The historic fertility declines in Western countries that occurred prior to diffusion
of modern contraceptives were achieved primarily through induced
abortion, abstinence, and use of traditional methods of contraception, in
particular withdrawal. While these alternative means of fertility regulation
have also contributed to contemporary fertility declines in developing countries,
modern contraception seems to have taken the center stage in the
scientific literature and policy debates. Indeed, fertility declines in developing
countries have been highly correlated with the diffusion of modern
contraception. Sub-Saharan Africa is no exception to this general pattern,
although, as is typical in the beginning of fertility transitions, the relationship
between fertility decline and contraceptive use is still relatively loose in
the region (Westoff and Bankole 2001). It thus seems especially important
to consider the role of alternative means of birth control, including traditional
contraceptive methods and periods of sexual abstinence or inactivity,
in the case of contemporary sub-Saharan Africa.