Knowledge of Ghana’s liberal abortion law and use of modern contraceptives among women of reproductive age
This study investigated the relationship between knowledge of Ghana's liberal abortion law, awareness of the monthly fertile period, and the use of modern contraceptives among women of reproductive age in Ghana.
College of Health researcher(s)
Abstract
Background
Modern contraceptives have been widely promoted as an effective tool for birth control. They are highly effective for preventing unintended pregnancies thereby reducing the risk of abortions, maternal morbidities, and mortalities. Abortion or planned abstinence from sexual intercourse may be perceived as alternatives to the use of modern contraceptives. The aim of this study was to assess whether knowledge of the legal status of abortion, and knowledge of the monthly fertile period, were associated with the use of modern contraceptives among women of reproductive age in Ghana.
Methods
We used nationally representative secondary data from the 2017 Ghana Maternal Health Survey. A weighted sample of 23,466 non-pregnant women aged 15–49 years were included in the study. Pearson chi-square and multivariable logistic regression analysis were conducted to assess the association between the independent and the outcomes variables. Sampling weight, cluster, and strata were applied at all levels of the analysis.
Results
More than half (55.4%) lived in urban area, 80.1% were 20 years or older, 52.2% were multiparous women, 61.9% had secondary or higher education, and 34.5% were in the lower two wealth quintiles. We found no statistically significant association between knowledge of the legal status of abortion and use of modern contraceptives, or between knowledge of the monthly fertile period and use of modern contraceptives. Women with history of an induced abortion were 1.57 times as likely to use modern contraceptives compared to those with no history [adjusted odds ratio (aOR) 1.57, 95% CI 1.41–1.75]. Each additional increase in knowledge of a different modern contraceptive method was associated with 1.25 times increase in modern contraceptive use (aOR 1.25, 95% CI 1.22–1.29).
Conclusions
Intensifying education on modern contraceptive methods and use, especially at abortion facilities, may help improve the uptake of modern contraceptives among women in Ghana.
Frequently Asked Questions about Contraceptive Use and Abortion Knowledge in Ghana
What was the primary aim of the Kumbeni et al. (2025) study in Ghana?
The study aimed to investigate the association between women's knowledge of the legal status of abortion in Ghana and their knowledge of their monthly fertile period with their use of modern contraceptives. It also explored how other factors like knowledge of different contraceptive methods and history of induced abortion might be related to contraceptive use.
What were the main findings regarding the relationship between knowledge of abortion law and contraceptive use in Ghana, according to the study?
The study found no statistically significant association between women's knowledge of Ghana's liberal abortion law and their use of modern contraceptives. In other words, knowing that abortion is legal did not appear to decrease or increase the likelihood of a woman using modern contraception.
Did knowledge of the fertile period influence contraceptive use in the study?
Similar to the abortion law knowledge, the study did not find a significant association between women's knowledge of their monthly fertile period and their use of modern contraceptives. Knowing when one is most fertile did not seem to strongly influence the decision to use modern contraception.
What factors were found to be associated with modern contraceptive use in the study?
The study found that women with a history of induced abortion were significantly more likely to use modern contraceptives. Additionally, the more modern contraceptive methods a woman knew, the more likely she was to use modern contraception. Other factors included marital status, place of residence (rural), access to media, age, parity, wealth index, and religion.
Why might knowledge of the abortion law not be associated with lower contraceptive use in Ghana?
The study suggests several possible explanations: despite the liberal abortion law, the cost of legal abortions may still be a barrier. Availability of abortion services may also be a challenge. Furthermore, the stigma surrounding abortion and religious beliefs may influence women to use contraceptives regardless of their knowledge of the legal status of abortion.
What are the potential reasons why knowledge of the fertile period didn't impact contraceptive use in the study?
The study points out that many women in Ghana may lack sexual autonomy and might be forced into sex during their fertile period, leading them to rely on contraception. Also, relying solely on knowledge of the fertile period can be challenging and less effective, especially with irregular menstrual cycles, and family planning interventions prioritize modern contraceptive use in Ghana.
What implications do these findings have for family planning programs in Ghana?
The findings suggest that intensifying education and counseling on various modern contraceptive methods, particularly at abortion facilities, may be an effective strategy to improve contraceptive uptake in Ghana. Awareness of a wider range of contraceptive options allows women to make informed choices.
What are some of the limitations of the study that should be considered when interpreting the results?
The study was based on cross-sectional data, which means that causality cannot be inferred. The data was self-reported, potentially introducing recall bias. Additionally, the study couldn't control for all possible confounding factors due to limitations in the available data.