people in Uganda reported that 17 percent of 15-19-year-olds previously had an abortion and 53 percent of 20-24-year-olds had done so (Agyei and Epema, 1992). A study among 20-29-year-olds in Yaoundé, Cameroon, found that 21 percent of women reported ever having an abortion and 29 percent of young men reported ever having a girlfriend who terminated a pregnancy for which they were responsible (Calvès, 2002). Indirect estimates of the abortion rate in the early 1990s for young people in six Latin American countries showed that this rate (the number of abortions per 1,000 15-19-year-olds per year) ranged from 13 in Mexico to 36 in the Dominican Republic (The Alan Guttmacher Institute, 1999).

For the five countries included in the Bankole, Singh, and Haas (1999) study, the number of abortions per pregnancy rises consistently with age in all countries except one (Cuba). In contrast, population-based estimates in India for married women suggest higher abortion ratios for teenagers—1.7 percent of all pregnancies at ages 15-19 versus 1.3 percent for older women (Jejeebhoy, 1998), but these ratios are quite low in comparison to other countries, most likely because of underreporting of abortions. Based on the extremely limited data, it would appear that younger women obtain abortions less often than older women, but they nevertheless may be at greater risk when they do.

Among young pregnant women observed at a public hospital in Mexico City, 72 percent of young women who had an unwanted pregnancy that was ultimately carried to full term reported an average of 2.3 unsuccessful attempts at abortion (Ehrenfeld, 1999). For the members of the group who did abort the pregnancy, one to four abortion attempts were made before success. Many of these attempts were self-induced: typically “strong injections” of unknown drugs, the consumption of infusions of various types, and even deliberately falling down stairs. This is a common pattern followed by women of all ages seeking abortion; several attempts are usually made before succeeding in obtaining an abortion, safe or unsafe.

Furthermore, although the evidence is scattered, it suggests that young women—and particularly those who are unmarried—are considerably more likely than married adult women to delay seeking abortion and hence to undergo second trimester abortions. In India, where abortion is not restricted, a study reports that while three in five unmarried young women who had a medical termination of pregnancy at a municipal general hospital from 1978 to 1983 sought second trimester abortions, only a quarter of all married young women did so (Aras, Pai, and Jain, 1987). A more recent study in rural Maharashtra observes that, while married women regardless of age sought abortion at an average of 10.9 and 10.8 weeks of gestation, respectively, unmarried young women sought it at 12.7 weeks (Ganatra and Hirve, 2002). In Tanzania, where abortion is legally restricted, a study of young women seeking postabortion care reports that, while about half

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