In Chile, improved services and counselling reduce abortion incidence.

A major abortion study was carried out in three peri-urban communities of metropolitan Santiago, Chile. Its aim was to assess ways of identifying women at high risk of induced abortion and to lower the rates of induced abortion in areas where the occurrence of induced abortion was known to be high. The first phase consisted of a baseline survey of three low-income urban communities in metropolitan Santiago. On the basis of the results of this survey a predictive instrument was devised that was later used to identify women at high risk of abortion. The survey and work on the predictive instrument was followed by an intervention phase which lasted 18 months. This included: improved family planning services and visits to households of women classified as being at a high risk of induced abortion in one of the communities; improved services but no special home counselling in the second community; and no intervention in the third (control) community. An important finding was that even with highly committed and very well trained interviewers women underreported induced abortions or reported them as spontaneous abortions. The study, however, demonstrated clearly the impact of the intervention. Over a two-year period, the abortion rate fell by 20%, and in the area of some intervention by 9%; the rate increased by 30% in the control community. These findings have been used to improve family planning services in low-income communities and in the design of reproductive health services for adolescents in poor areas of the city.