Around 40% of pregnancies worldwide are unintended and a half of those are terminated. Yet, few international comparisons of unintended pregnancy resolution (choosing birth or abortion) exist. This study analysed how parous women’s pregnancy intentions and abortion decisions are associated with their reproductive histories and country contexts using twelve Demographic and Health Surveys representing four context groups: post-Soviet/communist and Asian countries with liberal abortion legislation, and Asian and Latin American countries with restrictive abortion legislation. Similarities were found across contexts: preference to have children of both sexes, space births, stop childbearing after reaching desired family size and an increased likelihood of unintended pregnancy when using less-effective contraceptive methods versus none. Contextual factors most clearly associated with reports of unintended pregnancy resolution were type of abortion legislation and living in post-Soviet/communist contexts. Women’s propensity to report abortions and unintended pregnancy varied by context and the decision-making processes for pregnancy versus fertility management were different.

The termination of unwanted pregnancies is a growing health-related issue around the world. This study used the 2017 Ghana Maternal Health Survey to examine the factors associated with the prevalence of induced abortion in Ghana. The study sample included 18,116 women of reproductive age who had a pregnancy in the 5 years preceding the survey. A multivariate logistic regression technique was applied. The prevalence of induced abortion was higher among women aged 25–34 years, those who had secondary-level education, those living in urban areas and in the Ashanti region, those of Akan ethnicity and those belonging to non-Catholic Christian denominations. Moreover, the prevalence was higher among single women, those who had no children, those who started sexual intercourse before the age of 18, those who were currently using a contraceptive, those exposed to media and those who knew about the legality of abortion. The multivariate analysis found that education, place and region of residence, marital status, ethnicity, current contraceptive use, religion, age at sexual debut, media exposure and knowledge about abortion legality were all significant predictors of induced abortion among women in Ghana. The study findings support a call for action to strengthen family planning services and educational programmes on induced abortion in Ghana to reach the target groups identified.

Women tend to under-report or misreport their abortion experiences, mainly because abortion is considered a sensitive issue for cultural, religious, political or other reasons in many countries across the world. Turkey, where induced abortion is an increasingly sensitive issue due to intense statements against induced abortion on religious grounds by influential politicians, and a hidden agenda to prohibit the practice, especially in public health facilities, in recent years, is no exception. This study focused on the increase in level of misreporting of induced abortion in Turkey and its link to social desirability bias using pooled data from 1993 and 2013 Turkish Demographic and Health Surveys. A probabilistic classification model was used to classify women’s reported abortions. The findings confirmed that the level of misreporting of induced abortions has increased from 18% to 53% among all terminated pregnancies over the period 1993–2013 in Turkey. This marked increase, especially among women in the lower socioeconomic sections of society, may be largely associated with the prevailing political environment, and increase in social stigmatization against induced abortion in Turkey over recent decades.