مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
Study on the Relationship between Abortion Rates and Total Fertility Rates in Selected Countries Worldwide
Study on the Relationship between Abortion Rates and Total Fertility Rates in Selected Countries Worldwide
Fateme Modiri,1,*
1. Associate Professor, Department of Family Studies, National Institute for Population Research
Introduction: Introduction
Abortion is one of the complex and influential issues in the field of reproductive health and population, with various complicated health and demographic consequences. High rates of induced abortion are usually observed in developing countries where fertility is generally higher, but reproductive health services and adequate education are lacking (WHO, 2022). Some societies have adopted restrictive abortion policies due to declining fertility, based on the logic that reducing abortion rates will lead to increased fertility and population growth. This article aims to answer the question: Is there a direct correlation between the reduction in abortion rates and an increase in total fertility rates?
Several studies have examined the relationship between induced abortion and fertility. Sedgh et al. (2016) showed that in countries with limited access to contraceptive services, the rate of induced abortion is higher, which can affect fertility patterns. WHO studies (2012) emphasize that legal restrictions on abortion often lead to an increase in unsafe abortions and negative health outcomes, without significantly changing fertility rates. Santelli et al. (2017) identified education and access to contraceptive services as key factors in simultaneously controlling abortion and fertility rates.
Methods: Methodology
This study employs a comparative cross-national analysis to examine the relationship between abortion trends and total fertility rates (TFR) in selected countries. Sixteen countries were purposively selected based on their documented abortion rate trajectories and fertility patterns, as reported by the Guttmacher Institute (2020). The countries were categorized into two groups according to their abortion trends:
• Group 1 (Successful countries): Nine countries demonstrating declining abortion rates—Switzerland, Singapore, Russia, Denmark, Japan, Albania, Haiti, South Korea, and Tajikistan.
• Group 2 (Less successful countries): Seven countries exhibiting increasing abortion rates—Thailand, Indonesia, South Africa, Kenya, Cameroon, Burkina Faso, and Mozambique.
Total fertility rates for these countries were obtained from the United Nations World Population Prospects (2023) database. Data analysis focused on comparing abortion trends with corresponding changes in TFR over a defined temporal window, employing descriptive statistical methods to identify patterns and associations.
Comparison of Abortion Trends and TFR Trends in Selected Countries
No. Country Abortion Trend TFR TFR Trend
1 Switzerland Decreasing 1/52 Decreasing
2 Singapore Decreasing 1/42 Decreasing
3 Japan Decreasing 1/42 Decreasing
4 Russia Decreasing 1.57 Decreasing
5 Albania Decreasing 1/62 Decreasing
6 Denmark Decreasing 1/71 Decreasing
7 Haiti Decreasing 2/94 Decreasing
8 South Korea Decreasing 0/98 Decreasing
9 Tajikistan Decreasing 3/58 Decreasing
1 Thailand Increasing 1/52 Decreasing
2 Indonesia Increasing 2/31 Decreasing
3 South Africa Increasing 2/45 Decreasing
4 Kenya Increasing 3/49 Decreasing
5 Cameroon Increasing 4/57 Decreasing
6 Burkina Faso Increasing 5/19 Decreasing
7 Mozambique Increasing 4/85 Decreasing
Reference: Guttmacher (2020)
Results: Findings
Relationship between Abortion and Fertility: In the selected countries, a declining abortion rate did not lead to an increase in total fertility rates; instead, total fertility decreased in all countries.
Conclusion: Conclusion
Some studies have shown that reducing induced abortion rates without improving access to contraceptive methods and related education leads to increased unintended pregnancies, which may negatively affect maternal and child health (Santelli et al., 2017). Therefore, reducing induced abortion alone does not necessarily mean an increase in healthy and controlled fertility. Some studies suggest that achieving higher fertility and reducing abortion correlate with the following factors:
• Access to contraceptive services: Reduction in induced abortion rates occurs when contraceptive use increases (Santelli et al., 2017).
• Economic and social status: Women with limited financial resources and social support are more likely to undergo illegal abortions, impacting desired fertility (Delgado et al., 2019).
• Education and culture: Higher education and awareness reduce the need for induced abortion and increase planned pregnancies. Comprehensive education in countries has been reported to reduce induced abortion rates by up to 30% over 10 years (Santelli et al., 2017).
Induced abortion is used in some societies with limited access to effective contraception as a means to avoid unwanted pregnancies (Sedgh et al., 2016). Restrictive abortion policies alone are only one environmental factor and cannot lead to increased desirable fertility without comprehensive accompanying measures. Reducing induced abortion without comprehensive actions in education, access to contraceptive services, and social support cannot result in increased desirable and healthy fertility. Restrictive abortion policies alone are ineffective and may have negative health and social consequences. Therefore, multidimensional and evidence-based approaches are the best solution to improve reproductive health and increase healthy fertility in various societies. Addressing the causes of induced abortion and the reasons for declining fertility preferences, along with removing existing barriers with cultural considerations, can lead to positive outcomes.
References
• Delgado, M., et al. (2019). Psychosocial factors influencing pregnancy outcomes: a review. Journal of Reproductive Health, 16(2), 101-115.
• Santelli, J. S., Lindberg, L. D., Finer, L. B., & Singh, S. (2017). Explaining recent declines in adolescent pregnancy in the United States. American Journal of Public Health, 107(3), 449-455.
• Sedgh, G., Singh, S., & Hussain, R. (2016). Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning, 45(3), 301-314.
• World Health Organization (WHO). (2012). Safe abortion: technical and policy guidance for health systems.
• World Health Organization (WHO). (2022). Abortion Fact Sheet.
• United Nations (UN). (2023). World Population Prospects.