Harvard Center for Population and Development Studies, Harvard University, Cambridge, USA.
Int J Gynaecol Obstet. 2013 Nov;123 Suppl 1:e24-8. doi: 10.1016/j.ijgo.2013.07.008. Epub 2013 Aug 2.
An unresolved debate in demography concerns the causal sequence between the supply of contraception and the demand for smaller families in fertility decline. Through a mixed-methods approach, we explored the effect of a sudden increase in access to legal abortion on subsequent fertility decline when Ghana's criminal code was amended in 1985.
Using Ghana Demographic and Health Surveys, we constructed a panel of women aged 15-34 years and undertook a spline regression analysis to examine the effect of legal changes in 1985 and fertility decline controlling for social determinants of fertility. In addition, we conducted 17 key informant interviews (KIIs) to understand the reasons for the legal change and competing explanations for fertility decline.
Multivariate results indicated that the timing of the liberalization of the abortion law coincided with the onset of Ghana's fertility decline. The KIIs indicated that the reasons for the liberalization of reproductive health laws were in response to famine and physician advocacy.
While the timing of the abortion law liberalization coincided with the fertility decline in Ghana, we are unable to decouple the effect of the legal change from the effects of a severe famine that affected the region at the same time. Further research on documented and undocumented abortion in Ghana should be conducted to validate the contribution of legal abortion to fertility decline.
人口统计学中一个悬而未决的争论是避孕供应与生育率下降中较小家庭需求之间的因果关系。通过混合方法，我们探讨了加纳刑法在 1985 年修订后，合法堕胎机会突然增加对随后生育率下降的影响。
我们使用加纳人口与健康调查数据，构建了一个年龄在 15-34 岁的女性面板，并进行了样条回归分析，以考察 1985 年法律变化对生育率下降的影响，并控制生育的社会决定因素。此外，我们进行了 17 次关键知情人访谈（KII），以了解法律变化的原因和生育率下降的其他竞争解释。
多变量结果表明，堕胎法的自由化时间与加纳生育率下降的开始时间相吻合。KII 表明，生殖健康法自由化的原因是为了应对饥荒和医生的倡导。
虽然堕胎法的自由化时间与加纳的生育率下降相吻合，但我们无法将法律变革的影响与同时影响该地区的严重饥荒的影响分开。应在加纳进行有记录和无记录的堕胎方面的进一步研究，以验证合法堕胎对生育率下降的贡献。
