Legal abortion in South Australia: a review of the first 30 years

Objectives To review the first 30 years' experience of legal abortion in South Australia and its demographic implications. Data and methods Information was obtained from official abortion statistics and demographic publications of the Australian Bureau of Statistics. Standard demographic and statistical techniques of analysis were used. Results After an initial rise during the 1970s, abortion rates remained fairly constant for the next decade but have increased since 1990. The Pregnancy Advisory Centre opened in 1992, to reduce waiting times and to cater for late abortions. This resulted in an increase in abortions earlier in pregnancy and also an increase in late abortions. With the adoption of vacuum aspiration techniques and improved services, abortion is now a day-only procedure, performed by specially trained doctors. Morbidity and mortality have been greatly reduced. Concurrent sterilisation has also declined. The increase in abortion has affected all age groups, but particularly women under 30, consistent with the national trend towards the postponement of births. After an initial rapid decline, the total pregnancy rate has risen slightly since 1990, showing changes in patterns of contraceptive use. However, this is not reflected in an increase in the total confinement rate. Conclusion Overall, contraception has had a greater effect than abortion in reducing births in South Australia. The abortion rate is still lower than in the rest of Australia as calculated from Medicare data, even though this is an underestimate because it includes only fee-paying patients. There remains a need for continuing emphasis on better contraceptive use, including emergency contraception.