title: Post-abortion and induced abortion services in two public hospitals in Colombia.
abstract: OBJECTIVE
  Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion).
  
  
  METHODS
  Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities.
  
  
  RESULTS
  Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals.
  
  
  CONCLUSIONS
  Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women.
  
  
  CONCLUSIONS
  Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services.
authors.affiliation: Oregon Health & Science University, Portland, OR 97239, USA. Electronic address: darneyb@ohsu.edu.
authors.forename: Blair G
authors.initials: BG
authors.lastname: Darney
authors.affiliation: ESE Clínica de Maternidad Rafael Calvo, Cartagena, Colombia.
authors.forename: Willis
authors.initials: W
authors.lastname: Simancas-Mendoza
authors.affiliation: Oregon Health & Science University, Portland, OR 97239, USA.
authors.forename: Alison B
authors.initials: AB
authors.lastname: Edelman
authors.affiliation: Hospital General de Medellín, Universidad de Antioquia, Departamento de Ginecología y Obstetricia, NACER Salud Sexual y Reproductiva, Medellín, 050010 Colombia.
authors.forename: Camilo
authors.initials: C
authors.lastname: Guerra-Palacio
authors.affiliation: Oregon Health & Science University, Portland, OR 97239, USA; Global Network for Perinatal & Reproductive Health-FUNDARED-MATERNA.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.affiliation: World Health Organization, Department of Reproductive Health & Research, Geneva, 27 Switzerland.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Rodriguez
mesh_terms: D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000367:Age Factors; D015331:Cohort Studies; D003105:Colombia; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adolescents; Family planning; Reproductive health services