A score for measurement of the role of social vulnerability in decisions on abortion

OBJECTIVE: To devise a score allowing a better measure of the role of social vulnerability (SV) in a woman's attitude toward abortion. STUDY DESIGN: Consecutive sampling and semi-structured personal interviewing of 2641 women requesting legal termination of pregnancy from 1994 to 2001 in the county of Roanne, France. RESULTS: SV was estimated from each woman's situation with reference to work, family composition, marital status, health insurance status and characteristics of neighbourhood of residence. It was correlated with the income and home ownership situation. With a high SV level taken as reference, the relative risks (RR) of severe, moderate, and low SVP, respectively, were equal to 3.3 (1.8-6.1), 4.6 (2.5-8.6) and 7.2 (3.9-13.1) in women under 18.5 years of age; 1.2 (1.0-1.5), 2 (1.4-2.8), and 2.1 (1.4-3.2) from 18.5 to 19 years of age; 0.7 (0.6-0.8), 0.6 (0.5-0.8) and 0.4 (0.3-0.5) in those aged 19-28; and 0.9 (0.9-1), 0.7 (0.6-0.8) and 0.71 (0.6-0.8) in those over 28. The use of different basic hypotheses (cumulative time of pregnancy in women's life, withdrawal or restarting of the clock after each event in the case of recurrence) resulted in slight modification of the age cut-off points and the amplitude of RR also differed, but their order relative to SV categories was unchanged. CONCLUSIONS: At the individual level knowledge of SV allowed a good estimate of a woman's attitude to an unwanted pregnancy, and SV must be taken into consideration when future actions are planned.