Fertility Regulation in a Declining State Socialist

International Family Planning Perspectives Elwood Carlson is professor and Megumi Omori is Ph.D candidate, Department of Sociology, University of South Carolina, Columbia, SC, USA. The authors thank Kiril Donkov of the Bulgarian National Statistical Office, Tzveta Timtcheva and Christian Griva of the Bulgarian Ministry of Health, Marta Sougareva and Dimiter Filipov of the Institute of Demography in the Bulgarian Academy of Sciences and Nikolai Botev of the United Nations. They also thank Henry David, John Casterline and Barbara Anderson for their comments and suggestions. In the decade since the 1990 World Health Organization conference, “From Abortion to Contraception,”1 held in Tbilisi, Georgia, family planning efforts in eastern Europe have focused on increasing contraceptive use to reduce the region’s heavy reliance on induced abortion as the primary means of fertility regulation. However, the relationship between contraceptive use and abortion may be more complex than the conference title suggests. Both contraceptive use and abortion figure among the intervening variables affecting fertility that are outlined by Davis and Blake,2 but they do not necessarily vary inversely (i.e., an increase in one may not produce a decrease in the other). In this article, we use data on contraceptive use, births and abortions to examine trends in reliance on induced abortion in Bulgaria, women’s patterns of reliance on contraception and abortion during the past 20 years, and trends in the proportion of pregnancies ending in live births. Fertility Regulation in a Declining State Socialist Economy: Bulgaria, 1976–1995