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. 2025 Apr 12;22(1):52.
doi: 10.1186/s12978-025-02002-4.

Kenya's 2010 abortion law impacts contraceptive use and fertility rates

Maxwell Tii Kumbeni  1   2 , Marit L Bovbjerg  3 , S Marie Harvey  3 , Jeff Luck  3
Affiliations

Kenya's 2010 abortion law impacts contraceptive use and fertility rates

Maxwell Tii Kumbeni et al. Reprod Health. .

Abstract

Introduction: Prior research suggested that liberation of abortion laws in Sub-Saharan Africa (SSA) was associated with fewer abortion complications and deaths. However, few studies have examined the association of abortion law liberalization with modern contraceptive use and fertility rates among women in SSA. In this study, we assessed the impact of Kenya's 2010 abortion law liberalization on modern contraceptive use and number of recent births (births in the past 5 years ) among women of reproductive age in Kenya.

Methods: Data from three rounds of the Demographic and Health Surveys (2003-2016) for Kenya, Tanzania and Uganda were used for the analysis. We used the differences-in-differences estimator to assess the impact of the policy change in Kenya using Tanzania and Uganda as the control group. We performed multivariable logistic and Poisson regressions to estimate the adjusted odds ratios (aOR) and adjusted prevalence rate ratios (aPRR) with 95% confidence interval (CI) for modern contraceptive use and number of recent births respectively.

Results: A weighted sample of 117,163 women aged 15-49 years was used for the analyses. Modern contraceptive use increased from 25.4% and 19.4% to 39.1% and 27.2% for the intervention and control groups, respectively, in the post-intervention period. In contrast, the mean number of recent births declined from 0.71 and 0.88 to 0.63 and 0.80 for the intervention and control group, respectively in the post-intervention period. We found that Kenya's 2010 abortion law liberalization was associated with more people using modern contraception (aOR, 1.22; 95% CI 1.11, 1.34) and fewer recent births (aPRR, 0.95; 95% CI 0.91, 0.98).

Conclusion: Our findings suggest that Kenya's 2010 abortion law was surprisingly associated with higher use of modern contraceptives. Reforming restrictive abortion laws may indirectly improve use of contraceptives in Sub Saharan African countries.

Keywords: Abortion laws; Fertility rates; Kenya; Modern contraceptive use; Sub-Saharan Africa.

Plain language summary

Many countries in Sub Saharan Africa (SSA) have laws that prohibit legal termination of pregnancy (abortion) except when the pregnancy poses danger to the life of the woman. These laws, known as abortion laws, are often associated with high level of unsafe abortion practices and its related complications. Our study sought to examine the impact of Kenya’s 2010 abortion law on modern contraceptive uptake and number of recent births (births in the past 5 years). We used three rounds of cross sectional data from the Demographic and Health Surveys (DHS) in Kenya, Tanzania, and Uganda for the analysis. DHS data are mostly collected every five years with standard questionnaire across implementing countries. To assess the impact of Kenya’s abortion 2010 law, we used Tanzania and Uganda as the control group. We found that the change of the abortion law (from highly restrictive to moderately restrictive) was associated with an increase in the uptake of modern contraceptive methods among women in Kenya. Furthermore, change of the law was also associated with women in Kenya having fewer births (births that occurred five years prior to the surveys). Our study suggest that changes in laws that permit legal termination of pregnancy on broader grounds without restrictions in SSA countries, may help improve the use of reproductive health services such as modern contraceptives.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: We used deidentified publicly available secondary data which did not require ethical approval. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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