Kai Haldre


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    Majority of research about the protective and risk factors of repeated teenage pregnancy has been carried out in the US. Worldwide, there is more information available about subsequent adolescent deliveries than abortions. The main reason here is that the availability and quality of abortion statistics vary largely in countries. In many countries with restrictive laws abortion statistics hardly exist. Estonia is considered to be a country with liberal legislation and complete abortion data since 1992. From the same period, after regaining independence from Soviet occupation in 1991, Estonia has undergone major socio-economic changes including profound educational and health care reforms. According to the World Bank Analytical Classification of countries Estonia has turned from upper/lower income country in 1990-ies to high-income country since 2006.
    The objective of this presentation is to analyze trends in adolescent pregnancies in Estonia from 1992 until 2017 and the proportion of repeated pregnancies from 1996 until 2017.
    Methods. Data on abortions were obtained from the Estonian Medical Statistical Bureau (1992–1995) and the Estonian Abortion Registry (EAR, 1996–2017).

    The completion and return of an anonymous record card to the EAR for each abortion is obligatory for every institution licensed to perform pregnancy terminations. Data about births were obtained from the Estonian Medical Birth Registry, which was established in 1992. The number of women in the 15–19-year age group was obtained from the Statistical Office of Estonia.
    Results. The percentage of teenage mothers from all parturients was 14.6% in 1992 and 2.0% in 2017, the proportion of adolescents from all women terminating pregnancy was 11.4% in 1992 and 7.2% in 2017. During the same period teenage abortion and fertility rates have decreased 81.7% and 79.8% respectively. In 1996–2017 the average proportion of teenage abortion patients with repeat abortion has been 18%, over the years no clear increasing or decreasing trend can be observed (lowest 15.8% in 2005 and highest 22.3% in 1996), the same is true concerning delivery before the index abortion (average 16.1%, lowest 13.0% in 2015 and highest 20.4% in 1996).  In average, 8.4% of teenagers were multipara during 1996–2017 (lowest proportion - 6.0% - in 2005 and highest in 2015 - 11.8%).
    Conclusions. During the period of remarkable changes in the Estonian society and economic growth teenage fertility and abortion rates have decreased substantially and become a rather rare event. During the study period a little less than one fifth of teenage abortion patients have experienced previous delivery or abortion, around one tenth of teenage parturients are multipara. Thus the proportion of repeated pregnancies among adolescents has remained the same.