Junior Research Group Leader, School of Public Health, Department of Epidemiology and International Public Health, Bielefeld University, Bielefeld, Germany. Correspondence:
Sex Reprod Health Matters. 2021 Dec;29(1):1985814. doi: 10.1080/26410397.2021.1985814.
Medical abortion (MA) is recommended by the WHO as a safe and effective pregnancy termination method in the first trimester. From a feminist perspective, it is a non-medicalised, self-managed, emancipating procedure allowing persons seeking abortion to be more in control of their abortion, as opposed to surgical procedures. In European countries where MA is legal, the proportion of MA (relative to surgical abortions) varies greatly. We hypothesised that this ratio may be partly explained by country-level dimensions of gender equality. We assessed the association between MA ratios and gender equality in Europe in correlation and regression analyses, using several country-level gender equality indices. The relevance of other factors, i.e. date of introduction of MA and pregnancy week until which MA is permitted, was also investigated. MA ratios ranged from 24.4% (Italy) to 97.7% (Finland). MA was more frequent relative to surgical abortion in countries with higher levels of gender equality. All gender equality indices were associated with MA ratios (e.g. Global Gender Gap Index corr. coeff: 0.761, < 0.0001). Specifically, markers of economic and political gender equality seemed to drive the correlations. The pregnancy week until which MA is permitted was associated with both gender equality and MA ratios. Our study suggests that women's participation in the economic and political sphere may have repercussions on the methods offered and used through abortion services. It highlights the link between feminist perspectives, reproductive health policies and practices, and gender equality, especially in terms of access to economic resources and political representation.
医疗流产（MA）被世界卫生组织推荐为在妊娠早期安全有效的终止妊娠方法。从女权主义的角度来看，它是非医疗化、自我管理、解放性的程序，允许寻求堕胎的人更好地控制自己的堕胎，而不是手术程序。在 MA 合法的欧洲国家，MA 的比例（相对于手术堕胎）差异很大。我们假设，这种比例可能部分可以用性别平等的国家层面维度来解释。我们使用了几种国家层面的性别平等指数，对欧洲 MA 比率与性别平等之间的相关性和回归分析进行了评估。还调查了其他因素，即 MA 的引入日期和允许 MA 的妊娠周数的相关性。MA 比率从 24.4%（意大利）到 97.7%（芬兰）不等。在性别平等程度较高的国家，MA 相对于手术堕胎更为常见。所有性别平等指数都与 MA 比率相关（例如，全球性别差距指数相关系数：0.761，<0.0001）。具体来说，经济和政治性别平等的标志似乎推动了相关性。允许 MA 的妊娠周数与性别平等和 MA 比率都有关。我们的研究表明，妇女参与经济和政治领域可能会对堕胎服务提供和使用的方法产生影响。它强调了女权主义观点、生殖健康政策和实践与性别平等之间的联系，特别是在获得经济资源和政治代表权方面。
