Résumé : A number of surveys have been conducted using a new approach to questioning women about their abortion history. Data on the incidence of abortion is essential 1) to expose the severity of the public health problems caused by complications from illegal abortions, 2) to support legislative and programmatic change, 3) to determine the demand for contraception, and 4) to estimate fecundity and understand fertility dynamics. The use of an indirect approach may improve the accuracy of data collection about induced abortion. A study in Estonia used a filter question approach by asking women if any of their pregnancies did not result in a live birth and then asking them to describe the pregnancy outcome. This paper reports on the results of using a set of indirect questions that reminded the woman of having an unwanted pregnancy and then asked about the outcomes of the pregnancy. After achieving promising results in a field test in the Ivory Coast, the filter question and follow-up probe technique was used in clinic-based (in Ghana, Egypt, and Turkey), employment-based (in Bolivia), and population-based (in Mali) sample surveys. Based on results from these trials, the Demographic and Health Surveys used indirect questions in Indonesia and Senegal in 1993. In each case, the level of induced abortion appears to be underreported. In a 1994 Situation Analysis in Senegal, the indirect methodology was tested using a split-halves design with family planning (FP) and maternal/child health (MCH) clients. In each group (564 women asked direct questions and 557 asked indirect questions about abortion), 2% of the women admitted to having undergone abortion. However, reported levels of unwanted pregnancy are low in Senegal, and this topic may have been too sensitive to serve as an adequate filter question. A summary of results from studies on the use of the unwanted pregnancy filter question plus follow-up questions on abortion reveals that abortions are more commonly reported in FP/MCH clinic studies and in settings where abortion is legal. The mixed findings of the studies indicate that no single universally sensitive context exists for discussing abortion. More research is required to identify the best filter questions or the best way to establish a nonthreatening context.
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