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Induced Abortion and Migration to Metropolitan Paris by Sub-Saharan African Women: The Role of Intendedness of Pregnancy

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Abstract

Migration can affect reproductive outcomes due to different socioeconomic and cultural contexts before and after migration, to changes in the affective and conjugal status of women and to their life conditions. The aim of this study is to investigate the association between international migration and abortion. The data came from a retrospective life-event survey from sub-Saharan African women living in Île-de-France. Differences in abortion distribution before and after migration were assessed using the Pearson chi-square test, and the association between the predictor and the outcome was investigated using Generalized Estimating Equations. A total of 363 women and 1377 pregnancies were investigated. Among these pregnancies, 15.6% that occurred before and 11.0% that occurred after migration was reported as ended in abortion (p = 0.011). The odds of reporting having had an abortion was lower after migration (OR 0.59, 95% CI 0.42–0.84), even after adjustment. However, after including intendedness of pregnancy in the model, this association lost its significance. The difference in induced abortion occurrence between before and after migration is almost entirely due to a change in the intendedness of pregnancy. Thus, socioeconomic and cultural issues have a greater weight in the decision to abort than the legal interdiction of this practice.

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Notes

  1. Migrants are understood here as people born outside France, with non-French citizenship at the time of birth.

  2. This variable was constructed from the woman's statement that at the time of pregnancy she was in a long relationship exclusively, as opposed to the women who claimed to be in other relationship arrangements (long + short, long + transactional, short, transactional, short + transactional or no relationship at all).

  3. Intendedness of the pregnancy was divided into three categories: intended, mistimed and unwanted pregnancies. Intended pregnancies were those in which the woman said she wanted to become pregnant at that time. Mistimed were those in which she said she had not asked herself if she wanted to get pregnant or not, when she said she wanted to get pregnant but not at that moment (sooner or later in life) or when she said she did not know if she wanted to have a child. Unwanted were pregnancies in which the woman stated that she did not want to have (more) children.

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Acknowledgements

The PARCOURS Study Group included A. Desgrées du Loû, F. Lert, R. Dray Spira, N. Bajos, N. Lydié (scientific coordinators), J. Pannetier, A. Ravalihasy, A. Gosselin, E. Rodary, D. Pourette, J. Situ, P. Revault, P. Sogni, J. Gelly, Y le Strat, N. Razafindrasitma. This study was supported by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) and the Directorate-General of Health (DGS, French Ministry of Health). In addition, the first author had a postdoctoral scholarship granted by the National Council for Scientific and Technological Development (CNPq), Brazil. The authors would like to thank all of the people who participated in the study, the RAAC-Sida, COMEDE, FORIM and SOS hepatitis associations for their support in preparing and conducting the survey, G Vivier, E Lelièvre (INED) and A Gervais (AP-HP) for their support in preparing the questionnaire, ClinSearch and Ipsos for data collection, and the staff at all participating centers.

Funding

This study was supported by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) and the Directorate-General of Health (DGS, French Ministry of Health). In addition, the first author had a postdoctoral scholarship granted by the National Council for Scientific and Technological Development (CNPq), Brazil.

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Authors and Affiliations

  1. Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190, sala 803, Belo Horizonte, MG, 30130-100, Brazil

    Flávia Bulegon Pilecco & Agnès Guillaume

  2. Centre Population & Développement (UMR 196 - Université Paris Descartes/IRD), Paris, France

    Andrainolo Ravalihasy & Annabel Desgrées du Loû

Authors
  1. Flávia Bulegon Pilecco
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  2. Agnès Guillaume
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  3. Andrainolo Ravalihasy
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  4. Annabel Desgrées du Loû
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Consortia

the Parcours Study Group

  • A. Desgrées du Loû
  • , F Lert
  • , R Dray Spira
  • , N Bajos
  • , N Lydié
  • , J Pannetier
  • , A Ravalihasy
  • , A Gosselin
  • , E Rodary
  • , D Pourette
  • , J Situ
  • , P Revault
  • , P Sogni
  • , J Gelly
  • , Y le Strat
  •  & N Razafindrasitma

Corresponding author

Correspondence to Flávia Bulegon Pilecco.

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Conflict of interest

FBP, AG, AR and ADL declare that they have no potential conflicts of interest.

Ethical Approval

The study was approved by the French National Commission for Data Protection and Liberties (CNIL, decision DR-2011–484).

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Research Involving Human and Animal Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The members of the Parcours Study Group are placed in Acknowledgements section.

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Pilecco, F.B., Guillaume, A., Ravalihasy, A. et al. Induced Abortion and Migration to Metropolitan Paris by Sub-Saharan African Women: The Role of Intendedness of Pregnancy. J Immigrant Minority Health 22, 682–690 (2020). https://doi.org/10.1007/s10903-019-00956-9

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  • DOI: https://doi.org/10.1007/s10903-019-00956-9

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