Limits...
Population Policy: Abortion and Modern Contraception Are Substitutes

View Article: PubMed Central - PubMed

ABSTRACT

A longstanding debate exists in population policy about the relationship between modern contraception and abortion. Although theory predicts that they should be substitutes, the empirical evidence is difficult to interpret. What is required is a large-scale intervention that alters the supply (or full price) of one or the other and, importantly, that does so in isolation (reproductive health programs often bundle primary health care and family planning—and in some instances, abortion services). In this article, we study Nepal’s 2004 legalization of abortion provision and subsequent expansion of abortion services, an unusual and rapidly implemented policy meeting these requirements. Using four waves of rich individual-level data representative of fertile-age Nepalese women, we find robust evidence of substitution between modern contraception and abortion. This finding has important implications for public policy and foreign aid, suggesting that an effective strategy for reducing expensive and potentially unsafe abortions may be to expand the supply of modern contraceptives.

Electronic supplementary material: The online version of this article (doi:10.1007/s13524-016-0492-8) contains supplementary material, which is available to authorized users.

No MeSH data available.


Abortion and contraception trends in Nepal. Sources: Panel 1: abortion: Sedgh et al. (2011); contraception: 1970–1987 from Mauldin and Segal (1988), 1990–1995 from United Nations (2004), and 1996–2011 from MOHP et al. (2012). Panel 2: authors’ calculations are based on Demographic and Health Surveys of Nepal (1996–2011) (contraception) and Technical Committee for Implementation of Comprehensive Abortion Care (2010) (abortion facilities)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection


getmorefigures.php?uid=PMC5016566&req=5

Fig1: Abortion and contraception trends in Nepal. Sources: Panel 1: abortion: Sedgh et al. (2011); contraception: 1970–1987 from Mauldin and Segal (1988), 1990–1995 from United Nations (2004), and 1996–2011 from MOHP et al. (2012). Panel 2: authors’ calculations are based on Demographic and Health Surveys of Nepal (1996–2011) (contraception) and Technical Committee for Implementation of Comprehensive Abortion Care (2010) (abortion facilities)

Mentions: Figure 1 shows the contraceptive prevalence and abortion rates in Nepal over time. After a rapid, sustained increase in the use of modern contraceptives from the late 1970s until the mid-2000s (from only 2 % to 48 %), contraceptive prevalence then plateaued with the legalization of abortion in 2004 (Fig. 1, panel 1). As in other countries, this pattern of co-movement is consistent with substitution and occurred during a period of declining fertility, with Nepal’s total fertility rate falling from 4.6 in 1996 to 2.6 in 2011 (MOHP et al. 2012).Fig. 1


Population Policy: Abortion and Modern Contraception Are Substitutes
Abortion and contraception trends in Nepal. Sources: Panel 1: abortion: Sedgh et al. (2011); contraception: 1970–1987 from Mauldin and Segal (1988), 1990–1995 from United Nations (2004), and 1996–2011 from MOHP et al. (2012). Panel 2: authors’ calculations are based on Demographic and Health Surveys of Nepal (1996–2011) (contraception) and Technical Committee for Implementation of Comprehensive Abortion Care (2010) (abortion facilities)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5016566&req=5

Fig1: Abortion and contraception trends in Nepal. Sources: Panel 1: abortion: Sedgh et al. (2011); contraception: 1970–1987 from Mauldin and Segal (1988), 1990–1995 from United Nations (2004), and 1996–2011 from MOHP et al. (2012). Panel 2: authors’ calculations are based on Demographic and Health Surveys of Nepal (1996–2011) (contraception) and Technical Committee for Implementation of Comprehensive Abortion Care (2010) (abortion facilities)
Mentions: Figure 1 shows the contraceptive prevalence and abortion rates in Nepal over time. After a rapid, sustained increase in the use of modern contraceptives from the late 1970s until the mid-2000s (from only 2 % to 48 %), contraceptive prevalence then plateaued with the legalization of abortion in 2004 (Fig. 1, panel 1). As in other countries, this pattern of co-movement is consistent with substitution and occurred during a period of declining fertility, with Nepal’s total fertility rate falling from 4.6 in 1996 to 2.6 in 2011 (MOHP et al. 2012).Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

A longstanding debate exists in population policy about the relationship between modern contraception and abortion. Although theory predicts that they should be substitutes, the empirical evidence is difficult to interpret. What is required is a large-scale intervention that alters the supply (or full price) of one or the other and, importantly, that does so in isolation (reproductive health programs often bundle primary health care and family planning—and in some instances, abortion services). In this article, we study Nepal’s 2004 legalization of abortion provision and subsequent expansion of abortion services, an unusual and rapidly implemented policy meeting these requirements. Using four waves of rich individual-level data representative of fertile-age Nepalese women, we find robust evidence of substitution between modern contraception and abortion. This finding has important implications for public policy and foreign aid, suggesting that an effective strategy for reducing expensive and potentially unsafe abortions may be to expand the supply of modern contraceptives.

Electronic supplementary material: The online version of this article (doi:10.1007/s13524-016-0492-8) contains supplementary material, which is available to authorized users.

No MeSH data available.