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.

The rate of legal abortions in the United States has decreased over the last few decades. In 2022, there were around 19.9 legal abortions per 100 live births, whereas the rate was 34 abortions per 100 live births in the year 1990. Since the overturning of Roe v. Wade by the Supreme Court in 2022, states within the U.S. have the right to severely limit or completely ban abortion if they wish, meaning that access to such procedures varies significantly depending on the state or region. Abortion in the U.S. In 2022, there were over 613,000 legal abortions in the United States. Abortion rates in the U.S. are highest among women aged 25 to 29 years and more common among unmarried women than those who are married. In 2022, there were approximately 38 legal abortions per 100 live births among unmarried women compared to four abortions per 100 live births among women who were married.
Public opinion The issue of abortion has been and remains a divisive topic among the general public and continues to be a relevant political issue. As of May 2023, around 44 percent of the population was estimated to be pro-life, while 52 percent were pro-choice and three percent mixed or neither. However, this distribution has fluctuated over the years, with pro-lifers accounting for a larger percentage than pro-choicers as recently as 2019.

Abortion remains a controversial topic in the United States and has been an exceptionally political topic since the Supreme Court overturned Roe v. Wade in 2022. This ruling has allowed individual states to completely ban the procedure if they choose, which a number of states have since done. In 2022, the year of the overturning of Roe v. Wade, the highest rates of legal abortion in the United States were among women aged 25 to 29 years, with around **** abortions per 1,000 women. How many abortions are there in the United States each year? In 2022, there were an estimated ******* legal abortions in the United States. This was a decrease from the year before, and in general, the number of legal abortions per year in the U.S. has decreased since the late 1990s. The rate of abortion has also decreased significantly. In 1997, the rate of legal abortions per 100 live births was ****, but this had dropped to **** per 100 live births by the year 2022. At that time, the states with the highest rates of abortion were New Mexico, Illinois, and Kansas. Public opinion on abortion As of 20234, around ** percent of U.S. adults considered themselves pro-choice, while ** percent were pro-life. However, these numbers have fluctuated over the years, with a larger share of people identifying as pro-life just five years earlier. Nevertheless, a poll from 2024 indicated that only a small minority of U.S. adults want abortion to be illegal in all cases, with younger people more likely to support the legalization of abortion in any circumstance. Furthermore, surveys have shown that since the overturning of Roe v. Wade, U.S. adults have expressed being much more dissatisfied with abortion policy in the country, desiring less strict policy.

Abortion in the United States is still a contentious topic. In 2022, the leading state by number of legal abortions in the United States was Florida, which reported 82,581 abortions. In that year, New York reported 72.7 thousand abortions, followed by Illinois with almost 56.5 thousand. There were a total of almost 613,383 legal abortions in the United States in 2022.

Legal terminations of pregnancy. The total period abortion rate is the average number of abortions (NHS and private) that would occur per woman in an area, if women experienced the current age-specific abortion rates of that area throughout their childbearing ages. To reduce the number of unwanted pregnancies. Legacy unique identifier: P00609

Number of induced abortions, rates of induced abortions per 1,000 females of same age group, proportions of induced abortions across age groups, and ratios of induced abortions per 100 live births, by age group of patient, 1987 to 2000.

In 2022, the rate of abortion among adolescent women aged 19 years in the United States was around 12.4 per 1,000 population. Abortion in the United States remains a controversial and divisive subject. In 2022, the Supreme Court overturned Roe v. Wade, the historic court ruling that gave women the right to abortion. Now states are allowed to completely ban the procedure if they so choose. However, despite the ruling and subsequent abortion bans in many states, polls show the majority of U.S. adults still favor the legalization of abortion. How many abortions are there in the U.S. per year? In 2022, there were around 613,000 legal abortions in the United States. This was one of the lowest numbers recorded since the Roe v. Wade ruling in 1973. The rate of abortions per 100 live births in 2022 was 19.9, a significant decrease from a rate of 30.6 reported in 1997. The states with the highest rates of abortion in 2022 were New Mexico, Illinois, and Kansas, while Missouri and South Dakota had the lowest rates. Abortion among adolescents The rate of abortion among adolescent women in the United States aged 15 to 19 years has also decreased over the past decade. In 2013, there were around 8.2 abortions among adolescent women per 1,000 population. By the year 2022, this figure had dropped to 5.4 per 1,000 population. The majority of abortions among adolescents occur at week nine or less of gestation. The birth control pill is one of the safest and most effective ways to prevent unwanted pregnancy, but only around 23 percent of female high school students who were sexually active were using the pill in 2021.

Abortion statistics measure the number of induced abortions that occur in New Zealand hospitals or licensed abortion clinics.

Abortions in the Soviet Union became much more accessible under the Khrushchev administration in 1953, and the USSR's abortion rate subsequently developed into the highest in the world. The Soviet government did not begin releasing official statistical data until the 1970s, however it is believed that around six or seven million abortions were carried out each year in the 1950s and 1960s; a figure that remained fairly consistent until the late 1980s**. This high rate was, in-part, due to rapid urbanization and a desire for smaller families, as well as the lack of quality contraceptives produced by the Soviet government, and the widespread belief that abortion was safer than the side-effects of hormonal regulation via the pill. Relative to population size, there were between 97 and 106 abortions carried out per 1,000 women aged between 15 and 49 in the given years, which is roughly equal to one in ten women of childbearing age having an abortion each year (estimates for Russia alone suggest that this number was one in six in the 1960s). There were however regional disparities across the Soviet Union, as abortions were much more accessible and common in the European part of the country, and less available or socially acceptable in the Muslim-majority and rural regions of Asia. Abortion in the U.S. In the U.S. during this time, the abortion rate was much lower due to previous legal restrictions and lack of access, societal attitudes, and better access to contraceptives. Prior to 1973, abortions were either banned outright or only available under specific circumstances in all-but-four states. The Supreme Court case Roe v. Wade then saw the removal of most federal restrictions relating to abortion in the first trimester of pregnancy. This granted women across the country greater access to legal abortions; in 1975 there were over one million legal abortions performed in the U.S., and between 1.5 and 1.6 million in the 1980s. Proportional to population size, this equated to 29 abortions per 1,000 women aged between 15 and 45 in 1980, which is roughly equal to one in 34 women of childbearing age having an abortion in this year. Legacy During the decline and dissolution of the Soviet Union, the government began to promote the use of contraceptives, however the poor quality and supply of these reinforced former perceptions that they were more harmful than abortions. Additionally, medical institutions received much higher sums from the government when abortions were performed (relative to income from contraceptives), and these incentives delayed the drop in Russian and other post-Soviet states' abortion rates. While it is now generally accepted that contraception is safer than abortion, and awareness of the risks of infertility and maternal death has become more widespread, today, Soviet successor states have some of the highest abortion rates in the world by a considerable margin.

In the U.S., following the peak of almost 30 abortions per 1,000 women aged 15 to 44 in the 1980s, the abortion rate has gradually fallen with each decade, even dropping below the 1973 level in 2017. Although this is a side effect of improvements in contraception and education, a large part of this decline can be attributed to restricted access to abortion, particularly in rural and southern regions. While the majority of U.S. adults support Roe v. Wade, the Supreme Court overturned the ruling in June 2022, granting states the right to determine their own abortion laws.

Abortions: total period abortion rate, 11-49 years, annual, F

Legal terminations of pregnancy. The total period abortion rate is the average number of abortions (NHS and private) that would occur per woman in an area, if women experienced the current age-specific abortion rates of that area throughout their childbearing ages.

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.

The ethnic and racial distribution of legal abortions in the United States varies greatly by state. For example, in Idaho non-Hispanic white women accounted for 66 percent of all legal abortions in 2022, whereas only 19 percent of abortions in Mississippi were among white women. Since the Supreme Court overturned Roe v. Wade in 2022 many states, such as Mississippi, have made abortion illegal with limited exceptions. Which states have the most abortions? In 2022, the states with the highest total number of legal abortions were Florida, New York, and Illinois. That year, there were around 82,581 legal abortions in the state of Florida. Florida also had the fourth-highest rate of legal abortion per 100,000 women, with New Mexico reporting the highest rate. The states with the lowest rates of abortion that year were Missouri and South Dakota. Out-of-state abortions As many states have banned or restricted abortion since the overturning of Roe v. Wade, it is likely that more women will now have to travel out of state if they would like to receive an abortion. Even before the overturning of Roe v. Wade, a significant percentage of abortions in many states were performed on out-of-state residents. In 2022, around 69 percent of legal abortions in Kansas were performed on out-of-state residents, while out-of-state residents accounted for 62 percent of abortions in New Mexico. At that time, Illinois was the state with the highest total number of abortions performed on out-of-state residents, with around 16,849 such procedures.

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

A survey of women who obtained an abortion in the United States between June 2021 and July 2022 found that ** percent were Hispanic, while ** percent were white. This statistic shows the distribution of women in the U.S. who obtained an abortion from June 2021 to July 2022, by race/ethnicity.

The Ukraine Demographic and Health Survey (UDHS) is a nationally representative survey of 6,841 women age 15-49 and 3,178 men age 15-49. Survey fieldwork was conducted during the period July through November 2007. The UDHS was conducted by the Ukrainian Center for Social Reforms in close collaboration with the State Statistical Committee of Ukraine. The MEASURE DHS Project provided technical support for the survey. The U.S. Agency for International Development/Kyiv Regional Mission to Ukraine, Moldova, and Belarus provided funding. The survey is a nationally representative sample survey designed to provide information on population and health issues in Ukraine. The primary goal of the survey was to develop a single integrated set of demographic and health data for the population of the Ukraine. The UDHS was conducted from July to November 2007 by the Ukrainian Center for Social Reforms (UCSR) in close collaboration with the State Statistical Committee (SSC) of Ukraine, which provided organizational and methodological support. Macro International Inc. provided technical assistance for the survey through the MEASURE DHS project. USAID/Kyiv Regional Mission to Ukraine, Moldova and Belarus provided funding for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators. The 2007 UDHS collected national- and regional-level data on fertility and contraceptive use, maternal health, adult health and life style, infant and child mortality, tuberculosis, and HIV/AIDS and other sexually transmitted diseases. The survey obtained detailed information on these issues from women of reproductive age and, on certain topics, from men as well. The results of the 2007 UDHS are intended to provide the information needed to evaluate existing social programs and to design new strategies for improving the health of Ukrainians and health services for the people of Ukraine. The 2007 UDHS also contributes to the growing international database on demographic and health-related variables. MAIN RESULTS Fertility rates. A useful index of the level of fertility is the total fertility rate (TFR), which indicates the number of children a woman would have if she passed through the childbearing ages at the current age-specific fertility rates (ASFR). The TFR, estimated for the three-year period preceding the survey, is 1.2 children per woman. This is below replacement level. Contraception : Knowledge and ever use. Knowledge of contraception is widespread in Ukraine. Among married women, knowledge of at least one method is universal (99 percent). On average, married women reported knowledge of seven methods of contraception. Eighty-nine percent of married women have used a method of contraception at some time. Abortion rates. The use of abortion can be measured by the total abortion rate (TAR), which indicates the number of abortions a woman would have in her lifetime if she passed through her childbearing years at the current age-specific abortion rates. The UDHS estimate of the TAR indicates that a woman in Ukraine will have an average of 0.4 abortions during her lifetime. This rate is considerably lower than the comparable rate in the 1999 Ukraine Reproductive Health Survey (URHS) of 1.6. Despite this decline, among pregnancies ending in the three years preceding the survey, one in four pregnancies (25 percent) ended in an induced abortion. Antenatal care. Ukraine has a well-developed health system with an extensive infrastructure of facilities that provide maternal care services. Overall, the levels of antenatal care and delivery assistance are high. Virtually all mothers receive antenatal care from professional health providers (doctors, nurses, and midwives) with negligible differences between urban and rural areas. Seventy-five percent of pregnant women have six or more antenatal care visits; 27 percent have 15 or more ANC visits. The percentage is slightly higher in rural areas than in urban areas (78 percent compared with 73 percent). However, a smaller proportion of rural women than urban women have 15 or more antenatal care visits (23 percent and 29 percent, respectively). HIV/AIDS and other sexually transmitted infections : The currently low level of HIV infection in Ukraine provides a unique window of opportunity for early targeted interventions to prevent further spread of the disease. However, the increases in the cumulative incidence of HIV infection suggest that this window of opportunity is rapidly closing. Adult Health : The major causes of death in Ukraine are similar to those in industrialized countries (cardiovascular diseases, cancer, and accidents), but there is also a rising incidence of certain infectious diseases, such as multidrug-resistant tuberculosis. Women's status : Sixty-four percent of married women make decisions on their own about their own health care, 33 percent decide jointly with their husband/partner, and 1 percent say that their husband or someone else is the primary decisionmaker about the woman's own health care. Domestic Violence : Overall, 17 percent of women age 15-49 experienced some type of physical violence between age 15 and the time of the survey. Nine percent of all women experienced at least one episode of violence in the 12 months preceding the survey. One percent of the women said they had often been subjected to violent physical acts during the past year. Overall, the data indicate that husbands are the main perpetrators of physical violence against women. Human Trafficking : The UDHS collected information on respondents' awareness of human trafficking in Ukraine and, if applicable, knowledge about any household members who had been the victim of human trafficking during the three years preceding the survey. More than half (52 percent) of respondents to the household questionnaire reported that they had heard of a person experiencing this problem and 10 percent reported that they knew personally someone who had experienced human trafficking.

Abstract

Background: Unsafe abortion remains a significant cause of maternal morbidity and mortality in many African countries, including Kenya. In Kenya, abortion is legally restricted except when the life or health of a pregnant woman is in danger and in cases of rape or incest. The restrictions around abortion, pervasive stigma and negative attitudes of healthcare providers often increase the risks of unsafe abortion. Ten years ago, a study by the Ministry of Health, the African Population and Health Research Center (APHRC), and the Guttmacher Institute reported close to 464,690 induced abortions in 2012. Given the time that has passed since that study, and changes in the landscape of abortion in Kenya (e.g., the availability of medication abortion drugs, enactment of the 2017 Health Act that defined "trained providers" to include nurses and midwives, and the 2019 High Court ruling that reinstated the withdrawn Standards and guidelines for reduction of maternal mortality from unsafe abortion), policymakers and advocates in Kenya have raised the need for another national abortion incidence study. Objectives: To determine the incidence of induced abortions and the severity of abortion-related complications in Kenya. Methods: The proposed study will employ a quantitative cross-sectional design. The study will have four separate surveys: i) a nationally representative Health Facility Survey (HFS) to estimate the number of women who receive post-abortion care (PAC) following abortion complications, ii) a Knowledgeable Informants Survey (KIS) to collect information on the proportion of all women having abortions who receive facility-based treatment for abortion-related complications, iii) a Respondent-Driven Sampling survey (RDS) of women who have had an abortion to understand abortion incidence and safety, and iv) a Prospective Morbidity Survey (PMS) to provide the data necessary to describe characteristics of women receiving treatment for abortion complications, the severity of complications, the type of treatment received, and the delays in access to PAC. The PMS will also include a limited component involving clinical data abstraction from the medical charts/records of PAC clients. Utility of study: Evidence generated will contribute to a greater understanding of the incidence of induced abortions and the magnitude and severity of abortion-related complications. The evidence will support investment and decision-making toward addressing the contributors of unsafe abortions and unintended pregnancies, improving access to quality PAC services, and ultimately improving adolescent and maternal health in Kenya.

Geographic coverage

National coverage

Analysis unit

knowledgeable healthcare providers

Universe

Senior health provider, who is knowledgeable about the provision of PAC

Sampling procedure

The study population for the HFS is facilities that should theoretically offer PAC services based on the structure and functional operation of health facilities in Kenya. Health facility levels designated for PAC, according to the Kenya Essential Package of Health (KEPH), range from levels II to VI. These are also the facilities capable of offering normal delivery services to women. As of July 25, 2022, there were 13,931 operational and functional health facilities across Kenya from levels II to VI (capable of providing). Overall, there are six Level VI facilities and 47 Level 5 and county referral hospitals (these include 23 level V and 24 county referral hospitals) (We will include all Level V and VI facilities in the sample), 891 Level IV, 2225 Level III), and 10786 Level II (we will draw a proportionate sample of facilities within Levels II, III and IV). Altogether, we aim for a sample of 750 health facilities for the HFS component. We will divide Kenya into five regions for sampling purposes, following a previously used approach [50][51]. The emerging regions are 1) Coast and North Eastern, 2) Eastern, 3) Nairobi and Central, 4) Nyanza and Western, and 5) Rift Valley. Within selected facilities, respondents will be those most qualified to answer questions about PAC caseloads and the types of cases seen at the facility. Depending on the facility, these might be senior administrators, heads of the OBGYN ward, or heads of private clinics, including medical doctors, nurses, and midwives.

Sampling deviation

The initial sample was 766 facilities for the survey. There were several deviations from the sample,these included facilities that were not sampled but data was collected from them and others were sampled but data was not collected. we also had other facilities that were nonresponce due to the following reasons:facility closed down, facility does not exist, facility is non operational, facility does not offer post abortion care, insecurities reason and facility does not offer sexual reproductive health services.After all the adjustment the remaning sample that was used was 694

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire was written in english with a primary purpose of the HFS is to estimate the number of women who receive treatment in facilities for abortion-related complications. The HFS will be a statistically representative survey of all health facilities in Kenya classified as having the capacity to provide PAC services. In each selected health facility, a senior health provider, who is knowledgeable about the provision of PAC, is interviewed. Participants are asked whether their facility provides treatment for complications following induced or spontaneous abortions. If the facility provides treatment, they are asked the number of abortion patients (induced and spontaneous abortions (miscarriages), combined) treated in an average month and in the past month. Specifying these two periods aims to increase the likelihood of accurate recall and accounting for month-to-month variation, as there is seasonality to abortions. To produce an estimate for the year, these two numbers are averaged and multiplied by 12.

Cleaning operations

The software used was survey CTO for data collection which the datasets were directly downloaded from the surver itself to STATA and R Software

Response rate

The response rate was calculated in all the 5 regions against facility characteristics which included the facility ownership and facility level. The distribution was as follows: For Nairobi and Central we had 91.11, 81.82,80.00 for public, private for profit and private not for profit on the ownership side, for the Level of facility they had 84.62,91.30, 83.13, 83.33 and 66.67 for level 2,3,4,5 and 6 respectively. For Coast & North Eastern we had 100, 97.30 and 100 for public, private for profit and private not for profit on the ownership side, for the Level of facility they had 100,100, 97.78,100 for level 2,3,4 and 5 respectively. For Eastern we had 95.16, 94.74, 93.33 for public, private for profit and private not for profit on the ownership side, for the Level of facility they had 92.59, 100, 93.10,100 for level 2,3,4 and 5 respectively. For Nyanza & Western we had 100, 96.08,100 for public, private for profit and private not for profit on the ownership side, for the Level of facility they had 96, 100, 99.07, 100 for level 2,3,4 and 5 respectively. For Rift Valley we had 97.94, 95.83, 89.47 for public, private for profit and private not for profit on the ownership side, for the Level of facility they had 97.44, 93.55, 97.44, 93.33, 100 for level 2,3,4,5 and 6 respectively. The entries are pecentages.

Sampling error estimates

N/A

Despite its sociocultural and economic importance, dairy farming in Uruguay has not experienced a significant increase in cattle stocks in recent decades, partly due to low reproductive efficiency and a high risk of calf mortality. Neospora caninum is one of the primary abortive pathogens in dairy cattle; however, the economic losses caused by neosporosis in Uruguay remain uncalculated. This study aimed to assess the direct annual economic losses for the primary dairy sector (dairy farmers) due to abortions resulting from bovine neosporosis in the Uruguayan herd. An adjusted bioeconomic model was used to estimate the economic losses from early (second gestational trimester) or late (third gestational trimester) abortions, considering the Present Value (PV) of future production loss due to these abortions after deducting production costs (lost profits). The average economic loss per abortion due to neosporosis was US$ 868 (range 605–1,162) if the aborting cow remained in the herd without any additional abortions throughout its productive life and US$ 1,866 (range 782–2,825) if the cow was culled after the abortion. Individual losses varied based on the gestational stage and the age of the aborting cow, with the worst-case scenario being a late abortion in first-pregnancy heifers. The annual number of abortions due to neosporosis was estimated by considering the stock of cows and heifers of reproductive age at risk of abortion (pregnant) and the national seroprevalence of N. caninum in dairy herds, accounting for 90% vertical transmission and 10% horizontal transmission, with aborting seropositive dams representing 15 and 35%, respectively. The economic losses for the national herd were calculated by multiplying individual losses by the number of abortions across various simulated scenarios (second or third gestational trimester), adjusted according to sub-scenarios (with and without culling of the aborted cow). The estimated economic losses for the primary sector due to abortions occurring in 2018 totaled nearly US$ 12 million, which is attributed to the loss of offspring, delayed lactation, reduced productive life (fewer days in milk production/days of life), and early culling. These estimated losses reflect only the primary sector, excluding the secondary (industrial) and tertiary (services) sectors. In physical terms, abortions associated with neosporosis caused a total loss of 62 million L of milk, which is 3.3% of the volume industrialized annually in the country. The estimated losses did not account for profits lost by dairy farmers from beef production (i.e., breeding, fattening, and sale for slaughter of male calves from dairy breeds lost due to neosporosis) nor any indirect losses (for example, the loss of genetic merit, stunted growth of the national dairy stock, etc.). The characteristics of Uruguay’s grazing dairy production system require a tailored approach to estimating the economic impact of bovine diseases. This information can be used by farmers, veterinarians, and policymakers to evaluate the cost–benefit of implementing control and prevention strategies for bovine neosporosis at both the farm and national levels.

In 2022, there were around *** abortions carried out per 1,000 live births in Georgia, which was the highest rate of abortions in Europe in that year. Sweden and Bulgaria had *** and *** abortions per 1,000 live births, respectively. In Poland, where until very recently abortion was banned apart for some exceptional circumstances, only *** abortions per 1,000 births were conducted in 2022. Births in Europe Bulgaria had the youngest mean age of woman at childbirth in the EU in 2022 at 27.8 years. Romania and Moldova both had mean age for childbirths at just over 28 years of age. On the other hand, the average age at childbirth in Ireland, Spain, and Luxembourg was over 32 years of age. In every EU country, the fertility rate for a woman is under *** children, with some of the lowest rates found in Italy and Spain at ***. Contraception use In 2022, Norway had the highest share of women aged 15 to 49 years using any sort of contraception in Europe, with ** percent using. Czechia and Finland both had high levels of contraception use among women at **** and ** percent respectively. Just over a quarter of women use any form of contraception in Montenegro, the lowest share in Europe.

Abstract

The Turkmenistan Demographic and Health Survey (TDHS 2000) is the first national survey of maternal and child health in Turkmenistan. It is a nationally representative survey of 7,919 women of reproductive age (15-49). Survey fieldwork was conducted from June to September 2000.

The TDHS was sponsored by the Ministry of Health and Medical Industry (MOHMI) of the Republic of Turkmenistan. The Gurbansoltan Eje Clinical Research Center for Maternal and Child Health implemented the survey with technical assistance from the Demographic and Health Surveys Program. The National Institute of State Statistics and Information (Turkmenmelihasabat) conducted sampling activities for the survey. The U.S. Agency for InternationalDevelopment (USAID) provided funding for the survey. UNFPA/Turkmenistan assisted with survey coordination and logistic support.

The purpose of the survey was to develop a single integrated set of data for the government of Turkmenistan to use in planning effective policies and programs in the areas of health and nutrition. TDHS 2000 collected data on women's reproductive history, knowledge and use of contraceptive methods, breastfeeding practices and nutrition, vaccination coverage, and episodes of diseases among children under the age of five. Information on the knowledge of and attitudes toward HIV/AIDS, other sexually transmitted infections, and tuberculosis were also collected. The survey also included the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutrition status.

The TDHS 2000 also contributes to the growing international database on demographic and health-related variables.

MAIN RESULTS

The TDHS was designed to provide policymakers and program managers at MOHMI with detailed information on the health status of women and children. Some of the health indicators provided by the TDHS-such as fertility and infant mortality rates-are available from other sources. However, other survey indicators are not available from other sources-for example anemia status and nutritional indices for women and children. Thus, when taken together, the TDHS and existing data provide a more complete picture of health conditions in Turkmenistan than was previously available.

• Fertility rates. For the three years preceding the survey (mid-1997 to mid-2000), the estimated crude birth rate was 24.6 births per 1,000 population. This is higher than the MOHMI rate of 20.3 (the average of the annual rates for calendar years 1997 to 1999).

• Knowledge of contraceptive methods is widespread in Turkmenistan. Among currently married women, knowledge of at least one method is universal (99 percent). Married women have knowledge of, on average, six methods of contraception. Married women of all ages, all educational levels, all ethnic groups, and all regions of the country have a high level of knowledge of contraceptive methods.

• Abortion rates. For the three-year period preceding the survey (mid-1977 to mid2000), the total abortion rate for Turkmenistan was 0.9. The total abortion rate was higher in urban areas (1.0 abortions per woman) than in rural areas (0.7 abortions per woman). The highest levels of induced abortion were in Ashgabad City and the Lebap Region (1.1 and 1.2 abortions per woman, respectively).

• Antenatal care. Almost all respondents who gave birth in the last five years (98 percent) received antenatal care from either a doctor (81 percent) or a nurse/midwife (17 percent). In general, in Turkmenistan women seek antenatal care early and continue to receive care throughout their pregnancy. The median number of antenatal care visits is ten.

• Infant Mortality Rates In the TDHS, infant mortality data were collected based on the international definition of a live birth, i.e., a birth that shows any sign of life, irrespective of the gestational age at the time of delivery (United Nations, 1999). Because of the difference between the government data collection system and that of the TDHS in the definition of a live birth, the TDHS estimate of the infant mortality rate (IMR) would be expected to exceed the official government estimates.

• The TDHS was the first study of anemia in Turkmenistan based on a nationally representative sample of women and children. The survey measured the hemoglobin level of capillary blood.

• Acquired Immune deficiency Syndrome(Aids) Compared with other parts of the world, Turkmenistan has been relatively untouched by the AIDS epidemic. Currently, there is only one known case of AIDS and one other person known to be HIV positive in Turkmenistan. Almost no respondents reported that they knew an HIV-infected person or anyone who had died of AIDS.

• Knowledge. Awareness and knowledge ofHIV/AIDSislimited. Seventy-threepercentof respondents reported having heard of HIV/ AIDS, but only 50 percent believe that they could adoptbehavior patterns thatwould reduce their risk of contracting the disease. Further evidence of limited knowledge of HIV/AIDS was the fact that only 31 percent of respondents recognized that condom use is a risk-reducing behavior.

Geographic coverage

The Turkmenistan Demographic and Health Survey (TDHS) is a nationally representative survey. The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).

Analysis unit

• Household
• Women age 15-49

Universe

The population covered by the 2000 TKMDHS is defined as the universe of all women in the reproductive ages (i.e., women 15-49).

Kind of data

Sample survey data

Sampling procedure

SAMPLE DESIGN

The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).

The sample design was specified in terms of a target number of households in the six regions of Turkmenistan. The overall target number of households was set at 6,800. This number was allocated to the regions as follows: 800 to Ashgabad City, 1,000 to each of 4 regions (Akhal, Balkan, Lebap and Mary) and 2,000 to the remaining region (Dashoguz), for which more intensive analysis was desired.

The six regions of the country were further stratified into urban areas (cities, towns and small settlements) and rural areas (villages). The sampling frame consisted of the list of standard segments. Each standard segment was created on the basis of contiguous blocks that have clear boundaries-coinciding to the extent possible with census supervisor areas-and have between 200 and 500 households according to measures of size estimated by projection from to the 1995 Census data.

SAMPLE SELECTION

The sample was designed as a two-stage probability sample. Within regions the sample was to be self-weighting. The first stage involved the selection of standard segments (PSUs) by systematic sampling with probability proportional to size. This resulted in the selection of 231 standard segments:118 in urban areas and 113 in rural areas. A household listing operation was conducted in each selected standard segment. In the second stage, households were selected with probability proportional to the inverse of the first stage selection probability. On average, the number of households selected per standard segment was 28.

Since the sample for each of the six survey regions was self-weighting, the sampling fraction for each region was an important design parameter. The sampling fractions were estimated with projected census figures. The weighting factors for the six survey regions are inversely proportional to the sampling fractions.

SAMPLE IMPLEMENTATION

Implementation of the sample design resulted in the selection of 6,850 households. The data on household membership and age collected in the Household Questionnaire identified 8,250 women eligible for the Women's Questionnaire (i.e., women age 15-49 who were usual household members or who stayed in the household the night before the interviewer's visit).

From the 6,850 selected households, 6,391 were identified as current households and household interviews were completed in 6,302. This yields a household response rate of 98.6 percent. Of the 8,250 women who were eligible respondents, a total of 7,919 were interviewed. This yields an eligible woman response rate of 96.0 percent.

The overall response rate (94.7 percent) is the product of the household response rate and the eligible woman response rate. The overall response rate varies by region from 85.6 percent in Ashgabad City to 97.4 percent in the Balkan Region.

Mode of data collection

Face-to-face

Research instrument

Two questionnaires were used for TDHS 2000: a) the Household Questionnaire and b) Women's Questionnaire. These questionnaires were based on the model survey instruments developed for the MEASURE DHS+ project and were adapted to the data needs of Turkmenistan during consultations with specialists in the area of reproductive health and child health and nutrition. The questionnaires were developed at first in English and then translated into Russian and Turkmen. A pretest was conducted in April 2000. Based on the pretest, the questionnaires were revised and finalized.

a) The Household Questionnaire was used to enumerate all usual members and visitors in a sample household and to collect information related to the socioeconomic status of the household. In the first part of the Household Questionnaire, information was

Just over 222,000 abortions were carried out in France in 2008 and 2009. With 15 IVGs per 1,000 women, France is on the European average.Several sources can currently be used for annual IVG monitoring: pregnancy interruption bulletins (BIGs), which are required to be filled in by law, the annual statistics of health facilities (AHS) and data from the Medicalised Information Systems Programme (PMSI).The 2007 DREES survey of 11,500 women using abortion provides information on establishments and professionals practicing IVG and to question women about their management, trajectory and contraception in order to better understand the use of IVG.The health barometer of the National Institute of Prevention and Health Education (INPES), carried out every five years, allows to obtain IVG and IVG data.