The impact of a liberalisation law on legally induced abortion hospitalisations
Manuel Gonçalves-Pinho2 ,3, João V.Santos2 ,3, Antónia Costa1 ,4, Altamiro Costa-Pereira2 ,3, Alberto Freitas2
1Obstetrics and Gynecology Department, Hospital São João, Porto, Portugal, 2Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal, 3Centre for Health Technology and Services Research (CINTESIS), Porto, Portugal, 4Department of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal
Objectives: Legally induced abortion (LIA) for maternal option without /maternal pathology (MOLIA) was liberalised in Portugal in 2007. The aim of this paper was to study the impact of the liberalisation of abortion by maternal request on total LIA-related hospitalisation trends.
Method: We considered hospitalisations of legally induced abortion (ICD-9-CM codes 635.x) with discharges from 2000 to 2014. Data was obtained from a Portuguese administrative database, which contains all registered public hospitalisations in mainland Portugal. Hospitalisations per abortion were calculated by dividing the number of LIA hospitalisation by the number of LIA. Mean ages, number of hospitalisations per age group, complications, admission type and length of stay were also analysed.
Results: Hospitalisations rose during the study period. Since the liberalisation law was passed there was a significant decrease in the number of hospitalisations per abortion: from 1.07 in 2000 to 0.11 in 2014 (p < 0.001). Furthermore, the mean age remained stable since liberalisation (30.8 years before 2007 and 40.0 after). Abortion-related hospitalisations are more frequent in women aged 25-39. A significant decrease from the emergency to the scheduled type of admission occurred from 2000 to 2014 (from 83.5% to 56.7% of emergency admissions) (p < 0.001). Complications remained stable and delayed or excessive haemorrhage was the most frequent (4.6%) (p = 0.07).
Conclusions: Since the liberalisation, hospitalisations per abortion have decreased, reflecting the major impact that the liberalisation of MOLIA had on abortions trends nationwide. LIA-related hospitalisations are more frequent in women aged between 25-39 years old. This study shows the impact that MOLIA liberalisation law can bring to abortion and to hospitalisation trends.