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Contraception and abortion in Nepalese young women

with contraceptive use either. Table 1 shows that higher contraceptive use among less educated women compared to their
educated counterparts, although it was not statistically significant.
Table 2 presents the odds ratios of practicing contraception among young women from multivariable logistic regression
models. The results regarding the demographic characteristics of women who practiced contraception were supported in
the multivariable analyses. Among all the samples, women aged 15 – 19 was less likely to use contraception, which is
mostly because they were not married and were involved in sexual activity less frequently. NDHS 2016 shows that 72%
of women aged 15 – 19 never had sex in the last 1 year and among those who were sexually active only 15% had sexual
intercourse in the past 1 month compared to 40% among their counterparts aged 20 – 24 (MOH et al., 2017). The results
among married women verified the no differences for use of contraception between these two age groups.
The number of children ever born stood out prominently: young women with two or more children ever born were about
as much as 25 times of and women with one child were about 15 times of the odds of practicing contraception among the
entire sample, compared with women who had no children (the higher odds ratios were reduced to 6 times and 3 times
among the married sample). Women of the Janajati ethnic group were more likely to use family planning methods than
adolescents and women from other caste/ethnic groups. Young women from Madhesh province were significantly less
likely (65%) (OR = 0.35) (it was 69% in the married sample) than those from Province 1 to practice contraception. Young
women from Gandaki and Lumbini provinces were also less likely than those young women from Province 1 to practice
contraception. The odds of using contraception were the highest in Province 1 compared to all other provinces. This is also
supported by simple contraceptive use prevalence among adolescents and youth by provinces, as shown in Table 1 above.
The multivariable analysis shows that the economic status of respondents was positively related to the practice
of contraception. Compared to women from the poorest wealth quintile, women belonging to the rich quintile were
significantly 1.7 times more likely to use contraception (it was the same in the married sample) and it is even higher
(2.7 times) for women from the richest wealth quintile (it was 3.4 times among the married sample). The multivariable
logistic analyses largely confirm the results for the socioeconomic characteristics except for the association between
educations. Knowing about the legal status of abortion was associated with higher odds of contraceptive use among
married women, although such higher odds were not significant among the entire sample.

3.2. Descriptive profile of women having an abortion
Table 3 presents descriptive profiles of young women aged 15 – 24 who obtained an abortion in the past 5 years preceding
the survey of 2016. It also presents the results of Chi-square tests of the significance of the association between the various
background characteristics and having obtained an abortion. Overall, among all young women aged 15 – 24, about 1.8%
had an abortion during the 5 years preceding the survey. There was a significant distributional difference in the prevalence
of abortion over age, marital status, children ever born, contraceptive use, and wealth index.
The results in Table 4 show that women who ever gave one birth were nearly 6 times (OR=5.72) more than to have
an abortion than women without any birth. The odds ratio was even higher among women who ever gave two or more
births (OR= 7.14). The higher ratios for these two subgroups were reduced to 2 times and about 3 times in the married
sample. Women who were using modern traditional contraceptive methods were 6 times (OR = 6.17) (4.4 times in the
married sample) more likely to have an abortion than their counterparts using no contraception, implicating either a low
effectiveness of traditional methods of family planning or lower sexual activities among those who were not using any
methods. No difference in prevalence of abortion was found between women who were not using any contraceptive
method and women who were using modern contraceptive method. The richer a woman, the greater the odds they had an
abortion. Women from Karnali Province had nearly 6 times higher odds of having an abortion compared to women from
Province 1, but there was no provincial difference for other provinces compared to Province 1. The results are very similar
among the married sample with some reduced odds ratios for few factors as we also noted above.

3.3. Descriptive profile of women obtaining safe abortion services
In NDHS 2016, a total of 492 women aged 15 – 49 reported having had an abortion 5 years preceding the survey
(MOH et al., 2017), and 51% of them were performed at government authorized health facilities. Among the youth
aged 15 – 24, the total number of recent abortions in the past 5 years was 83 with 42 abortions that were “safe” or
performed at government authorized health facilities and the remaining 41 abortions were “unsafe” (see Table 5).
Caste/ethnic group and the number of children ever born were the only demographic variables associated with abortion
safety. It was only ecological region that was significantly associated with abortion safety among the five socioeconomic
variables. Knowledge of the legal status of abortion was also associated with abortion safety.

82 International Journal of Population Studies | 2021, Volume 7, Issue 1