Résumé : A survey of abortion patients at a reproductive health clinic in Bogota, Colombia, suggests that, even in a country with strong legal and moral sanctions against abortion, women's personal needs to avoid the long-term negative consequences of an unwanted pregnancy will prevail. The Orientame clinic provides among other services vacuum aspiration of retained products of conception to women who present with incomplete abortion. The 602 study subjects were interviewed in October 1990-January 1991 at the clinic before the abortion procedure. Their average age was 27 years (range of 16-48 years) and 31% had some university education. The average age at first intercourse was 19 years (61% became sexually active before this age) compared to the national average of 21 years; the average number of pregnancies was 3, only 1 of which was desired. The frequency of unwanted pregnancy was highest among those who lived with a permanent partner and already had 5-8 children. 43% of subjects did not want any more children. The index abortion was the 1st for 66%, the 2nd for 26%, the 3rd for 7%, and the 4th for 1%. While 87% had some experience with contraception (which is widely available in Colombia despite the illegality of abortion), only 58% had been using a method when this pregnancy occurred. Of those who did not want any more children, 14% were using an effective method, 49% a less effective method, and 37% were not using any method. Overall, the most common methods in use when pregnancy occurred were rhythm (17%), vaginal foam (11%), pill (7%), and condoms (7%). Sterilization is culturally unacceptable in Colombia, there is considerable misinformation regarding the side effects associated with effective methods, and women who use a less effective method often do so incorrectly and without understanding of how it works. Although 80% had been exposed to anti-abortion ideas and 25% considered the procedure a sin, they regarded prevention of an unwanted child a higher value. The main reasons for not wanting pregnancy were fears of single parenting, partner opposition, or restrictions of educational or employment opportunities. Overall, these findings pinpoint a need for increased education about and access to effective contraception.
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