Objective: To test the hypothesis that the correlation between legal abortion and socio-economic conditions, known from the time when abortion was restricted, has current validity. To evaluate the effect of social class on network support and psychological reactions.
Design: Consecutive sampling and semistructured personal interviewing.
Subjects: 444 women living in the city of Gothenburg and applying for legal termination of pregnancy in the first trimester.
Setting: The department of gynaecology at a university hospital with primary care responsibility for legal abortions.
Results: The 667 health administration districts of Gothenburg were ranked into four groups according to the mean income. Women living in lower socio-economic districts were younger. Irrespective of age, previous experience of induced abortion was more common among them (p < 0.001). Unsatisfactory network response or support was common (37%), but equally shared between the social classes. Discontinuation of oral contraception during the previous six months was twice as common among teenagers (40.0%) as among other women (p < 0.001) but without social differences. Pitman's permutation test was used for statistical analyses.
Conclusion: Socio-economic conditions have a strong and inverse correlation to previous experience of induced abortion. Psychological reactions and needs did not vary with class.
PIP: Given attempts on the part of the Swedish parliament to restrict access to abortion, investigations of the social class composition of current abortion seekers are essential. In this study, socioeconomic data were collected on 444 consecutive first-trimester abortions performed at Sweden's University of Gothenburg Hospital in 1986-87. Gothenburg's 667 districts were classified into four strata on the basis of mean income for males 25-49 years of age and percentages of home ownership and families receiving social welfare. 45 abortion patients were in group A (high income), 74 in group B, 98 in group C, and 227 in group D (poverty level). Mean gestational age was similar (9.4 weeks) in all groups, but low-income abortion patients were significantly younger and had twice the rate of prior abortions than the most affluent women (48.9% versus 24.4%). Moreover, 15.4% of the poorest women compared to only 2.2% of the wealthiest women had undergone another abortion within two years of the index pregnancy termination. There were no significant differences along social class lines in terms of emotional responses to the need for abortion or perceptions of support from significant others. Overall, these findings confirm that any attempts to curtail abortion rights would have the greatest impact on low-income women. They further suggest a need for increased family planning program resources in low-income districts, including distribution of free contraception, to reduce the high incidence of repeat abortion.