Induced abortion in adolescents in a Portuguese district hospital between 2010 and 2023, a retrospective study

Abstract Introduction: In Portugal, there was a decrease in the number of induced abortion (IA) between 2011 and 2021, with a slight increase since 2022. The percentage of abortion by women request performed in women under 20 years old has been decreasing, ranging between 8.3% and 9.1%. Aim: To characterize the IA performed in adolescents in a Portuguese district hospital. Study Design, Population and Methods: Retrospective descriptive observational study that included all young women under the age of 20 who underwent IA between 2010 and 2023. Sociodemographic aspects, obstetric and contraceptive history, characteristics of the abortions, and subsequent counseling were analyzed. Results: During the study period, 712 IA were performed on 669 adolescents, with a decreasing trend observed between 2010 and 2021, followed by an increase in the last two years. The minimum age was 13 years (median age 18 years) and 88.9% of the adolescents were single. 85.9% were Portuguese and, among the foreigners, 61.7% were from Portuguese-speaking African countries. The majority (68.3%) were students and, among those who worked, 49.1% were unemployed. Roughly half (47.5%) did not use contraception, and the main method, when used, was the condom (29.2%). Additionally, 10.1% had previously undergone at least one IA and 8% had at least one child. In 56.6% of the cases, there was a referral to a family planning appointment at primary health care, and the main contraceptive methods chosen after abortion were hormonal (95.2%), with long-acting methods preferred in 44.8% of cases. Conclusions: The recent increasing trend of IA in adolescence, a period of particular vulnerability, should prompt intervention. It is crucial to optimize strategies that involve education, awareness, and promotion of accessibility to more effective contraceptive methods, particularly long-acting methods, as well as to reinforce referrals and ensure follow-up of these young women.