Can we identify women at
risk of more than one termination of pregnancy?
H. St.John (1), H. Critchley
(1), A. Glasier (2)
Department of Obstetrics & Gynaecology, Lothian
University Hospitals NHS Trust, Little France, Edinburgh EH16 4SA, Scotland,
UK (1); Family Planning and Well Women Services, 18 Dean Terrace, Edinburgh,
EH4 1NL, Scotland, UK (2)
Introduction: One in five women will have more than
one abortion in their lifetime. The recurrent pregnancy termination rate (i.e.,
women who undergo a second abortion) varies around the country but is between
20 and 30%.
Aims and Methods: This study was designed to identify risk factors
in women requesting termination of pregnancy (TOP) after previous TOP(s) so
that women at risk of recurrence, attending for the first time could be
identified. A retrospective case note review of 358 women undergoing TOP
during October and November 2000 was performed.
Results: Twenty-six percent of
women had had a previous TOP. Women undergoing a second or subsequent
therapeutic abortion were more likely to be older and have experienced more
pregnancies to full term but these two factors were confounded. When women
were both parous and deprived the risk of them having had more than one TOP
was over 50%.
Conclusion: The reasons for increasing rates of repeat abortion
are probably complex and numerous. This study suggests that women who undergo
more than one abortion may be socially and emotionally disadvantaged. Whether
the rate of repeat abortion can be influenced by identifying women and
targeting them for specific interventions remains to be seen.