Several countries in Eastern Europe and Eurasia have a markedly high abortion rate and low prevalence of modern family planning (FP) methods. Explanations for the extensive use of abortion and low use of modern methods in the region cover a broad range of factors at both the health care system level and the individual level. One system-level factor that has received little attention with respect to reproductive choices is the pervasiveness of informal payments for health care. Although not thought to explain all of the reproductive health (RH) choices that women make, it is theorized that informal payments create disincentives for providers to promote FP options. This project intended to gain a more complete picture of how this system operates and understand the role payments play in RH service provision and the decision to use FP in two countries: Azerbaijan and Albania.This study explored the reasons behind the low level of modern contraceptive use among abortion clients in Tirana, Albania, and the role that financial factors might play in it.