Induced abortion in Colombia: new estimates and change between 1989 and 2008.

CONTEXT Although abortion was made legal in Colombia under selected circumstances in 2006, no national studies have examined whether the incidence of the procedure has changed since the previous estimate in 1989. METHODS Data on the number of women treated for abortion complications were obtained from a nationally representative survey of 300 public and private health facilities, and estimates of the likelihood that women obtaining abortions experience complications and receive treatment at a facility were obtained from a survey of 102 knowledgeable professionals. Indirect estimation techniques were used to calculate national and regional abortion measures for 2008, which were compared with previously published 1989 estimates. Numbers and rates of unintended pregnancy were also calculated. RESULTS In 2008, an estimated 93,300 women were treated for induced abortion complications in public and private health facilities. An estimated 400,400 induced abortions were performed, which translates to a rate of 39 per 1,000 women aged 15-44, a slight increase from 1989 (36 per 1,000). Rates varied widely across regions, from 66 in Bogotá to 18 in Oriental. Despite the new abortion law, only 322 legal abortions were performed in 2008. Between 1989 and 2008, the proportion of pregnancies ending in induced abortion increased from 22% to 29%, and the proportion of pregnancies that were unintended rose from 52% to 67%. CONCLUSION Improvements in provision of and access to contraceptive and legal abortion services are needed to meet the increased demand among women and couples to prevent unintended pregnancy and unsafe abortion.