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RESEARCH ARTICLE

Abortion: findings from women and men participating in the Understanding Fertility Management in contemporary Australia national survey

Heather Rowe A G , Sara Holton A , Maggie Kirkman A , Christine Bayly B , Lynne Jordan C , Kathleen McNamee C D , John McBain E , Vikki Sinnott F and Jane Fisher A
+ Author Affiliations
- Author Affiliations

A Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, Vic. 3004, Australia.

B The Royal Women’s Hospital, 20 Flemington Road, Parkville, Vic. 3052, Australia.

C Family Planning Victoria, 901 Whitehorse Road, Box Hill, Vic. 3128, Australia.

D Department of Obstetrics and Gynaecology, Monash University, Clayton, Vic. 3168, Australia.

E Melbourne IVF, 344 Victoria Parade, East Melbourne, Vic. 3002, Australia.

F Victorian Government Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia.

G Corresponding author. Email: heather.rowe@monash.edu

Sexual Health 14(6) 566-573 https://doi.org/10.1071/SH17004
Submitted: 9 January 2017  Accepted: 8 May 2017   Published: 22 June 2017

Abstract

Background: There are few reliable Australian abortion data. The aim was to investigate prevalence, sexual experiences and socioeconomic characteristics of women and men who report having had or being a partner in an abortion. Methods: A cross-sectional survey of women and men aged 18–50 years randomly selected from the Australian Electoral Roll was used. Weighted multivariable analyses were conducted. Results: Data from 2235 returned (of 15 480) mailed surveys were analysed. One in six women and one in 10 men had experienced or been a partner in an abortion. In adjusted analyses, for women, experience of sexual coercion [adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) 1.46, 3.24] was associated with significantly increased odds of abortion, and socioeconomic advantage (AOR = 0.57; 95% CI 0.39, 0.84), being comfortable negotiating contraceptive use (AOR 0.26; 95% CI 0.09, 0.73) and importance of religion in fertility choices (AOR = 0.55; 95% CI 0.35, 0.87) were associated with significantly reduced odds. For men, sexual coercion (AOR = 3.05; 95% CI 1.51, 6.18) and metropolitan residence (AOR = 1.70; 95% CI 1.06, 2.75) significantly increased the odds of reporting being a partner in an abortion. Conclusions: The findings contribute to scarce information about abortion in Australia. The high prevalence of abortion suggests that effective contraceptive counselling and accessible contraception services are not sufficient, and that there is a continuing need for universal pregnancy advice and abortion services. The association between sexual coercion and abortion warrants further investigation.

Additional keywords: gender, pregnancy termination, reproductive health, social determinants, termination of pregnancy.


References

[1]  de Costa C, Douglas H, Hamblin J, Ramsay P, Shircore M. Abortion law across Australia – a review of nine jurisdictions. Aust N Z J Obstet Gynaecol 2015; 55 105–11.
Abortion law across Australia – a review of nine jurisdictions.Crossref | GoogleScholarGoogle Scholar |

[2]  Pratt A, Biggs A, Buckmaster L. How many abortions are there in Australia? A discussion of abortion statistics, their limitations, and options for improved statistical collection. Parliamentary Library Research Brief Information analysis and advice for the Parliament. 2005; 9. Available online at: http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22library%2Fprspub%2FCF7F6%22 [verified 7 June 2017]

[3]  Scheil W, Jolly K, Scott J, Catcheside B, Sage L, Kennare R. Pregnancy outcome in South Australia 2013. Adelaide: Pregnancy Outcome Unit, SA Health, Government of South Australia; 2015. Available online at: http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/health+statistics/pregnancy+outcome+statistics [verified 01 February 2016].

[4]  Grayson N, Hargreaves J, Sullivan E. Use of routinely collected national data sets for reporting on induced abortion in Australia. Sydney: AIHW National Perinatal Statistics Unit; 2005.

[5]  Smith A, Rissel C, Richters J, Grulich A, de Visser R. Sex in Australia: reproductive experiences and reproductive health among a representative sample of women. Aust N Z J Public Health 2003; 27 204–9.
Sex in Australia: reproductive experiences and reproductive health among a representative sample of women.Crossref | GoogleScholarGoogle Scholar |

[6]  Abigail W, Power C, Belan I. Changing patterns in women seeking terminations of pregnancy: a trend analysis of data from one service provider 1996–2006. Aust N Z J Public Health 2008; 32 230–7.
Changing patterns in women seeking terminations of pregnancy: a trend analysis of data from one service provider 1996–2006.Crossref | GoogleScholarGoogle Scholar |

[7]  Rowe H, Kirkman M, Hardiman A, Mallett S, Rosenthal D. Considering abortion: 12-month audit of records of women contacting a Pregnancy Advisory Service. Med J Aust 2009; 190 69–71.

[8]  Kirkman M, Rowe H, Hardiman A, Mallett S, Rosenthal D. Reasons women give for abortion: a review of the literature. Arch Wom Ment Health 2009; 12 365–78.
Reasons women give for abortion: a review of the literature.Crossref | GoogleScholarGoogle Scholar |

[9]  Doran F, Nancarrow S. Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review. J Fam Plann Reprod Health Care 2015; 41 170–80.
Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[10]  Bacchus L, Mezey G, Bewley S. A qualitative exploration of the nature of domestic violence in pregnancy. Violence Against Women 2006; 12 588–604.
A qualitative exploration of the nature of domestic violence in pregnancy.Crossref | GoogleScholarGoogle Scholar |

[11]  Australian Electoral Commission. Demographic classification of divisions. (Canberra: Australian Electoral Commission; 2008). Available online at: http://results.aec.gov.au/13745/website/GeneralDemographicByDivision-13745-NAT.htm [verified 8 June 2017].

[12]  Rowe H, Holton S, Kirkman M, Bayly C, Jordan L, McNamee K, McBain J, Sinnott V, Fisher J. Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey. Aust N Z J Public Health 2016; 40 104–9.
Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey.Crossref | GoogleScholarGoogle Scholar |

[13]  IBM Corporation. SPSS Statistics for Windows. Version 20.0. Armonk, NY: IBM Corp.; 2011.

[14]  Stata Corp. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP; 2015.

[15]  Kessler R, Little R, Groves R. Advances in strategies for minimizing and adjusting for survey nonresponse. Epidemiol Rev 1995; 17 192–204.
Advances in strategies for minimizing and adjusting for survey nonresponse.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK28%2FltFCltQ%3D%3D&md5=30008f785d1cc10e854724b3076da11bCAS |

[16]  Australian Bureau of Statistics. 2011 Census. Canberra: Australian Bureau of Statistics; 2013. Available online at: http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/2?opendocument&navpos=220 [verified 6 December 2016].

[17]  Australian Bureau of Statistics. Australia based data for sex, basic community profile table B01, for 2011 Census. Canberra: ABS. Available online at: http://stat.abs.gov.au/Index.aspx?DataSetCode=ABS_CENSUS2011_B01 [verified 6 December 2014].

[18]  Australian Bureau of Statistics. Australian Health Survey: Health Service Usage and Health Related Actions, 2011–12. Canberra: Australian Bureau of Statistics; 2013. Available online at: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/E334D0A98272E4DCCA257B39000F2DCF?opendocument [verified 14 September 2014].

[19]  Australian Bureau of Statistics. Migration, Australia, 2009–10. Canberra: Australian Bureau of Statistics; 2011. Available online at: http://www.abs.gov.au/ausstats/abs@.nsf/0/52F24D6A97BC0A67CA2578B0001197B8?opendocument [verified 14 September 2014].

[20]  de Costa CM, Russell DB, Carrette M. Views and practices of induced abortion among Australian Fellows and specialist trainees of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Med J Aust 2010; 193 13–6.

[21]  Doran F, Hornibrook J. Rural New South Wales women’s access to abortion services: highlights from an exploratory qualitative study. Aust J Rural Health 2014; 22 121–6.
Rural New South Wales women’s access to abortion services: highlights from an exploratory qualitative study.Crossref | GoogleScholarGoogle Scholar |

[22]  Holton S, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Barriers to managing fertility: findings from the Understanding Fertility Management in Contemporary Australia Facebook discussion group. Interact J Med Res 2016; 5 e7
Barriers to managing fertility: findings from the Understanding Fertility Management in Contemporary Australia Facebook discussion group.Crossref | GoogleScholarGoogle Scholar |

[23]  de Costa CM, Russell DB, de Costa NR, Carrette M, McNamee HM. Introducing early medical abortion in Australia: there is a need to update abortion laws. Sex Health 2007; 4 223–6.
Introducing early medical abortion in Australia: there is a need to update abortion laws.Crossref | GoogleScholarGoogle Scholar |

[24]  Government of South Australia Department of Health. Standards for the management of termination of pregnancy in South Australia. Adelaide: South Australian Department for Health and Ageing; 2014.

[25]  Stewart F. “Once you get a reputation, your life’s like... ‘wrecked’”: the implications of reputation for young women’s sexual health and well-being. Women Stud Int Forum 1999; 22 373–83.
“Once you get a reputation, your life’s like... ‘wrecked’”: the implications of reputation for young women’s sexual health and well-being.Crossref | GoogleScholarGoogle Scholar |

[26]  Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J. Disparities in family planning. Am J Obstet Gynecol 2010; 202 214–20.
Disparities in family planning.Crossref | GoogleScholarGoogle Scholar |

[27]  Free C, Raymond MJO. Young women’s accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study. BMJ 2002; 325 1393–7.
Young women’s accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study.Crossref | GoogleScholarGoogle Scholar |

[28]  Moore AM, Frohwirth L, Miller E. Male reproductive control of women who have experienced intimate partner violence in the United States. Soc Sci Med 2010; 70 1737–44.
Male reproductive control of women who have experienced intimate partner violence in the United States.Crossref | GoogleScholarGoogle Scholar |

[29]  Taft A, Watson L. Termination of pregnancy: associations with violence and other factors in a national cohort of young Australian women. Aust N Z J Public Health 2007; 31 135–42.
Termination of pregnancy: associations with violence and other factors in a national cohort of young Australian women.Crossref | GoogleScholarGoogle Scholar |

[30]  de Visser RO, Badcock PB, Rissel C, Richters J, Smith AMA, Grulich AE, Simpson JM. Experiences of sexual coercion in a representative sample of adults: the Second Australian Study of Health and Relationships. Sex Health 2014; 11 472–80.
Experiences of sexual coercion in a representative sample of adults: the Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |

[31]  Coker AL, Davis KE, Arias I, Desai S, Sanderson M, Brandt HM, Smith PH. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med 2002; 23 260–8.
Physical and mental health effects of intimate partner violence for men and women.Crossref | GoogleScholarGoogle Scholar |

[32]  Campbell JC. Health consequences of intimate partner violence. Lancet 2002; 359 1331–6.
Health consequences of intimate partner violence.Crossref | GoogleScholarGoogle Scholar |

[33]  Putnam F.. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry 2003; 42 269–78.
Ten-year research update review: child sexual abuse.Crossref | GoogleScholarGoogle Scholar |

[34]  Glasier A, Gülmezoglu AM, Schmid GP, Moreno CG, Van Look PFA. Sexual and reproductive health: a matter of life and death. Lancet 2006; 368 1595–607.
Sexual and reproductive health: a matter of life and death.Crossref | GoogleScholarGoogle Scholar |

[35]  Victorian Government Department of Education and Training. Respectful relationships education. Melbourne: Victorian Government; 2009. Available online at: http://www.education.vic.gov.au/about/programs/health/Pages/respectfulrelationships.aspx [verified 2 May 2017].

[36]  Australian Government Department of Social Services. The national plan to reduce violence against women and their children 2010–2022. Canberra: Australian Government; 2011. Available online at: https://www.dss.gov.au/our-responsibilities/women/programs-services/reducing-violence/the-national-plan-to-reduce-violence-against-women-and-their-children-2010-2022 [verified 6 December 2016].

[37]  Taylor D, Levi A, Simmonds K. Reframing unintended pregnancy prevention: a public health model. Contraception 2010; 81 363–6.
Reframing unintended pregnancy prevention: a public health model.Crossref | GoogleScholarGoogle Scholar |