Contraceptive use and fertility in Guatemala

Abstract

In 1983, one-quarter of married Guatemalan women aged 15-44 years were using contraception, and female sterilization was the most prevalent method. Fertility rates for the population were at correspondingly high levels, with an overall total fertility rate of about six births per woman. Contraceptive prevalence varied by residence and ethnic group; less than 5 percent of currently married Indian women and about 50 percent of married women in the capital city area were using contraception. From 1978 to 1983, prevalence increased overall by six percentage points, with surgical contraception accounting for most of the increase. Findings of the study suggest that different strategies need to be employed among Ladino and Indian women in order to increase contraceptive prevalence in these subgroups.

PIP: A 1983 survey shows that Guatemala continues to have a relatively low level of contraceptive use by Latin American standards. However, by comparing the results of the 1983 survey with those of a similar survey conducted in 1978, it is clear that contraceptive use has increased slightly. During the 5-year interval between these surveys, the % of married women aged 15-44 years old who were using contraception increased from 19 to 25%. Most of the increase in prevalence was in the use of sterilization, which was found to be the most prevalent method in both surveys. This report describes the results of the 1983 Family Planning and Maternal/Child Health Survey conducted in Guatemala. Also discussed are trends in fertility, breastfeeding, contraceptive use, source of contraception, and women at risk of unplanned pregnancies since the 1978 survey. The 1983 data indicate that mean parity was higher for Indian women than for Ladino women at every age above 20. The mean parity for all women in the 1983 survey is slightly less than that of women in the 1978 survey, but of generally the same magnitude. Overall, the mean duration of breastfeeding estimated from the 1983 survey is 18 months. Postpartum amenorrhea averages about 12 months for all groups. A comparison of duration of breastfeeding for respondents in the 1978 survey with those in the 1983 survey provides no evidence of a trend away from breastfeeding in Guatemala. Overall, 1/4 of married women aged 15-44 were using contraceptive methods at the time of the 1983 survey. The most prevalent method was female sterilization (10%), which, together with male sterilization, accounted for 45% of all contraceptive use. The 2nd most commonly used method, oral contraceptives, had a relatively low prevalence of 5%, followed by rhythm, the IUD, injectables and vaginal methods, and finally, the condom. Contraceptive use also varied by age, reaching a peak among married women 30-39 years old and was lowest for those 15-24. Use of contraception was strongly related to education, being lowest among women with little or formal education. Results in general suggest that contraceptive use is part of a larger predisposition among women to use modern health care. Among Indians, the major reason given for nonuse of contraceptives unrelated to pregnancy was lack of knowledge of contraception or where to obtain family planning services. Among Ladinos, the most frequently mentioned reason was fear of contraception or fear of side effects. The methods of choice for nonusers desiring to use a method were oral contraceptives (27%), sterilization (18%) and injectables (14%). The survey data indicate that the family planning program in Guatemala should be oriented toward high parity, married, nonworking women living in the interior, both Ladino and Indian, who have less than a primary school education. Family planning efforts need to incorporate different approaches for Ladino and Indian women.