Women are satisfied with legal abortion care in Mexico City, and the vast majority start using an effective contraceptive method afterward.
In 2007, elective first-trimester abortions were legalized in Mexico City. Abortions were initially provided at designated public hospitals; later the Mexico City Ministry of Health created three specialized health centers focused on providing abortion services. In addition to these public facilities offering abortions to Mexico City residents free of charge (and for a small fee to women from other parts of Mexico and the region), a number of private clinics in the city offer abortion services.
The legalization of first-trimester abortions in Mexico City was an important advance for the reproductive health and rights of women in the region. The Population Council examined the characteristics of women accessing legal abortions and their experiences with the services offered to help advocates and service providers reach even more women and improve their quality of care.
To determine the characteristics of women receiving legal abortions and evaluate the services they are offered, the Council (in collaboration with the Ministry of Health and the National Institute of Public Health) analyzed the clinical records of the more than 20,000 women who obtained abortions at one of the 15 designated hospital facilities during the first three years following legalization.
Of these women:
- Two-thirds (67%) already had one or more children
- 25% were aged 30 or older
- Nearly half (44%) were married or in a long-term relationship
- More than half (60%) had attended school for 10 or more years
- The vast majority (84%) identified as Catholic.
The Council also conducted in-depth interviews with 25 women obtaining abortions at one specialized public abortion clinic and two private facilities in 2008. Overall, women were satisfied with their experiences at both public and private clinics. They reported receiving adequate counseling and being treated with respect. Women experienced much shorter waiting times at the private clinics, and some praised the pre-abortion counseling session with a psychologist that a private clinic offered.
While intake forms do not note which contraceptive methods were used or how recently, 80% of women in the records analysis study reported some prior use of contraception, and 84% selected a contraceptive method following their abortion. The most commonly chosen method was the IUD, selected by about 40% of women. In the qualitative study, most respondents said they had not been using a contraceptive method at the time they became pregnant. Most (21 of 25) chose a method following their abortion, with the IUD again most commonly selected. To further explore women’s contraceptive use following an abortion, the Council is conducting a longitudinal study among women obtaining abortions at both public and private clinics. The study examines which methods women select and how long they continue with the method, their satisfaction with the method, and reasons for discontinuation among women who stop using a method.
The Council’s findings dispel some common misperceptions about women seeking abortions, such as that they are largely young, unmarried, childless, or non-religious. However, they also indicate that legal abortion services may not be reaching everyone who needs them. In particular, the finding that most women obtaining abortions have 10 or more years of schooling (compared with the national average of 8 years) suggests that the most disadvantaged rural and indigenous women may still face barriers to obtaining safe, legal abortions.
Among women who have obtained abortions, positive responses from women who used public-sector facilities indicate that the Mexico City Ministry of Health is providing recognizably high-quality services. The research also highlights areas for improvement, including long waiting times and the scarcity of facilities. Since the Council’s qualitative study was conducted, the Ministry has opened two additional specialized abortion clinics, and the majority of women obtaining legal abortion in the public health system are cared for in one of these health centers.