Women who have repeat abortions (Three or more) have a 35% increased risk of complications in a future pregnancy. There is also an increased risk of a baby's death around the time of birth, suggests previous studies.
The study, conducted by the UPV/EHU's Social Determinants of Health
and Demographic Change (OPIK) research group, analyzed firstly the
voluntary pregnancy termination rate and the differences between the
immigrant and the native population (women between the ages of 12 and
49), and secondly, the differences in terms of the educational
attainment of women who undergo voluntary pregnancy termination.
‘The extent to which inequalities affect voluntary pregnancy terminations has been analyzed by a study of the University of Basque Country.
were interested in seeing the extent to which inequalities exist in the
Basque Country despite the fact that, in principle, access to healthcare
services (also with respect to voluntary pregnancy terminations) is
universal and free of charge for the whole population, irrespective of
people's social position," explained Yolanda-González Rábago, a member
of the research group.
The differences emerging from the data are substantial since during
the period studied the abortion rate among native women was 3.9 per
thousand while among women from Sub-Saharan Africa it was 45.6 per
thousand, 26.5 among South American women, and 22.9 per thousand among
those from Central America and the Caribbean.
With respect to repeat abortions (1.9 per thousand), immigrant women
also had a higher rate of repeats even though in this case there are
significant differences in terms of the origin of the immigrant women.
So the women from Sub-Saharan Africa had a rate of repeat abortions of
21.5 per thousand, whereas among women from South America it was 9.8 per
thousand, or 8.8 per thousand among women from Romania, and from other
European countries outside the European Union.
The data also indicate that the delaying of abortions after the
first twelve weeks is more frequent among immigrant women. Yet their
life circumstances play a significant role in this delay, since when
these level out, only in the case of women from Central America and the
Caribbean are the differences between native and immigrant women
A low level of educational attainment a risk factor
The OPIK group also studied the differences in voluntary pregnancy
termination in terms of the educational attainment of the women. The
results indicate that educational attainment is a factor that
substantially determines the rates of voluntary terminations. Women
(both native and immigrant) with a level of primary education or lower
have a rate of voluntary pregnancy termination of 17.7 per thousand,
while this rate falls to 6.2 per thousand in women who have been through
secondary education, and to 3.9 in those with university degrees.
Furthermore, the chances of having more than one abortion is much higher
among women with primary education (nine per thousand) or secondary
education (2.5 per thousand) than among those who have been through
higher education (0.7 per thousand), and the risk of delay up until the
second quarter of pregnancy in having the abortion is also higher among
women with primary education (0.8 per thousand) when compared with
university graduates (0.2 per thousand).
Yet according to González-Rábago, it is surprising that the data on
immigrant women with a higher level of educational attainment are not
more similar to those of Basque women, "we thought educational
attainment was going to neutralise the effect of being an immigrant, but
that does not appear to be a protective factor and does not lower the
risk of voluntary pregnancy termination. This could be because their
socioeconomic situation does not correspond to their educational
attainment; there are highly qualified immigrant women who work in very
precarious employment sectors". That is why the inequalities are very
tangible in this area since, according to the authors, "even though
among native women educational attainment is a factor that determines
their position in the social hierarchy, this does not seem to be the
case among immigrant women".
Inequality and cultural factors
Even though the research does not address the causes of inequality,
"what is true is that it does provide a working hypothesis," says
Yolanda González-Rábago. In this respect, as other studies across
Europe already also indicate, "factors of a cultural nature prior to
pregnancy, less sexual education and less egalitarian relations between
men and women (reduced power of decision in the couple) may lead to
immigrant women having more unwanted pregnancies". Factors of a social
type such as a reduced network of contacts and family structures in the
Basque Country as well as the socioeconomic level could account for the
fact that immigrant women are more likely to terminate unwanted
pregnancies than Basque women.
"Improving information is essential for addressing inequalities, and
preventing, insofar as it is possible, unwanted pregnancies but also so
that once these women become pregnant, the more vulnerable ones know
about the channels and scope of the coverage offered by the Basque
healthcare system enabling them to have an early abortion," says Yolanda
González-Rábago. At the end of the day, it is about minimizing the
risks posed by delaying the termination of the pregnancy and repeat
To achieve this, according to the conclusions of the study, what is
needed are specific campaigns geared towards the more disadvantaged
population groups, campaigns that focus above all on immigrant women
such as those from Sub-Saharan Africa or South America, among whom the
rates of voluntary pregnancy terminations, repetition and delay in
having them done are the highest.