Post-abortion and induced abortion services in two public hospitals in Colombia

Blair Darney, Willis Simancas-Mendoza, Alison Edelman, Camilo Guerra-Palacio, Jorge Tolosa, Maria Rodriguez

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Study design: Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Results: Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with.99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Conclusion: Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Implications: Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalContraception
Volume90
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Colombia
Induced Abortion
Public Hospitals
Legal Abortion
Curettage
Public Sector
Vacuum
Women's Health
Quality Improvement
Documentation
Cohort Studies
Retrospective Studies
Logistic Models
Technology

Keywords

  • Adolescents
  • Family planning
  • Reproductive health services

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Post-abortion and induced abortion services in two public hospitals in Colombia. / Darney, Blair; Simancas-Mendoza, Willis; Edelman, Alison; Guerra-Palacio, Camilo; Tolosa, Jorge; Rodriguez, Maria.

In: Contraception, Vol. 90, No. 1, 2014, p. 36-41.

Research output: Contribution to journalArticle

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abstract = "Objective: Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Study design: Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Results: Adolescents made up 22{\%} of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95{\%} CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with.99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Conclusion: Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Implications: Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services.",
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