Repeat induced abortion in 30 Chinese provinces: A cross-sectional study

Objective: To report the proportion and determinants of repeat induced abortions in China. Methods: Cross-sectional data were collected of 79 954 women who received an induced abortion from 297 hospitals across 30 Chinese provinces in 2013, using a stratified cluster sampling design. Logistic and Poisson regression models were fitted to identify characteristics associated with repeat abortion. Putative factors included age, household registration (hukou) status, marital status, education, occupation, reproductive history, and current contraceptive practices. Results: Of all abortions, 65.2% were repeat induced abortions. The proportion of repeat abortions varied substantially across provinces, from 36.9% in Qinghai to 85% in Hubei. The strongest factors associated with repeat induced abortion were being older than 40 years (adjusted odds ratio [OR_adj] 7.0, 95% confidence interval [CI] 6.2–7.9), divorced or widowed (OR_adj 2.1, 95% CI 1.6–2.7), and using oral contraceptives (OR_adj 2.1, 95% CI 1.9–2.3). Conclusion: A high proportion of repeat induced abortion was observed across many Chinese provinces, highlighting the need to reduce the incidence of unwanted pregnancy. Several sociodemographic and clinical factors were found to be significantly associated with repeat abortions and should be considered in post-abortion family planning services.