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 mortality rates have declinedin most parts of sub-Saharan Africa. One of the most striking trends observed is the rapid rate ofurbanization, and the often remarkably large gaps in fertility between rural and urban areas.While a large literature has highlighted the importance of migration and urbanization withincountries? demographic transitions, relatively little is known regarding the impact of migrationon migrants? reproductive health outcomes in general, and abortion in particular. In this paper,we use detailed pregnancy and migration histories collected as part of the Household andWelfare Study of Accra (HAWS) to examine the association between migration and pregnancyoutcomes among women residing in the urban slums of Accra, Ghana. We find that thecompleted fertility patterns of lifetime Accra residents are remarkably similar to those ofresidents who migrated. Our results suggest that recent migrants have an increased risk ofpregnancy, but not an increased risk of live birth in the first years post-move as compared tothose who had never moved. This gap seems to be largely explained by an increased risk ofmiscarriage or abortion among recent migrants. The increased risk of pregnancy loss may be dueto a lack of social network, increased stress, and increased access to and knowledge on abortivemeasures. Increasing access to contraceptives for recent migrants has the potential to reduce theincidence of unwanted pregnancies, lower the prevalence of abortion and contribute to improvedmaternal health outcomes.