The rate of induced abortion is very high in several countries in eastern Europe and central Asia where the use of modern contraception has lagged. In the Republic of Georgia the rate of 3.1 abortions per woman in 2003-05 may be the highest in the world. The abortion rate had declined from 3.8 in 1996-99. This report is a study of that change based on interview data collected in the Reproductive Health Surveys conducted in 1999 and 2005 by the Centers for Disease Control and Prevention.
Couples in Georgia are clearly aiming for very small families with a total fertility rate of 1.6 births per woman. Because their desired family size is reached early in marriage, women are exposed to the risk of unintentional pregnancy over a long period of time. The latest survey showed that 62 percent of pregnancies were unintended with almost all (96 percent) of these terminated by abortion.
Contraceptive use is relatively low in Georgia with only 27 percent of married women using a modern method, a slight increase from five years earlier. Contraceptive failure rates are particularly high among women using traditional methods, mostly withdrawal. Nonuse of any contraception is the main explanation of the high abortion rate, accounting for nearly two-thirds of all abortions.
Several simulations showed the large effect on the reduction of abortion by increases in the use of modern contraceptive methods. For example, if nonusers at high risk of unintended pregnancy and those using a traditional method were to use a modern method, the abortion rate could be expected to drop by 53 percent.
There has been a decline in the proportion of women who say they would have an abortion if they became unintentionally pregnant. This change is concentrated among women who are not at risk of an unintended pregnancy.
The evidence is overwhelming that the way to reduce abortion in Georgia (and elsewhere) is to increase the proportion using modern methods of contraception.