Modeling the process leading to abortion: an application to French survey data

In this study, we model women's recourse to induced abortion as resulting from a process that starts with sexual intercourse and contraceptive use (or nonuse), continues with the occurrence of an unintended pregnancy, and ends with the woman's decision to terminate the pregnancy and her access to abortion services. Our model includes two often-neglected proximate determinants of abortion: sexual practices and access to abortion services. We relate three sociodemographic characteristics--women's educational level, their relationship status, and their age--step by step to the stages of the abortion process. We apply our framework using data from the COCON survey, a national survey on reproductive health conducted in France in 2000. Our model shows that sociodemographic variables may have opposite impacts as the abortion process unfolds. For example, women's educational level can be positively linked to the probability of practicing contraception but negatively linked to the propensity to carry the unintended pregnancy to term. This conceptual framework brings together knowledge that is currently dispersed in the literature and helps to identify the source of abortion-rate differentials.