Objective: To analyze the effect of changes in system of health and social care on reproductive health of women. In particular to analyze the changes in frequency of induced abortions as a basis for evaluation of changes in contraceptive use.
Design: Retrospective comparative epidemiological study.
Setting: Institute for the Care of Mother and Child, Praha 4--Podolí.
Methods: The database of the Czech Office of Health Statistics and Information was used. Besides comparison of absolute numbers of induced abortions we used international criteria "Abortion rate" and "Abortion ratio". These parameters were compared with maternal age, marital status, level of education, and number of children.
Results: Since the legislature on induced abortions came into effect till 1991 the annual variations of the number of induced abortions in the Czech Republic were inverse to changes in number of births due to current fertility. However, since then the number of abortions has been decreasing while the number of births was also decreasing. Using the abortion ratio as a measure, we were able to observe the decrease from 34.3 to 29.1% during 1993-1997, however the later value is still higher than in developed world. According to the selected social-demographic parameters of women we have seen the highest decrease of absolute number of abortions among married women, women with two children, and women with secondary education. According to the number of abortions per 1000 women of reproductive age there has also been decrease among married women, however also among women 15-19 year and among women with university education. The smallest decrease of abortion rate has been observed among single women.
Conclusions: In this part of the study we analyzed the decrease of induced abortions during 1993-1997 related to four selected social-demographic characteristics of women of reproductive age. Our results will be used for further analyses of relationship of contraception and induced abortions during the specified period. Such analysis is a subject of separate study.