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Background In Estonia, termination of pregnancy is allowed until 12 gestational weeks on request or for medical reasons, and until 22 gestational weeks only for women under 15 or over 45 years of age and for severe medical illness of the mother or the fetus. Information about all induced abortions is collected in the central digital Abortion Registry since 1996. The source document for collection of data is the Abortion Card which is filled in for every abortion that has taken place in a health care institution by all health care institutions (incl. private doctors) who do abortions or provide medical care to women who have had an abortion. The choice of contraceptive devices is large and their price is affordable. Sexual education is included in school curriculum. Councelling about contraception is free for all citizens until 25 years of age. Termination of pregnancy is free only for medical reasons, in other cases there is a small fee. Methods Data for the analysis was obtained from the Estonian Abortion Registry. Results The total number of induced abortions in Estonia decreased from 25803 in 1992 to 4017 in 2017. The abortion rate per 1000 women aged 15-49 declined from 69.6 in 1992 to 14.0 in 2017. The abortion rate among women under 20 has declined from 43 in 1996 to 10.8 in 2017. The abortion rate has always been the highest in the age group from 20 to 24 years. Abortion rates in 2017 varied in different counties from 7.4 to 17.3. In 1996, 97.8 % of preganancies were terminated surgically, in 2017, only 22.3%. Conclusions Although induced abortion is legal and not restricted in Estonia, the abortion rate has fallen rapidly due to sexual education at school, free youth councelling services and easily available contraceptive devices. Abortion Registry database is a valuable source of information for evaluating and planning public health interventions. Regional differences in abortion rates deserve further interventions. Key messages Abortion rates in Estonia have fallen rapidly due to sexual education, free councelling and available contraceptive devices. The Estonian Abortion Registry is a valuable source of information for public health interventions.

Induced abortions in Estonia, 1992-2017: registry-based study