Saikia Daisy, Pradhan Manas Ranjan
Department of Fertility and Social Demography, International Institute for Population Sciences, Mumbai, India.
J Biosoc Sci. 2023 May 17:1-16. doi: 10.1017/S0021932023000081.
Induced abortion is closely associated with maternal morbidity, mortality, and reproductive rights of women and thus continues to draw research interest. This study assesses the reasons for abortion and their predictors using India's National Family Health Survey-5 (2019-21) data. The sample of women aged 15-49 who had terminated their last pregnancy by induced abortion in the five years preceding the survey (n=5835) was considered for analysis. Multinomial logistic regression was used to check the adjusted effects of the socioeconomic predictors on the reasons for abortion. Stata (v16.0) was used for the data analysis. Women were more likely to abort their pregnancy at home/other than in the public health sector if unintended pregnancies (RR: 2.79; CI: 2.15-3.61) and sex-selective abortions (RR: 2.43; CI: 1.67-3.55) rather than life risk. The study found unintended pregnancy as the primary contributor to induced abortion. However, some women undergo the procedure due to medical reasons and the undesired gender of the unborn child. Unintended pregnancies that end in abortion are strongly correlated with gestational age, method of abortion, place of abortion, number of surviving children, religion, place of residence, and region. Again, there is a strong association between the sex-selective reason for abortion and the gestational age, method of abortion, place of abortion, number of surviving children, proper knowledge of the ovulatory cycle, religion, wealth quintile, and region. Women had abortions mainly due to unintended pregnancies, and there was socioeconomic, demographic, and geographic variation in the reasons for abortion in India. Sex-selective abortions continue to exist, especially among women of higher parity, poorest households and from the central, eastern, and north-eastern regions. The key to reducing unintended pregnancies and abortions is raising the understanding of contraception and empowering women in reproductive decisions. Reducing unintended pregnancies will contribute to lower induced abortion and thus improve women's health.
人工流产与孕产妇发病率、死亡率以及妇女的生殖权利密切相关，因此一直吸引着研究兴趣。本研究利用印度国家家庭健康调查-5（2019 - 2021年）的数据评估了人工流产的原因及其预测因素。分析样本为在调查前五年通过人工流产终止最后一次妊娠的15 - 49岁女性（n = 5835）。采用多项逻辑回归来检验社会经济预测因素对人工流产原因的调整效应。数据分析使用了Stata（v16.0）。如果是意外怀孕（风险比：2.79；置信区间：2.15 - 3.61）和性别选择性流产（风险比：2.43；置信区间：1.67 - 3.55）而非生命风险，女性更有可能在家中/而非在公共卫生部门进行人工流产。研究发现意外怀孕是人工流产的主要原因。然而，一些女性因医疗原因和未出生胎儿的性别不理想而进行该手术。以人工流产告终的意外怀孕与孕周、流产方式、流产地点、存活子女数量、宗教、居住地点和地区密切相关。同样，性别选择性流产原因与孕周、流产方式、流产地点、存活子女数量、对排卵周期的正确了解、宗教、财富五分位数和地区之间存在很强的关联。女性进行人工流产主要是由于意外怀孕，并且印度人工流产原因在社会经济、人口统计学和地理方面存在差异。性别选择性流产仍然存在，尤其是在多胎次女性、最贫困家庭以及来自中部、东部和东北部地区的女性中。减少意外怀孕和人工流产的关键在于提高对避孕的认识并赋予女性生殖决策的权力。减少意外怀孕将有助于降低人工流产率，从而改善女性健康。
