Fertility Regulation among Women in Abidjan, Cote d'Ivoire: Contraception, Abortion or Both?

In Cote dIvoire where contraceptive prevalence is low abortion is thought to play an important role in the current fertility decline. However data on abortion which is illegal are scarce. A retrospective survey on abortion and contraceptive practices was conducted in 1998 among 2400 women who attended four general health centers in Abidjan. Multinomial logistic regression was performed to analyze the independent effects of social and demographic variables on the odds that women would adopt one of three fertility regulation behaviors instead of doing nothing at all. Results show that 40% of women reported controlling their fertility through contraceptive use alone 30% through reliance on both contraception and abortion and 3% through abortion alone; some 27% did nothing to control fertility. Muslims had consistently lower odds than Christians of adopting any of the three behaviors instead of doing nothing (odds ratios (OR) 0.2-0.5). Being unmarried and better educated were associated with significantly elevated odds of adopting each of the three behaviors (OR 1.4-33.8). Finally the odds of using abortion alone were significantly higher among women younger than 25 than among those aged 25-34 (2.0). In conclusion the relationship between abortion and contraception is highly complex. Whereas women who do not have access to contraceptives or who experience method failure often resort to abortion abortion can also trigger subsequent reliance on contraception. (authors)