adolescents are less likely than older women to obtain safe abortions, and more likely to terminate pregnancies after the first trimester.

Conclusion: Despite recent declines, abortion rates remain high in many countries and adolescents continue to face barriers to accessing abortion services. Research on factors that determine how adolescents resolve their pregnancies could inform policy and programmatic efforts to improve teen pregnancy outcomes.