Trends and factors associated with previous induced abortions among young women in Foshan, China: insights from a retrospective cross-sectional study

Objectives This study aims to explore the history of prior abortions and the factors influencing them among young women seeking abortion services in Foshan, Guangdong, China. Design This is a retrospective, cross-sectional study of young women seeking abortion care. Setting Gynaecological outpatient clinics at the Department of Gynaecology, Foshan Women and Children Hospital Affiliated to Guangdong Medical University, Foshan, Guangdong, China, between 2013 and 2023. Participants A total of 7361 young women aged 12–25 years seeking abortion services. Measures Data on abortion history, sociodemographic factors, contraceptive use and postabortion contraceptive choices were collected and analysed, with special emphasis on the incidence of repeat abortions and the factors associated with them. Results Of the 7361 participants, 34.2% reported at least one previous abortion, underscoring a notable public health concern. The mean age of the participants was 22.30 years (SD=2.13). Women with a history of abortion were significantly older than those without (22.57 vs 22.08 years, p<0.001). Logistic regression analyses suggested higher, but not statistically significant, odds of prior abortion among women aged 20–25 years compared with those aged 12–19 years (adjusted OR (aOR) 1.23, 95% CI 0.93 to 1.63, p=0.151). There was no significant difference in the odds of prior abortion between urban and rural residents (rural vs urban: aOR 0.94, 95% CI 0.67 to 1.32, p=0.732), and single or divorced women had higher odds of reporting a prior abortion than married women (aOR 1.39, 95% CI 1.12 to 1.73, p=0.003). Importantly, while 13.92% of women reported using no contraceptive method at the time of conception, postabortion counselling reduced non-acceptance to only 3.65%, demonstrating the effectiveness of intervention but highlighting remaining gaps in prepregnancy contraceptive access. Women with a prior abortion history demonstrated higher postabortion contraceptive acceptance (80.30% vs 77.25%, p<0.01) and increased uptake of long-acting reversible contraception, particularly intrauterine devices and systems (18.96% vs 10.76%, p<0.001). Conclusions This study underscores the need for targeted interventions to address the multifaceted factors leading to repeat abortions among young women in China. The results offer valuable insights for improving reproductive health outcomes in this vulnerable population and highlight the importance of expanding access to contraceptive education and services in China.