Effectiveness of family planning policies: the abortion paradox

PLoS One. 2014 Mar 26;9(3):e91539. doi: 10.1371/journal.pone.0091539. eCollection 2014.

Abstract

Objective: The relation between levels of contraceptive use and the incidence of induced abortion remains a topic of heated debate. Many of the contradictions are likely due to the fact that abortion is the end point of a process that starts with sexual activity, contraceptive use (or non-use), followed by unwanted pregnancy, a decision to terminate, and access to abortion. Trends in abortion rates reflect changes in each step of this process, and opposing trends may cancel each other out. This paper aims to investigate the roles played by the dissemination of contraception and the evolving norms of motherhood on changes in abortion rates.

Methods: Drawing data from six national probability surveys that explored contraception and pregnancy wantedness in France from 1978 through 2010, we used multivariate linear regression to explore the associations between trends in contraceptive rates and trends in (i) abortion rates, (ii) unwanted pregnancy rates, (iii) and unwanted birth rates, and to determine which of these 3 associations was strongest.

Findings: The association between contraceptive rates and abortion rates over time was weaker than that between contraception rates and unwanted pregnancy rates (p = 0.003). Similarly, the association between contraceptive rates and unwanted birth rates over time was weaker than that between contraceptive rates and unwanted pregnancy rates (p = 0.000).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced / statistics & numerical data*
  • Contraception / statistics & numerical data
  • Contraception Behavior
  • Family Planning Policy*
  • Female
  • France / epidemiology
  • Health Surveys
  • Humans
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Unwanted
  • Probability
  • Sexual Behavior

Grants and funding

The surveys were supported by funding from National Institute of Health and Medical Research (INSERM) and the National Institute for Demographic Research (INED). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.