Is repeat abortion a public health problem among chinese adolescents? A cross-sectional survey in 30 provinces

The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing repeat abortions. The primary reason for the current unintended pregnancies was non-use of contraception (68%). Adolescents receiving abortions who had an increased risk of repeat abortions were those who had children (OR 2.57, 95% CI 1.80–3.67), those who resided in a middle-developed region (OR 1.81, 95% CI 1.30–2.50), those who resided in a relatively poor region (OR 2.40, 95% CI 1.78–3.23), and those who had used contraception during the 6 months preceding the survey (OR 1.38, 95% CI 1.12–1.71 for condom use). The occupation as a student was a protective factor for adolescents (OR 0.64, 95% CI 0.50–0.83). Adolescents should be offered equal access to FP to that of married women in China to reduce unintended pregnancies and repeat abortions. Correct and consistent contraception practice should be promoted.