TY - JOUR
T1 - Con la ley y sin la ley/With and without the law
T2 - Utilization of abortion services and case fatality in Mexico, 2000–2016
AU - Darney, Blair G.
AU - Fuentes-Rivera, Evelyn
AU - Polo, Gerardo
AU - Saavedra-Avendaño, Biani
AU - Alexander, Lily T.
AU - Schiavon, Raffaela
N1 - Funding Information:
BGD was supported by a Society of Family Planning Research Fund award (SFPRF12‐2) and a grant from the Agency for Healthcare Research and Quality (K12HS022981). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Publisher Copyright:
© 2019 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Objective: To describe utilization of health services for, and case fatality from, abortion in Mexico. Method: A historical cohort study using a census of state-level aggregate hospital discharge and primary care clinic data across Mexico's 32 states from January 2000 to December 2016. Abortive events and changes over time in utilization per 1000 women aged 15–44 years, and case fatality per 100 000 abortion-related events were described by year, health sector, and state. Associations of location (Mexico City vs 31 other states) and time (Mexico City implemented legal abortion services in 2007) with outcomes were tested by linear regression, controlling for secular trends. Results: The national abortion utilization rate was 6.7 per 1000 women in 2000, peaked at 7.9 in 2011, and plateaued to 7.0 in 2016. In Mexico City, utilization peaked at 16.7 in 2014 and then plateaued. Nationwide, the case-fatality rate declined over time from 53.7 deaths per 100 000 events in 2000 to 33.0 in 2016. Case fatality declined more rapidly in Mexico City than in the other 31 states to 12.3 in 2015. Conclusion: Case fatality from abortive events has decreased across Mexico. Where abortion became legal, utilization increased sharply but plateaued afterward.
AB - Objective: To describe utilization of health services for, and case fatality from, abortion in Mexico. Method: A historical cohort study using a census of state-level aggregate hospital discharge and primary care clinic data across Mexico's 32 states from January 2000 to December 2016. Abortive events and changes over time in utilization per 1000 women aged 15–44 years, and case fatality per 100 000 abortion-related events were described by year, health sector, and state. Associations of location (Mexico City vs 31 other states) and time (Mexico City implemented legal abortion services in 2007) with outcomes were tested by linear regression, controlling for secular trends. Results: The national abortion utilization rate was 6.7 per 1000 women in 2000, peaked at 7.9 in 2011, and plateaued to 7.0 in 2016. In Mexico City, utilization peaked at 16.7 in 2014 and then plateaued. Nationwide, the case-fatality rate declined over time from 53.7 deaths per 100 000 events in 2000 to 33.0 in 2016. Case fatality declined more rapidly in Mexico City than in the other 31 states to 12.3 in 2015. Conclusion: Case fatality from abortive events has decreased across Mexico. Where abortion became legal, utilization increased sharply but plateaued afterward.
KW - Abortion
KW - Abortive events
KW - Case fatality
KW - Health system
KW - Mexico
KW - Public health sector
KW - Utilization
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U2 - 10.1002/ijgo.13077
DO - 10.1002/ijgo.13077
M3 - Article
C2 - 31821537
AN - SCOPUS:85079019102
SN - 0020-7292
VL - 148
SP - 369
EP - 374
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -