(Withdrawn) How reproductive health laws help to explain the gap between contraceptive use and fertility decline: the curious case of Ghana

Jocelyn E. Finlay, Harvard University
Paul Cruickshank, Harvard University
Ashley M. Fox, Columbia University
Kavita Sivaramakrishnan, Harvard University

We observe that fertility rates decline dramatically following the liberalization of abortion law in Ghana and then later when there was a liberalization of contraceptive laws. The usual pathway: liberalization of reproductive health law; increase in abortion and contraceptive use; and decline in fertility, however, is not evident in the data – reports of abortion and contraceptive use did not match the stimulus (legal change) and outcome (fertility decline). This led our analysis to consider two core options. The first that there was under-reporting of abortion and contraceptive use; the second, that the change of abortion and reproductive health laws invoked the concept of ideation and greater awareness of reproductive health had an effect on fertility without changing contraceptive use. We explore the role of international agencies, domestic politics and the church in shaping the legal change and how these bodies influenced changes in attitudes and availability following the legal change. This analysis sheds new light on the mysterious case of fertility decline not matching contraceptive use trends in countries like Ghana.