Njokwe Getrude, Kijima Yoko
University of Pretoria, P. Bag X28, Hatfield, Pretoria, 0028, South Africa.
National Graduate Institute for Policy Studies, 7-22-1 Roppongi, Minato-ku, Tokyo, 106-8677, Japan.
J Health Popul Nutr. 2025 Aug 20;44(1):302. doi: 10.1186/s41043-025-01034-7.
Restrictive abortion laws in many African nations are associated with risks such as unsafe procedures and teenage motherhood. This study examines how abortion legalization influences sexual and reproductive health and women's empowerment in South Africa, using a difference-in-differences design. Analyzing variations in birth cohorts and access to health care facilities with abortion services across provinces, the study finds no direct causal impact of the abortion policy on teenage motherhood, fertility rates, early sexual debut, high school completion, or college attendance, though negative associations with teenage motherhood and fertility rates and positive associations with early sexual debut, high school completion, and college attendance, were observed. The study suggests that limited access to health care facilities with abortion services and cultural taboos contribute to underreporting of behaviors. Given these findings, we recommend prioritizing access to contraception and creating supportive environments for adolescent girls living in vulnerable situations, including improved access to health care facilities that offer abortion services.
许多非洲国家严格的堕胎法律与不安全堕胎程序和少女怀孕等风险相关。本研究采用双重差分设计，考察堕胎合法化如何影响南非的性健康和生殖健康以及妇女赋权。通过分析不同出生队列以及各省获得堕胎服务的医疗保健设施的差异，研究发现堕胎政策对少女怀孕、生育率、初次性行为过早、高中完成率或大学入学率没有直接因果影响，不过观察到与少女怀孕和生育率呈负相关，与初次性行为过早、高中完成率和大学入学率呈正相关。研究表明，获得堕胎服务的医疗保健设施有限以及文化禁忌导致行为报告不足。鉴于这些发现，我们建议优先提供避孕措施，并为生活在脆弱处境中的少女创造支持性环境，包括改善获得提供堕胎服务的医疗保健设施的机会。
