FERTILITY REGULATION IN A DECLINING STATE SOCIALIST ECONOMY - BULGARIA, 1976-1995

Context: Although reproductive behavior in eastern Europe is believed to have altered with the decline of the state socialist systems, there are few data available with which to elucidate changes. Methods: Find ings from a 1976 World Fertility Survey of married women and from a 19 95 survey of married and unmarried women are used to assess changes in contraceptive usage during a two-decade time period in Bulgaria. Data on the number of births and abortions from the country's vital and he alth statistics system are then used to analyze corresponding changes in reproductive outcomes. Results: Among married women aged 15-44, use of modern contraceptive methods increased from 6% in 1976 to 46% in 1 995, while their reliance on traditional methods decreased from 70% to 40%. The proportion of women using no method decreased from 25% in 19 76 to 14% in 1995. Although married women under the age of 20 did not increase their practice of contraception as much as women aged 20-44, their reliance on modern methods increased from 1% in 1976 to 18% in 1 995. During the same 20-year time period, an increasing share of pregn ancies ended in abortion, while live births declined in relative frequ ency. In 1976, 49% of all pregnancies ended in abortion; by 1995, the proportion had increased to 57%. Conclusions: Concurrent with an incre ase in the practice of contraception, Bulgarian women's reliance on in duced abortion also increased. The trend evidenced in Bulgaria provide s a fresh example of a multiphasic response: A strong stimulus (in thi s case a declining economy) created an urgency among Bulgarians to con trol their fertility by all available options.