Conclusions

Although there are certain common features among women who have aborted in Latin America and the Caribbean, it is impossible to speak of a single socio-demographic profile of those that resort to this practice in the region. The few research results we have considered in this chapter show, in addition to the main reasons for interrupting a pregnancy, a wide range of situations among Latin American countries and sometimes even within them. The diversity shown in these studies also depends on the methodologies and information sources used. The evidence available and the specificity of certain surveys, such as those undertaken in a hospital environment, explain the presence of particular profiles in certain countries. These correspond to the population studied – for example, women who have access to health institutions where abortions are performed or those hospitalized for complications derived from this practice. For this reasons, the profiles obtained are unlikely to be representative of the population in general.

Nevertheless, there are certain common features among those that abort. Although this practice is observed among women of different ages in the region, it is apparently concentrated among younger and therefore more fertile women. In certain countries such as Colombia and Cuba, as well as French Guyana, Guadeloupe and Martinique, the incidence of abortion among young women is even higher among those under 20. This can partly be explained by the difficulties experienced by those in this age group in obtaining access to contraceptive methods, despite the fact that a larger number of young women tend to have sexual relations at an increasingly early age.

It should also be pointed out that a considerable proportion of unwanted pregnancies among young women and adolescents, which are often interrupted, are the result of rape.  Before they reach adulthood, women in Latin America, as in other parts of the world, are extremely vulnerable to sexual abuse. Surveys undertaken on the general population and studies conducted in services oriented towards women illustrate the legal, institutional and moral barriers faced by younger women in obtaining access to reproductive health services, either to interrupt a pregnancy resulting from rape or to be treated for abortion complications. If these barriers remain, it would not be surprising if there were an increase in the incidence of unsafe abortion among them.

The studies reviewed also reveal that the proportion of women over the age of 40 seeking abortions is usually small. This trend is likely to increase in the future, due to the growing number of women of this age that opt for sterilization in many Latin American countries. On the other hand, the high use of abortion may explain the low fertility rates of women in Cuba and other countries in the region.

Another distinguishing feature is the greater frequency of abortions among married women and women in consensual unions in certain countries, such as Colombia and Peru, whereas in others, the greatest incidence occurs among single women, as in Cuba and Brazil. There are also contrasts according to parity that reveal women’s reproductive preferences, either for spacing births or for limiting the number of their offspring. For many young women, abortion serves as a means of delaying the birth of their first child, for a variety of reasons, as tends to happen in Colombia. It is also important to note the occurrence of repeat abortions, particularly among young women.

A surprising, less expected fact worth noting – as Guillaume (2004) does in her analysis of abortion in Africa – is the high proportion of women with high educational  level that seek abortion. According to the author, one would expect that these women would have greater access to safe contraceptive methods and therefore to greater use of them. One would also assume that they would be more aware of the consequences for their physical and mental welfare of exposing themselves to high-risk abortions. The evidence available suggests that women with high educational attainment use more birth control and also abort often in some social contexts in Colombia, Peru and the Dominican Republic. Moreover, women who use contraception engage in strategies to regulate their fertility, and in the event of contraceptive failure, they interrupt their pregnancies more often than women who do not use any method.

Although there is only limited information on the different degrees of resorting to abortion of the various socioeconomic strata, the divergence observed between the greater frequency of abortion within the lowest strata in Colombia and the much lower frequency within the poorest strata in Mexico should be treated extremely cautiously, regarding the latter country. This is because, as is widely known, it is women from the lowest social classes that resort most often to clandestine abortions, which are not registered. The results of certain studies on women admitted to hospitals for abortion complications, as in the case of Peru, corroborate the fact that in most countries it is precisely the poorest women who most often opt to interrupt their pregnancies.

On the other hand, the reasons leading to an unwanted pregnancy that may end in an abortion can largely be explained by cultural and social factors. These include those related to female identity (such as women’s ability to negotiate with their partners), which also leads to their having unprotected sex. Taking up what Lamas points out in this chapter, there are three main causes underlying an unwanted pregnancy. The first refers to the human condition, in which sexual violence, neglect, forgetfulness and unconscious desires play key roles. The second refers to the lack of response to social wants, and the third refers to contraceptive failure. In addition, there is the lack of awareness that many women have of the high possibility of becoming pregnant when they have sex without the necessary prevention, which takes one back to the lack of a preventive culture already mentioned in other chapters.

The scant empirical evidence available on the reasons that lead women to seek an abortion in countries in the region should be regarded far more cautiously. The way this issue is researched is still flawed. Women’s primary motivations are often poorly defined and many others related to their social surroundings are unknown. Nevertheless, it is observed that the type of relationship among the couple and the influence of the males regarding a pregnancy are key reasons to abort. Other reasons may also be linked to the woman’s relationship to her parents and other family members, particularly in the case of adolescents. This is not counting the financial difficulties faced by the woman as well as her situation vis-à-vis her work or her studies, in addition to her life project.

In the majority of countries in the region, there are still very few studies that consider the broad range of reasons for aborting. Although the ones mentioned above are included in some of the studies documented earlier, there are hardly any designed to explore issues related to women’s autonomy and rights, and this is a vital insufficiency. This type of response could be due to the fact that surveys do not generally include aspects such as these, which have an enormous influence on the reasons leading a woman to abort. Issues of women’s autonomy and rights must be socialized among the population and taken into account by the various programs and interventions related to abortion and family planning.

The aspects of abortion included in this chapter raise questions that have yet to be answered. It is essential to develop better criteria and more effective methods for collecting information on the characteristics of women who abort in Latin America and the Caribbean. This would enable researchers to more effectively determine their profile and motivations, which, far from remaining unchanged, tend to vary during the decision process timing to abort. Thus it would be possible to go beyond the particularities and reasons that tend to be attributed to those that interrupt their pregnancies, assumptions that often lack the elements for a broader, better-founded understanding. To this end, a broader perspective is required to record the experiences of women at various stages of their decision to resort to abortion and at various stages of their lives, as well as those of other social actors that participate in this process.

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