Contraceptive practice in the United States, 1982-1988

Use of oral contraceptives by married women declined markedly between 1973 and 1982, but analysis of data from the 1988 National Survey of Family Growth shows that this decline stopped between 1982 and 1988. Reliance on female sterilization continued to increase, however, and it remained the leading method among currently married and formerly married women. Among women of all marital statuses, IUD use dropped by two-thirds between 1982 and 1988, from 2.2 million to 0.7 million women. As the proportion of less-educated, low-income, black and Hispanic contraceptive users choosing the IUD decreased, the proportion relying on female sterilization increased. Among college-educated white women, use of female sterilization did not increase; instead, pill use rose in this group. Condom use increased most sharply among teenagers and rose among never-married white and black women, but the pill was still the leading method by far in these groups, regardless of race. Among never-married black women, reliance on sterilization increased significantly between 1982 and 1988, with female sterilization becoming the second leading method. Use of the diaphragm declined sharply over the same period among never-married white women and among those who intended to have more children, as did use of periodic abstinence (rhythm and natural family planning) and foam.

Fertility intentions and subsequent behavior: a longitudinal study in rural India

This report compares fertility and family planning intentions of rural Indian women in 1975 with actual outcomes in 1987. Ninety-four of 103 respondents who had fewer children than they wanted in 1975 and had stated definite intentions with respect to future fertility and contraceptive use were reinterviewed in 1987. Overall, women had fewer children than desired and stopped childbearing when they reached or closely approximated their ideal number of sons. Since sons were clearly the determinant of "reproductive success," it is argued that only a significant change in the status of rural women can bring about widespread compliance with the official family planning program's two-child norm.

Trends in use of oral contraceptives--data from the 1987 National Health Interview Survey

Despite fluctuations in current use rates for oral contraceptives, ever-use of the pill has remained remarkably stable for all cohorts of U.S. women born since 1945. Approximately 80 percent of these women report having used the pill at some time. Average duration of use is about five years among cohorts who had access to the pill from their earliest reproductive years. Among women born before 1940, whites are more likely than blacks to have ever used the pill, but no racial difference is evident among women in later cohorts. Age at first use of the pill has declined with each succeeding five-year birth cohort. Black women are more likely than white women to have used oral contraceptives before age 18, but by age 25, about three-fourths of blacks and whites have used the pill. Among ever-users born before 1945, the majority began taking the pill after their first full-term pregnancy; this pattern is reversed among more recent cohorts.

Contraceptive knowledge and practices in Ilorin, Nigeria: 1983-88

This report describes changes in knowledge and use of contraceptives in Ilorin, Nigeria between 1983 and 1988, a period marked both by dramatic changes in Nigeria's economic climate, as a result of the decline in the value of oil exports, and by considerable increases in public programs aimed at promoting the use of family planning and reducing fertility. The report is based on the analysis of two surveys of married women aged 15-35 years who lived in the city of Ilorin. By 1988, knowledge of modern methods of contraception had become virtually universal in Ilorin, even among women with no education and among those living in the poorest areas of the city. Current use of contraceptives had also increased considerably since 1983, reaching prevalence rates of 15 percent among women with primary education, 20 percent among those with secondary education, and 40 percent among those with postsecondary education. Each of these groups of women experienced at least a doubling of contraceptive prevalence between 1983 and 1988. Although use among uneducated women was still low in absolute terms (prevalence of 4.5 percent), these women also experienced a substantial relative increase in use.

Family planning in Rwanda: status and prospects

This article analyzes the status and future prospects of family planning in Rwanda. The use of traditional contraceptive methods is examined and major constraints to modern contraceptive use are discussed, both for potential users (low demand) and family planning delivery systems (poor supply). Current contraceptive prevalence, as well as evidence of potentially higher demand, are analyzed. Contraceptive prevalence for modern methods is estimated at 3-4 percent, for 1988, of women of reproductive age who are at risk of exposure to conception. An attempt is also made to target future contraceptive prevalence rates needed to attain specific levels of fertility. Finally, the prospects for family planning as well as recommendations to increase contraceptive use are reviewed.

[Fertility and health in Mexico]

Fertility, health, and family planning are not independent factors, but rather involve a series of biological and social mechanisms in close interaction with one another. The impact that a high fertility rate has on health is reflected mainly in a rise in the rates of maternal and child mortality. Similarly, fertility has a greater negative effect upon the health of groups characterized by high reproductive risk, high parity, short intergenesic intervals, and unwanted pregnancies. On the other hand, family planning -and specifically the use of contraceptive methods-helps to achieve a lowering of the fertility rate and also has a positive effect on maternal-child health. This situation can be observed in the case of Mexico, where fertility rates and tendencies, as well as maternal and child mortality, have been reduced during the past decade.

Contraceptive use and fertility decline in Chogoria, Kenya

This article describes the results pertaining to fertility and family planning from a 1985 survey conducted in the catchment area of Chogoria Hospital in central Kenya. Current contraceptive prevalence was found to be quite high, 43 percent as opposed to 17 percent for Kenya as a whole. The total fertility rate of 5.2 births per woman was 2.5 births lower than the national rate. Very few women reported wanting to have large numbers of children or thinking that fate or God should determine family size. Although these data cannot conclusively demonstrate that the family planning program operating in the area has been responsible for reduced fertility there, they do provide some support for this hypothesis.

The effectiveness of family-planning programmes

By the mid-1960s, countries that accounted for 66% of the population of developing countries had adopted policies designed to reduce their rates of population growth; by 1986, the corresponding figure had reached 78%. In the developing regions as a whole, fertility has fallen by more than 30% since 1950. Contraceptive use has risen sharply, and there has been more than 10-fold increase in the number of couples in developing countries who use contraceptives. There is a very strong association between use of contraception and fertility in developing countries. Social and economic modernization is also taking place, although quite unevenly in the developing regions, so that the relationship of modernization is fertility is not very easy to demonstrate. In general, the experience of the developing countries suggest that a strong family- planning program effort can, and does, lead to a more rapid fertility decline than would be likely based only on socioeconomic variables. The effectiveness of family-planning programs can be enhanced by increasing the range of choice of contraceptive methods offered. However, it is difficult to disentangle the various factors that contribute to the effectiveness of family-planning programs. The public sector is the main supplier of family-planning services in most developing countries, and there is no clear trend towards the reliance on the private sector.

Contraceptive practice in New Zealand

A survey of contraceptive practice in New Zealand was carried out using a population-based sample of women, aged 25 to 54, selected as control subjects in a national case-control study. The results showed that sterilisation has become the most common means of family limitation. Overall, 45% of women aged 25 to 54 were in a union where one or the other partner had been sterilised. Vasectomy was the most common method of contraceptive sterilisation. The frequency of hysterectomy contributed to the high rates of sterilisation; 12% of women had had a hysterectomy. Over 80% of New Zealand women had used an oral contraceptive at some time, but only 11% were using the pill at the time of the survey. Comparison with earlier studies of contraceptive use in New Zealand show there has been a marked increase in the prevalence of contraceptive sterilisation, and a marked decrease in the use of oral contraceptives.

Contraceptive discontinuation among married women in the United States

Using data from the 1982 National Survey of Family Growth (NSFG), this analysis reports differentials in contraceptive discontinuation among married women aged 15-44 years in the United States. The total discontinuation rate is broken down into change to no method (termination) or to a different method (a method switch), and rates are obtained for specific methods. In addition, sociodemographic differences in risks associated with each type of discontinuation are shown. Discontinuation rates are compared to use-failure rates to provide a more comprehensive understanding of the implications of discontinuation for contraceptive efficacy.

U.S. women's contraceptive attitudes and practice: how have they changed in the 1980s?

Between 1982 and 1987, favorable opinion of the pill increased steadily among American women (from 65 to 76 percent), and favorable opinion of the condom rose sharply (from 38 to 60 percent). Approval of the IUD dropped during the period (from 26 percent to 19 percent). During the five years, the proportion of married women aged 18-44 who were exposed to the risk of unintended pregnancy remained the same (78 percent), but the proportion among unmarried women rose significantly (from 64 percent to 69 percent). This change was primarily the result of an increase--from 68 percent to 76 percent--in the proportion of never-married women who had ever had intercourse. The overall level of contraceptive use among 18-44-year-olds who were exposed to risk remained stable over the period, at about 93 percent, but use of the most effective methods (sterilization, pill and IUD) went up, from 68 percent to 71 percent. All of the net increase in effective-method use, however, was limited to married women, among whom reliance on both sterilization and the pill increased (from 46 to 51 percent and from 17 to 22 percent, respectively). Pill use also rose among unmarried women (from 43 to 48 percent), but there was no change in the level of sterilization. The prevalence of IUD use declined among both married and unmarried women (to three percent in each case). Condom use remained steady among married women, at about 15 percent, but among the unmarried it increased markedly, from nine to 16 percent.(ABSTRACT TRUNCATED AT 250 WORDS)