A central issue in the study of abortion is its close link to contraceptive practice. The uncertainties and difficulties women experience in determining the moment and conditions of their sexual relations largely explain the insufficient use of contraceptive methods in fertility control. As Faúndes and Barzelatto point out (2005), there are geographical, social, economic and institutional barriers to family planning that are greater among the more disadvantaged sectors of the population. It is therefore a serious mistake to confer the entire responsibility for contraception on women. Male domination in decisions related to reproductive health, particularly sexuality, hampers the use of contraception, particularly if the male opposes these methods. Negotiating contraceptive use tends to be difficult, particularly for young women. Added to this is a certain reticence on the part of women regarding hormonal contraception or other methods, for fear of possible side effects. These factors largely explain the decision to resort to abortion.
As Marston and Cleland so rightly point out (2003), “the link between contraceptive use levels and abortion continues to elicit heated debate. Some observers hold that the use of abortion declines as the prevalence of contraception use increases, while others report that greater use of family planning methods contributes to an increase in the incidence of abortion”.
The dissemination of the knowledge and use of contraceptive methods leads to another option besides abortion for preventing or delaying the birth of a child: preventing an unwanted or unforeseen pregnancy. This has lead one to assume that the generalization of the use of contraceptives constitutes an alternative for eliminating the practice of abortion (Marston and Cleland, 2003). In fact, there are authors who state that the abortion rate is primarily a reflection of the availability and quality of the family planning and sex education services in a country (Ketting, 1993). They also remind us that the variation in abortion rates may be estimated by the prevalence of contraceptives and their effective use, the dominant preferences regarding fertility, the laws and policies concerning abortion and contraception, and the link between these two. Contraceptive use is a key factor. For example, when contraceptives are not available, particularly for adolescents, abortion rates are high and tend to increase (Kulczycki, 1996).
Abortion is undoubtedly the oldest method that exists for regulating and controlling fertility, and one that has been practiced in all places and societies and by different socioeconomic groups (Pommier, 1991; Marston and Cleland, 2003). However, abortion will continue to be an alternative, as it is today, even in the United States, France and other countries where contraception use is widespread and highly effective. As The Alan Guttmacher Institute points out, (p.29) “Although broader, improved family planning may translate into the reduction of unwanted pregnancies […] failures in the use of contraceptive methods will never completely disappear and unwanted pregnancies will continue occurring” (Alan Guttmacher Institute, 1994).
Likewise, other authors note that ever since contraceptive practices and methods came to be known, both abortion and contraception have been used to prevent pregnancy and control the number of one’s offspring (David and Pick de Weiss, 1992).
For their part, Faúndes and Barzelatto (2005) state that the high unsatisfied demand for contraceptives, concept that has been defined as the proportion of women that have sex and do not wish to get pregnant at a specific time or ever again and yet do not use any contraceptive method, constitutes one of the main factors determining unsafe abortion. They add that some of the factors that lead to a lower use of contraceptives include the lack of knowledge about them and negative or side effects, often erroneously attributed to certain modern methods, together with their lack of availability. The economic, cultural, physical (and institutional) barriers to obtaining access to contraceptives also discourage their use, meaning that there are unforeseen pregnancies and abortions as a result.