Assessment of medical and social factors determining abortive behavior of women in a megalopolis (using the example of St. Petersburg).

The topic of abortion is the most relevant against the background of the unfavorable demographic situation in modern Russia. Being one of the methods of intra-family birth control, artificial termination of pregnancy depends on a variety of external and internal factors. Also, the high prevalence of this problem directly affects the indicators of the natural movement of the population, mediating long-term adverse effects on the reproductive system and the fertile potential of women. Objective: to assess the frequency of abortions in St. Petersburg and to study their medical and social risk factors. Materials and methods: an assessment of the prevalence of abortions in St. Petersburg and the Russian Federation as a whole (2017–2022) was carried out, as well as an analysis of the results of a survey of women who received an abortion referral regarding abortive factors. Results: A 5-year downward trend in the frequency of abortions is recorded. At the same time, the rate of decline in St. Petersburg is lower than the average federal and national average. In the structure of abortions, there is an increase in the proportion of pre-pregnancy, early-term medical abortions and abortions for social reasons. The survey revealed that abortive behavior was more common among visitors from other regions, those with secondary education, those working in budget organizations, those in a registered or civil marriage, those with low or high incomes, and those with children of 2 or more. At the same time, with a high self-assessment of knowledge on contraception, the majority of abortions occurred when using ineffective methods or lack of protection. Conclusion. Despite the positive nature of the dynamics of the decrease in the frequency of abortions, there are fears of a worsening of the situation. The fight against abortive behavior should primarily include broad health education of the population about effective methods of contraception, as well as the development of significant social and economic measures to support women faced with reproductive choice.