What is the Profile of Women that Have Abortions in the Countries in the Region?

The broad, complex range of factors at play in the practice of abortion makes it difficult to outline and describe the socio-demographic profiles of women who resort to this practice in the various countries of Latin America and the Caribbean. The limitations of the different sources and methods of collecting information mentioned in a previous chapter should be considered when one explores the characteristics of these women.

Studies that seek to profile them are usually analyzed on the basis of surveys carried out for the population as a whole or for certain groups of the population, or through hospital records or interviews with women under medical treatment for abortion complications. The information available is very uneven, and in the case of surveys usually comes from studies undertaken with specific populations in certain regions, cities or zones that are predominantly urban, meaning that they ignore an important part of the population. The empirical evidence drawn from public health institutions to which women turn for treatment of abortion complications refers mainly to persons of few economic resources. Young or single women often do not even have access to hospitals. Women with medium to high economic resources go to private hospitals, and therefore it is more difficult to obtain information on them, since abortions tend to be recorded less frequently at these facilities. At the same time, the differences in the indicators used and in the criteria for classifying the data obtained make it difficult to compare the characteristics of women from different countries.

Generally speaking, there is a certain reductionism in the indicators used in surveys about the profile of women who have abortions, particularly in reference to the reasons underlying the decision to interrupt the pregnancy. This is largely due to the tradition of studies in the field of demography, which consists of emphasizing certain classic socio-demographic features to describe the behavior of women, as in the case of research on fertility. It is also the result of the limitations inherent to this method for recording information on the attitudes, motives, perceptions, norms and meanings regarding the occurrence of abortion.

Finally, there are still very few studies exploring other characteristics of women who resort to abortion, such as the number of children they have, whether they have had previous abortions, their sexual and contraceptive experiences, and the process of negotiating with their partners. All these are important elements for understanding the issue better. Likewise, researchers often do not know what factors affect the practice of abortion, such as the conditions of access to perform an abortion according to its legal status in the country, restricted access to family planning methods, and moral and religious sanctions for pregnancies out of wedlock. This is compounded by the economic difficulties and cultural barriers faced by women with a need to abort. Because of all this, it is essential to know, as part of the profile of these women and their decision-making process, the various reasons that lead them to resort to this practice. Women’s decisions are not static, and they tend to change in face of a new pregnancy according to different conditions that surround  this event.  Researchers should also take into account the perceptions, assessments and attitudes of women and other actors and of those that form part of the social networks that influence and intervene in this process.

A Practice that Occurs more Frequently at Certain Ages.

On the basis of a review of 300 studies published between 1985 and 2002, Shah and Ahman (2004) analyzed the profile of women who resort to abortion according to their age (Table 1). They found that of 3.7 million unsafe abortions estimated to have been performed in 2000 in Latin America and the Caribbean, the largest proportion corresponded to women aged between 20 and 24 (29%), a proportion which fell as the women’s age increased. The abortion rate was 43 per 1000 women aged 20 to 24 and 41‰ of those aged 25 to 29; it fell to 28 per 1000 among women aged 30 to 34 and was 21 per 1000 of those aged 35 to 39 and only 14‰ for the group of women aged 40 to 44. For teenagers and young women under the age of 20, the abortion rate was 20 per 1000 women. Conversely, the abortion ratio per 100 live births, which in this region is the highest in the world, was approximately 30% among women aged 15 to 24 (varying from 28% to 31%), 41% for those aged 35 to 39 and almost double that for those aged 40 to 44. The increase in this rate from the age of 35 onwards reflects the low fertility of these ages, resulting largely from women’s use of sterilization. For these authors, abortion in the region plays an important role in fertility regulation in that it constitutes a means of spacing out births at the beginning of a women’s fertile life, as well as limiting their offspring at later stages.

Likewise, the results of studies conducted by Bankole et al., (1999), based on government statistics (Cuba, 1990), surveys (Guyana 1996), and hospital records (Brazil 1992-93, Chile 1989, Colombia 1990, Dominican Republic 1991, Mexico 1991 and Peru 1990) at the beginning of the 1990s show that Latin American women over the age of 40 constitute the lowest proportion of those that have abortions (10% of the total) whereas teenagers and young women account for the highest percentages in virtually all the countries, both in the group under the age of 20 and in the group aged 20 to 24 (Table 2). For these authors, the differences can also be explained by the frequent practice of sterilization as a family planning method.

According to the same source, by the beginning of the 1990’s, Cuba was the country with the largest proportion of abortions in these two age groups, to which a third of the total number of women who aborted belonged. In second place was Brazil, where the proportion was 23% and 36% for each of these age ranges. However, Mexico, Peru, Chile and Guyana seemed to have fewer abortions among teenagers (9% to 11% were women under the age of 20), which increased in the group aged 20 to 24 with figures ranging from the 25% to 30%. Columbia and the Dominican Republic had similar proportions in these large age groups, and their position was intermediate in terms of the proportion of abortions occurring among the youngest group of women (17% for those under 20) (Table 2).

It is estimated that the abortion rate in Cuba during the 1990s was highest among young women: 90 for every 1000 women under the age of 20 and 87.9‰ for those aged 20 to 24. The rate fell drastically to 54.4‰ for women aged 25 to 29, to 33.2‰ for those aged 30 to 34, and to just half of this for the group aged 35 to 39 (15.6‰) (Bankole et al., 1999). In a municipality of Havana, a study was carried out that obtained similar results for women aged 13 to 34 (Álvarez et al., 1999). According to this study, among women under 20, the abortion rate was virtually twice that of women aged 20 to 24. In the first of these groups there were two abortions for each live birth in the year prior to the survey. This trend is confirmed in the study undertaken by Álvarez (2005) in the same country in 2004. According to the author, the predominance of abortions in adolescents is due to the fact that they do not always consider the risk of pregnancy. It is also linked to the male domination that characterizes couples in this island country. This situation also reflects the intense sexual activity of adolescents, among which there is a low prevalence of contraceptive use. Access to contraceptives is fairly limited in Cuba, due above all to the insufficient supply of contraceptives at public health institutions.

A similar trend is observed in other parts of the Caribbean. This is true of the French Antilles, where abortion is authorized at the women’s request, as it is in Cuba. Among the young women of Guadeloupe, in 1995 abortion was frequent: 42% of the pregnancies of women aged 12 to 17 and of those aged 18 to 19 ended in abortion. In Martinique, the percentages were 57% and 44% for each of these age ranges. Conversely, in French Guyana, they were 20% and 22%. Abortion is also common at the end of the fertile lives of women of the Caribbean and nearby regions, due primarily to the scant use of contraceptives at this stage: 54% of the pregnancies of women aged 45 or over ended in abortion in Guadeloupe, as opposed to 56% in Martinique and just 47% in French Guyana (Boudan, 2000). In Guadeloupe, in 2003, six out of every ten women under 20 years old had interrupted a pregnancy, as had 46% of those aged 20 to 24 and one out of every three of those aged 25 to 34. Among older women, 41% had done so (Claire, 2003).

Likewise, a survey conducted in 22 cities in Colombia in 1992 showed that although the possibility of having an abortion was considerable for all age groups, it is women under the age of 25 who resorted to this practice most often, particularly those aged 15 to 19. According to the study, a young women under the age of 20 who is pregnant has twice the risk of aborting as a women older than 45.  Just under half (45%) of the women consulted in this younger age group had had a experience of abortion, as opposed to a third of those aged 20 to 24. In the case of women aged 45 to 49, although the practice was limited to a quarter of them, it is still high (25%) (Zamudio et al., 1999).

The study by Ojeda (Ojeda, 2004; Ojeda et al., 2003), conducted in 1992 and 1993 on 815 Mexican women in the Tijuana/San Diego border region who cross over into the US to have an abortion in safe conditions, found that most of these women were aged between 20 and 29 and some used abortion to postpone starting their reproductive trajectory. The authors reveal different behavior according to certain characteristics of these women: the majority of those that aborted who use Spanish to communicate in writing were over 30 (40.7%), followed by the group aged 25 to 29 (28%) and the group aged 20 to 24 (26%), with the youngest group (14 to 19) accounting for a mere 6%. Among those that were able to write in English, the highest percentage was concentrated among women aged 25 to 29 (43%) and those aged 20 to 24 (28%). The lowest percentages among English speakers were found among teenagers aged 14 to 19 (12%) and among those older than 30 (17%). Conversely, a pattern similar to the above was observed among non-Hispanic women in these same hospitals: 7% of those in this subgroup that aborted were aged 14 to 19, 28% were aged 20 to 24, 40% were aged 20 to 29 and 25% were 30 or over.

Likewise, in the study conducted in the year 2000 in Uruguay with information from a clandestine clinic, it was found that the age of women who aborted there was concentrated in the group aged 20 to 24 (27%) followed by the group aged 25 to 29 (23%) (Sanseviero, 2003). The same tendency is observed in the rest of this South American country: the highest abortion rates coincide with the ages of greatest fertility, 20 to 29. The abortion rate in women ages 20 to 24 is 71.3 per thousand, in other words, one out of every 14 women of this age range abort. As for younger women ages 15 to 19, the rate is 63.4 per thousand; in other words one out every 30 interrupts her pregnancy (Sanseviero, 2003).

Studies undertaken on the basis of hospital records or surveys carried out in hospitals also show the profiles by age of the women that seek treatment there. A study conducted by the Latin American Federation of Obstetricians and Gynecologists in 1990 in Bolivia, Columbia, Peru and Venezuela found that over half of the patients treated for abortion complications in hospitals were over age 20, with an average age of 27. Of these, over half were concentrated in the group aged 20 to 29 (27% for those aged 20 to 24 and 26% for those aged 25 to 29) whereas 13.5% were under 20 (Pardo and Uriza, 1991).

A study was conducted along the same lines in 1990 in Santiago on women treated for abortion complications at nine hospitals in the Chilean capital. It was found that a minority (11%) of these were young women under the age of 20 (Lavin quoted by the Alan Guttmacher Institute, 1996).

The findings of another study on poor women of urban origin admitted for abortion complications to a hospital in the northern Brazilian city of Fortaleza show a different trend. Just over a third of these women (36%) were aged between 20 and 24, nearly a quarter were aged 25 to 29, and a similar proportion were under the age of 19 (24% and 23% respectively). Likewise, nearly one out of every 10 women was aged between 30 and 34 (12%) and a much smaller proportion were age 35 or over (6%) (Misago and Fonseca, 1999). Another study carried out between 1993 and 1994 on 620 women admitted for abortion complications to the hospital of the southern city of Florianopolis, also in Brazil, showed that most of the women who interrupted their pregnancies were young, under 25, single and had only completed elementary school (Fonseca et al., 1998).

A similar study was conducted in Peru on the basis of data obtained from women who aborted in two hospitals in Lima (Barrig et al., 1993). It was found that the largest proportion of women treated here were aged 20 to 39:  25% of those discharged from the Perinatal Maternal Institute were 25 to 29, whereas in the Rebagliati hospital, 28% were aged 30 to 39. In both hospitals, the proportion of young women aged 15 to 19 attended for the same reason was low: 7% in the first hospital and 1% in the second. The percentages of women aged 40 to 44 who were attended in these hospitals were 3% and 16%, respectively. In a study conducted in this country in the year 2000, Ferrando (2002) found that 62% of the women hospitalized due to abortion complications were under 30, 14% of these being under 20.

In Argentina, a study conducted on women who received treatment for abortion complications in 2004 indicates that they had an average age of 27. Of the women included in the study, 17% were aged 10 to 19 and 50% were aged 20 to 29 (Romero et al., 2005).

The Oriéntame Foundation in Colombia undertook a similar study from 1990 to 1991 on 602 women treated to interrupt their pregnancy. The authors of this study show that the ages of these women ranged from 16 to 48. Over half were aged 20 to 29, and the mean age was 27, as in the Argentinean study above (Mora Téllez and Villarreal, 1993).

Likewise, in 1990, Dr. Armando Valle Gay carried out a study on the basis of records of 100 women treated for abortion complications in Mexico’s General Hospital. Of the total sample, 30% of the women were aged 21 to 25, 26% were aged 15 to 20 and 25% were aged 25 to 30 (quoted by GIRE, 2000). Another study conducted in 119 hospitals of the Health Secretariat in the same country provides interesting information on women who abort. According to that study, for which 58,000 abortions performed in these hospitals were considered (the majority using D&C and 7,000 using manual endouterine aspiration), 21% to 22% of the women attended were under 20 while 64% to 65% were aged 20 to 24 (Quezada et al., 2005).

Likewise, Paiewonsky (1999) found that almost half of the 352 women interviewed who were attended for abortion complications in two hospitals in Santo Domingo in 1992 were aged between 20 and 29. Those aged 20 to 24 accounted for 16% while those aged 25 to 29 accounted for 33%.

In a study carried out on women suffering from abortion complications in hospitals in three Bolivian cities in 1996 and 1997, adolescents accounted for 16% in La Paz on both dates, and between 16% and 30% in Santa Cruz and between 12% and 30% in Sucre for both of these years (Díaz et al., 1999).

Another important study was carried out in another country whose abortion laws are extremely restrictive and where three clinics in urban cities offer MVA services. A review of the clinical histories of more than 10,000 women who received treatment for abortions from the year 2000 to the year 2002 show that over half of them were aged 13 to 24 (55%) and over a third were aged 25 to 34 (35%) (Aldrich et al., 2005).

This evidence, which shows the significant proportion of adolescent and young women who needed to be hospitalized for abortion complications, particularly in countries with restrictive legislation, shows the greater barriers faced by these women in obtaining access to safe abortion procedures (see Chapters 5 and 7).

Marital Status, Parity and Abortion.

Various studies conducted in countries in the region showed that married women are most likely to have abortions. Nevertheless, these results should be regarded with caution. For example, in the case of hospital registers, all those living with their partners or in a stable relationship tend to have greater and easier access to health services.  This fact has also been observed at the start of family planning programs, and it continues to prevail in many countries.

The information on this topic varied considerably between the different Latin Americans countries and according to the source of data used and the context of the study. In the 10 de Octubre Municipality of Cuba, the proportion of women who aborted was higher among single women and common law wives (12% in each case) than among married women (8%) or divorcees, widows, and those that were separated (9%). The ratio of abortion to live births was greater among single women and women in common law unions (14% to 6% respectively) than among married women and the rest of the women (from 8% to 10%). These results show the importance of considering the number of live births. Those that did not live with their partners had more abortions than those that did (14% as opposed to 8%) (Álvarez, 1994).

The results of a survey undertaken in urban areas of Colombia show that 27% of the women aged 15 to 19 had been pregnant at least once and also had a higher level of abortions (45%), while the vast majority of women aged 35 to 39 (94%) were already mothers, but only 29% had had abortions. The distribution of abortions according to the order of pregnancy indicated that just under half (43%) of all cases occurred during the first pregnancy  Differences were also observed by region and by socioeconomic status (Zamudio et al., 1999). According to this study, the link between the number of children and abortions showed that women with two children had fewer abortions (23%) than those that had had 6 children (41%) although percentages fell slightly among those that had had between 7 and 10 or more offspring (between 34% and 39%). As the authors point out, this is probably due either to the fact that abortions are less common among older women or to the higher infant mortality of previous generations.

A study mentioned earlier conducted by the Latin American Federation of Obstetricians and Gynecologists in 1990 in hospitals in Bolivia, Columbia, Peru and Venezuela, showed that the majority of patients treated for abortion complications were married (79%), half had two or more children and 70% had not had any other abortions (Pardo and Uriza, 1991).

A similar situation was observed in the study at nine hospitals in Chile in 1990 on women treated for abortion complications: the majority of these women were married or lived common law unions, had children and had completed 7 or more years of schooling (78%, 76% and 80% respectively) (Lavin quoted by the  Alan Guttmacher Institute, 1996).

In Colombia, according to hospital data for 1990, nearly three quarters of the women admitted for abortion complications were married or lived in common-law unions (72%) a figure that was higher in Peru (88%) (Bankole et al., 1999). Nevertheless, these last authors show that in other countries in the region, unmarried pregnant women are more likely to opt for an abortion. This was observed in Brazil, where 53% of the women who aborted were single, 39% were married or had a stable partner and 9% were either separated or divorced (Misago and Fonseca, 1994; 1999). Of the women in this study, 59% had between one and three children, 8% had over 5, 34% had none and 22% of them had had a previous abortion (Misago and Fonseca, 1999).

In the Dominican Republic, the interviews conducted on women attended for abortion complications at two hospitals in Santo Domingo showed that the majority of the women had stable relationships with their partners: 66% had common-law unions, 13% were married, and 9% declared they have lived in consensual unions but at the moment of the interview now lived alone and the majority of all the women had children (Paiewonsky, 1999). A study conducted on women hospitalized for abortion complications in three cities in Bolivia, Díaz et al. (1999) notes that the majority of these women (60% to 70%) were married or were in common-law unions. It also shows that many of them had already had abortions: in the city of La Paz, 47% to 48% of women had had at least one abortion. In Sucre this figure was 26% and in Santa Cruz, 34% in 1996 and 46% in 1997. 20% of the total group of women had given birth to two or more children.

At least 6 out of every ten women who chose to abort in several countries in the region had had one child or more, although the magnitude varies among them For example, in Brazil, the proportion was 66%, in Colombia, this figure rose to 71%, in Peru it is estimated at 76% and in the Dominican Republic it was 92% (Bankole et al., 1999).

In Lima, Peru, the data obtained from the study mentioned above conducted by the Perinatal and Rebagliati Hospitals (Barrig et al., 1993) show that among the women treated for abortion complications, marriages prevailed (87%). Differences were also found between the two hospitals in the average age of the woman at the birth of her first child. In the second hospital, which treats mainly middle-class women, a quarter of the patients were under 21 when they gave birth to their first child. In the first hospital, which attends poorer women, almost three quarters were minors. Conversely, 47% of the women attended at the Rebagliati and 38% attended at the Perinatal Hospital had had a previous abortion. Of the total group of women in both hospitals, 60% had had an abortion, while 40% had two or more. At the same time, Ferrando (2002) indicates that in the case of women hospitalized for abortion complications in Lima, less than a third did not have any children (30%), whereas twice this figure said that they had between one and four children (60%). This same study shows that the majority of women had a stable partner (83%), whom they were either married to or living in consensual unions (23% and 60% respectively).

A similar study was carried out at a clandestine clinic in a South American country. Over three-quarters of the women who went to this clinic for an abortion were married (78%), over half had no children (54%), 46% had had previous pregnancies and 13% had had at least one abortion (Strickler et al., 2001).. Different results are found in the study by Aldrich et al. (2005) conducted between 2002 and 2004 on women that received medical abortions in a country  (anonymous one) where abortion is illegal, in which 84% of the women who aborted were single.

These results show that there is no clearly defined profile of women that resort to abortion and that this practice affects both married and single women with or without children. They also corroborate the role of abortion both as a procedure for spacing out pregnancies and for limiting the number of women’s offspring.

Educational Attainment: A Determining Factor in Abortion?

Educational attainment has been found to be a major discriminating factor in many studies related to women’s reproductive behavior. However, in the case of abortion, no clear link has been observed between educational attainment and the incidence of this practice. In some countries, the evidence shows that the women who are more likely to resort to abortion are those with a high educational level, in others the percentage is concentrated among those that only finished either elementary or secondary school, and in still others there seem to be contradictory results according to the studies undertaken. That is why, in the various situations described, as is also the case with the issues documented in other chapters, one should bear in mind the fact that statistical evidence depends among other factors on the socio-geographical sphere considered, differences in conditions of access to educational institutions and health services, and above all on the methodology and the sources of information used.

The results of the research conducted in 1990 in four South American countries: Bolivia, Colombia, Peru and Venezuela, on women hospitalized for abortion complications, show that over half the women admitted to hospitals for abortion complications had failed to complete secondary school (56%), just under a third had to failed to complete elementary school or had finished this school cycle (16% y 13% respectively). The average number of years of schooling for these countries as a whole was 6.95 years (Pardo and Uriza, 1991).

The study mentioned above, conducted with 4,359 women in a hospital in the Brazilian city of Fortaleza, shows a similar pattern to that observed earlier: less than a half of the women who had had an abortion had completed between 5 and 8 years of schooling (46%). Just over a fifth (23%) had completed 8 or more years of schooling, a number that is slightly lower than that for women with very low educational level (28%). Only 4.3% of them had never been to school at all (Misago and Fonseca, 1999). In this social context one should keep in mind that they were poor women in urban areas who went to public hospitals to be treated for abortion complications.

The results of the study by Bankole et al. (1999) conducted in 1990 which includes women hospitalized for abortion complications show that in Colombia the highest percentages of women who decided to abort had completed secondary school (30%), whereas a significant proportion of the women had university degrees or higher levels of education (19%). 28% had only completed elementary school, whereas 23% of the women had no education at all (Bankole et al., 1999). In Peru, a similar tendency to Colombia was observed, since a third of those who resorted to abortion were university students (34%), followed by those that had completed elementary school (27%) or had secondary school education (23%). Of the women with no schooling at all, only 16% had aborted (Bankole et al., 1999). Conversely, the opposite relationship can be observed in the Dominican Republic, where the highest percentage of women who abort is concentrated among those that have completed elementary school (59%), as opposed to 29% of the women who have completed secondary school, 7% who had had no schooling at all and only 5% with university or higher education (Paiewonsky, 1999; Bankole et al., 1999).

In Mexico, the aforementioned study by Dr. Armando Valle Gay conducted on 100 women hospitalized for abortion complications reveals the low levels of educational attainment of these women. 16% were illiterate, 44% of the women had not completed elementary school, 28% had completed primary school and only 3% were professional women (GIRE, 2003).

In the study mentioned earlier conducted at a clandestine abortion service in the Southern Cone in 1995, it was found that 9 out of every 10 women had completed secondary school and that just under a third were studying at the time the study was carried out (Strickler et al., 2001). When this 1995 study was compared with data from 1970 from the same context, the authors concluded that nowadays women who resort to abortion are younger and better educated than before. This change is largely due, as has been stated in several studies, to the greater access to and permanence of women in the school system in countries in the region. Aldrich et al. (2005) study on three clinics in a country where abortion is illegal shows that women who interrupted their pregnancy had a high educational level; over half had university studies (56%), 32% had completed secondary school and 11% had completed technical studies.

According to the study conducted in Lima mentioned earlier, the majority of women with higher studies went to the Rebagliati Hospital, whereas in the case of the Perinatal Maternal Institute, the largest percentage of those treated had completed secondary school. Of all the women discharged from the first hospital center, 37% had university studies, 58% had completed secondary school and 5% had completed primary school. In the second hospital, 1% had pursued university studies, 63% had completed secondary school and 36% had completed elementary school (Barrig et al., 1993). As one might expect, these differences are due to the characteristics of the patient population in each of these institutions, since the Perinatal hospital treats families with scant resources, and the Rebagliati patients are employees who pay 6% of their monthly salary to social security. In other words, Rebagliati patients belong to intermediate socioeconomic strata.

In the study mentioned earlier, conducted in the 10 de Octubre Municipality in Havana, pre-university women had had more than one abortion per live birth. Among those that had completed secondary school, the number of abortions was higher (Álvarez, 1994).

The results of the survey in the urban areas of Colombia also demonstrated greater prevalence of abortion in women with high educational attainment. Of the total number of women who had some university studies or had completed an undergraduate or graduate degree, 27% and 25% respectively had opted for abortion, as opposed to 29% who had failed to complete primary school. The percentages fell among women who had complete or incomplete secondary school studies: 23% had completed primary school, 21% had attended some secondary school and 18% had completed secondary school (Zamudio et al., 1999).

This same pattern is more obvious in this country when one observes the distribution of abortions per hundred pregnancies. Abortion is more common among women who have some university studies (28%). It was 20% among those that had completed their university studies and fell significantly among women who had completed or failed to complete secondary school (13% in each case). The smallest proportions were found among those that had only studied in primary school, whether or not they had finished (10 and 9% respectively) (Zamudio et al., 1999).

Occupation and Differentiation by Socioeconomic Strata

As GIRE (2003) so rightly points out, women who resort to abortion belong to all socioeconomic levels and live in all kinds of places. “Peasant women and women who live in cities, women with scant resources and women with high incomes, professionals and illiterates, housewives and students, young women and not so young women have abortions.” Nevertheless, the majority of studies examine the situation in urban context and above all in the lowest social strata.

In Colombia, Zamudio et al. (1999), identified three types of occupations among the urban women interviewed: housewives, students that work and employees. In relation to the number of pregnancies that the women had had, the first group showed less experience of abortion and the percentage increased according to the number of pregnancies. Of the women who worked and studied, 90% aborted during their first or second pregnancy, whereas only 40% of the employees did this. Housewives resorted to this practice in larger proportions (40% of all cases) after a sixth pregnancy. The number of abortions per hundred pregnancies was 49 among women who study and work, 15.3 among those that only work and 9 among housewives (Zamudio et al., 1999).

At the same time, the authors point to the differences between women who had resorted to abortion at some time in their lives according to their belonging to one of six social strata: high, upper-middle, middle, lower-middle, low and very low. The results of the study conducted on this issue showed that at one of the extremes of the social scale, of greatest poverty, there was a greater tendency to have abortions (27%). Among the low and/or upper middle classes 24% had undergone an abortion. High and middle class women resorted to this practice to a lesser extent: 17% of high strata and 22% of the middle and also the lower-middle strata. Nevertheless, if one observes the data on abortion for every 100 pregnancies, percentages rise with the social level, with the exception of the highest level. These were 11% at the very low level, 12% at the low and lower-middle level and 15% among the middle classes, 17% among the upper middle classes and 9% among the upper classes. These evidences suggest that the preferred family size and the control women exert to achieve this takes place through the use of contraceptive methods or by resorting to abortion. However, the occurrence of abortion may depend on other factors, such as marital status and the stability of the couple. As the authors of this rigorous study state, “the comparison between risk of pregnancy and risk of abortion is extremely thought-provoking. Although the risk of  pregnancy increases with each lower social stratum since prevention is less common at this level, the risk of abortion is also less among the same social classes because a greater number of pregnancies end in births” (p.24). Conversely, the higher use of contraceptive methods among the middle and upper classes reflects the lower degree of tolerance towards unwanted pregnancy, and therefore it is among this group that women are more likely to resort abortion (Zamudio et al., 1999).

In another study conducted in Colombia between 1990 and 1991 with 620 women from Bogotá who had performed an abortion, it was observed that 90.5% of these women came from the city, 8.3% lived in a village and 1.2% lived in a rural setting. From all these women, 31.2% had had access to higher education and only 2% were illiterate. Women with a higher educational level were aged between 20 and 29 and 48% of the latter were working at the time. According to the authors, this shows that the higher a women’s educational level and the greater her professional expectations, the less her goals were compatible with motherhood (Mora Téllez and Villarreal, 1993).

In Brazil, according to a study by Misago and Fonseca (1999), the highest percentage of women who had an abortion were housewives (34%), 15.1% were domestic servants, and the rest were divided between students, employees in the service sector, seamstresses, farm workers, shop workers and unemployed women.

Likewise, Barrig et al. (1993) observed in the study they conducted in Peru that 80% of the women treated for abortion at the Rebagliati hospital were workers, whereas in the case of the Perinatal hospital this percentage was 68%. In the first hospital, 69% of these women had a profession or independent trade, whereas in the second, 74% were employees. Conversely, abortion rates did not vary significantly between those that worked and those that did not in the study mentioned earlier that was conducted in the 10 de Octubre Municipality of Havana in Cuba (Álvarez, 1994).

Other studies have emphasized the conditions in which abortion is performed and the risks associated with this practice according to the social class of the women involved, their access to health services and other aspects. In one of them, the authors state that 54% of poor rural women who abort in Latin America suffer complications, 44% of poor urban women experience complications, whereas only 13% of wealthier urban women suffer complications (The Alan Guttmacher Institute, 1994).

Zamudio et al. (1999), describe the differences observed between the different regions of Colombia. In this country, the average number of abortions per woman at risk (in other words for each one who has been pregnant at least once), is 0.29. This number rises to 1.28 for each of those that have aborted on at least one occasion. This last average is highest in Bogotá (1.30), among the upper middle classes (1.31), among women who have had 7 or more pregnancies (1.44) and among those that have failed to complete primary school (1.37). Women in the capital who abort have 33% more pregnancies than the general overall average for those living in other Colombian regions included in the study. In considering the proportion of abortions for every 100 pregnancies, the authors corroborate the greater incidence of abortions in Bogotá. Thus, for example, in the Andean region, where the lowest incidence of abortions is found, 7.23 out of every 100 pregnancies were interrupted, whereas in Bogotá the proportion rises to 14.6. But researchers warn that the fact that a higher percentage of stillborn children and miscarriages has been reported in the Andean region may suggest that a considerable number of the women who aborted intentionally in this region reported the event as a miscarriage.

On the basis of a national survey conducted in 2003 in Mexico, Menkes and Suárez (2005) showed the differences in abortion practices among adolescents by socioeconomic stratus. Women from the lowest strata are least likely to resort to abortion (4.9%) with the incidence increasing as their material conditions improve (6.1% among the lower strata and 9.3% among the upper middle class strata). This pattern is not confirmed in the study by Ferrando (2002) in Peru, since she observed that women in unfavorable socioeconomic conditions have a greater risk of abortion complications: whereas 44% of women from the poor rural stratum and 27% from the poor urban stratum face this risk., only 24% of women from the non-poor rural strata and 5% of the non-poor urban strata are in this situation.

Profile of Women who Become Pregnant as a Result of Rape

An extremely important matter and one that has scarcely been studied is the profile of women who abort due to rape. The Population Council explored the issue based on the review of 231 medical files of women who became pregnant for this reason and were treated between 1991 and 2001 in the Mexico City General Hospital (Lara et al., 2003). It found that two-thirds of them were aged between 10 and 19, a quarter was aged between 20 and 29 and the rest were women over 30. Almost all the women interviewed were single (95%) and over a third were students (36%). A similar proportion were engaged in domestic labor (35%) and the rest had a paid employment (29%). Just under half had studied for 13 or more years (45%), just over a quarter were women with medium (between 6 and 9 years) educational attainment (27%), while a fifth (21%) had not finished elementary school (they attended school for up to five years or not at all). In 90% of the cases analyzed, this was their first pregnancy.

197 of the 230 women who became pregnant as a result of rape were followed up on. Only 22% had abortions in the General Hospital; in other words, only 44 women had abortions. In no case had they been pregnant over 12 weeks and most of them had been pregnant an average of 8.3 weeks. Another 7 women experienced miscarriages, and 5 failed to return to the hospital after a favorable verdict by the hospital ethics committee allowing them to have an abortion. Over 72% of the women continued their pregnancy, 77% of these due to the fact that they were over 12 weeks pregnant and above all because they were denied permission. Not permitting them to abort contravened existing legislation and their reproductive rights, since in Mexico as in some other Latin American countries, abortion is permitted when pregnancy is the result of rape.

Another study conducted between 2002 and 2005 in Mexico City shows that 33 of 49 requests to interrupt pregnancy as result of rape were authorized. In this case, more than half of the applications were from adolescents and young women: 8 of whom were under 15, 10 between the ages of 15 and 19, and 8 between 20 and 29 years old (Ubaldi Garcete and Winocur, 2005).

Evidence from these two studies reveals the greater risk of rape among younger women and particularly the difficulties they experience in obtaining an abortion. Although, as mentioned earlier, abortion in cases of rape is a widely recognized right in the legislation of certain countries in the region, the authorities often prevent it from being exercised.

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