Wednesday, September 7, 2011

Colombian Experience

Family Planning Services Not Keeping Up with
Demand for Smaller Families
The first assessment in two decades of abortion in Colombia shows that one in 26 Colombian women had an abortion in 2008 and that approximately 30% of all pregnancies ended in abortion. According to the new report, Unintended Pregnancy and Induced Abortion in Colombia: Causes and Consequences, released today by the Guttmacher Institute andFundación Oriéntame, 400,412 induced abortions were performed in the country in 2008, an increase from 288,400 in 1989. However, the abortion rate has not changed substantially over the past two decades; rather, the increase in procedures mostly reflects the growing number of women of reproductive age. Despite a 2006 court ruling that allowed access to legal abortion under certain circumstances, virtually all abortions in Colombia—at least 99.9%—are illegal procedures. These clandestine procedures pose health risks to women: An estimated 132,000 women (one-third of all women having an abortion) experience complications that require medical attention.
“The study’s findings make clear the need to remove institutional and bureaucratic obstacles for women seeking a legal procedure and ensure that health facilities with the capacity and mandate to provide safe and legal procedures do so,” says Cristina Villareal, director of Fundación Oriéntame and a coauthor of the report. “Six out of 10 health facilities in Colombia that have the capacity to provide postabortion care do not provide it, and about nine out of every 10 of these facilities do not offer legal abortion services.”
The researchers, who analyzed nationally representative data from surveys of health professionals and of 300 health facilities, found that abortion rates within Colombia varied significantly by region and that outcomes differed according to women’s economic status. Abortion rates ranged from 18 per 1,000 women aged 15–44 in the region of Oriental to 66 per 1,000 in Bogotá. More than half of poor rural women experienced complications, while in the metropolitan and wealthy region of Bogotá, the complication rate was 25%.
Over the past two decades, there has been a growing preference for a smaller family size in Colombia, yet the proportion of births that were unplanned rose from about one-third in 1990 to slightly more than half in 2010. This trend is connected with the overall increase in unintended pregnancy over the past 20 years.
“We must bear in mind that unintended pregnancy is the reason for the vast majority of abortions,” notes Elena Prada, of the Guttmacher Institute and another author of the report. “Improved family planning services and increased use of contraception are key in reducing unintended pregnancies, and thus abortions, in Colombia.”
The authors recommend that to reduce unsafe abortion and help women plan their births, contraceptive services must be strengthened, the coverage and quality of postabortion services must be improved, and the 2006 court decision on abortion (Sentencia C-355) must be better implemented to provide access to legal abortion services. They also urge that special attention be devoted to poor and rural women, who are the most likely to develop complications and the least likely to receive treatment.
Click on the links below for additional information, available in both English and Spanish. 
English: Unintended Pregnancy and Induced Abortion in Colombia: Causes and Consequences
Spanish: Embarazo no deseado y aborto inducido en Colombia: causas y consecuencias

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