Abstract
BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees.MethodsRetrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n = 277) and Maori women (n = 128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups.ResultsChinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05).ConclusionsFollowing contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about contraception and where to access it, so women can be better prepared to avoid unplanned pregnancy.
Highlights
IntroductionThe sexual reproductive health of Asian women in New Zealand has received negative attention in the media and in public health circles over the past decade. [1] Chinese are the largest ethnic group within the fast-growing Asian population in New Zealand, [2] and the majority (78%) are overseas-born. [3] Concerns arose following a report in 2001 that revealed Asian women had the highest abortion ratio of all ethnic groups in New Zealand, at 311 abortions per 1000 pregnancies. [4] By comparison, European women had 210 abortions per 1000 and Maori (the indigenous people of New Zealand) women had 257 per 1000 pregnancies. [4] The 2001 report highlighted the higher rate of terminated pregnancies among teenage Asian women compared to women in other ethnic groups. [4] In 2003, a study on the use of contraception by Asian women (most of whom were Chinese migrants on student visas) seeking abortion at a private New Zealand clinic showed that 80% of the women had been using no form of contraception prior to becoming pregnant. [5] It was suggested in several published papers and the New Zealand media that immigrant Chinese women were using abortion as a form of contraception, [1] [5] a perception that has been reiterated again more recently. [6] These issues and the related discourse on the ‘problem’ of Asian women’s sexuality were critically discussed by Simon-Kumar in 2009. [1]Prevention of unplanned pregnancies requires consistent use of effective contraception
In light of the reports on contraceptive non-use and the higher abortion ratios, we aimed to describe the peri-abortion contraceptive choices of Chinese women presenting to a public hospital abortion clinic in New Zealand
Characteristics of participants We identified 320 Chinese women from the electronic records pertaining to women presenting to the hospital abortion clinic over the 43 month period covering August 2006 to February 2010
Summary
The sexual reproductive health of Asian women in New Zealand has received negative attention in the media and in public health circles over the past decade. [1] Chinese are the largest ethnic group within the fast-growing Asian population in New Zealand, [2] and the majority (78%) are overseas-born. [3] Concerns arose following a report in 2001 that revealed Asian women had the highest abortion ratio of all ethnic groups in New Zealand, at 311 abortions per 1000 pregnancies. [4] By comparison, European women had 210 abortions per 1000 and Maori (the indigenous people of New Zealand) women had 257 per 1000 pregnancies. [4] The 2001 report highlighted the higher rate of terminated pregnancies among teenage Asian women compared to women in other ethnic groups. [4] In 2003, a study on the use of contraception by Asian women (most of whom were Chinese migrants on student visas) seeking abortion at a private New Zealand clinic showed that 80% of the women had been using no form of contraception prior to becoming pregnant. [5] It was suggested in several published papers and the New Zealand media that immigrant Chinese women were using abortion as a form of contraception, [1] [5] a perception that has been reiterated again more recently. [6] These issues and the related discourse on the ‘problem’ of Asian women’s sexuality were critically discussed by Simon-Kumar in 2009. [1]Prevention of unplanned pregnancies requires consistent use of effective contraception. [3] Concerns arose following a report in 2001 that revealed Asian women had the highest abortion ratio of all ethnic groups in New Zealand, at 311 abortions per 1000 pregnancies. [4] In 2003, a study on the use of contraception by Asian women (most of whom were Chinese migrants on student visas) seeking abortion at a private New Zealand clinic showed that 80% of the women had been using no form of contraception prior to becoming pregnant. Women presenting for abortion in New Zealand receive preabortion counseling, and discussion about pregnancy prevention and contraception is a key component. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees
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