Induced Abortion and Fertility: A Quarter Century of Experience in Eastern Europe

Abstract

The role of induced abortion in modifying fertility-particularly in Eastern Europe, but also in some other parts of the world-is believed to be powerful. Pointing to the relatively high incidence of induced abortion in Eastern European countries, some observers even consider induced abortion to be the main factor regulating fertility in that region. ' Is this belief based on correct analysis? The long-term effect of induced abortion both in absolute terms and relative to other factors inhibiting fertility has not been assessed in any country or region. The importance of such analyses is attested to by the fact that, irrespective of its legal status, induced abortion is practiced in almost every country around the globe.2 Moreover, when and where abortion legislation is restrictive,3 illegal abortions are often performed under conditions that result in serious health impairment to women. In some developing countries, treatment for medical complications resulting from illegal abortions is a major drain on health resources.4 This analysis of the role of induced abortion as a factor modifying fertility is based on the experience of countries of Eastern Europe.5 These countries over the past quarter century have enacted legislative measures that reflect a wide range of public attitudes concerning abortion and also possess reasonably reliable data that make it possible to explore fertility-related aspects of the incidence and legality of induced abortion. A systematic analysis of this experience can shed light not only on an important issue in the demography of Eastern Europe but also on the demographic consequences of abortion and abortion legislation more broadly. In the first section, after reviewing the history of abortion legislation in the region and summarizing salient trends in the incidence of induced abortion, an attempt is made to establish the extent to which legal abortions replaced