title: Effectiveness of family planning policies: the abortion paradox.
abstract: OBJECTIVE
  The relation between levels of contraceptive use and the incidence of induced abortion remains a topic of heated debate. Many of the contradictions are likely due to the fact that abortion is the end point of a process that starts with sexual activity, contraceptive use (or non-use), followed by unwanted pregnancy, a decision to terminate, and access to abortion. Trends in abortion rates reflect changes in each step of this process, and opposing trends may cancel each other out. This paper aims to investigate the roles played by the dissemination of contraception and the evolving norms of motherhood on changes in abortion rates.
  
  
  METHODS
  Drawing data from six national probability surveys that explored contraception and pregnancy wantedness in France from 1978 through 2010, we used multivariate linear regression to explore the associations between trends in contraceptive rates and trends in (i) abortion rates, (ii) unwanted pregnancy rates, (iii) and unwanted birth rates, and to determine which of these 3 associations was strongest.
  
  
  RESULTS
  The association between contraceptive rates and abortion rates over time was weaker than that between contraception rates and unwanted pregnancy rates (p = 0.003). Similarly, the association between contraceptive rates and unwanted birth rates over time was weaker than that between contraceptive rates and unwanted pregnancy rates (p = 0.000).
authors.affiliation: Gender, Sexual and Reproductive Health, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Le Kremlin-Bicêtre, France; Institut National d'Etudes Démographiques, F-75020, Paris, France; Université Paris Sud, F-94807, Kremlin Bicêtre, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bajos
authors.affiliation: Gender, Sexual and Reproductive Health, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Le Kremlin-Bicêtre, France.
authors.forename: Mireille
authors.initials: M
authors.lastname: Le Guen
authors.affiliation: Gender, Sexual and Reproductive Health, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Le Kremlin-Bicêtre, France.
authors.forename: Aline
authors.initials: A
authors.lastname: Bohet
authors.affiliation: Gender, Sexual and Reproductive Health, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Le Kremlin-Bicêtre, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Panjo
authors.affiliation: Gender, Sexual and Reproductive Health, CESP Centre for research in Epidemiology and Population Health, U1018, Inserm, F-94807, Le Kremlin-Bicêtre, France; Institut National d'Etudes Démographiques, F-75020, Paris, France; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, United States of America.
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D003267:Contraception / Q000706:statistics & numerical data; D003268:Contraception Behavior; D016656:Family Planning Policy; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011275:Pregnancy, Unwanted; D011336:Probability; D012725:Sexual Behavior