Factors associated with contraception and induced abortion among young women in Nepal

This study analyzed data from the 2016 Nepal Demographic and Health Survey (NDHS) supplemented by key indicators from several previous waves of NDHS to identify the sociodemographic profiles of women aged 15 – 24 who were using contraceptive methods and sought an abortion within 5 years before surveys. To augment the abortion analysis, field monitoring data of the Gorkha Safe Abortion (GSA) project were also used. Results from multivariable analyses show that women who ever gave a birth, who were from Province 1, who were economically well-off, and who knew the legal status of abortion, were more likely to practice contraception than their respective counterparts. Results, further, reveal that women practicing traditional methods of family planning were more likely to have an abortion than their counterparts not using any contraception. Women with two or more children ever born were more likely to have an abortion. Women from Karnali Province were most likely to have an abortion. Rich women were most likely to have an abortion than poor women. Regarding safe abortion, it is found that women living in the Tarai area were most likely to have a safe abortion than other geographic areas, due perhaps to family health services being more accessible in the Tarai area. Although the analyses found no relationship between age and abortions, perhaps due to small sample, the GSA project data clearly indicate that women under age 20, and those from Dalit community in particular, were more likely to seek an abortion than women aged 20 – 24. One lesson learned from the GSA project is that the pay-off for increasing access to safe abortion for hard-to-reach populations is high. To understand the complexity of sexual behaviors, contraceptive uses, and abortions among young women, more research using both qualitative and quantitative approaches are needed.