Based on available evidence, this review article posits that contemporary use of abortion in sub-Saharan Africa often
substitutes for and sometimes surpasses modern contraceptive practice. Some studies and some data sets indicate that
this occurs not only among adolescents but also within older age groups. In several sub-Saharan cities, particularly
where contraceptive use is low and access to clinical abortion is high (though largely illegal), abortion appears to be the
method of choice for limiting or spacing births. Even in rural areas, women may regularly resort to abortion, often using
extremely unsafe procedures, instead of contraception. Available data seem to indicate that relatively high levels of
abortion correlate with low access to modern contraception, low status of women, strong sanctions against out-of-
wedlock pregnancy, traditional tolerance of abortion, and availability of modern abortion practices. Abortion has been
and will likely continue to be used to plan families within much of sub-Saharan Africa.