The number of abortion-related deaths in the U.S. has decreased dramatically since 1973. In 1973, the number of deaths related to abortions was 47. In 2021, the number of reported deaths related to abortions had decreased to just five. Abortion is the act of ending a pregnancy so that it does not result in the birth of a baby. Abortions in the U.S. Abortions can be performed in a surgical setting or a medical setting (the pill). The number of legal abortions reported in the U.S. has generally declined yearly since 1990. The most frequently performed kind of abortion in the U.S. in 2022 were medical abortions. Abortion and the legality and morality of the procedure has been a publicly debated topic in the United States for many years. Public opinions on abortion Opinions on abortion in the United States can be divided into two campaigns. Pro-choice is the belief that women have the right to decide when they want to become pregnant and if they want to terminate the pregnancy through an abortion. Pro-life, is the belief that women should not be able to choose to have an abortion. As of 2023, around 52 percent of the U.S. population was pro-choice, while 44 percent considered themselves pro-life. However, these shares have fluctuated over the past couple decades, with a majority of people saying they were pro-life as recently as 2019.

In 2022, there were around 613 thousand legal abortions in the United States. The number of legal abortions in the United States has decreased significantly since the early 1990’s. This number will probably continue to decrease in the coming years since many states have severely limited or completely banned abortion after the overturning of Roe v. Wade by the Supreme Court in 2022. The states with the highest abortion rates In 2022, the rate of legal abortions per live births in the United States was 19.9 per 100. In comparison, in 1990 there were 34.4 abortions per 100 live births. The states with the highest rates of abortion per live births are New Mexico, Illinois, and Florida. In Florida, there were around 37 abortions per 100 live births in 2022. Florida had the highest total number of abortions that year, followed by New York and Illinois. Missouri and South Dakota had the lowest number of abortions in 2022. Out-of-state abortions Critics of the Supreme Court decision to overturn Roe v. Wade argue that while those who can afford it may be able to travel to other states for an abortion if their state bans the procedure, poorer residents will have no such choice. Even before the overturning of Roe v. Wade, out-of-state residents already accounted for a high share of abortions in certain states. In 2022, 69 percent of abortions in Kansas were performed on out-of-state residents, while out-of-state residents accounted for around 62 percent of abortions in New Mexico. Illinois had the highest total number of abortions performed on out-of-state residents that year, with around 16,849 procedures.

In 2021, a total of 13 deaths were reported to have occurred as a result of complications following an abortion in Argentina, down from 23 deaths registered a year earlier. Abortion is one of the leading causes of pregnancy-related deaths in Argentina.

In December 2020, abortion in Argentina was legalized up until the 14th week of pregnancy. Before the law passed, abortion was only decriminalized in cases where the pregnant person's life or health was in danger, or if the pregnancy was the result of rape.

According to the World Health Organization, from 2010 to 2014, there were around 55 million abortions worldwide, 45% of which were unsafe. In Brazil, data on abortion and its complications are incomplete. Health care data are only available for the public sector and mortality data depend on investigations of deaths. This study sought to describe the situation of abortion in the country using public data available in the different Information Systems - SIM (mortality), SINASC (live births) and SIH (hospitalization). From 2008 to 2015, there were around 200,000 hospitalizations/year for procedures related to abortion, 1,600 of which for medical and legal reasons. From 2006 to 2015, we found 770 maternal deaths in SIM whose underlying cause was abortion. There was a discreet reduction in the number of deaths from abortion in the period, with regional variation. This number could be increased by around 29% per year if deaths with mentions of abortion and declared with a different underlying cause were considered. Among the deaths reported as resulting from abortion, 1% were abortions due to medical and legal reasons and 56.5% were non-specified abortions. The proportion of deaths from abortion identified in SIH, in relation to the total number of deaths from abortion identified in SIM, varied between 47.4% in 2008 and 72.2% in 2015. Although official health data do not allow us to estimate the number of abortions in Brazil, we were able to establish the profile of women at higher risk for death from abortion: black and indigenous women, with low educational levels, under 14 and over 40 years of age, living in the North Northeast and Central regions, without a partner.

The 1997 the Kyrgyz Republic Demographic and Health Survey (KRDHS) is a nationally representative survey of 3,848 women age 15-49. Fieldwork was conducted from August to November 1997. The KRDHS was sponsored by the Ministry of Health (MOH), and was funded by the United States Agency for International Development. The Research Institute of Obstetrics and Pediatrics implemented the survey with technical assistance from the Demographic and Health Surveys (DHS) program. The purpose of the KRDHS was to provide data to the MOH on factors which determine the health status of women and children such as fertility, contraception, induced abortion, maternal care, infant mortality, nutritional status, and anemia. Some statistics presented in this report are currently available to the MOH from other sources. For example, the MOH collects and regularly publishes information on fertility, contraception, induced abortion and infant mortality. However, the survey presents information on these indices in a manner which is not currently available, i.e., by population subgroups such as those defined by age, marital duration, education, and ethnicity. Additionally, the survey provides statistics on some issues not previously available in the Kyrgyz Republic: for example, breastfeeding practices and anemia status of women and children. When considered together, existing MOH data and the KRDHS data provide a more complete picture of the health conditions in the Kyrgyz Republic than was previously available. A secondary objective of the survey was to enhance the capabilities of institutions in the Kyrgyz Republic to collect, process, and analyze population and health data. MAIN FINDINGS FERTILITY Fertility Rates. Survey results indicate a total fertility rate (TFR) for all of the Kyrgyz Republic of 3.4 children per woman. Fertility levels differ for different population groups. The TFR for women living in urban areas (2.3 children per woman) is substantially lower than for women living in rural areas (3.9). The TFR for Kyrgyz women (3.6 children per woman) is higher than for women of Russian ethnicity (1.5) but lower than Uzbek women (4.2). Among the regions of the Kyrgyz Republic, the TFR is lowest in Bishkek City (1.7 children per woman), and the highest in the East Region (4.3), and intermediate in the North and South Regions (3.1 and3.9, respectively). Time Trends. The KRDHS data show that fertility has declined in the Kyrgyz Republic in recent years. The decline in fertility from 5-9 to 0-4 years prior to the survey increases with age, from an 8 percent decline among 20-24 year olds to a 38 percent decline among 35-39 year olds. The declining trend in fertility can be seen by comparing the completed family size of women near the end of their childbearing years with the current TFR. Completed family size among women 40-49 is 4.6 children which is more than one child greater than the current TFR (3.4). Birth Intervals. Overall, 30 percent of births in the Kyrgyz Republic take place within 24 months of the previous birth. The median birth interval is 31.9 months. Age at Onset of Childbearing. The median age at which women in the Kyrgyz Republic begin childbearing has been holding steady over the past two decades at approximately 21.6 years. Most women have their first birth while in their early twenties, although about 20 percent of women give birth before age 20. Nearly half of married women in the Kyrgyz Republic (45 percent) do not want to have more children. Additional one-quarter of women (26 percent) want to delay their next birth by at least two years. These are the women who are potentially in need of some method of family planning. FAMILY PLANNING Ever Use. Among currently married women, 83 percent report having used a method of contraception at some time. The women most likely to have ever used a method of contraception are those age 30-44 (among both currently married and all women). Current Use. Overall, among currently married women, 60 percent report that they are currently using a contraceptive method. About half (49 percent) are using a modern method of contraception and another 11 percent are using a traditional method. The IUD is by far the most commonly used method; 38 percent of currently married women are using the IUD. Other modern methods of contraception account for only a small amount of use among currently married women: pills (2 percent), condoms (6 percent), and injectables and female sterilization (1 and 2 percent, respectively). Thus, the practice of family planning in the Kyrgyz Republic places high reliance on a single method, the IUD. Source of Methods. The vast majority of women obtain their contraceptives through the public sector (97 percent): 35 percent from a government hospital, and 36 percent from a women counseling center. The source of supply of the method depends on the method being used. For example, most women using IUDs obtain them at women counseling centers (42 percent) or hospitals (39 percent). Government pharmacies supply 46 percent of pill users and 75 percent of condom users. Pill users also obtain supplies from women counseling centers or (33 percent). Fertility Preferences. A majority of women in the Kyrgyz Republic (45 percent) indicated that they desire no more children. By age 25-29, 20 percent want no more children, and by age 30-34, nearly half (46 percent) want no more children. Thus, many women come to the preference to stop childbearing at relatively young ages-when they have 20 or more potential years of childbearing ahead of them. For some of these women, the most appropriate method of contraception may be a long-acting method such as female sterilization. However, there is a deficiency of use of this method in the Kyrgyz Republic. In the interests of providing a broad range of safe and effective methods, information about and access to sterilization should be increased so that individual women can make informed decisions about using this method. INDUCED ABORTION Abortion Rates. From the KRDHS data, the total abortion rate (TAR)-the number of abortions a woman will have in her lifetime based on the currently prevailing abortion rates-was calculated. For the Kyrgyz Republic, the TAR for the period from mid-1994 to mid-1997 is 1.6 abortions per woman. The TAR for the Kyrgyz Republic is lower than recent estimates of the TAR for other areas of the former Soviet Union such as Kazakhstan (1.8), and Yekaterinburg and Perm in Russia (2.3 and 2.8, respectively), but higher than for Uzbekistan (0.7). The TAR is higher in urban areas (2.1 abortions per woman) than in rural areas (1.3). The TAR in Bishkek City is 2.0 which is two times higher than in other regions of the Kyrgyz Republic. Additionally the TAR is substantially lower among ethnic Kyrgyz women (1.3) than among women of Uzbek and Russian ethnicities (1.9 and 2.2 percent, respectively). INFANT MORTALITY In the KRDHS, infant mortality data were collected based on the international definition of a live birth which, irrespective of the duration of pregnancy, is a birth that breathes or shows any sign of life (United Nations, 1992). Mortality Rates. For the five-year period before the survey (i.e., approximately mid-1992 to mid1997), infant mortality in the Kyrgyz Republic is estimated at 61 infant deaths per 1,000 births. The estimates of neonatal and postneonatal mortality are 32 and 30 per 1,000. The MOH publishes infant mortality rates annually but the definition of a live birth used by the MOH differs from that used in the survey. As is the case in most of the republics of the former Soviet Union, a pregnancy that terminates at less than 28 weeks of gestation is considered premature and is classified as a late miscarriage even if signs of life are present at the time of delivery. Thus, some events classified as late miscarriages in the MOH system would be classified as live births and infant deaths according to the definitions used in the KRDHS. Infant mortality rates based on the MOH data for the years 1983 through 1996 show a persistent declining trend throughout the period, starting at about 40 per 1,000 in the early 1980s and declining to 26 per 1,000 in 1996. This time trend is similar to that displayed by the rates estimated from the KRDHS. Thus, the estimates from both the KRDHS and the Ministry document a substantial decline in infant mortality; 25 percent over the period from 1982-87 to 1992-97 according to the KRDHS and 28 percent over the period from 1983-87 to 1993-96 according to the MOH estimates. This is strong evidence of improvements in infant survivorship in recent years in the Kyrgyz Republic. It should be noted that the rates from the survey are much higher than the MOH rates. For example, the KRDHS estimate of 61 per 1,000 for the period 1992-97 is twice the MOH estimate of 29 per 1,000 for 1993-96. Certainly, one factor leading to this difference are the differences in the definitions of a live birth and infant death in the KRDHS survey and in the MOH protocols. A thorough assessment of the difference between the two estimates would need to take into consideration the sampling variability of the survey's estimate. However, given the magnitude of the difference, it is likely that it arises from a combination of definitional and methodological differences between the survey and MOH registration system. MATERNAL AND CHILD HEALTH The Kyrgyz Republic has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. This system includes special delivery hospitals, the obstetrics and gynecology departments of general hospitals, women counseling centers, and doctor's assistant/midwife posts (FAPs). There is an extensive network of FAPs throughout the rural areas. Delivery. Virtually all births in the Kyrgyz Republic (96 percent) are delivered at health facilities: 95 percent in delivery hospitals and another 1 percent in either general hospitals

Abstract Objective To study the structure ofmaternalmortality caused by abortion in the Tula region. Methods The medical records of deceased pregnant women, childbirth, and postpartum from January 01, 2001, to December 31, 2015, were analyzed. Results Overall, 204,095 abortion cases were recorded in the Tula region for over 15 years. The frequency of abortion was reduced 4-fold, with 18,200 in 2001 to 4,538 in 2015. The rate of abortions per 1,000 women (age 15-44 years) for 15 years decreased by 40.5%, that is, from 46.53 (2001) to 18.84 (2015), and that of abortions per 100 live births and stillbirths was 29.5%, that is, from 161.7 (2001) to 41.5 (2015). Five women died from abortion complications that began outside of the hospital, which accounted for 0.01% of the total number. In the structure of causes of maternal mortality for 15 years, abortion represented 14.3% of the cases. Lethality mainly occurred in the period from 2001 to 2005 (4 cases). Among thematernal deaths, many women died in rural areas after pregnancy termination at 18 to 20 weeks of gestation (n = 4). In addition, three women died from sepsis and two from bleeding. Conclusion The introduction of modern, effective technologies of family planning has reduced maternal mortality due to abortion.

In 2022, the states with the highest rates of abortion per 1,000 women aged 15 to 44 years in the United States were New Mexico, Illinois, and Kansas. The states with the lowest rates of abortion were Missouri and South Dakota. Abortion differences among the states In 2022, the U.S. Supreme Court overturned Roe v. Wade allowing states to restrict the practice of abortion or outright ban it completely. A number of states immediately banned the procedure through trigger laws they had in place in anticipation of the ruling. Even before the ruling, abortion accessibility and rates varied greatly from state to state, but this difference has become even more pronounced. For example, in 2022, Florida had an abortion rate of 20.5 per 1,000 women, while the rate in Missouri was just .1. Florida had the highest total number of abortions that year, followed by New York and Illinois. While Florida reported around 82,581 abortions in 2022, there were just 88 such procedures in Missouri. Public opinion on abortion In the United States, the debate surrounding abortion is often divided among those who are “pro-life” and think abortion should be restricted or banned and those who are “pro-choice” and believe the decision to abort a pregnancy should be up to the woman. Gallup polls show the distribution of people in the United States who are pro-life or pro-choice has fluctuated over the years but in 2023 around 52 percent of respondents stated they were pro-choice while 44 percent said they were pro-life. Older respondents are more likely to express views limiting access to abortion, while younger people are more likely to believe abortion should be legal under any circumstance. However, just a small minority of people of all ages believe abortion should be illegal in all circumstances.

Objective: To test whether there is an association between abortion legislation and maternal mortality outcomes after controlling for other factors thought to influence maternal health. Design: Population-based natural experiment. Setting and data sources: Official maternal mortality data from 32 federal states of Mexico between 2002 and 2011. Main outcomes: Maternal mortality ratio (MMR), MMR with any abortive outcome (MMRAO) and induced abortion mortality ratio (iAMR). Independent variables: Abortion legislation grouped as less (n=18) or more permissive (n=14); constitutional amendment protecting the unborn (n=17); skilled attendance at birth; all-abortion hospitalisation ratio; low birth weight rate; contraceptive use; total fertility rates (TFR); clean water; sanitation; female literacy rate and intimate-partner violence. Main results: Over the 10-year period, states with less permissive abortion legislation exhibited lower MMR (38.3 vs 49.6; p<0.001), MMRAO (2.7 vs 3.7; p<0.0...

Context

Induced abortion in New Zealand is regulated under the Contraception, Sterilisation, and Abortion Act 1977. This act established the Abortion Supervisory Committee (ASC) to oversee the operation of the Act. One of the roles of the ASC is "to obtain, monitor, analyse, collate, and disseminate information relating to the performance of abortions in New Zealand". Stats NZ is responsible for collating, analysing and disseminating abortion statistics on behalf of the ASC. https://www.stats.govt.nz

Content

Abortion statistics measure the number of induced abortions that are performed in New Zealand hospitals or licensed abortion clinics. Publisher: Statistics New Zealand. Rights: Statistics New Zealand https://www.stats.govt.nz/

Acknowledgements

https://www.stats.govt.nz/

Photo by Luemen Carlson on Unsplash

Inspiration

Women with an unwanted pregnancy who cannot access safe abortion is at risk of unsafe abortion. Women living in low-income countries and poor women are more likely to have an unsafe abortion. Deaths and injuries are higher when unsafe abortion is performed later in pregnancy. The rate of unsafe abortions is higher where access to effective contraception and safe abortion is limited or unavailable. https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion

Context

Definition: Abortion is the termination of pregnancy by removing or expelling a fetus or fetus from the womb that resulted in or resulted from its death. Miscarriage can happen spontaneously due to complications during pregnancy or it can occur. Can we offer some solutions to do statistics and solve them?

Content

These data include the percentages and ages that the person undergoes with the abortion process

Notes on Specific Variables:

1. Period: This is the period in which the ratios were calculated.
2. Age_of_woman: The ages that vary between the females who have an abortion.

Data and replication for The Impact of Legal Abortion on Maternal MortalityAbstract: Legal abortion has recently been suggested as an essential healthcare service. In this study, we consider whether abortion legalization over 1969-1973 improved women's health, measured by maternal mortality. Our event-study results indicate that legal abortion substantially lowered non-white maternal mortality by 30-50%, with 134 non-white maternal deaths averted nationally in the first year abortion became legal. We also find that early state-level legalizations were crucial, and more influential than the Roe v. Wade decision itself.

ABSTRACT This article analyzes maternal deaths of adolescents in Piauí and describes the stories of those who died due to induced abortion between 2008 and 2013. The study was conducted in two stages. The first, quantitative, obtained demographic data and basic causes of deaths from the Mortality Information System. In the second, qualitative, the mothers of the adolescents were interviewed. Adolescents’ deaths accounted for 17.2% (50 cases) of total maternal deaths. The majority of the adolescents lived in inner cities (78%) and was black (70%). The causes of death were hypertensive disorders (28%), puerperal infection (16%), hemorrhage (12%), thromboembolism (12%) and abortion (10%). The use of medication occurred in all cases of abortion, with abundant bleeding and pelvic pain being the main reasons for seeking hospital care. There was delay in the diagnosis and appropriate treatment of abortion complications, which may have contributed to the death of the adolescents. Maternal deaths among adolescents were mostly caused by conditions considered preventable. The stories of young women who died of abortion complications have highlighted the need for better-qualified health care, as well as laws and public policies that protect women who decide to terminate their pregnancies.

Proportion of abortion related deaths reported by study quality.

In 2022, there were around ** legal abortions per 100 live births among unmarried women in the United States. In comparison, the rate of abortion per live births among married women was around **** per 100. The abortion rates for both married and unmarried women in the United States have decreased over the last few decades. Abortion statistics in the United States In 2022, the overall rate of abortion in the United States per 100 live births was ****. Abortion in the U.S. is most common among women aged 25 to 29 years, with around ***abortions per 1,000 women in this age group. The most common method of abortion in 2022 was medical abortion with a gestation of nine weeks or less, followed by surgical abortion with a gestation of 13 weeks or less. Medical abortion involves taking prescription medication to end the pregnancy, while surgical abortion involves a surgical procedure. The two main types of surgical abortion are vacuum aspiration and dilation and evacuation (D&E). Abortion-related deaths in the United States are very rare, with only **** such deaths reported in 2021. Abortion among adolescents In 2022, the abortion rate among adolescent women in the United States aged 15 to 19 years was *** per 1,000 population. In comparison, in 2013, this rate was *** per 1,000 women. Perhaps unsurprisingly, the abortion rate among adolescent women increases with age. In 2022, those aged 19 years had the highest rate of abortion among teenagers. The majority of abortions performed on adolescent women are done in week **** or less of gestation. In 2022, there were around ****** abortions performed on adolescent women in week nine or less of gestation, while ***** abortion procedures were carried out after week nine of gestation.

Users can access data related to international women’s health as well as data on population and families, education, work, power and decision making, violence against women, poverty, and environment. Background World’s Women Reports are prepared by the Statistics Division of the United Nations Department for Economic and Social Affairs (UNDESA). Reports are produced in five year intervals and began in 1990. A major theme of the reports is comparing women’s situation globally to that of men in a variety of fields. Health data is available related to life expectancy, cause of death, chronic disease, HIV/AIDS, prenatal care, maternal morbidity, reproductive health, contraceptive use, induced abortion, mortality of children under 5, and immunization. User functionality Users can download full text or specific chapter versions of the reports in color and black and white. A limited number of graphs are available for download directly from the website. Topics include obesity and underweight children. Data Notes The report and data tables are available for download in PDF format. The next report is scheduled to be released in 2015. The most recent report was released in 2010.

Abstract

The 1993 Romanian Reproductive Health Survey (RRHS-93) is a household-based survey designed to collect information from a representative sample of women of reproductive age throughout Romania. This nationwide probability survey of reproductive health is the first to be carried out in Romania since 1978.

During the previous regime, contraceptives and sex education were generally unavailable and importation and sale of contraceptives was forbidden; traditional contraceptive methods, with their high failure rates, were almost the only means to avoid unintended pregnancies.

In the absence of modern contraception, illegal abortions, most of them self-induced or induced by lay persons, were widely used to avert unwanted births. Although the extent of the prevalence of illegal abortions was impossible to assess, the dramatic effect on women's health was obvious to government officials but concealed from the public for many years. The true scope of the impact this policy had on reproductive health came to worldwide attention only after the December 1989 revolution and the change of government. During the last decade (1979-1989), Romania had the highest maternal mortality rate in Europe, a rate ten times higher than that of any other European country, and most of these maternal deaths were abortion-related (Stephenson et al., 1992). The magnitude of abortion complications is difficult to quantify but unofficial estimates suggest that nearly 20% of the 4.9 million women of reproductive age are thought to have impaired fertility (UNFPA 1990). The high number of unwanted pregnancies resulting in children abandoned in overcrowded orphanages by families who had been too frightened to attempt an illegal abortion, but who were too poor to afford to raise their child, was another shocking disclosure.

After revoking the restrictive law on abortion and contraception at the end of December 1989, the availability of safe abortion resulted in a drastic decline in me maternal mortality rate and improved women's health and their reproductive rights. However, the health planners who strived to design a family planning program were confronted with a difficult mission: to formulate and implement strategies aimed at improving family planning practices in a climate of economic and political changes and resistance to modern contraception by both the public and the health care providers. Also, insufficient infrastructure, absence of family planning logistics and managerial skills, and the shortage or uneven distribution of the contraceptive supplies were other critical factors that have diminished the impact of the newly founded program.

The survey was specifically designed to meet the following objectives: -to assess the current situation in Romania concerning abortion, contraception and various other reproductive health issues; -to enable policy makers, program managers and researchers to evaluate and improve existing programs and to develop new strategies; -to measure changes in fertility and contraceptive prevalence rates and study factors which affect these changes, such as geographic and socio-demographic factors, breastfeeding patterns, use of induced abortion, and availability of family planning; -to identify and focus further reproductive health studies toward high risk groups.

Geographic coverage

The 1993 RRHS was designed to collect information from a representative sample of women of reproductive age throughout Romania.

Analysis unit

Women of reproductive age

Universe

The universe from which the respondents were selected included all females between the ages of 15 and 44, regardless of marital status, who were living in Romania when the survey was carried out.

Kind of data

Sample survey data [ssd]

Sampling procedure

The 1993 RRHS was designed to collect information from a representative sample of women of reproductive age throughout Romania. The universe from which the respondents were selected included all females between the ages of 15 and 44, regardless of marital status, who were living in Romania when the survey was carried out.

The survey employed a stratified sample with independent estimates for Bucharest, the capital city, and the 40 judets outside of Bucharest, or the Interior. Bucharest, together with its surroundings, the Agricultural Sector of Ilfov, is the equivalent of a judet. The 1992 census was used as the sampling frame (Comisia Nationala pentru Statistica, 1992). Since there were roughly equal numbers of urban and rural households in the Interior, the Interior sample was designed to be self-weighting. With a projected area probability sample of 5,000 women, 1,000 in Bucharest and 4,000 in the Interior, regional estimates are also possible for the Interior. Based on census data (percentage of households with at least one women 15-44 and unoccupied households) and a projected response rate of 90%, a total of 12,387 households were sampled to obtain complete interviews for approximately 5,000 women. Bucharest was oversampled and represents 22 percent of the sample, although it includes 11 percent of the total population.

The first stage of the three-stage sample design was a selection of "Census Sectors" with probability proportional to the number of households recorded in the 1992 Census. This was accomplished using a systematic sample with a random start in both strata or domains. In the second stage of sampling, clusters of households were randomly selected in each Census Sector chosen in the first stage. Cluster size determination was based on the number of households required to obtain 15 interviews per cluster, on average, in Bucharest, and 20 in the Interior. To obtain an average of 15/20 interviews, cluster sizes varied from 39 to 50 households due to different proportions of unoccupied household and variations in the proportion of households containing females 15-44 years of age by geographic area. Finally, one woman between the ages of 15 and 44 was selected at random for interviewing in each of the households.

Since only one woman was selected from each household containing women of reproductive age, all results have been weighted to compensate for the fact that some households included more than one eligible woman. Survey results are also weighted to adjust for the oversampling of households in Bucharest.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire was first drafted by CDC/DRH consultants based on a core questionnaire used in the 1993 Czech Republic RHS. This core questionnaire was modified, including adding modules targeted to explore important issues for Romania, such as induced abortion and maternal mortality. The survey instrument was then reviewed by Romanian experts in reproductive health and family planning, as well as by AID and AID cooperating agencies who have worked in Eastern Europe. Based on these reviews, a pretest questionnaire was developed and field tested in April 1993.

The RRHS questionnaire covered a wide range of topics related to reproductive health in Romania. The specific areas included were: - Social, economic and demographic characteristics - Pregnancy history - Knowledge and use of contraceptive methods - Sexuality and contraception among young adults - Use of maternal and child health services - Morbidity during pregnancy - Women's health issues - Knowledge and attitudes about contraception - Knowledge about HIV/AIDS

The questionnaire had two components: (1) A short household module that was used to collect residential and geographic information, as well as selected characteristics about all women of childbearing age living in sampled households, and information on interview status. This module was also used to select a respondent randomly when there was more than one eligible woman in the household. (2) The longer individual questionnaire collected information on reproductive health topics discussed below. For Hungarian language speakers, the interview was conducted in their native language.

The major subjects on which information was collected are: pregnancies and childbearing (a history of all pregnancies and births, including use of abortion and planning status of pregnancies); family planning (knowledge and history of use of methods of preventing pregnancy, reasons for use of less effective methods of contraception, pregnancy intentions, and fecundity); maternal and child health (health information about the most recent pregnancy and birth and the use of services); young adult reproductive health (information on sexual relations and pregnancy among females 15-24 years old); women's health (health behavior and use of women's health services); reproductive health knowledge and attitudes (especially regarding birth control pills and IUDs); knowledge about HIV/AIDS transmission and prevention; and socioeconomic characteristics of women and their husbands/families. The sisterhood module to estimate maternal mortality was also part of the questionnaire.

Response rate

Of the 12,387 households selected, 5,283 included at least one 15- to 44 year-old woman. Of this number, 4,861 were successfully interviewed, for a response rate of 92.0%. Only 1.1% the of selected women refused to be interviewed, while another 6.1% could not be located. Response rates were slightly better in Bucharest and other urban areas (93%) than in rural areas (89%).

Data appraisal

The age distribution of the RRHS sample closely reflected that of the female population as a whole (Comisia Nationala pentru Statistica, 1993A). The sample population is essentially within two percentage points of the census

Unsafe abortions account for roughly 13 percent of maternal deaths worldwide. In addition, millions of women suffer nonfatal health consequences of unsafe abortion every year. Information on unsafe abortion can be instrumental in helping policy makers and program planners identify measures needed to improve maternal health. Insufficient information at the country level perpetuates the invisibility of the problem of unsafe abortion and results in governments giving it little priority in policy decisions, service delivery or program implementation. This project was the first-ever national study of the incidence of induced abortion and health consequences of unsafe abortion in Tanzania. The three-year project aimed to: Provide evidence on the incidence of induced abortion in Tanzania, at the national and regional levels and by women's place of residence and economic status Document the incidence of abortion complications Document the methods and providers used to perform abortions in Tanzania

Abstract

The principal objective of the 2007 Ghana Maternal Health Survey (GMHS) is intended to serve as a source of data on maternal health and maternal death for policymakers and the research community involved in the Reducing Maternal Morbidity and Mortality (R3M) program. Specifically, the data collected in the GMHS is intended to help the Government of Ghana and the consortium of organizations participating in the R3M program to launch a series of collaborative efforts to significantly expand women's access to modern family planning services and comprehensive abortion care (CAC), reduce unwanted fertility, and reduce severe complications and deaths resulting from unsafe abortion. The GMHS collected data from a nationally representative sample of households and women of reproductive age (15-49). The data were collected in two phases. The primary objectives of the 2007 GMHS were: • To collect data at the national level that will allow an assessment of the level of maternal mortality in Ghana for the country as a whole, for the R3M program regions (Greater Accra, Ashanti and Eastern Regions), and for the non-program regions; • To identify specific causes of maternal and non-maternal deaths, and specifically to be able to identify deaths due to abortion-related causes, among adult women; •To collect data on women’s perceptions and experience with antenatal, maternity, and emergency obstetrical care, especially with regard to care received before, during, and after the termination or abortion of a pregnancy; • To measure indicators of the utilization of maternal health services and especially post-abortion care services in Ghana; and • To provide baseline data for the R3M program and for follow-on studies and surveys that will be used to observe possible reductions in maternal mortality as well as reductions in abortion-related mortality.It also contributes to the ever-growing international database on maternal health-related information.

The pregnancy-related mortality ratio (PRMR) for the 7-year period preceding the survey, calculated from the sibling history data, is 451 deaths per 100,000 live births and for the 5-year period preceding the survey is 378 deaths per 100,000 live births.Induced abortion accounts for more than one in ten maternal deaths and the obstetric risk from induced abortion is highest among young women age 15-24. Although almost all women seek antenatal care from a health professional, only one in two women deliver in a health facility, and three in four women seek postnatal care. Despite the emphasis on continuity of care, less than one in two women receive all three maternity care components (antenatal care, delivery care, and postnatal care) from a skilled provider. Clearly, Ghana has a long way to go towards achieving the MDG-5 target.

Geographic coverage

National

Analysis unit

Individual

Universe

1. All women age 12-49 years in households and residents in Ghana

Kind of data

Sample survey data [ssd]

Sampling procedure

To achieve the above-mentioned objectives and to obtain an accurate measure of the causes of maternal mortality at the national level, and for the Reducing Maternal Morbidity and Mortality( R3M) regions (Greater Accra, Ashanti and Eastern regions) and other regions (Western, Central, Volta, Brong Ahafo, Northern, Upper East and Upper West), 1600 primary sampling units were selected (half from the R3M regions and half from the other regions) within the 10 administrative regions of the country, across urban and rural areas. The primary sampling units consisted of wards or subwards drawn from the 2000 Population Census. This sample size was estimated from information in the 2003 Ghana DHS survey; it was expected that each primary sampling unit would yield, on average, 150 households. GSS and GHS enumerators carried out a complete mapping and listing of the 1600 selected clusters. This first phase of data collection yielded a total of 227,715 households.

A short household questionnaire was administered to identify deaths that occurred in the five years preceding the survey to women age 12-49 in each household listed in the selected cluster. In the second phase of data collection a verbal autopsy questionnaire was administered in all households identified in the first phase as having experienced the death of a woman age 12-49. This yielded a total of 4,203 completed verbal autopsy questionnaires.

In the second phase of fieldwork, 400 clusters were randomly selected from the 1600 clusters identified in the first phase. Households with women age 15-49 were selected from these 400 clusters (half from the R3M regions and half from the other regions) and were stratified by region and urban-rural residence to yield 10,858 completed household interviews and 10,370 individual women's interviews. These households were selected randomly and independently from the households identified in the first phase as having experienced a female death.

Institutional populations (those in hospitals, army barracks, etc.) and households residing in refugee camps were excluded from the GMHS sample.

Sampling deviation

No deviation of the original sample design was made

Mode of data collection

Face-to-face [f2f]

Research instrument

The GMHS used four questionnaires: (1) a Phase I short household questionnaire administered at the time of listing; (2) a Phase II verbal autopsy questionnaire administered in households identified at listing as having experienced the death of a female household member age 12-49; (3) a Phase II long-form household questionnaire administered in independently selected households chosen for the individual woman’s interview, and (4) a Phase II questionnaire for individual women age 15-49 in the same phase two selected households. The primary purpose of the short household questionnaire administered at the time of listing during Phase I was to identify deaths to women age 12-49, for administering the verbal autopsy questionnaire on the causes of female deaths, particularly maternal deaths and abortion-related deaths. Unique identifiers for households in phase one and households in phase two were not maintained; therefore households cannot be matched across both phases of the survey. During the first phase of the survey, all households in each selected cluster were listed and administered the short household questionnaire. This questionnaire was administered to identify households that experienced the death of a female [regular] household member in the five years preceding the survey. The verbal autopsy questionnaire (VAQ) was administered during the second phase of fieldwork in those households in which thefemale who died was age 12-49. The VAQ was designed to collect as much information as possible on the causes of all female deaths, to inform the subsequent categorization of maternal deaths, and facilitate specific identification of abortion-related deaths. During the second phase of fieldwork, a longer household questionnaire was administered in the independent subsample of households, to identify eligible women age 15- 49 for the individual woman’s questionnaire and to obtain some background information on the socioeconomic status of these women. The individual questionnaire included the maternal mortality module, which allows for the calculation of direct estimates of pregnancy-related mortality rates and ratios based on the sibling history. The individual questionnaire also gathered information on abortions and miscarriages, the utilization of maternal health services and post-abortion care, women’s knowledge of the legality of abortion in Ghana, the services they have utilized for abortion and if not, the reasons they have not been able to access professional health care for abortions, the places that offer abortion-related care, the persons offering such services, and other related questions. During the design of these questionnaires, input was sought from a variety of organizations that are expected to use the resulting data. After preparation of the questionnaires in English, they were translated into three languages: Akan, Ga, and Ewe. Back translations into English were carried out by people other than the initial translators to verify the accuracy of the translations in the three languages to be used. All problems arising during the translations were resolved before the pretest. The translated questionnaires were pretested to detect any problems in the translations or the flow of the questionnaire, as well as to gauge the length of time required for interviews. GSS and GHS engaged 20 interviewers for approximately two weeks for the pretest (with proficiency in each of the local languages used in the survey). All the pretest interviewers were trained for two weeks. The pretest interviewing took about one week to complete, during which approximately 30 women were interviewed in each of the local languages. The pretest results were used to modify the survey instruments as necessary. All changes in the questionnaire after the pretest were agreed to by GSS, GHS, and Macro. GSS and GHS were responsible for producing a sufficient number of the various questionnaires for the main fieldwork. During the pretest and main survey training, experts in the areas of health and family planning were identified by GSS and GHS to provide guidance in the presentation of topics in their fields, as they relate to the GMHS questionnaires. Other technical documents that were finalized include: • Household listing manual, listing forms and cartographic materials; • Interviewer’s manual; • Supervisor’s manual; • Interviewer and Supervisor’s

State comparisons data for births, deaths, infant death, disease, abortion, median age, marriages, divorces, physicians, nurses, and health insurance coverage. Data include a national ranking.

Eurostat’s annual data collections on demographic and migration statistics are structured as follows:

• NOWCAST: Annual data collection on provisional monthly data on live births and deaths covering at least six months of the reference year (Article 4.3 of the Commission implementing regulation (EU) No 205/2014).
• DEMOBAL (Demographic balance): Annual data collection on provisional data on population, total live births and total deaths at national level (Article 4.1 of the Commission implementing regulation (EU) No 205/2014).
• POPSTAT (Population statistics): The most in-depth annual national and regional demographic and migration data collection. The data relate to populations, births, deaths, immigrants, emigrants, marriages and divorces, and is broken down into several categories (Article 3 of Regulation (EU) No 1260/2013 and Article 3 of Regulation (EC) No 862/2007).

The aim is to collect annual mandatory and voluntary demographic data from the national statistical institutes. Mandatory data are those defined by the legislation listed under ‘6.1. Institutional mandate - legal acts and other agreements’.

The completeness of the demographic data collected on a voluntary basis depends on the availability and completeness of information provided by the national statistical institutes. For more information on mandatory/voluntary data collection, see 6.1. Institutional mandate - legal acts and other agreements’.

The following statistics on live births are collected from the National Statistical Institutes:

• Live births by month of occurrence;
• Live births by mother's age, year of birth and by:
  • region (NUTS 2) of residence
  • region (NUTS 3) of residence
  • mother's country of birth
  • mother's country of citizenship
  • live-birth order
  • sex of the new-born
  • mother's legal marital status
  • employment status of the mother
  • mother's educational attainment (ISCED 2011);
• Live births by birth weight and duration of gestation;
• Legally induced abortions by mother's age and parity;
• Late fœtal deaths by mother's age.

Statistics on fertility: based on the different breakdowns of data on live births and on legally induced abortions received, Eurostat produces the following:

• Statistics available in the online table Population change - Demographic balance and crude rates at national level (demo_gind):
  • natural change of the population, crude birth rate;
• Statistics available in the online table Fertility indicators (demo_find):
  • the proportion of live births outside marriage
  • total fertility rate
  • the mean age of women at childbirth
  • the mean age of women at the birth of first / second / third / fourth and higher child
  • the median age of women at childbirth
  • the percentage of first / second / third / fourth and higher live births Fertility rates by age (demo_frate);
• Fertility rates by age and NUTS 2 region (demo_r_frate2);
• Total fertility rate by NUTS 3 region (demo_r_frate3);
• Statistics available in the online table Abortion indicators (demo_fabortind):
  • abortion rate
  • abortion ratio