Repeat induced abortions in Georgia, characteristics of women with multiple pregnancy terminations: secondary analysis of the Reproductive Health Survey 2010



      To examine the multi-faceted characteristics of women with repeat induced abortions and assess post-abortion family planning service provision in Georgia.

      Study design

      We performed secondary analysis of the data from the Georgian Reproductive Health Survey 2010. A logistic regression model was used to assess the socio-demographic and behavioral factors, contraceptive practices in relation to repeat induced abortions for 2203 women of reproductive age with at least one induced abortion. The Chi-Square test was used to evaluate provision of post-abortion family planning services.


      Among the targeted women, 70% (n = 1539) had repeat induced abortions. The odds of terminating pregnancy raised exponentially with age (OR 3.12, 95% CI: 2.11–4.61), number of complete pregnancies (3 vs. 0–1 complete pregnancies: OR 3.25, 95% CI: 2.36–4.48) and lower education (OR 1.38, 95% CI: 1.10–1.73). The current use of contraception had a protective effect on the occurrence of repeat induced abortions (OR 0.69, 95% CI: 0.53–0.89 for modern and OR 0.68, 95% CI: 0.50–0.92 for traditional methods).
      The contraceptive counseling and family planning method was provided only to 32% and 6% of post-abortion women, respectively before discharge from the clinic. Repeat induced abortions were found to be significantly more common (P < 0.05) among women who did not receive any post-abortion contraceptive at the site of care (n = 1627/1929) compared to those who left the abortion facility with family planning method (n = 94/125).


      Low education, higher age, high parity and non-usage of contraceptives carry an increased risk of repeat induced abortions. Post-abortion family planning service delivery is limited in Georgia. Mandating provision of universal post-abortion contraception at the sites of care has a potential to reduce repeat induced abortions and should become a standard of practice for all clinics providing abortion services in Georgia.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Avdeev A.
        • Blum A.
        • Troitskaya I.
        The history of abortion statistics in Russia and the USSR from 1900 to 1991.
        Population: Engl. Sel. 1995; 7: 39-66
        • Serbanescu F.
        • Morris L.
        • Nutsubidze N.
        • Imnadze P.
        Womens Reproductive Health Survey Georgia 1999–2000.
        2000 (Final report)
        • Bustashvili M.
        • Kandelaki G.
        • Sturua L.
        • et al.
        Reproductive Health Survey Georgia.
        2010 (Final report)
        • Brown J.S.
        • Adera T.
        • Masho S.W.
        Previous abortion and the risk of low birth weight and preterm births.
        J Epidemiol Community Health. 2008; 62: 16
        • Infante-Rivard C.
        • Gauthier R.
        Induced abortion as a risk factor for subsequent fetal loss.
        Epidemiology. 1996; 7: 540
        • Parazzini F.
        • Ferraroni M.
        • Tozzi L.
        • Ricci E.
        Induced abortions and risk of ectopic pregnancy.
        Hum Reprod. 1995; 10: 1841-1844
        • Jones R.K.
        • Singh S.
        • Finer L.B.
        • Frohwirth L.F.
        Repeat abortion in the United States. Occasional Report No. 29.
        • Fisher W.A.
        Characteristics of women undergoing repeat induced abortion.
        CMAJ. 2005; 172: 637
        • Saint John H.
        • Critchley H.
        • Glasier A.
        Can we identify women at risk of more than one termination of pregnancy.
        Contraception. 2005; 71: 31
        • Heikinheimo O.
        • Gissler M.
        • Suhonen S.
        Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion.
        Contraception. 2008; 78: 149
        • Prager S.W.
        • Steinauer J.E.
        • Foster D.G.
        • Darney P.D.
        • Drey E.A.
        Risk factors for repeat elective abortion.
        Am J Obstet Gynecol. 2007; 197 (e1–e6): 575
        • Makenzius M.
        • Tydén T.
        • Darj E.
        • Larsson M.
        Repeat induced abortion—a matter of individual behaviour or societal factors? A cross-sectional study among Swedish women.
        Eur J Contracept Reprod Health Care. 2011; 16: 369-377
        • Citernesi A.
        • Dubini V.
        • Uglietti A.
        • Elena Ricci E.
        • Cipriani S.
        • Parazzini F.
        Intimate partner violence and repeat induced abortion in Italy: a cross sectional study.
        Eur J Contracept Reprod Health Care. 2015; 20: 344-349
        • Westfall J.M.
        • Kallail K.J.
        Repeat abortion and use of primary care health services.
        Fam Plan Perspect. 1995; 27: 162
        • Picavet C.
        • Goenee M.
        • Wijsen C.
        Characteristics of women who have repeat abortions in the Netherlands.
        Eur J Contracept Reprod Health Care. 2013; 18: 327-334
        • Keenan K.
        • Grundy E.
        • Kenward M.G.
        • Leon D.A.
        Women’s risk of repeat abortions is strongly associated with slcohol consumption: a longitudinal analysis of a Russian National Panel Study, 1994–2009.
        PLoS One. 2014; 9: e90356
        • Millar W.J.
        • Wadhera S.
        • Henshaw S.K.
        Repeat abortions in Canada, 1975–1993.
        Fam Plan Perspect. 1997; 29: 20-24
        • Kozinszky Z.
        • Devosa I.
        • Sikovanyecz J.
        • et al.
        Predictive model of repeat induced abortion in Hungary.
        Cent Eur J Med. 2011; 6: 701
        • Thapa S.
        • Neupane S.
        Risk factors for repeat abortion in Nepal.
        Int J Gynaecol Obstet. 2013; 120: 32
        • Mhamdi El S.
        • Salah A.B.
        • Bouanene I.
        • et al.
        Obstetric and psychological characteristics of women seeking multiple abortions in the region of Monastir (Tunisia): results of a cross-sectional design.
        BMC Womens Health. 2015; 15: 40
        • Bajos N.
        • Moreau C.
        • Prioux F.
        Increase of repeat abortion in France: from contraceptive issues to postponement of childbearing age.
        Rev Epidemiol Sante Publique. 2013; 61: 291-298
        • McCall S.J.
        • Flett G.
        • Okpo E.
        • Bhattacharya S.
        Who has a repeat abortion? Identifying women at risk of repeated terminations of pregnancy: analysis of routinely collected health care data.
        J Fam Plan Reprod Health Care. 2016; 42: 133-142
        • Tripney J.
        • Bird K.S.
        • Kwan I.
        The impact of post-abortion care family planning counselling and services in low-income countries: a systematic review of the evidence.
        University Of London, Institute of Education, Social Science Research Unit, EPPI Report, 2011
        • Zhu J.L.
        • Zhang W.
        • Cheng Y.
        • et al.
        Impact of post-abortion family planning services on contraceptive use and abortion rate among young women in China: a cluster randomized trial.
        Eur J Contracept Reprod Health Care. 2009; 14: 46-54