Bongaarts J, Westoff C F
Policy Research Division, Population Council, New York, USA.
Stud Fam Plann. 2000 Sep;31(3):193-202. doi: 10.1111/j.1728-4465.2000.00193.x.
This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used in this analysis links the abortion rate to its direct determinants, including couples' reproductive preferences, the prevalence and effectiveness of contraceptive practice to implement these preferences, and the probability of undergoing an abortion to avoid an unintended birth when a contraceptive fails or is not used. An assessment of the tradeoff between contraception and abortion yields estimates of the decline in the total abortion rate that would result from an illustrative increase of 10 percentage points in prevalence. This effect varies among societies, primarily because the tendency to obtain an abortion after an unintended pregnancy varies. For example, in a population with an abortion probability of 0.5, a 10 percentage-point increase in prevalence would avert approximately 0.45 abortions per woman, assuming contraception is 95 percent effective. If all unintended pregnancies were aborted, this effect would be three times larger. Eliminating all unintended pregnancies and subsequent abortions would require a rise in contraceptive prevalence to the level at which all fecund women who do not wish to become pregnant practice contraception that is 100 percent effective. A procedure is provided for estimating this "perfect" level of contraceptive prevalence.
本研究探讨了避孕普及率和有效性的进一步提高在降低堕胎率方面的潜在作用。本分析中使用的模型将堕胎率与其直接决定因素联系起来,这些因素包括夫妇的生育偏好、实现这些偏好的避孕措施的普及率和有效性,以及在避孕失败或未采取避孕措施时为避免意外生育而进行堕胎的概率。对避孕与堕胎之间权衡的评估得出了一个估计值,即普及率假设性地提高10个百分点会导致总堕胎率下降的幅度。这种影响在不同社会之间有所不同,主要是因为意外怀孕后选择堕胎的倾向各不相同。例如,在堕胎概率为0.5的人群中,假设避孕措施的有效性为95%,普及率提高10个百分点将使每位女性避免约0.45次堕胎。如果所有意外怀孕都进行堕胎,这种影响将扩大三倍。消除所有意外怀孕及随后的堕胎需要将避孕普及率提高到这样一个水平,即所有不想怀孕的育龄妇女都采取100%有效的避孕措施。文中提供了一种估计这种“完美”避孕普及率水平的方法。