Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.
Over the last few decades, total fertility rates, child morbidity, and child mortality rates have declined in most parts of sub-Saharan Africa. Among the most striking trends observed are the rapid rate of urbanization and the often remarkably large gaps in fertility between rural and urban areas. Although a large literature has highlighted the importance of migration and urbanization within countries' demographic transitions, relatively little is known regarding the impact of migration on migrants' reproductive health outcomes in general and abortion in particular. In this article, we use detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. We find that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated. Our results suggest that recent migrants have an increased risk of pregnancy but not an increased risk of live birth in the first years post-move compared with those who had never moved. This gap seems to be largely explained by an increased risk of miscarriage or abortion among recent migrants. Increasing access to contraceptives for recent migrants has the potential to reduce the incidence of unwanted pregnancies, lower the prevalence of unsafe abortion, and contribute to improved maternal health outcomes.
Department of Health Policy, Evaluative Sciences and Statistics, Harvard University, 14 Story Street, 4th floor, Cambridge, MA, 02138, USA, srokicki@fas.harvard.edu.
Slawa
S
Rokicki
Livia
L
Montana
Günther
G
Fink
D000028:Abortion, Induced / Q000706:statistics & numerical data* / Q000639:trends; D000069:Acculturation; D000328:Adult; D000367:Age Factors; D001723:Birth Rate / Q000639:trends*; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D011157:Population Dynamics / Q000706:statistics & numerical data* / Q000639:trends; D011203:Poverty / Q000706:statistics & numerical data* / Q000639:trends; D060728:Reproductive Health / Q000706:statistics & numerical data / Q000639:trends; D017584:Reproductive History; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data* / Q000639:trends; D014507:Urbanization / Q000639:trends