title: The role of birthplace and educational attainment on induced abortion inequalities.
abstract: Induced abortion (IA) has shown social inequality related to birthplace and education with higher rates of IAs in immigrant and in less educated women relative to their native and highly educated counterparts. This study examined the independent and joint effects of birthplace and education on IA, repeated and IA performed during the 2nd trimester of pregnancy among women residing in the Basque Country, Spain.
  
  
  
  We conducted a cross-sectional population-based study of IA among women aged 25-49 years residing in the Basque Country, Spain, between 2011 and 2013. Log-binomial regression was used to quantify the independent and joint effects of birthplace and education attainment on all outcomes.
  
  
  
  Immigrant women exhibited higher probability of having an IAs (PR: 5.31), a repeated (PR: 7.23) or a 2nd trimester IAs (PR: 4.07) than women born in Spain. We observed higher probabilities for all outcomes among women with a primary or less education relative to those with a graduate education (All IAs PR: 2.51; repeated PR: 6.00; 2nd trimester PR: 3.08). However, no significant heterogeneity was observed for the effect of education on the association of birthplace with IAs, repeated or 2nd trimester IAs.
  
  
  
  Birthplace and education are key factors to explain not only an IA decision but also having a repeated or a 2nd trimester IA. However, the effects of birthplace and education may be independent from each other on these outcomes. A better understanding of these factors on IAs is needed when designing programs for sexual and reproductive health aimed to reduce inequalities among women.
authors.affiliation: Department of Sociology 2, University of the Basque Country UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain. yolanda.gonzalezr@ehu.eus.|Social Determinants of Health and Demographic Change - Opik, Leioa, Spain. yolanda.gonzalezr@ehu.eus.
authors.forename: Yolanda
authors.identifier: 0000-0003-3387-5631
authors.initials: Y
authors.lastname: González-Rábago
authors.affiliation: Department of Nursing I, University of the Basque Country UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain.|Social Determinants of Health and Demographic Change - Opik, Leioa, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Rodriguez-Alvarez
authors.affiliation: Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, USA.|Social Determinants of Health and Demographic Change - Opik, Leioa, Spain.
authors.forename: Luisa N
authors.initials: LN
authors.lastname: Borrell
authors.affiliation: Department of Sociology 2, University of the Basque Country UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain.|Social Determinants of Health and Demographic Change - Opik, Leioa, Spain.
authors.forename: Unai
authors.initials: U
authors.lastname: Martín
mesh_terms: D000028:Abortion, Induced / Q000523:psychology* / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D036801:Parturition / Q000523:psychology*; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D037841:Pregnant People / Q000523:psychology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013030:Spain; D055815:Young Adult
keywords: Education; Immigration; Induced abortion; Inequalities; Repeat induced abortion; Second trimester induced abortion