Sociodemographic determinants of repeated medical termination of pregnancy (MTP)

Introduction: Medical terminations of pregnancy (MTP) were legalised in Italy in 1978 with the aim of reducing the health risks of women caused by the practice of clandestine abortions. Women seeking an abortion must go to a physician, an obstetric/gynaecological clinic or a family advisory centre (Italian National Health Service structures designed to promote reproductive health) in order to obtain the necessary certification. In all cases, healthcare personnel are required to offer counselling and health education concerning contraceptive techniques. Objectives: To investigate the phenomenon of repeated medical terminations of pregnancy (MTPr) in the Abruzzo region of Italy with reference to the possible sociodemographic determinants of the women and the role of family advisory centres in preventing MTPr. Methods: We used data concerning the notifications of MTP performed in Abruzzo in the period 1990–2001, archived on the basis of a standardised coding system. The associations between the sociodemographic variable of the women (age, citizenship, educational level, marital status, number of children), recourse to a family advisory centre and MTPr were evaluated by means of multiple logistic regressions. Results: The number of MTPs performed in Abruzzo between 1990 and 2001 was 35 856. Although the annual absolute number of MTPs decreased during the observation period (from 3593 MTPs in 1990 to 2645 in 2001), the percentage of women undergoing repeated MTP remained relatively constant at an average of 22.7 (1.1)%. Multiple logistic analysis (Table 1) showed that the women at greatest risk of MTPr are older, non-Italian, married, and have a larger number of children. Furthermore, as recourse to a family advisory centre seems to have a protective effect (OR = 0.6) against MTPr, it is recommendable that their counselling and health promotion activities are strengthened.