Predictors of pregnancy termination for psychosocial reasons by Australian women: secondary analysis of the Australian Longitudinal Study of Women's Health

Conference:

SAPC ASM 2016 - Dublin

Talk Code:

EP2C.03

Presenter:

Danielle Mazza

Co-authors:

Angela J Taft, Lyndsey F Watson, Jayne C Lucke, Rhonda L Powell, Kathleen McNamee

Author institutions:

Monash University, La Trobe University, University of Canterbury, Family Planning Victoria

Problem

Pregnancy termination rates can now be reasonably estimated; however, there is still a lack of high quality data about the incidence and determinants of termination. The aim of our study is to identify factors that put Australian women at risk of pregnancy termination at different periods of their reproductive life.

Approach

We conducted a secondary analysis of data from the Australian Longitudinal Study of Women’s Health. Participants were Australian women born in 1973-1978 who were first surveyed at age 18-23 years and who responded to at least two consecutive surveys out of a total of five surveys. The primary outcome measure was pregnancy termination and the explanatory variables were sociodemographic factors, contraception, prior terminations, alcohol, drugs, childhood sexual abuse, violence, and mental health. Longitudinal logistic regression models were fitted to assess the associations between explanatory variables and pregnancy termination.

Findings

The proportion of women reporting new terminations reduced from 7% at surveys 1 and 2 to 2% at surveys 4 and 5. By survey 5, 16% reported ≤ 1 termination, but only 2% reported a new termination. Women in their twenties were more likely to have a termination if they were unmarried (aOR1.75 CI 1.20-2.56), had one child (aOR1.88 CI 1.18-2.98), used less effective methods of contraception (aOR2.18 CI 1.65-2.89), increased to risky alcohol use (aOR1.65 CI 1.14-2.38), used illicit drugs ≤ 12 months (aOR3.09 CI 2.28-4.19), reported childhood sexual abuse (aOR1.40 CI 1.08-1.80), or reported recent partner violence (aOR2.42 CI 1.61-3.64). By their thirties, women were more likely to terminate if they ceased to be married (aOR2.65 CI 1.74-4.05) or were unmarried (aOR2.24 CI 1.49-3.39), had two children (aOR2.11 CI 1.42-3.13), reported recent non-partner violence (aOR2.14 CI 1.30-3.52) or used illicit drugs < 12 months (aOR2.68 CI 1.76-4.08). Women with aspirations to be fully employed (OR1.58 CI 1.37-1.83) or self-employed (OR1.28 CI 1.04-1.57), have no children (OR1.41 CI 1.14-1.75), and further their education (OR 2.08 CI 1.68-2.57) were more likely to terminate than other women.

Consequences

Efforts to reduce unwanted pregnancy should focus on factors that affect women’s reproductive autonomy, such as effective contraception, interpersonal violence, and illicit drug use.

Submitted by:

Danielle Mazza

Funding acknowledgement:

The authors acknowledge the that the research on which this paper is based on was conducted as part of the Australian Longitudinal Study on Women’s Health, the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health for funding and to the women who provided the survey data.