Changing patterns in women seeking terminations of pregnancy: a trend analysis of data from one service provider 1996-2006

Objectives: The purpose of this study was to assess emerging trends in five characteristics: age, first ever pregnancy, contraception at time of conception, contraception choices post-operatively and referral source of women presenting for a termination of pregnancy (1996–2006) from a southern service in Adelaide, South Australia. Method: A time-series study, from 1996 to 2006, using 3,434 cases from a termination of pregnancy service provider. Five characteristics associated with women attending for a termination of pregnancy were examined. Data were analysed using simple linear regression analyses and one-way ANOVA. Results: There was a significant increase in women aged 30–50 years having a pregnancy terminated (ANOVA F1,9 = 5.901, p=0.041), with 67% of women using contraception at the time of conception. An increasing percentage of women chose not to use any contraception post-operatively (ANOVA F1,9 = 14.409, p=0.006), although 90% of women left the service with contraception. Additionally, there was a significant decline in women using natural family planning methods (ANOVA F1,9 = 13.654, p=0.006). Referral patterns changed significantly over the ten years, with fewer women being referred by a general practitioner (ANOVA F1,9 = 46.492, p=0.000) and family planning clinics (ANOVA F1,9 = 13.011, p=0.007). Conclusions and implications: Termination of pregnancy patterns from a hospital based regional termination service have changed over the past ten years in this study population. There are implications for policy, strategic plans and health promotion activities in the southern region of Adelaide.Wendy Abigail, Charmaine Power and Ingrid Bela

A systematic review of trend studies of women seeking termination of pregnancy

This article reports a systematic review of trend studies (1995-2006) that answers five questions: What are the patterns of: (1) age of women seeking termination of pregnancy, (2) first ever pregnancy ending in a termination, (3) contraception usage at the time of conception, (4) contraception chosen immediately post-operatively and (5) referral sources to termination of pregnancy services? Background: Fertility patterns are changing and there is evidence to indicate that numbers of older women conceiving for the first time is increasing. At the same time there are new methods of contraception widely available. Little is known about the implications of these changes on termination patterns. Design An extensive electronic search of databases such as CINAHL, MEDLINE® In–Process (OVID) and was conducted from January 1995 - June 2006 for trend studies in pregnancy terminations. Methods: Articles chosen were based on trend studies greater than five years, contained primary quantitative research and official government statistical reports. Results: Results of the search showed age was unable to be compared due to the many variations in measurements and time periods, there was only limited research worldwide of trends in contraception at the time of conception in relation to a termination of pregnancy. Additionally, there were no studies worldwide in the past 11 years which specifically examined trends in the characteristics of the number of first ever pregnancies which ended in a termination, contraception choices post-operative of a termination of pregnancy, or referral source to a termination of pregnancy provider. Conclusion: Little is reported in the literature on trends in the five characteristics related to pregnancy termination. Relevance to clinical practice Evidence about the changing patterns of women seeking pregnancy termination is needed to inform policy and practice and to ensure that health promotion strategies are underpinned by accurate information that reflects the needs of the populations of women in relation to their reproductive health