Abortion in Adolescence

Unwanted Pregnancy and Fertility Levels

Pregnancy among women under 19 is a common event in Latin America (Langer and Espinoza, 2002), where, according to Persaud (1994), over a third of women have their first child before the age of 20. It is estimated that in countries in this region and the Caribbean, 16.5% of all births were to women under the age of 20 during the period from 1995 to 2000. In the Caribbean, the proportion was 15.9%, while it was 16.6% in South America and 16.4% in Central America. This indicator is quite high compared with that in other regions in the world. In southern Asia, for example, it is only 10% (United Nations, 2002).

Langer and Espinoza (2002) state that it is not exactly known how many adolescent pregnancies in Latin America and the Caribbean are wanted. Some authors estimate that between 35% and 52% of these pregnancies occurring in the region were unplanned (FNUAP, 1997 quoted in Schutt-Aine and Maddaleno, 2003). It is estimated that 95% of adolescent pregnancies diagnosed or monitored by the Profamilia Youth Center established in Colombia were unwanted (Ramírez, 1991). Fertility levels among them are often closely linked to an increase in unprotected sex at an early age.

During the period from 1995 to 2000, fertility rates estimated for Latin America and the Caribbean rose to 75 of each thousand women between the ages 15 to 19. Yet there were significant differences between sub-regions and countries. In the Caribbean, the rate for Guadeloupe was 19‰, for Martinique, 27‰, for Barbados, like Trinidad and Tobago, it was 43‰, rising to 115‰ in the Dominican Republic. In Central America, Belize had a rate of 80‰ and Nicaragua, 139‰. In South America, it was 62‰ in Peru and Uruguay and 109‰ in Venezuela (United Nations, 2002).

According to the most recent Demographic and Health Surveys conducted from 1995 to 2000, adolescent fertility rates were approximately 116 to 119 per 1000 women aged 15 to 19 in the Dominican Republic, Guatemala and Nicaragua. In these countries, the importance of this group within overall fertility rates varied, from representing 19% of all pregnancies in the first country, to 12% in the second and 18% in the third. In Bolivia, the fertility rate among women in this age range was 84‰, as opposed to 86‰ in Brazil and Haiti, and 90‰ in Colombia. The proportion of adolescent fertility within total fertility was 9% in Haiti and 19% in Colombia. Finally, in Peru, where adolescent fertility rates are lower (66‰), these contributed a mere 12% to overall fertility. These rates have not evolved in the same way in all countries. In Colombia, adolescent fertility rose from 70 to 90‰ from 1990 to 2005, whereas the total fertility rate (TFR) declined from 2.8 to 2.4 children per woman of reproductive age. In Bolivia, there was a decline in the fertility rate of adolescent women from 99‰ in 1989 to 84‰ in 2003. During this period, the TFR in this country declined from 5 to 3.8 children per woman.

Despite this, adolescent fertility in the region, although perceived to be high, does not appear to be on the rise, according to various studies. The weight of this population’s pregnancies within overall fertility is, however, greater than it once was, both since this population is increasing and since fertility rates for those under 20 have declined more slowly than those for older groups. (Pantelides, 2004). In Latin America as a whole, there was a 14.4% decline in overall fertility rates during the period from 1950 to 1970, and a 46.4% decrease from 1970 to 2000. However, the drop in fertility among adolescents aged 15 to 19 was only 9.1% during the first period and 16.8% during the second (Ferrando, 2004). For Brazil, Pinto (1998) observes that the number of pregnancies among teenagers aged 15 to 19 would appear to be stable, whereas among those under age 15, there is an upward trend. In Colombia, the proportion of mothers among women aged 15 to 19 years old decline form 14 to 10% from 1985 to 1990 (Profamilia, 1992).

The period from 1975 to 1995 in Mexico saw a significant decline in adolescent fertility rates. In 1975, this sector of women registered a fertility rate of 130 births per thousand women, a figure that declined to 81‰ in 1995. Nevertheless, between “1975 and 2000, the contribution of the group aged 15 to 19 to the overall fertility rate has increased from 11 to 15 per cent”. Moreover, according to official estimates, in the year 2000 there were 366 thousand births to women ages 15 to 19, accounting for approximately 17% of the total births in the country (Consejo Nacional de Población, 2000).

In the Dominican Republic, the TFR fell by 35% between 1981, when it was 4.9 children per woman, and 1996, when it was 3.2 children. But the fertility rates among women ages 15 to 19 did not seem to have changed. During these two years, the rate was 112‰ after having been 104‰ in 1986 and 88‰ in 1991 (Magnani et al., 2001).

Cuba also saw a decline in fertility rate of adolescents aged 15 to 19. The rate was 65‰ during the period from 1991 to 1993, and 51‰ in the year 2000. Conversely, there was an increase in the pregnancy rate from 193 to 198‰ from this period to the last year mentioned. The author of the study states that “the explanation for the growing disproportion between fertility rates and pregnancy rates is basically due to abortion”. He also holds that in Havana there is a greater proportion of abortions in adolescent pregnancies whereas in other countries, most of these adolescent pregnancies result in live births (González, 2005).

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