Reasons for Seeking Abortion

Abortion as a result of an unwanted pregnancy is a problem that is determine by a variety of factors, including the difference of power between genders, insufficient sexual and reproductive education, particularly for young people, as well as the impossibility of obtaining access to basic health and family planning services (CRLP, 1999). Certain reasons for resorting to abortion are closely linked to the widespread context of violence in many Latin American countries, placing women in a situation of vulnerability and risk. This is compounded by other factors, such as sexual abuse or child and teenage prostitution, the absence of parents, the state’s deficient attention to sexual and reproductive health, in addition to the opposition of the Catholic hierarchy to contraception. This means that many women resort to clandestine abortions, which are often or usually performed in high risk conditions (CDD, 1997).

The information available on women’s reasons for resorting to abortion is insufficient. This is partially due to the fact that in most Latin American and the Caribbean countries, abortion is illegal except in exceptional cases, making it extremely difficult to obtain well-documented information on the phenomenon. At the same time, the existence of moral and religious precepts against it means that many of the women who abort prefer to keep silent or give other reasons for losing their pregnancy rather than suffering the loss of social prestige caused by this practice.

Added to these impediments is the difficulty of obtaining information on abortion through an instrument such as a survey since abortion is a sensitive issue, one which is often painful and socially condemned and which, above all, is rarely due to a single cause. The reasons leading to abortion are often complex and interrelated. As mentioned earlier; they include several barriers and difficulties that women have to face. Often, too, not all the causes are declared in surveys. The first reason given is often the only one the interviewees recall, or else interviewees respond according to the battery of options in the survey without necessarily giving the real reasons why they interrupted a pregnancy. For this reason the combination of quantitative and qualitative approaches is a better alternative. This last approach provides a more in-depth knowledge on aspects such as the experiences of those that abort, which allows researchers, among other things, to improve the surveys or other instruments generally used in quantitative studies.

As Guillaume (2004) points out, “abortion is the response to an unforeseen or unwanted pregnancy and although this is the most commonly declared reason for resorting to abortion, it does not allow us to understand the reason for the perception or the significance of this pregnancy for women and why they really wanted to interrupt it. Even in countries where the prevalence of contraception is extremely high, and access to family planning services is adequate, such as France, approximately 220 000 abortions are performed each year and the reasons for the persistence of these unwanted pregnancies are not sufficiently known”.

It is therefore extremely difficult to have an overview of this issue and to compare the few data available from the various countries, since the questions and answers regarding reasons expressed in the surveys are very diverse (Bankole et al., 1998). They are therefore often classified simplistically and univocally, and while in some surveys, for example, a long list of reasons is given, in others economic, social and cultural reasons are included in the same answer. Moreover, very few surveys incorporate a human rights perspective or regard and investigate the option to abort as a women’s personal decision.

At the same time, the reasons for aborting are neither universal nor common to all women. They vary according to age, the stage in a women’s life cycle, whether she has had children, her socioeconomic living conditions, her access to family planning and her degree of religiousness. They also depend on the woman’s social and personal values or those of her partner, the relationship between her and her partner, the number of offspring she wishes to have, the meaning she gives to motherhood, as well as the social acceptance of pregnancies out of wedlock. Some reasons are directly linked to personal development, in the sense of women’s expectations and life projects, like studying or working. Other reasons respond to the social, cultural, economic or political circumstances prevalent in each country, to cases of pregnancy due to rape, or fear of rejection on the part of a partner or parents that might be felt by pregnant unmarried women, particularly if they are young, as discussed earlier. Likewise, various circumstances may intervene in the decision to interrupt a pregnancy. These include scarcity of resources and the greater economic demands involved in childcare, or a lack of housing, something that Cuban women often stress, for example.  Circumstances might also include the high value placed on a male son, with the consequent actions taken to limit the birth of women, as occurs particularly in China, India and other nations. One should also mention the specific unforeseen or very specific circumstances of the moment that pregnant women face, whether or not their pregnancies were planned, which are almost always absent from the bibliography on the issue. These include the sudden abandonment or death of a partner, the loss of a job and the emergence of a serious illness in the woman. This is why the reasons that lead women to abort are the result of the intersection of material, cultural and personal conditions and of circumstances that occur in a conjunctive fashion (Zamudio et al., 1994).

From the studies dedicated to the subject of abortion, undertaken by various institutions or by specialists on the topic, one can draw a list of the main reasons for interrupting a pregnancy, which may correspond to the population as a whole or to specific groups, such as adolescents, who face very specific circumstances. These reasons are presented in studies conducted in various countries (Institut Alan Guttmacher, 1994; Bankole et al., 1998; Olukoya et al., 2001). The main reasons for resorting to abortion that appear in the literature on the subject include the following:

• Economic difficulties that are exacerbated by an unforseen pregnancy. Women or their partners may lack sufficient economic means or support from their families or the state for looking after their children, particularly when women have a full-time job or work two shifts. Adolescents and young women usually lack financial autonomy, and may also lack help from their relatives, their partner or the father of their child.
• The impossibility of continuing one’s studies due to pregnancy, as a result of which young students may choose to have an abortion to be able to continue their education.
• Unstable relationships or conflictive relationships with their partners or lack of affection towards their child’s father.
• Stigmatization, disapproval, or social and moral pressure arising from a premarital pregnancy or pregnancy out of wedlock and the perception of rejection (including penalization in certain societies) that may be experienced by women in this situation, by the family and the community.
• Contraceptive failure due to ineffectiveness or incorrect use, or failure to use contraceptives, due to fears about possible side effects. This sort of reason varies according to the degree of access to contraceptive practice, such as incentives to use contraceptives or not, access to specific information on these methods, adapting the latter to the specific characteristics of users and limits on obtaining access to quality family planning services, particularly in certain sectors of the population, such as young women, residents in rural areas, indigenous women, etc.
• Pregnancy as a result of rape or incest, in other words, due to sexual coercion, abuse or violence.
• Pressure by parents or the person who made them pregnant for women to abort or else in the case of a premature pregnancy when they are already the mother of a child who is only a few months old.
•  Due to specific unforeseen/conjontural circumstances, such as those cited earlier.
• When the reasons for resorting to abortion are closely linked to the causes established by legislation, such as interrupting a pregnancy to preserve a women’s physical and mental health if it threatens her life or in the case of malformations of the fetus.
• Finally, although there is virtually no evidence on this, are women’s personal decisions, the exercise of their freedom to decide when and how many children to have or even not have children – on other words, the exercise of their sexual and reproductive rights. This includes the pursuit of their aspirations, expectations and life projects at specific and various stages of women life, such as continuing and completing their degree, finding a job or to remain in the one they have, etc.

According to Bankole et al. (1998), in Latin America, the most common reasons for interrupting pregnancy are socioeconomic (being unable to raise a child and complications at work or with their studies), problems with one’s partner or reasons linked to the women’s age. The frequency of consensual unions and the risk of the collapse of the latter explain many of these abortions.

Langer (2002) examines the causes and results of unwanted pregnancy in Latin America and the Caribbean and summarizes the four main reasons why abortion has increased in the region: 1) People’s growing desire to reduce the size of their families. 2) The lack of access to family planning methods. 3) The degree of reliability of contraceptive methods and their possible failure. 4) Involuntary sexual relations.

As noted in another article by the Alan Guttmacher Institute (1999), the majority of studies on women hospitalized for abortion complications concludes that the main reasons for resorting to this practice can be summarized in the financial, personal or familial impossibility of having or supporting a child. Many women are unmarried or in unstable relationships, and if they are single or very young, they are aware of the difficulties of assuming the responsibilities of raising a child, either alone or without sufficient economic support. Nevertheless, as pointed out in this study, given that the majority of the women who abort are married and already have one or more children, it is the social difficulties and precarious economic conditions in which millions of people in rural areas or poor urban marginalized zones in Latin America live that have led to the desire by couples to control the number of their offspring and to have fewer children. In addition, there are other facts that lead to a higher incidence of abortion. These are associated with the improvement of women’s educational attainment and their growing participation in the labor market.

There has obviously been a need to interrupt a pregnancy for various reasons throughout history. In today’s world, women who resort to abortion largely do so due to the failure of a health system that will help them deal safely with an unwanted pregnancy. “It has been documented that certain women decide to interrupt a pregnancy due to the need not to procreate any more, either temporarily or permanently or because of the economic difficulties associated with the need to maintain a household, hold down a job, continue with an education program or because of their partner’s or family’s negative attitude towards the pregnancy” (p.10) (Espinoza et al., 2003).

As Lamas (2003) points out, for defenders of women’s rights, the three main causes underlying an unwanted pregnancy are firstly, those that have to do with the “human condition”: forgetfulness, irresponsibility and unconscious desires. In these, sexual violence and individual neglect play a key role. A second category of causes is linked to social wants, particularly the lack of broad sex education programs, which translates into widespread reproductive ignorance. Finally, there are causes related to contraceptive failure. According to Lamas, the first type of cause is the most complex and difficult one to deal with, since it involves transgressions of the human condition, in which neglect, mistakes and forgetfulness are part of its essential nature. Also at play in this type of cause is the particularity of individual, subjectivity features, in sexual and reproductive processes.

Using examples from various studies, we will now document the main reasons for resorting to abortion that the literature documents in certain countries in the region. These reasons focus on the following aspects: the interruption of an unwanted, unforeseen or unplanned pregnancy, as a means used in every generation and throughout history to regulate fertility, economic, social, familial, conjugal and specific work difficulties, and the circumstances of the legal and moral context surrounding the unwanted pregnancy.

Abortion as a Means of Limiting or Spacing Pregnancies

Given the desire and need to regulate fertility, abortion has often been regarded as a means of spacing births, either because pregnancy occurs at an inopportune moment, or because the woman wishes to limit the number of her offspring (Guillaume, 2004). This situation traditionally occurs around what is known as unforeseen, unplanned or unwanted pregnancy. Of the women participating in surveys conducted in 10 Latin American countries, 24% to 65% had had at least one child during the previous five years and declared that they did not desire the last pregnancy at the time it occurred or that they did not wish to have any more children ever (Alan Guttmacher Institute, 1996). Many of the pregnancies that occur in these circumstances are produced either because contraceptive methods are not used, or because of the failure or incorrect use of them. According to World Health Organization estimates, of the 18 million annual pregnancies in Latin America and the Caribbean, 52% are unplanned and 21% end in abortion (CRLP, 2003).

Along these same lines, estimates by the Alan Guttmacher Institute (1994) for the 1990s show that 40% to 60% of the pregnancies in six Latin American countries were unplanned and therefore ended in an unwanted birth or an abortion. In Brazil, the proportion was 56% for unwanted pregnancies and 35% of them ending in abortions, and in Chile the proportions were 54% and 31% respectively. In Peru, 60% of pregnancies were unwanted and 30% of pregnancies ended in abortion. In the Dominican Republic, these figures were 48% and 28% respectively, as opposed to 50% and 26% in Colombia and 40% and 17% in Mexico.

Another highly questionable concept related to the desire and need to space births or limit the number of one’s offspring, is that of “unmet needs for contraception,” widely used in the literature on fertility and contraceptive practice, which usually refers to women who say that they do not wish to become pregnant, yet do not use any kind of contraceptive method, whether modern or traditional. This is an illustrative aspect of women’s reasons for resorting to abortion, the underlying reasons for which must be explored, both as regards their use or non-use of contraception and as regards the practice of abortion and the meaning of the desire not to become pregnant. In Latin America, unmet needs for contraception varie from 17% among common-law women aged 15 to 44 in Colombia to 43% within the same women aged in Bolivia (Alan Guttmacher, 1999). In this respect, it is argued that women resort to an abortion in the event of an unwanted pregnancy either as a result of social or cultural barriers to contraceptive use, failures or perceived fears of its use, difficulties in access to quality family planning services, unsuitable practices by health service providers and/or because of the failure to consider women’s specific needs in this respect (Camarena and Lerner, 2005).

In Brazil, De Souza e Silva (1998) stated that the main reasons for interrupting a pregnancy included not wanting children, already having the desired number of children, and failure to use contraceptive methods, or using ineffective ones. Based on a study undertaken in Sao Paulo in 1993, De Souza e Silva and González de Morell (2001) showed that the improper use of the pill led to unwanted pregnancies, illegal abortions and finally permanent sterilizations, the latter usually performed through unnecessary cesareans. The authors suggest that the inappropriate design and functioning of family planning programs has perpetuated the problem of abortion, since women who are highly motivated to control the number of their offspring resort to both abortion and contraception.

In Puerto Rico, the results of a study undertaken at 10 private clinics in 1991 show that of the 371 women interviewed who received abortion services, over half said that they were using some form of contraception before becoming pregnant (59%). A third of these, however, said that they had stopped using the contraceptives due to the side effects they produced (32%) (Reproductive Health Matters, 1993). In Peru, according to a study conducted on women admitted to hospital for abortion complications, Ferrando (2002) notes that 54% of the women aborted because, according to them, “it was an unwanted pregnancy.” In 27% of all cases, the reasons for these pregnancies being unwanted were related to the desired number of children already achieved, in 22% they were due to the fact that women felt that the pregnancy had occurred too early, in another 22% of cases they were due to problems within the couple, and in 8% to the failure of the contraceptive method used.

At the same time, access to limited available methods, the human condition of contraceptive use, the low effectiveness of the latter, particularly traditional methods like periodic abstinence and withdrawal, may lead a woman to resort to abortion. Most authors state that contraceptive failure or women’s refusal to use contraceptives are the most commonly expressed reasons that lead to this practice. (Villarreal Mejía and Mora Téllez, 1993; Villarreal, 1992; Strickler et al., 2001; Azize Vargas et al., 1993; Zamudio et al. 1999) Given the importance of the relationship between contraception and abortion, this issue is documented in more detail in Chapter 8.

The Woman’s Context and the Practice of Abortion

In their study on abortion in Colombia, Villarreal and Mora Téllez (1992) conclude that the decision to interrupt a pregnancy is a difficult process for Colombian women, largely due to the social, cultural and religious values that condemn abortion and exalt motherhood. Most of the women participating in their study, however, adapt their beliefs to justify abortion, arguing that “it is more of a sin to bring a child into the world to suffer.”

Along these same lines, in another qualitative study also conducted in Bogotá on adolescent pregnancy and the options available to women in these circumstances, Mora (2004) argues that women who opt for abortion, “in evaluating their experience, use the dominant social and religious assumptions as a basis and therefore, those that were most affected expressed religious conflict and guilt.” The study also shows how young women’s decisions regarding abortion are mediated by the reaction this practice elicits in their partners, abortion being a common option among those that fail to receive a positive response from their partners regarding the pregnancy. The literature on the subject describes the importance given to the couple’s relationship, particularly males’ participation and involvement in the practice of abortion (see Chapter 9).

Through a focus group, Martignon (1992) recorded the testimony of six professional women from Colombia who had experienced the interruption of a pregnancy at some time in their lives. On the basis of analysis of this testimony, Martignon holds that the link with the woman’s partner may play a key role in the decision process to abort and the experience of the abortion, due to the presence or absence of a mutual life project to have a child. An abortion prompted by fears of single motherhood, mainly as a result of a woman’s tenuous relationship with her partner, was often experienced in silence and terror. In the cases where the woman’s partner was supportive, this reduced the negative impact of the experience. Women found it helpful to receive qualified help, to have company and to remain calm. The reaction to this abortion was often a strong desire to forget, coupled with a persistent feeling of guilt.

In Peru, Rosario Cardichi (1993) used women’s testimonies to analyze the psychosocial impact of abortion from a feminist perspective. The author holds that women’s non-use of contraceptives sometimes serves as a mechanism for avoiding unwanted sexual relations. Among the reasons associated with choosing abortion, she finds, as do many other studies, that the partner’s absence or presence, in addition to the quality and future of the relationship, play a key role. Other factors that triggered the decision to abort, as mentioned earlier by other authors, were the continuation of a life project, fear of the family’s reaction, a shortage of financial resources, contraceptive failure and health problems, as well as pregnancy being associated with rape.

On the basis of a survey conducted in Colombian urban areas mentioned earlier, Zamudio et al., (1999) provided rigorous, well-founded evidence on the three main reasons for aborting mentioned by the women interviewed: the pressure caused by the type of link they maintained with their partners, the relationship with their families, and their perception of the suitability of the moment for pregnancy, in terms of their economic and work status and life plan. The differentiations identified by socioeconomic strata undoubtedly constitute a major contribution to these results, to the extent that they lend different meanings to the reasons given for abortion.

In reference to the first kind of reason given, the authors found that pressure to abort from the partner involved in the pregnancy occurred in 26% of all cases. The pressure was slightly greater in the event of a first pregnancy (33%) and slightly less in the event of a second, third or fourth pregnancy (29%, 31% and 30% respectively). Pressure from the woman’s partner varied according to the social stratum to which they belonged. There was greater pressure in the lower middle class (34%) and less pressure among the lower class (27%). Proportions were similar in the lowest, middle and upper middle class (30% in the first two and 31% in the last).

The second most frequently mentioned reason in the study was the relationship with the woman’s family, which, although important in all strata, exerted a different influence in each of them. In the lower strata, an unwanted pregnancy considerably increased the economic burden, whereas in the middle classes, pregnancy was regarded as an impediment to reaching a good marital agreement for the daughter or enabling her to continue studying. Among the higher classes, the fact that having a child would prevent the woman from achieving a good marriage appears to have been the most important reason.

The third cause, involving financial and work aspects and the woman’s life project, was associated more with a woman’s job and the violation of her rights that tends to be experienced if she becomes pregnant and has a child. Although Colombian legislation states that an expectant mother may not be fired, this regulation is rarely complied with: women fear being fired and being deprived of a financial income if they continue with their pregnancy, and they therefore decide to abort.

In their study on abortion with medication in Mexico, Colombia, Ecuador and Peru, completed in 2005, Lafaurie et al. (2005), identify four main reasons leading a woman to interrupt her pregnancy: those related to significant persons in her life, such as her partner, family or children; those depending on the consequences of a pregnancy on her personal life project; economic conditions; and those related to health. They stress that woman’s relationship with her partner is a central factor, together with social and familial approval of the pregnancy.

Women’s social and familial context of origin and marital status are also factors that have been used to explain why women, particularly young women, seek abortion. Early, unprotected sex also explains the frequency of interrupted pregnancies.

In Colombia, women, particularly young ones, tend to place a great deal of importance on ensuring that their parents do not find out about their pregnancy, due to their reaction to it, which may be related to the strong kinship links they establish, as happened with the women in the study undertaken by Mora et al. (1995) Another important factor is the stigmatization of pregnancy outside the marital relationship. According to the study, the main reasons for aborting were the family expectations placed on them. In other words, women decisions were based on the desire not to disappoint their parents with an unexpected pregnancy, although they also mentioned their plans to go on studying. A third (33%) of the 60 women that participated in this qualitative study indicated that the main reason for aborting was the difficulties having a child this would involve, particularly in terms of their lives, mainly their jobs.

Conversely, the study by Misago and Fonseca (1999) suggests that the parental reaction in Brazil is not as important a reason for seeking an abortion. Likewise, only 21.7% of the women consulted in the study said that they would resort to an abortion if their partner did not wish to have any more children. Álvarez (1994; 1999) also obtained findings about the same aspect of abortion in a study conducted in Cuba. She found that 15% of the women interviewed gave family issues as the reason for interrupting a pregnancy, 7% mentioned reasons related to living arrangements, financial limitations and problems with their partners and 5% said that they had already achieved their desired family size. In Peru, in his study of women hospitalized for abortion complications, Ferrando (2002) stated that 8% of women reported having aborted for fear of their parents’ reaction, 2% said they had done so in response to pressure from their partners and 5% said that they had been raped.

For many women, financial problems are one of the main reasons why they abort, closely linked to the lack of means for assuming responsibility for the care and upbringing of their children. Other factors include their life plans, particularly among professional women, as well as having to stop studying, which would compromise their future economic prospects and life conditions.

The study by Armando Valle Gay, conducted on 100 women admitted for abortion complications to Mexico’s General Hospital in 1990, mentions that the main reasons that led the women interviewed to abort were, in descending order: socioeconomic reasons (34%), lack of family planning (“I hadn’t thought about it”) (24%), better education for their children (16%), marital problems (12%), family problems (9%) and health problems (5%) (GIRE, 2003). In her survey of women hospitalized for abortion complications in Peru, Ferrando (2002) reports that 28% of the women gave financial problems as a reason.

The study conducted in Puerto Rico on women who attend private clinics to interrupt a pregnancy also mentions financial difficulties and the inability to assume responsibility for raising a child as the main reasons for aborting (Reproductive Health Matters, 1993). A similar argument is found in the study by Núñez and Palma (1990). The authors note that women treated for abortion complications in a hospital in Mexico declared that they aborted, mainly, for financial reasons.

In the study on Brazil by Misago and Fonseca (1999), a high percentage of the women interviewed justified abortion in the event of not having a comfortable financial situation. In this country, according to the data from this study, half the women regarded the lack of financial reasons as a significant reason for having an abortion (51%). Likewise, in the aforementioned study in the municipality in Havana (Álvarez, 1994; 1999), just over a quarter of the women admitted for abortion complications to a hospital there (28%) felt that abortion was appropriate if the woman were experiencing financial hardship. However, in another study carried out in Argentina, this same reason was not regarded as important (López and Masautis, 1994).

In other studies, as was shown also above, a precarious financial situation or the fact that an unplanned pregnancy will harm the woman’s work or studies are not always perceived as important reasons for seeking an abortion.

In the aforementioned study by Ojeda (2004) on women from Tijuana, Mexico, who had abortions in the US city of San Diego, the reasons they gave for aborting were that they were too young for childbearing, they did not want to cope with the responsibility of raising a child and they lacked time to do so, among other reasons. Women’s health was the main reason for having an abortion among various groups of women, particularly the Hispanic ones. Another, albeit less important reason was not wanting to have any more children.

It is worth noting that the results of surveys, such as reproductive health ones, which recorded the opinions of specific population groups, showed that the decision to abort for reasons related to the family context  is somehow crucial, In a survey conducted in Mexico in 1991, 23% of the persons consulted thought that there was sufficient reason to abort if the woman became pregnant by a man she did not know well or did not love. 7% thought it was enough if she did not have a partner or did not wish to raise a child without a father and 23% felt it was enough if the future mother did not feel sufficiently responsible or was immature. This last cause was considered sufficient reason to abort among a larger proportion of younger women and those with fewer children. Other reasons given included the expectant woman being under-age and not wishing to have children (17%) or wishing to complete her studies (14%) (Núñez, 2001). Another study in the same country shows that very few people think that a woman being underage or a single mother (20% in each case) is sufficient reason to abort (García et al., 2001).

Legal Environment and Social Acceptance of Abortion

As observed in Chapter 2, several opinion surveys have been applied in Latin America and the Caribbean to determine the circumstances in which women agree that they should seek an abortion. These may be closely linked to legal grounds and to certain moral conditions under which abortion is permitted in a particular society. It should be borne in mind, however, that although the patterns of individual decision regarding abortion are largely socially shaped, this does not necessarily mean that prevailing social values always coincide with the reasons that lead a particular woman to interrupt an abortion. The human condition, people’s individual-subjective perceptions and the self experiences surrounding abortion also mean that legal, moral, religious and cultural precepts are internalized differently and lead to various different responses.

On the basis of studies linked more closely to the influence of the legal and moral sphere on abortion, one can infer that there were certain concurrences in the responses by persons from various sectors of the population interviewed on the issue of the circumstances under which they would approve of or support abortion. The acceptance of this practice focuses mainly on cases involving the protection of woman’s life and health, rape and to a lesser extent, fetal malformation (see Chapter 2).

However, studies that have focused on the reasons for seeking an abortion show that, outside the aforementioned opinion surveys, most of the surveys or qualitative studies do not consider those linked to the legal sphere. This does not mean that health reasons, which are frequent grounds for legal abortion, are not mentioned in some of them, such as those documented in this chapter, although fetal malformations are rarely mentioned. Likewise, there are very few studies where women and to a far lesser extent other social actors point to rape as a reason, even in countries where it is legal to resort to abortion in this case. It is therefore essential to review the literature recently produced in the region, to see the way in which the question of the exercise of human rights, particularly sexual and reproductive rights, and above all, those related to the interruption of pregnancy, have been dealt with. A research task is still pending.

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