The influence of health care on contraceptive acceptance in rural Mexico

Abstract

This paper offers two types of evidence in support of the idea that family planning services are most expediently provided as an integral part of the health and medical organization for maternity care. First, prenatal care and medical attention at delivery are found to be closely associated with postpartum contraceptive acceptance in a 1981 survey of family planning in rural Mexico. Second, interviews of a sample of doctors, nurses, and auxiliaries who provide maternal health services to the rural population reveal that these practitioners favor long birth intervals and small completed families, that they recommend the use of modern contraceptive methods including female sterilization, and that those in the employ of public institutions are motivated to recruit acceptors of these methods. The main impediment to contraceptive acceptance in this context is believed to be fear of side effects and permanent health consequences rather than the desire for additional children.

PIP: The institutions and, to an even greater degree, the individuals who provide maternal and child health care services have not occupied a prominent place in recent discussions on the determinants of fertility and contraceptive use. Yet, from the woman's perspective, the use of a modern contraceptive method is often a new and frightening alternative with important but unknown health consequences. Moreover, in matters concerning childrearing and reproduction, one could reasonably expect that mothers would be influenced by the counsel of doctors, nurses, and midwives. This paper offers 2 types of evidence in support of the idea that family planning services in rural Mexico are most expediently provided as an integral part of the health and medical organization for maternity care. 1) prenatal care and medical attention at delivery are found to be closely associated with postpartum contraceptive acceptance in 1981 survey of family planing in rural Mexico. 2) interviews of a sample of doctors, nurses, and auxiliaries who provide maternal health services to the rural population reveal that these practitioners favor long birth intervals and small completed families, that they recommend the use of modern contraceptive methods including female sterilization, and that those in the employ of public institutions are motivated to recruit acceptors of these methods. The main impediment to contraceptive acceptance in this context is believed to be fear of side effects and permanent health consequences rather than the desire for additional children.