Incidence of induced abortions in Peru.

Antonio Bernabé-Ortiz and colleagues misleadingly assert that, although access to induced abortion services is legally restricted in Peru, the incidence of induced abortion is “as high as, or higher than, the estimated incidence in many countries where induced abortion is legal and safe.” The abortion rate (the number of abortions per 1000 women of reproductive age) is greatly influenced by a number of factors, namely contraceptive behaviour and fertility rates, and thus it is not a good measure to use to evaluate the impact of the legal status of abortion on the incidence of abortions in a particular jurisdiction. The estimated total fertility rate is 2.86 in Peru; in comparison, it is 2.04 in the United States and 1.66 in the United Kingdom. Therefore, it is not surprising that the abortion rate in Peru may be similar to the rates in the United States and United Kingdom. The legal status of abortion may strongly affect postconceptional attitudes concerning pregnancy termination; this effect is much better described by the abortion ratio (the number of abortions per 1000 live births). Of the approximately 8660 pregnancies reported by participants in the study by Bernabé-Ortiz and colleagues, 1127 ended in induced abortions and 996 in spontaneous abortions. This means that there were approximately 6538 live births and the abortion ratio was 172.3. The authors referred to a study with US data from 2001, in which there were 6.4 million pregnancies, 1.1 million spontaneous abortions and 1.3 million induced abortions. The corresponding abortion ratio was 325. More recent US data indicate that there were 1 206 200 abortions and 4 138 349 births in 2005. The corresponding abortion ratio was 291.5. In England and Wales, 193 737 induced abortions and 669 601 live births were registered in 2006, with a corresponding abortion ratio of 289.3. These data show that there is a lower incidence of abortion in Peru than in other countries where abortion is legal.