Stanley Henshaw


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    Global trends in abortion and contraception


    Trends in abortion and contraception: Global overview

    Stanley K. Henshaw, USA

    The long-term worldwide trend toward liberalization of laws governing induced abortion has continued in recent years, though at a slow pace, with significant liberalization since 2005 in Colombia, Ethiopia, Mexi-co City, Niger, Portugal, Spain, Thailand and Togo, while new restrictions in a few countries had relatively little impact.  Nevertheless, about 37% of the world’s population lives in countries where restrictions make it difficult or impossible to obtain a legal abortion.

    The World Health Organization estimates that about 42 million induced abortions occur every year, almost half illegally.  Abortion rates are moderate to high in most developing countries, though a few countries with excellent family planning services or little interest in fertility control have low rates.

    Abortion rates have declined in recent years in a majority of industrialized countries with complete statis-tics, especially in Eastern and Central European countries where rates were relative-ly high. Abortion rates in most industrialized countries are in the range of 7 to 16 abortions per 1,000 women aged 15-44.  Rates would be lower in many developed countries if not for immigrants from developing areas that have relatively high abortion rates.

    Trends in abortion rates to a large extent reflect changes in contraceptive practice. The UN Population Division’s estimate of the proportion of married women of reproductive age using contraception increased from 58% in 1998 to 63% in 2009.  In the more developed regions, the proportion of users remained about the same but there was a shift from traditional methods in favor of IUD, condom and pill. In less developed regions, use of all methods increased except male sterilization.  Abortion rates have not necessarily fallen, however, because more couples are seeking to control their fertility.  Worldwide, the most popular methods are female steriliza-tion, IUD, and contraceptive pill, in that order.

    In the United States, a marked fall in the abortion rate of teenagers since 1995 accompanied greater use of hormonal methods, condoms, and dual methods. Increased contraceptive use and a shift from traditional to modern methods have contributed to declining abortion rates in formerly Soviet-bloc countries.

    In the United States, where half of unintended pregnancies result from imperfect use of contraceptives, increasing acceptance of the IUD promises to reduce the high rates of unintended pregnancy and abortion.

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    The Impact of Religion of Abortion Utilization
    Stanley K. Henshaw, The Guttmacher Institute, New York, USA,

    Three aspects of religion potentially influence abortion practice: religious structures and
    authorities, the effect of religious dogma on individual behavior, and religiosity (the
    intensity of religious belief).
    Religious structures and authorities often influence abortion laws and policies; examples
    are the Catholic Church in Latin America and Islamic authorities in Indonesia.
    Religious dogma can affect abortion utilization by reducing sexual activity outside of
    marriage, influencing the use of contraception, and causing women to continue unwanted
    pregnancies. In practice, however, religious affiliation appears to have little effect even
    when the religions differ in their positions on abortion. In the United States, Catholic
    teenagers are no less likely to be sexually active than are Protestant teenagers, and
    though Catholic women are slightly more likely than other women to use withdrawal or
    rhythm, their contraceptive use is similar in other respects. Similarly, a survey of abortion
    patients found that Catholics were about as likely as other women to have used a
    contraceptive method when they became pregnant, though they were more likely to have
    used withdrawal or periodic abstinence. The abortion rate among Catholic women is at
    least as high as that of Protestant women. Studies in Nigeria and India have found little
    relation between religious affiliation and abortion rates.
    Religiosity, on the other hand, is associated with negative attitudes toward abortion, almost
    without regard to the particular religion. In the United States, religiosity (being a “born-
    again” Christian or attending church frequently) is associated with lower rates of sexual
    activity among teenagers and lower abortion rates, though not with any particular pattern
    of contraceptive use. However, the personality characteristics that influence this religious
    behavior may also reduce the need and inclination to choose abortion.