Education, Place of Residence and Utilization of Legal Abortion Services in Mexico City, 2013-2015

CONTEXT: Although abortion is illegal in most of Mexico, it was decriminalized in Mexico City in 2007, creating an island of legal abortion in a sea of restricted access. The characteristics of women seeking abortions in Mexico City-notably their socioeconomic status and place of residence-have not been well documented. METHODS: Medical records from 22,732 women who sought abortions at one of four primary-level clinics in Mexico City in 2013-2015 were used to examine characteristics of women seeking legal abortion. Linear regression analyses were used to explore differences between women from Mexico City and those from elsewhere in Mexico, using education as a proxy for socioeconomic status. Because of geographic differences in population structure, women's education level was normalized in some models. RESULTS: Most abortion seekers came from Mexico City (66%) or its surrounding metropolitan area (22%), while the remainder came from bordering states (7%) or the rest of Mexico (5%). Abortion seekers from the rest of Mexico had, on average, 1.4 more years of education than did those from Mexico City. In regression models that normalized education levels, the difference in educational attainment between women from the rest of Mexico and those from Mexico City was 4.9 years (unadjusted model) and 3.2 years (adjusted model). CONCLUSIONS: These findings, in conjunction with the literature on unsafe abortion in Mexico, suggest that women from outside Mexico City who have low levels of education may be less likely than their more educated peers to benefit from the safe abortion services provided in the city.