Socio-demographic factors and indications in second trimester voluntary abortion

Background. According to Italian Law, second trimester termination of pregn ancy is allowed for life threatening conditions or for severe psychological distress, linked or not to prenatal diagnosis of foetal abnormalities. Soc io-demographic factors related to this condition have been analysed. Methods. Clinical records of 330 patients admitted during the years 1988-19 97 to the Obstetrics and Gynaecology Department, University of Bari, Italy, for voluntary second trimester abortion, were examined. Maternal psychiatr ic indications have been given in nearly all of the cases. In 123 cases the indications were secondary to the women suffering a psychiatric disorder d ue to foetal pathologies. In 205 cases - where poor social conditions were more frequent - the indication was given on the ground of a psychiatric dis order linked to the pregnancy itself. Results. Significantly higher incidence of teenagers (23.3%) and singles (5 0%) in women who underwent a late abortion. Students were 16.4% in this gro up. In primary psychiatric indication singles prevail (74.4%) and students represent 23.6% while in secondary psychiatric indication the married were 84.7%, students only 4.8%. In primary psychiatric indication 32.5% of women aged nineteen or less, while in secondary psychiatric indication this perc entage was 8%. Conclusions. Among patients who have a late abortion, teenagers, students a nd singles are prevalent, these patients have significantly more primary ps ychiatric indications, not linked to foetal abnormalities. The high percent age of teenagers with primary psychiatric indication could depend on inadeq uate information and social service. Reduction of mid-trimester termination s of pregnancy can be significantly achieved intervening in this group of y oung women. On the other hand, in secondary indications earlier diagnosis o f foetal abnomalities must be encouraged (villocentesis instead of amniocen tesis) and abortion discouraged when the foetal pathology is minor, treatab le or unlikely to significantly impair the future quality of life.