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Document Type
Analytical Studies
Publication Topic(s)
Maternal Health
Armenia, Turkey, Kazakhstan, Kyrgyz Republic, Turkmenistan, Uzbekistan
Charles F. Westoff, Office of Population Research Princeton University and ORC Macro, Calverton, Maryland, USA
Publication Date
February 2005
Publication ID

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This report is an analysis of recent trends in abortion and contraception in 12 countries of central Asia and eastern Europe—Armenia, Azerbaijan, Georgia, Kazakhstan, the Kyrgyz Republic, Moldova, Romania, Russia, Turkey, Turkmenistan, Ukraine, and Uzbekistan—where abortion had long been a major if not the principal method of birth control. All of these countries have experienced sharp declines in the number of children desired and in fertility rates. Despite increasing preferences for small families, abortion rates in eight of these countries have recently declined, while the use of modern contraceptive methods has steadily increased. Two of the remaining four countries experienced little change in the prevalence of modern contraceptive methods and witnessed an increase in abortion, while in the two other countries, the number of children desired is very low and unintentional pregnancies have increased.

Most abortions are associated with pregnancies that occurred as a result of contraceptive failure—particularly the use of traditional methods such as withdrawal—and pregnancies of women who were not using contraception despite not wanting any (more) children (the “unmet need for family planning” category). In two-thirds of the countries, contraceptive failure accounts for most abortions, while in the other third, unmet need for family planning contributes most of the abortions. A cross-sectional analysis of 18 countries shows a very high negative correlation between abortion and the use of modern contraceptive methods but a moderately high positive correlation between abortion and the use of traditional contraceptive methods.

In a series of simulation models, the implications for further reductions in the prevalence of abortion are estimated. For example, if the women currently using modern methods of contraception were joined by those currently using traditional methods, abortion rates on average could be reduced by 23 percent; if women classified as having unmet need for family planning were also added to this group, abortion rates could be reduced by as much as 55 percent.

The report also examines some of the main covariates of the use of modern contraception and abortion, as well as attitudes toward abortion. Multivariate analyses using a standard set of variables for all countries highlights the importance of age, urban residence, and education. The main conclusions are that there is strong evidence that modern contraceptive methods are replacing abortion as the primary means of family planning. At the same time, there will be continuing if not increasing pressure to avoid unintended pregnancies, which often end in abortion.