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Abortion rate and contraceptive practices in immigrant and native women in Sweden

Department of Women and Child Health, Karolinska Hospital, Stockholm, Sweden, Lotti.helström{at}ks.se

Viveca Odlind

Department of Women and Child Health, Karolinska Hospital, Stockholm, Sweden

Catharina Zätterström

Department of Women and Child Health, Karolinska Hospital, Stockholm, Sweden

Monica Johansson

Department of Women and Child Health, Karolinska Hospital, Stockholm, Sweden

Fredrik Granath

Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Hospital, Stockholm, Sweden

Nestor Correia

Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden

Anders Ekbom

Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Hospital, Stockholm, Sweden, Department of Epidemiology, Harvard School of Public Health, Boston, USA

Aim: The aim of this study was to analyse whether immigrant women request induced abortion more frequently than Swedish-born women and, if so, to study possible explanations, including contraceptive practices and attitudes. Methods: All women who requested induced abortion during a period of one year were included in the study. The 1,289 women, of whom 36% were born outside Sweden, were interviewed by a nurse-midwife who, using a structured protocol, gathered information on socioeconomic factors, reasons for abortion, experience of contraceptive methods, and family planning counselling. The proportion of women with non-Swedish origin in the study population was compared with the official demographic statistics of the corresponding area. Results: The number of women born outside Sweden who requested induced abortion was larger than expected from their proportion in the population. The immigrant women originated from 77 countries and four continents, the largest subgroup, 11%, coming from Iran. Immigrant women had less experience of contraceptive use, more previous pregnancies and more induced abortions than women born in Sweden. In a multivariate analysis, immigrant status and educational level were found to be independent risk factors for repeat abortion. Conclusion: Immigrant status seems to be an independent risk factor for induced abortion. The immigrant women originated from a wide range of cultures. There is no reason to believe that the women in this heterogeneous group should have any cultural factor in common that could explain their higher proneness to seek induced abortion. The most probable cause is that immigrant status is associated more often with low education, weak social network, poverty, unemployment, and being outside common pathways to healthcare.

Key Words: contraception • ethnicity • immigrant • induced abortion.

Scandinavian Journal of Public Health, Vol. 31, No. 6, 405-410 (2003)
DOI: 10.1080/14034940210165181


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