The role of abortion in the last stage of fertility decline in Vietnam.

CONTEXT Vietnam has experienced a rapid fertility decline over the last three decades, yet fertility rates vary considerably across the country's 54 ethnic groups. METHODS Data were drawn from the 2001 Vietnam National Health Survey, which collected information from 27,097 currently married women aged 15-49 on their birth and abortion history over the preceding five years, as well as their current contraceptive use. Multivariate regression analyses identified associations between individual, household and community characteristics and women's contraceptive use and abortion history, and examined ethnic differences in the types of methods used and in abortion incidence. RESULTS Vietnam's total fertility rate was 1.6 children per woman, whereas the rate among ethnic minorities in the northern uplands and central highlands was 2.6 and 2.8, respectively. These groups also had a lower abortion rate than the national average (0.3-0.5 vs. 0.7), and were less likely than the group comprising the Kinh majority and the Chinese minority to have used either a modern or traditional contraceptive (odds ratios, 0.4-0.7) or to have had an abortion (0.2-0.6). The likelihood of having had an abortion was elevated among older (5.6-21.2) and better educated women (1.4-1.7), as well as among those with one or two children and those from socioeconomically advantaged ethnic groups (1.2-1.4). Finally, abortion rates were higher among women who practiced traditional methods than among those who used modern ones. CONCLUSIONS Because better access to abortion is unlikely by itself to reduce fertility among high-fertility minority groups, programs that provide supportive reproductive health services and that target young, low-parity and less educated women may help to lower fertility among these groups.