1. Introduction Conclusion References Methods Results
Demographic characteristics of 400 women from Ireland and the Philippines who completed the online consultation form of the telemedical abortion service Women on Web
Marlies Schellekens, Rebecca Gomperts, Kristina Gemzell-Daniellson
Women on Web and Karolinska Insituted
Introduction
The most common reason for an abortion from both the Philippines and Ireland was “I just cannot have a child at this point in my life (n=146, n=114 respectively.) There was also a significant difference in how age factored into the decision to have an abortion. In the Philippines, women were more likely to list “I am too young” as a reason. This positively corresponds with the lower average age in the sample from the Philippines. In Ireland, women were more likely to list “my family is complete” (n=51) as a reason to have an abortion than in the Philippines (n=14). This correlates to older women in Ireland, and their amount of previous children. In Ireland more women reported already having children (n=105) than in the Philippines (n=87). Irish women additionally listed “I am too old” as a reason more frequently than Filipino women.
Women on Web is an international reproductive rights collective which provides information and referrals to women in countries where abortion is restricted.
Although several studies have analyzed the outcome of the service (1,2,3) so far no research has been done of the demographic of the women who fill in the online consultation. Therefore, a sample was taken from the Philippines and Ireland, two very different Catholic countries with strict anti-abortion legislation.
The Philippines
Access to reproductive healthcare is difficult in the Philippines, where a large majority of the million inhabitants identify as Catholic (4)(5). The Catholic Church only supports “natural” contraceptive methods such as periodic abstinence (6). The poorest are often left without access to pregnancy prevention.(7) Average rates of contraceptive usage are currently at approximately 50% for wealthy women while the rate for poorer women is significantly lower, at 41%(6). Irala et al. (2009) found that within a survey of 4,000 Filipino teenagers, approximately half were unaware of how effective condoms were in preventing STIs and pregnancies (8).
In 2008, 44% of women with unmet contraception needs reported not using contraception based on fears of side effects and 41% did not use contraception because they did not think they were at a risk of becoming pregnant (6).
Abortion has been illegal in the Philippines since 1930 under the Revised Penal Code of the Philippines. Under all other conditions, abortion is punishable with prison time ranging from six months to one year. (9) Data collected by Guttmacher from found that approximately, 15% of pregnancies each year result in an induced abortion and, an estimated 470,000 abortions occur annually. (10)
Ireland
Since 1980, contraceptives have been available and accessible in Ireland. There is widespread support and use of the emergency contraceptive pill, Norlevo, which has been accessible without a prescription since early 2011 (11). In 2010 a study by the HSE Crisis Pregnancy Program found that 64.8% of people ages use contraceptives. However, younger adults (18 to 25) were almost five times as likely to have used a method of contraception in the previous year than adults ages (12).
Ireland stands out in Europe as having some of the strictest abortion legislation in the continent. Those who assist in an abortion can also be charged and serve time in prison. (13). A study done by the Department of Health in the UK revealed that in 2011, 6,151 abortions were performed in the UK on non-residents. 83% of these were women from Northern Ireland and the Republic of Ireland.(14)
Conclusion
We found that geographical cultural and political differences also correspond with demographic characteristics of women who completed the online consultation. For example average rates of contraceptive usage the Philippines is 41% to 50%. On the other hand in Ireland contraceptives are widely available and accessible and 64.8% of people aged use contraceptives. Our analyses found that more women from the Philippines reported that the unwanted pregnancy was caused because they did not use contraceptives compared to women from the Ireland (70.5% vs 41.5%).
References
1- Gomperts RJ et al. Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services. BJOG Aug;115(9):1171-5; discussion
2- Gomperts R et al. Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine. Acta Obstet Gynecol Scand Feb;91(2):
3- Gomperts R et al. Provision of medical abortion using telemedicine in Brazil. Contraception Nov 12. 4- 5-
6- Guttmacher, 2009 “Facts on Barriers to Contraceptive Use in the Philippines.”
7-Guttmacher, 2009 “meeting Women’s contraceptive Needs in the Philippines”
8-Irawa, et al journal article 9-
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Methods
A sample of 400 women who completed the online consultation of the Women on Web service in 2012 from the Philippines and Ireland were analyzed. This study analyses the differences in age, number of children, cause of unwanted pregnancy and reason for abortion between Ireland and the Phillipines. The groups were compared by performing Chi-Square tests. P-values < 0.05 were considered statistically significant.
Results
In 2012, the average woman in the Philippines using Women on Web was 26 years old. In Ireland, the average age was slightly higher, at 28 years. There was a significant difference in the reported cause of pregnancy between each country. The majority of women in the Philippines were pregnant because they did not use contraception (n=141) whereas women in Ireland predominately listed failed contraception as the cause of their pregnancy (n=111). There was also a significant difference in reported cases of rape as a cause of pregnancy. In the Philippines, five women said that their rape was the cause of pregnancy, versus zero of the sample taken from Ireland.