Invited paper| Volume 21, ISSUE 3, SUPPLEMENT , S16-S20, May 2011

Sociodemographic Factors Associated With Obstacles to Abortion Care: Findings From a Survey of Abortion Patients in Mexico City



      First-trimester abortion was legalized in Mexico City in 2007, and services are now provided at public and private sites throughout the city. However, little is known about the obstacles women face when seeking abortion care.


      We surveyed women who obtained abortion services (n = 398) at three public sector facilities in Mexico City to identify the obstacles women faced when obtaining abortions. We used logistic regression to test whether obstacles varied by sociodemographic characteristics.


      Women with low education were more likely than high school–educated women to report difficulty getting appointments. Unmarried women and women with low education were more likely than married women or high school educated women to report difficulty getting time off work for appointments and arranging for transportation to the facility. Separated or divorced women were more likely than married women to report partner or other family member opposition to the abortion. Women who lived outside of Mexico City were more likely than Mexico City residents to report difficulty with transportation.


      Education, marital status, and place of residence were associated with the obstacles women reported. Strategies to improve access to care should be targeted to the groups at highest risk of experiencing obstacles: Women with primary education or lower, single women, separated/divorced women, and those residing outside of Mexico City.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women's Health Issues
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bertrand J.T.
        • Hardee K.
        • Magnani R.J.
        • Angle M.A.
        Access, quality of care and medical barriers in family planning programs.
        International Family Planning Perspectives. 1995; 21: 64-69
        • Drey E.A.
        • Foster D.G.
        • Jackson R.A.
        • Lee S.J.
        • Cardenas L.H.
        • Darney P.D.
        Risk factors associated with presenting for abortion in the second trimester.
        Obstetrics and Gynecology. 2006; 107: 128-135
        • Grupo de Información en Reproducción Elegida. (GIRE)
        El aborto en los códigos penales de las entidades federativas 2010.
        (Available:) (Accessed January 4, 2011)
        • Grupo de Información en Reproducción Elegida. (GIRE)
        Cifras sobre aborto en el DF 2007-2011.
        (Available:) (Accessed March 21, 2011)
        • Jejeebhoy S.J.
        • Kalyanwala S.
        • Zavier A.J.F.
        • Kumar R.
        • Jha N.
        Experience seeking abortion among unmarried young women in Bihar and Jharkhand, India: Delays and disadvantages.
        Reproductive Health Matters. 2010; 18: 163-174
        • Juarez F.
        • Singh S.
        • Garcia S.G.
        • Diaz Olavarrieta C.
        Estimates of induced abortion in Mexico: What’s changed between 1990 and 2006?.
        International Family Planning Perspectives. 2008; 34: 158-168
        • Juárez F.
        • Palma J.L.
        • Singh S.
        • Bankole A.
        Barreras para la Maternidad Segura en Mexico.
        The Guttmacher Institute, New York2010
        • Hord C.E.
        • Benson J.
        • Potts J.L.
        • Billings D.L.
        Unsafe abortion in Africa: An overview and recommendations for action.
        in: Warriner I.K. Shah I.H. Preventing unsafe abortion and its consequences: Priorities for research and action. The Guttmacher Institute, New York2006: 115-150
        • Long J.S.
        • Freese J.
        Regression models for categorical dependent variables using Stata.
        2nd ed. StataCorp LP, College Station, TX2006
        • Madrazo A.
        The evolution of Mexico City’s abortion laws: From public morality to women’s autonomy.
        International Journal of Gynecology and Obstetrics. 2009; 106: 266-269
        • Major B.
        • Richards C.
        • Cooper M.L.
        • Cozzarelli C.
        • Zubek J.
        Personal resilience, cognitive appraisals and coping: An integrative model of adjustment to abortion.
        Journal of Personality and Social Psychology. 1998; 74: 735-752
        • Picker Institute
        From the patient’s perspective: Quality of abortion care.
        Report prepared for the Kaiser Family Foundation. 1999; (Available:) (Accessed January 4, 2011)
        • Sánchez-Fuentes M.L.
        • Paine J.
        • Elliott-Buettner B.
        The decriminalisation of abortion in Mexico City: How did abortion rights become a political priority?.
        Gender & Development. 2008; 16: 345-360
        • Secretaría de Salud del Distrito Federal (SSDF)
        Mexico’s Federal District (DF) Ministry of Health Program for Legal Abortion.
        Author, Mexico City2008
        • Secretaría de Salud del Distrito Federal (SSDF)
        2009 Agenda Estadística.
        Author, Mexico City2010 (Available:) (Accessed January 4, 2011)
        • Sousa A.
        • Lozano R.
        • Gakidou E.
        Exploring the determinants of unsafe abortion: Improving the evidence base in Mexico.
        Health Policy and Planning. 2010; 25: 300-310
        • Varga C.A.
        Pregnancy termination among South African adolescents.
        Studies in Family Planning. 2002; 33: 283-298
        • Wiebe E.R.
        • Sandhu S.
        Access to abortion: What women want from abortion services.
        Journal of Obstetrics and Gynaecology Canada. 2008; 30: 327-331
        • Wilson J.F.
        The crucial link between literacy and health.
        Annals of Internal Medicine. 2003; 139: 875-878


      Davida Becker, PhD, is a research scholar at the Center for the Study of Women at the University of California, Los Angeles. Her research focuses on the accessibility and quality of reproductive health services and disparities in reproductive health outcomes.


      Claudia Diaz Olavarrieta, PhD, is a senior researcher at the Population and Health Center at the National Institute of Public Health of Mexico.


      Clara Juarez, PhD, is a professor and researcher at the Center for Health Systems Research at the National Institute of Public Health of Mexico. Her work focuses on using qualitative methods and applied anthropology to research public health.


      Sandra G. Garcia, ScM, ScD, is Mexico Country Director for the Population Council, an international organization committed to improving the health of the world's most vulnerable populations. Sandy implements and oversees the Council's public health research in Latin America.


      Patricio Sanhueza Smith, MD, is the Reproductive Health Coordinator of the Mexico City Ministry of Health.


      Cynthia Harper, PhD, is an associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco. Her work focuses on women's reproductive health in low-resource settings and among vulnerable populations in the United States.