Abortion Research in Latin America

Author(s): Santiago Gaslonde Sainz

Source: Studies in Family Planning, Vol. 7, No. 8 (Aug., 1976), pp. 211-217
Published by: Population Council
Stable URL: http://www.jstor.org/stable/1965156
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Studies in Family Planning

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Abortion Research in Latin America
SANTIAGO GASLONDE SAINZ

The incidence of induced abortion in Latin America iL in-
creasing even though it is illegal in most countries in the re-
gion. The few countries that do allow abortion permit it only
in special, limited situations. Consequently, abortions are
often carried out under unsafe circumstances that endanger
the health and life of the woman. This contributes to maternal
mortality, and it also results in a high use of obstetrical and
gynecological services and expends human and material re-
sources that are needed for other health areas.
All family planning programs in the region, whether official
or private, have public health objectives aimed primarily at
reducing the practice of abortion. In order to plan preventive
programs, and particularly, in order to be able to evaluate
the effectiveness of such programs in achieving their goals,
it is especially important to know the scope and nature of
the problem.
that they have had abortions, and the effect of preventive
measures (family planning programs) on its incidence.
Problems and issues in the use of data from such surveys
are discussed below, and findings from some of the major
studies are presented.
Problems in Abortion Research
Comparisons of the various studies and interpretations of
the findings are hampered by differences in definitions, cri-
teria, and methodology used and by misunderstandings of
what the data represent. These main problem areas are dis-
cussed here in an attempt to foster wiser use of past survey
data and better design of future studies.
COMPARABILITY OF STUDIES

The issue of comparability of studies is a problem common

Research Approaches
to most research carried out by different organizations in dif-
ferent countries at different times. In these Latin American
HOSPITAL STUDIES studies, for example, there is a good deal of variation in the
choice of target populations. Some studies cover only married
A good deal of research on abortion has been carried out
or cohabiting women; others include widowed, separated, or
in recent years in Latin American countries. Most of this
divorced women and omit only the never-married; and some
research has taken place in hospital settings among selected
studies address themselves to all women regardless of marital
samples of women hospitalized for complications of abortion.
status. Some interviewers question couples, including the
From their clinical histories and from death certificates, re-
husband or male partner in their studies.
searchers have studied the cause (spontaneous or induced)
Similar differences are found with respect to age. Women
of abortions, the complications and consequences, the costs
interviewed in the studies cited in the Appendix fall into a
involved, and the part induced abortion plays in maternal
variety of age ranges, from as wide as 15-49 to as narrow
mortality. Using this information, legal, medical-legal, psy-
as 20-40. Age breakdowns use categories of 5, 10, or even
chological, and social aspects of abortion practices have also
15 years, which confounds comparison even further.
been investigated.
The methodology used in the collection of abortion data
While some of these studies are of particular interest to
in surveys is usually retrospective, investigating the total or
health planners, for example the study by Plaza and Briones
recent past of the woman. Some of the research, however,
(1963) on the costs of hospitalization of women admitted after
is prospective, in which monthly or quarterly visits were paid
abortions, they are not included in this report because such
to the women in the sample in order to collect ongoing infor-
samples are preselected for women who have had abortions,
mation. Most surveys use measures of the cumulative inci-
and the findings cannot be generalized to other women.
dence of abortion instead of annual rates, grouping together
both distant and recent events so that it becomes difficult
SURVEY RESEARCH or impossible to detect trends over time. Finally, some studies
separate induced abortions from spontaneous abortions while
Since 1959-60, when the first fertility survey on the Latin
others combine the two into one category.
American continent' was conducted by the United Nations
Latin American Demographic Center (CELADE) in Santiago,
Chile, an increasing number of epidemiological studies have DEFINITION OF ABORTION
collected data on abortion, either in conjunction with other
The definition of "abortion" used can be crucial to the
fertility information or as the sole topic of concern. These
comparability of studies. Tietze and Murstein's (1975) over-
surveys have focused on the geographical and historical inci-
view of international data on induced abortion omits data
dence of abortion, the characteristics of women who report
from Latin America. The authors explain, "While a number
of Latin American authors have tried to quantify the inci-
'Some fertility surveys had been conducted prior to this in Puerto Rico. dence [of illegal abortion], the results of their studies have

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 not been included in this report because they are not compara-
ble with data for other countries. Although in some of these
surveys attempts were made to separate induced abortions
from those reported as spontaneous, the validity of the-se data
is doubtful" (p. 16).
We cannot avoid admitting that they are right, even though
the criticism might apply to some of this author's own work.
In Latin American investigations that attempted to separate
spontaneous abortions from induced abortions, the number
of induced abortions was seriously underreported. The find-
ings were not even consistent with hospital data on cases
of complications from induced abortions. Such medical evi-
dence leaves little room for doubt, even though the woman
herself may deny that the abortion was induced.
In most studies, only fetal "losses" (perdidas) have been
recorded, with no attempt made to distinguish between spon-
taneous and induced abortion.2 The research has been carried
out in this way for reasons that investigators (this author
among them) find valid in the Latin American setting, where
it is quite unrealistic to believe that women who have induced
an abortion will admit to this in an interview. As many obste-
tricians and gynecologists well know, often women hospi-
talized for treatment of complications of an abortion will deny
that it was induced, even when there is incontrovertible proof
(such as a piece of the probe still in the uterus or injuries
to the woman or fetus). Such a woman does not trust her
physician to keep a secret, and she would have even less
confidence in the word of a stranger who comes to her home
for an interview.
In an environment where the combined weight of tradition,
prejudice, religion, the low status of women, the law, and
other factors that influence and create moral and legal sanc-
tions against induced abortion encourages only secrecy, pre-
tense, and lying, one can hardly expect the statements of
the women interviewed about induced abortion to reflect, or
even approach, the truth. The exception may be women living
in areas where induced abortion, although not legal, is an
accepted fact of life and is viewed with indifference by public
authorities. However, where women do not dare to tell the
truth about this subject, many of them will tell half-truths
and call induced abortions "losses" if they are offered the
chance. A loss signifies something spontaneous or involuntary
and is therefore not morally or legally sanctionable. It can
be reported without risk. If this opportunity is not given to
the woman, however, she will usually say nothing about in-
duced abortions and, if pressured, may refuse to continue
the interview. By asking about losses and not abortions, the
investigator is likely to obtain more reliable total abortion
figures.
After estimating the percentage of spontaneous abortions
in all pregnancies, it is possible to arrive at an estimate of
the number of induced abortions by subtraction. The problem
lies in determining this arbitrary percentage. Authors differ
greatly as to how they think this should be done (see French
and Bierman, 1952; UN Population Division, 1954; and World
Health Organization, 1970). The percentage of spontaneous
abortions in all pregnancies can differ from country to
country, by social class, ethnic group, and by age and parity.
It is therefore rather difficult to settle on a measurement for
the incidence of spontaneous abortions among all pregnancies
so that this figure reflects the true state of affairs in the area
2The term perdidas ordinarily includes stillbirths.
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under investigation. The exact figure used in the adjustment
is, however, of relatively little importance. What is crucial
is always to use the same proportion for the whole country,
whether making regional comparisons between different
groups of women at one point in time or the same group
of women over a period of time. If this is done, the margin
of error of the measurement tends, with successive compari-
sons, to be cancelled out, as is true with any measuring instru-
ment. In any case, the error will probably be smaller than
that of the investigator who insists on separate survey data
for spontaneous and induced abortions.
From the public health point of view, however, the distinc-
tion between spontaneous and induced abortion remains an
important one. Whereas in both cases patients with complica-
tions are hospitalized (it is not known what proportion of
cases do require hospitalization), induced abortions tend to
present more serious complications than spontaneous abor-
tions and therefore cost more in terms of bed-days, staff time,
antibiotics, blood transfusions, and so forth. Abortion pre-
vention in the two cases is rooted in different approaches:
prevention of spontaneous abortion is fundamentally a medi-
cal matter, while prevention of induced abortion is basically
a social matter (that is, if we consider family planning a social
and not a strictly medical issue).
In general, this author believes that making a distinction
between the two types of abortion is not advisable in the
study of abortion as a social phenomenon under current con-
ditions in most countries of Latin America. The distinction
is important, however, in the context of prevention and treat-
ment, and it should be made in the study of abortions requir-
ing hospitalization where more reliable data can be obtained.
Better still would be a combination of the two types of stud-
ies.
EVALUATION OF UNDERREPORTING
Most surveys of induced abortion are retrospective in na-
ture. The measures used are the proportion of abortions
among all pregnancies or the rate of abortions to women inter-
viewed about their total fertility history or a specific period
of their history. Not only is there always a high degree of
distortion present when such an approach is used, but the
results do not give the current incidence of abortion or the
incidence at any point in the past, although they may show
trends in the level of abortion over time. In reporting her
history, a respondent is most likely to forget abortions in the
distant past, somewhat less likely to forget stillbirths, and
least likely to forget live births, particularly if the offspring
are still alive at the time of the interview. Thus, the number
of pregnancies terminated in abortion, and as a result the
proportion of pregnancies terminated in abortion, appear very
low and often do not even reach the level one would confi-
dently predict for spontaneous abortions. This is an effect
in addition to the intentional misreporting of pregnancies and
outcomes.
If we assume little fluctuation in the extent of underreport-
ing at any given time or place, it becomes possible to identify
by age, marital status, socioeconomic or educational level,
and parity, those groups of women who are at greatest risk
of abortion. These women can then become the prime target
for any preventive action contemplated.
The issue of underreporting is more problematic, however,
when examining trends over time. For example, events in
 TABLE 1 Annual changes in pregnancy rates, proportions of pregnancies ending in
abortion, and abortion rates in four major Latin American cities during the late 1960s

Ages 20-34 Ages 35-44

Pregnancies Abortions Abortions Pregnancies Abortions Abortions

per 1,000 per 1,000 per 1,000 per 1,000 per 1,000 per 1,000
City and years women pregnancies women women pregnancies women

A. Actual rates and proportions

Bogota
1963-66 209 124 25 70 135 9
1967 161 138 22 76 240 18
Lima
1965-68 232 108 25 106 191 20
1969 224 214 48 63 250 16
Panama City
1963-66 227 163 37 44 260 11
1967 204 163 33 53 438 23
Buenos Aires
1964-67 142 195 28 42 353 15
1968 153 160 25 52 316 16

B. Annual percentage changea

Bogota -9.2 4.5 - 4.8 3.4 31.1 40.0
Lima -1.4 39.2 36.8 -16.2 12.4 - 8.0
Panama City -4.0 0 - 4.3 8.2 27.4 43.6
Buenos Aires 3.1 - 7.2 - 4.3 9.5 - 4.2 2.7

aCalculated as annual change in the 2.5 year span between the earlier four-year period and the middle of the
latter year.
SOURCE: Gaslonde (1973).

the distant past are more often forgotten than recent ones. INTERPRETATION OF SUMMARY MEASURES
The sample size diminishes the further back in time one goes.
Even when one considers the summary measures of abor-
Women of childbearing age at the time of the survey may
tions per 1,000 pregnancies or abortions per 1,000 women,
have been children themselves ten years earlier. On the other
there is room for disagreement in interpretation.3 The proba-
hand, there may be some gains resulting from greater honesty
bility that a woman will abort in any given year is the product
of responses about distant events. Some investigators think
of two probabilities-the probability of becoming pregnant
that women are more inclined to tell the truth about past abor-
multiplied by the probability of aborting once she is pregnant
tions than about recent incidents because the "blame"-and
(as measured by the proportion of abortions among pregnan-
therefore the sanction-for abortions that occurred long ago
cies).
remains buried in the past. Some scholars argue that young
women are now less inhibited about discussing their abortions If we let P = pregnancies observed during the year
than older generations were and that their greater candor has A = abortions undergone in the same year
created a false impression that the incidence of abortion has W = women interviewed
risen recently. However, in the Latin American Studies Pro- pP = probability of becoming pregnant =
gram (PEAL) surveys conducted by CELADE in Bogota, P/W
Buenos Aires, Lima, and Panama City during the late 1960s pAP= probability of aborting a pregnancy =
(Gaslonde, 1973), both younger (20-34) and older (35-44) A/P
women reported increasing proportions of pregnancies ending pA probability a woman will abort = A/W
in abortion except in Buenos Aires, where the proportions then, pP x pAP= pA, or
fell for both age groups, and among younger women in Pan- P A = A
ama City, where the figure was unchanged between 1963-66 w P W.
and 1967 (see Table 1).
Using this equation with measures from the PEAL survey
in Lima, Panama City, and Buenos Aires (Gaslonde, 1973)
STANDARDIZATION OF COMPARISONS for four-year periods in the mid- and late-1960s, we have the
following annual probabilities:
Another kind of distortion-one that can be attributed to
the analyst rather than to the survey instrument or to respon-
Becoming Aborting A woman's
dent bias or error-occurs when comparisons are made, for pregnant a pregnancy aborting
example, between women of differing socioeconomic or edu- City (P/W) (A/P) (A/W)
cational levels, and when investigators fail to standardize for
Lima 0.161 x 0.123 = 0.0198
age and marital status. These different groups of women may Panama City 0.144 x 0.165 = 0.0238
have very different characteristics. The category "illiterate" Buenos Aires 0.088 x 0.217 = 0.0190
is composed predominantly of older women in consensual
unions while "university graduates" are usually younger,
3The ratio of abortions to live births is rarely used by Latin American authors.
single, or legally married women. Standardization often pro-
The two measures described here are more appropriately characterized as
duces corrected measurements that are very different from proportions than as ratios since, by definition, a proportion occurs within the
those obtained from the general sample. universe that defines it, i.e., the numerator is included in the denominator.

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 TABLE 2 Abortion rates among sexually active women by contraceptive use status:
Panama City, 1968

Number Pregnancies Abortions Abortions

Contraceptive per 1,000 per 1,000 per 1,000
use status W P A women pregnancies women

Users, effective methodsa 357 38 7 106.4 184.2 19.6

Users, other methods 152 43 12 282.9 279.1 78.9
All users 509 81 19 159.1 234.6 37.3
Nonusers 265 130 24 490.6 184.6 90.6
All sexually active women 774 211 43 272.6 203.8 55.6

W=Women; P=Pregnancies; A=Abortions.

apills, IUDs, sterilization.

Obviously, the total abortion figures would decline in absolute

Although the probability of aborti-ng a pregnancy (AIP) was
greatest in Buenos Aires (217 abortions per i,000 pregnancies
as compared with 123 in Lima and 165 in Panama City), the
probability a woman would abort (A/W) was least in Buenos
Aires, where the abortion rate was 19 abortions per 1,000
women compared with 19.8 in Lima and 23.8 in Panama City.
Some authors would say that there were more abortions in
Buenos Aires, based on the higher number of abortions per
1,000 pregnancies; others would maintain that there were
more in Lima and Panama City, citing the higher rates of
abortions per 1,000 women. Neither interpretation is wrong,
but the confusion engendered by the two approaches can be
great. The confusion increases when we try to study the ef-
fects of contraceptive practice on the incidence of abortion.
The PEAL survey in Panama City (Gaslonde, 1973) studied
the pregnancy histories of a group of women who were sex-
ually active during the year preceding the survey (1968). The
results, broken down by contraceptive use, are shown in
Table 2. If we look at the proportions of abortions among
pregnancies, the women who used contraceptives had 27 per-
cent more abortions per 1,000 pregnancies once they had be-
come pregnant than the women who did not use contracep-
tives. The abortion rate per 1,000 women, however, was 37.3
for the group that had used contraceptives and 90.6 for the
group that had not. The women who had used contraceptives
had 58 percent fewer abortions than the women who had not
used contraceptives because the probability of the nonuser's
becoming pregnant was three times greater. For nonusers,
the lower probability of aborting a pregrnancy was offset by
the much higher probability of becoming pregnant.
As another example of the importance of interpreting these
measures clearly, let us suppose that the estimated propor-
tions of pregnancies per 1,000 women and abortions per 1,000
pregnancies in Panama City remain constant over a five-year
period for both categories of women, users and nonusers.
Let us also suppose that, over the same period of time, more
women adopt contraception and the percentage of sexually
active women who are using contraceptives rises from 65.3
to 85. If another survey were carried out five years after the
first, among the same total of 774 women we would find 162
pregnancies instead of 211 and 35 abortions instead of 43.
The summary measures for the sample would change in the
following manner:
* The number of abortions per 1,000 pregnancies would rise
from 203.8 to 217.2, an increase of 6.6 percent.
* The rate of abortions per 1,000 women would drop from
55.6 to 45.3, a decrease of 18.3 percent.
terms and as measured by the rate of abortions per 1,000
woman, but some might say that abortions had increased with
the intensification of family planning activities, citing only
the observable increase in the proportion of abortions among
pregnancies.
When Walter Mertens (1970), in an otherwise brilliant ar-
ticle based on the works of Chilean writers, says, "There
are some signs that induced abortion is more frequent in
women who use contraceptives" (emphasis added), he com-
mits a flagrant error that he could have avoided if he had
added, "once they become pregnant." This apparently small
detail is of the utmost signficance in understanding whether
contraception is an effective preventive measure against the
problem of induced abortion.
Which of the two measurements should be used then? Both
are necessary, but their different utility must be understood.
The proportion of abortions among pregnancies is impor-
tant to those trying to prevent abortion through such efforts
as family planning. Even though it is underreported in most
retrospective Latin American data, this measure emphasizes
the need to provide women with effective and easy-to-use
contraceptive methods so as to prevent their having an un-
wanted pregnancy, which might end in abortion.
The rate of abortions per 1,000 women, which indicates the
prevalence of abortions in the population, is what the health
planner needs to know in order to be able to anticipate de-
mand for services and supplies-hospital beds, medical per-
sonnel, medication, blood for transfusions, and so on. This
measure, and not the number of abortions per 1,000 pregnan-
cies, is the one that will be of most use for this purpose.
Findings from Past Surveys
Despite the problems of underreporting and lack of com-
parability, the results of past surveys are of enormous useful-
ness to all those addressing themselves to, and attempting
to solve, the problem of induced abortion in Latin America.
INCREASED INCIDENCE OF ABORTION
Survey findings presented in the Appendix show that the
general trend, in the past few years at least, has been one
of increasing frequency of abortion, particularly in urban
areas. In all cases where comparison across time could be
made for similar groups of women, the proportion of pregnan-
cies ending in abortion rose, as did the rate of abortion per

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 1,000 women. This finding demonstrates that, despite laws
against abortion in Latin America, women are increasingly
resorting to abortion.
IMPACT OF FAMILY PLANNING
As discussed earlier, comparative studies of the effect of
family planning on abortion aid in the planning and evaluation
of family planning programs aimed at reducing the practice
of abortion. One way to do this using data from abortion
surveys is to examine changes in proportions of pregnancies
ending in abortion and in rates of abortion per 1,000 women
in comparison with changes in the pregnancy rate. Data in
Table 1, from the PEAL studies, show such information for
Bogota, Lima, Panama City, and Buenos Aires. It is assumed
that all changes in pregnancy rates per 1,000 women over
the time period studied can be ascribed to changes in contra-
ceptive practice rather than to factors affecting exposure to
coitus (age at which sexual relations begin, celibacy, dissolu-
tion of unions, voluntary and involuntary abstinence, and fre-
quency of coitus).
Even though the proportion of abortions per 1,000 pregnan-
cies rose in Bogota, Lima, and Panama City, decreases in
the pregnancy rates (assumed to be results of contraceptive
practice) resulted in decreased rates of abortion per 1,000
women aged 20-34 in Bogota and Panama City, and among
women aged 35-44 in Lima. The decrease in pregnancies per
woman in the 20-34 age group in Lima was not large enough,
however, to offset the steep rise in the proportion of pregnan-
cies ending in abortion. In Buenos Aires, on the other hand,
pregnancy rates rose, but the proportion of pregnancies end-
ing in abortion fell for both age groups. The actual figures
show that Buenos Aires was also distinguished from the other
cities by lower rates of pregnancies per 1,000 women. Al-
though surveys have shown that use of contraceptives is
widespread in Buenos Aires, the methods most used are the
traditional ones with low use-effectiveness. While they do
help lower the pregnancy rate, high failure rates lead to a
high number of unwanted pregnancies, which are then termi-
nated by abortion.
While such survey data are useful, contraceptive use is nec-
essarily inferred rather than documented from them. Compar-
ative measures of pregnancies and abortions to contraceptive
users and nonusers can be calculated from the sexual history
data obtained from questionnaires in the CELADE abortion
surveys, as was done for Panama City in the preceding discus-
sion. These questionnaires are designed to record the sexual
activity of the respondent during the 12 months prior to the
survey. The 12 months are divided among three categories:
(1) months of pregnancy, (2) months of abstinence, and (3)
months of sexual activity. In the first category the question-
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naire can determine whether intercourse after the last men-
struation was protected or unprotected. For the second cate-
gory, reasons for abstinence (absence of mate, separation,
illness, and so forth) are coded; and in the final category,
again, contraceptive use or nonuse is classified.
From the total observations one can calculate woman-
months of sexual activity according to whether they were
protected or unprotected and numbers of abortions and births
throughout the year. Using the Gaslonde-Carrasco technique
(Gaslonde and Carrasco, 1973), one can then compare cate-
gories of woman-months for live births and abortions avoided
through the use of contraception, especially use as a result
of family planning programs. Such comparisons permit the
conclusion that women who use effective methods of contra-
ception have fewer abortions than those who use less effec-
tive methods, and that even those women who use the less
effective methods have fewer abortions than those who do
not practice contraception at all.4
Summary
Surveys dealing with abortion in Latin America have pro-
vided useful information despite problems in the collection
and use of the data. Considerations that should be taken into
account in designing abortion surveys and using the resultant
information have been discussed here. Special attention has
been paid to the need for a broad definition of "abortion"
in order to overcome difficulties in gathering information
about abortion in Latin America.
Surveys have shown increasing incidence of abortion
throughout Latin America in the recent past. In examining
changes over time it is crucial to interpret clearly and care-
fully the summary measures of proportion of pregnancies
ending in abortion and abortion rates per 1,000 women. It
is also important to realize that the level and direction of
change of the abortion rate depends on both the rate at which
women are becoming pregnant and the proportion of pregnan-
cies ending in abortion.
Better survey design and techniques and more careful use
of the resulting information will aid in the planning and evalu-
ation of programs aimed at reducing abortion in Latin
America.
4The technique in question has a distinct advantage over other techniques
used to calculate births and abortions averted. It is not based on hypothetical
situations with probabilities calculated for other times and other places (e.g.,
probabilities of having sexual relations, of becoming separated or widowed,
of dying at a still-fertile age) but, rather, the method is based on actual findings
among groups of women at a given point in time. In addition, the previous
year's sexual activity report, unlike a pregnancy history, provides information
on contraceptive use for each month of the year and is therefore a much more
reliable measure. For other uses of the sexual activity history, see Gaslonde
and Bocaz (1970).
APPENDIX Summary of abortion data from major surveys in Latin America

Abortions per
Abortions 1,o000 women
Age at per, 1,000
Location survey Years pregnancies Annual Total Source Comments

Argentina
Buenos Aires 20-49 1963 246 12 In 1968-69 (3), cumulative abortions per 1,000 women by
15-44 1964-67 217 88 3 socioeconomic level were: low, 293; middle, 276; high, 463.
15-44 1968 188 99 3
15-49 1968-69 297 3

Chile
Santiago 20-24 1961 155 44.9 10 Family planning activities intensified between 1963 and 1967
20-24 1966 201 56.5 10
Quinta Normal 1964 232 16 Survey in low-income area of Santiago.
Colombia
Bogota 15-44 1964-67 115 16 3
15-44 1968 147 18 3
Urban areas 15-49 1969 .111 171 2 Urban = population over 20,000; rural = under 20,000.
Rural areas 15-49 1969 76 219 2 Prada (2, 15) found evidence of serious underreporting.
Costa Rica
San Jose 20-49 1963 120 7 Gomez (7) found evidence of underreporting.
Mexico
Mexico City 20-49 1963 155 12
1968 128 267 1 1

Nicaragua
Managua 1968 90 13 Only 4 percent of abortions were reported as induced.
Panama
Panama City 20-49 1963 98 211 1 Almost all abortions reported as spontaneous.
15-44 1964-67 165 24 4 1968-69 study (4) found that cumulative abortion rates per
15-44 1968 192 27 4 1,000 women by socioeconomic level and standardized for
age and marital status were: low, 334; middle, 332; high, 205.

Paraguay
Asuncion 15-44 1965 110 15 5 Increase in abortion in Paraguay occurred before the initiation
15-44 1966 130 18 5 of family planning activities in 1969.
15-44 1967 159 21 5
15-44 1968 207 31 5
15-44 1969 237 35 5
15-49 1971 146 5
Coronel
Oviedo and
Villarrica 15-44 1965 108 22 5
15-44 1966 125 24 5
15-44 1967 143 26 5
15-44 1968 147 27 5
15-44 1969 162 28 5
15-49 1971 125 5
Kaakupe and
Ypacarai 15-44 1965 75 12 5
15-44 1966 89 13 5
15-44 1967 152 18 5
15-44 1968 186 24 5
15-44 1969 186 24 5
15-49 1971 124 5

Peru
Lima 15-44 1965-68 123 20 4 1965 survey (8) of women aged 20-40, 96 percent of whom
15-44 1969 227 32 4 were married or cohabiting, found abortions per 1,000
pregnancies by socioeconomic level were: low, 150; middle,
198; high, 191.

NOTE: The measures refer to all fetal deaths (induced and spontaneous abortions as well as stillbirths) except for Chile where only induced abortions are shown.

4. Gaslonde, S. 1973. "Analisis preliminar de algunos datos sobre

References
I. Araica, H. ca. 1965. "Informe de la encuesta de fecundidad de
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ABOUTTHE AUTHOR Santiago Gaslonde Sainz, M.D., is medi-
cal director of the Office of Coordination, Family Planning
Program, Ministry of Health and Social Services, Caracas,
Venezuela.