Kenya's 2010 abortion law impacts contraceptive use and fertility rates

Prior research suggested that liberation of abortion laws in Sub-Saharan Africa (SSA) was associated with fewer abortion complications and deaths. However, few studies have examined the association of abortion law liberalization with modern contraceptive use and fertility rates  among women in SSA. In this study, we assessed the impact of Kenya's 2010 abortion law liberalization on modern contraceptive use and number of recent births (births in the past 5 years ) among women of reproductive age in Kenya.

Data from three rounds of the Demographic and Health Surveys (2003-2016) for Kenya, Tanzania and Uganda were used for the analysis. We used the differences-in-differences estimator to assess the impact of the policy change in Kenya using Tanzania and Uganda as the control group. We performed multivariable logistic and Poisson regressions to estimate the adjusted odds ratios (aOR) and adjusted prevalence rate ratios (aPRR) with 95% confidence interval (CI) for modern contraceptive use and number of recent births respectively.

A weighted sample of 117,163 women aged 15-49 years was used for the analyses. Modern contraceptive use increased from 25.4% and 19.4% to 39.1% and 27.2% for the intervention and control groups, respectively, in the post-intervention period. In contrast, the mean number of recent births declined from 0.71 and 0.88 to 0.63 and 0.80 for the intervention and control group, respectively in the post-intervention period. We found that Kenya's 2010 abortion law liberalization was associated with more people using modern contraception (aOR, 1.22; 95% CI 1.11, 1.34) and fewer recent births (aPRR, 0.95; 95% CI 0.91, 0.98).

Our findings suggest that Kenya's 2010 abortion law was surprisingly associated with higher use of modern contraceptives. Reforming restrictive abortion laws may indirectly improve use of contraceptives in Sub Saharan African countries.