Trends over 50 years with liberal abortion laws in the Nordic countries.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 02 01 2024
accepted: 04 06 2024
medline: 10 7 2024
pubmed: 10 7 2024
entrez: 10 7 2024
Statut: epublish

Résumé

During the 1970s the Nordic countries liberalized their abortion laws. We assessed epidemiological trends for induced abortion on all Nordic countries, considered legal similarities and diversities, effects of new medical innovations and changes in practical and legal provisions during the subsequent years. New legislation strengthened surveillance of induced abortion in all countries and mandated hospitals that performed abortions to report to national abortion registers. Published data from the Nordic abortion registers were considered and new comparative analyses done. The data cover complete national populations. After an increase in abortion rates during the first years following liberalization, the general abortion rates stabilized and even decreased in all Nordic countries, especially for women under 25 years. From the mid-1980s higher awareness about pregnancy termination led women to present at an earlier gestational age, which was accelerated by the introduction of medical abortion some years later. Most terminations (80-86%) are now done before the 9th gestational week in all countries, primarily by medical rather than surgical means. Introduction of routine ultrasound screening in pregnancy during the late 1980s, increased the number of 2nd trimester abortions on fetal anomaly indications without an overall increase in the proportion of 2nd relative to 1st trimester abortions. Further refinement of ultrasound screening and non-invasive prenatal diagnostic methods led to a slight increase in the proportion of early 2nd trimester abortions after the year 2000. Country-specific differences in abortion rates have remained stable over the 50 years of liberalized abortion laws.

Sections du résumé

BACKGROUND BACKGROUND
During the 1970s the Nordic countries liberalized their abortion laws.
OBJECTIVE OBJECTIVE
We assessed epidemiological trends for induced abortion on all Nordic countries, considered legal similarities and diversities, effects of new medical innovations and changes in practical and legal provisions during the subsequent years.
METHODS METHODS
New legislation strengthened surveillance of induced abortion in all countries and mandated hospitals that performed abortions to report to national abortion registers. Published data from the Nordic abortion registers were considered and new comparative analyses done. The data cover complete national populations.
RESULTS AND CONCLUSIONS CONCLUSIONS
After an increase in abortion rates during the first years following liberalization, the general abortion rates stabilized and even decreased in all Nordic countries, especially for women under 25 years. From the mid-1980s higher awareness about pregnancy termination led women to present at an earlier gestational age, which was accelerated by the introduction of medical abortion some years later. Most terminations (80-86%) are now done before the 9th gestational week in all countries, primarily by medical rather than surgical means. Introduction of routine ultrasound screening in pregnancy during the late 1980s, increased the number of 2nd trimester abortions on fetal anomaly indications without an overall increase in the proportion of 2nd relative to 1st trimester abortions. Further refinement of ultrasound screening and non-invasive prenatal diagnostic methods led to a slight increase in the proportion of early 2nd trimester abortions after the year 2000. Country-specific differences in abortion rates have remained stable over the 50 years of liberalized abortion laws.

Identifiants

pubmed: 38985688
doi: 10.1371/journal.pone.0305701
pii: PONE-D-23-43920
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0305701

Informations de copyright

Copyright: © 2024 Skjeldestad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Finn Egil Skjeldestad (FE)

Department of Community Medicine, Research Group Epidemiology of Chronic Diseases, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.

Mika Gissler (M)

Department of Knowledge Brokers, THL, Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Molecular Medicine and Surgery, Region Stockholm, Academic Primary Health Care Centre, Stockholm, Karolinska Institutet, Stockholm, Sweden.

Reynir Tómas Geirsson (RT)

University Department of Obstetrics and Gynecology, Women's Clinic, Landspitali University Hospital, Reykjavik, Iceland.
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Anna Heino (A)

Department of Knowledge Brokers, THL, Finnish Institute for Health and Welfare, Helsinki, Finland.

Hildur Björk Sigbjörnsdottir (HB)

Health Information Section, Directorate of Health, Reykjavik, Iceland.

Rupali Akerkar (R)

Devision of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.

Kristina Gemzell-Danielsson (K)

Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institute, and Karolinska University Hospital, Stockholm, Sweden.

Oskari Heikinheimo (O)

Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Mette Løkeland (M)

Devision of Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway.
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.

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