Trends in fertility and abortion in Czechia.

The assessment of the development of fertility and abortion rates over the last three decades shows that Czechia has reached the top position in Europe with a total fertility rate of 1.83 children per woman in 2021. The postponement of fertility to women's older age, which was behind the sharp drop in fertility to 1.1, has been gradually slowed down and halted between 2015 and 2021. In recent years, there has been an increase in fertility rates for women aged 30 and older as well as a balanced increase for women under 30. In the European context Czechia has maintained its position as a country with lower rates of reproductive ageing. The favourable demographic position of Czechia among European countries is also illustrated by the relatively low level of the abortion rate. The postponement of female fertility to older ages has not been accompanied by an increase in the abortion rate among young women, but on the contrary a decline in fertility has been accompanied by a decline in the abortion rate. Given the year-on-year increase in total fertility (from 1.71 in 2020 to 1.83 in 2021), the initial effect of the COVID-19 pandemic on fertility can be assessed positively. However, the subsequent decline to 1.62 in 2022 is already the result of a combination of adverse effects stemming from the consequences of antipandemic measures and worsening economic conditions, to which new security risks associated with the war in Ukraine have subsequently been added. This has created the conditions for a further postponement of fertility until women are older.

Changes in contraceptive behavior in Czechia.

The rapid increase in the proportion of women using hormonal contraception in the 1990s was positively reflected in a rapid decline in the number of abortions. Czechia was unique not only among Eastern European countries, but also worldwide. At the same time the decline in the prevalence of hormonal contraception from a peak of almost 50 % in 2007 to 30 % in 2021 meant a slowing and gradual halt in the further decline in abortions. The results of the GGP 2020-2022 survey in Czechia showed that the lower use of hormonal contraception among women was only partly offset by the increased use of other reliable methods of protection against unintended pregnancy (e.g. condom use). The largest decline in the use of hormonal contraceptives in the form of the pill occurred among the youngest women aged 18-27 years, from 76 to 37 %, which was partly reflected in the more intensive use of condoms (an increase from 21 to 35% in the 18-27 age group), but is worrying, that this age group saw the largest increase in the use of less reliable methods (withdrawal from 11 to 22 % and an increase in the use of the barren days method from 1 to 6 %) and also the largest increase in the proportion of women using neither method (from 7 to 17 %). The lowest proportion of female hormonal pill users was found among female with higher education. However an important finding is that when less reliable methods are used, there is an effort to combine at least two methods. Women have a more important role in determining how to protect themselves from unintended pregnancy.