Incidence of induced abortion by age and state, Mexico, 2009: new estimates using a modified methodology.

CONTEXT Because abortion laws in Mexico, which are generally highly restrictive, are determined by individual states, state-level data are essential for policymakers to make informed decisions. In addition, age-specific abortion estimates are needed, given societal concern about young women's risk for unwanted pregnancy and abortion. METHODS The Abortion Incidence Complications Method, an established approach designed to obtain national and broad regional estimates, was extended to produce for the first time estimates for age-groups and states. Data included government statistics on postabortion patients and health professionals' estimates concerning abortion complications. States were classified into six regions according to level of development. RESULTS In 2009, the abortion rate in Mexico was 38 per 1,000 women aged 15-44. The rate was 54 per 1,000 in Region 1 (Mexico City), the most developed region; 35-41 per 1,000 in Regions 2, 3 and 4, which are moderately developed; and 26-27 in Regions 5 and 6, which are the least developed. States' rates of abortion incidence and treatment for induced abortion complications were generally consistent with development level, although exceptions emerged. Age-specific abortion rates peaked among women aged 20-24 and then steadily declined with age; this pattern was observed nationally, regionally and in most states. CONCLUSION Extension of the Abortion Incidence Complications Method to obtain state- and age-specific data is feasible. Unsafe abortion is common in all states of Mexico, especially among women aged 15-24, suggesting a need for improved family planning and postabortion services.