Abortion Incidence Estimation

Estimates of abortion incidence are critical for reproductive health programming. Incidence data help to:

  • Document the prevalence of unintended pregnancies
  • Understand trends in abortion over time
  • Monitor progress toward the improvement of maternal health
  • Highlight gaps in the provision of contraceptive services
  • Aid governments in designing programs to effectively reduce unsafe abortion

There are many approaches to estimating abortion incidence. These fall into two main categories:

Direct methods involve collecting information directly from people seeking or providing abortion services.

Indirect methods are generally used where abortion is illegal or criminalized and assess abortion incidence by gathering information from health facility records, key informants or social networks.

Direct Methods for Estimating Abortion Incidence

  • Official health system statistics: These data are collected directly by health facilities. In Sub-Saharan Africa, such data are often nonexistent or, where they are available, may be of poor quality due to incomplete or inaccurate records.
  • Medical records: Medical records are a written account of a person’s health and medical treatment history. In Sub-Saharan Africa, such data are often nonexistent or, where they are available, may be of poor quality due to incomplete or inaccurate records.
  • Community-based surveys: Data are collected from a sample of women in the community of interest regarding their experience with pregnancies they sought to terminate.

Estimating Abortion Incidence Using the Abortion Incidence Complications Method

  • Abortion incidence complications method (AICM): The AICM is one of the most commonly used indirect approaches for estimating the incidence of induced abortion. It is used in settings where abortion is illegal or restricted or where it is broadly permitted but safe abortion may not be accessible. Estimates are based on the number of women treated in medical facilities for abortion complications using a nationally representative survey of health facilities and purposive sample of knowledgeable informant surveys. Originally developed in the early 1990s, the AICM method has been used in more than 25 countries.
  • Modified abortion incidence complications method (modified AICM): A modification in which the proportion that treated complications represent of all abortions is estimated through a community-based survey of women rather than a knowledgeable informants survey.

Abortion Incidence Estimation Methods Currently Under Development

While the AICM is a widely accepted method for measuring abortion incidence, it does have some drawbacks and limitations. In response, researchers have been working to develop new abortion estimation methods. While none of them have been shown to produce accurate estimates, researchers are working to improve how they work. These include:

  • List experiment
  • Confidant method
  • Random response technique

Find toolkit Resources on Abortion Incidence Estimation