Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa

Abstract Restrictive abortion laws in many African nations are associated with risks such as unsafe procedures and teenage motherhood. This study examines how abortion legalization influences sexual and reproductive health and women’s empowerment in South Africa, using a difference-in-differences de...

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Main Authors: Getrude Njokwe, Yoko Kijima
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Health, Population and Nutrition
Subjects:
Online Access:https://doi.org/10.1186/s41043-025-01034-7
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author Getrude Njokwe
Yoko Kijima
author_facet Getrude Njokwe
Yoko Kijima
author_sort Getrude Njokwe
collection DOAJ
description Abstract Restrictive abortion laws in many African nations are associated with risks such as unsafe procedures and teenage motherhood. This study examines how abortion legalization influences sexual and reproductive health and women’s empowerment in South Africa, using a difference-in-differences design. Analyzing variations in birth cohorts and access to health care facilities with abortion services across provinces, the study finds no direct causal impact of the abortion policy on teenage motherhood, fertility rates, early sexual debut, high school completion, or college attendance, though negative associations with teenage motherhood and fertility rates and positive associations with early sexual debut, high school completion, and college attendance, were observed. The study suggests that limited access to health care facilities with abortion services and cultural taboos contribute to underreporting of behaviors. Given these findings, we recommend prioritizing access to contraception and creating supportive environments for adolescent girls living in vulnerable situations, including improved access to health care facilities that offer abortion services.
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publishDate 2025-08-01
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spelling doaj-art-1092b55dd0f14f0bb863a8c9a82332852025-08-24T11:35:44ZengBMCJournal of Health, Population and Nutrition2072-13152025-08-0144111210.1186/s41043-025-01034-7Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South AfricaGetrude Njokwe0Yoko Kijima1University of PretoriaNational Graduate Institute for Policy StudiesAbstract Restrictive abortion laws in many African nations are associated with risks such as unsafe procedures and teenage motherhood. This study examines how abortion legalization influences sexual and reproductive health and women’s empowerment in South Africa, using a difference-in-differences design. Analyzing variations in birth cohorts and access to health care facilities with abortion services across provinces, the study finds no direct causal impact of the abortion policy on teenage motherhood, fertility rates, early sexual debut, high school completion, or college attendance, though negative associations with teenage motherhood and fertility rates and positive associations with early sexual debut, high school completion, and college attendance, were observed. The study suggests that limited access to health care facilities with abortion services and cultural taboos contribute to underreporting of behaviors. Given these findings, we recommend prioritizing access to contraception and creating supportive environments for adolescent girls living in vulnerable situations, including improved access to health care facilities that offer abortion services.https://doi.org/10.1186/s41043-025-01034-7Abortion legalizationFertilitySchoolingAdolescentDifference-in-differenceSouth Africa
spellingShingle Getrude Njokwe
Yoko Kijima
Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
Journal of Health, Population and Nutrition
Abortion legalization
Fertility
Schooling
Adolescent
Difference-in-difference
South Africa
title Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
title_full Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
title_fullStr Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
title_full_unstemmed Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
title_short Abortion legalization, teen sexual and reproductive health behaviors, and women’s empowerment in South Africa
title_sort abortion legalization teen sexual and reproductive health behaviors and women s empowerment in south africa
topic Abortion legalization
Fertility
Schooling
Adolescent
Difference-in-difference
South Africa
url https://doi.org/10.1186/s41043-025-01034-7
work_keys_str_mv AT getrudenjokwe abortionlegalizationteensexualandreproductivehealthbehaviorsandwomensempowermentinsouthafrica
AT yokokijima abortionlegalizationteensexualandreproductivehealthbehaviorsandwomensempowermentinsouthafrica