The impact on fertility of contraceptive failure in China in the 1980s

Abstract

Contraceptive failure was an important determinant of fertility in China in the 1980s. Based on the data from the China Two-per-Thousand Fertility Survey, this study shows that about 7% of the general fertility rate of currently married women aged 15-49 for a 12-month period is attributed to contraceptive failure, mainly due to the high failure rate associated with IUD use. A number of demographic characteristics are associated with contraceptive use, and with contraceptive failure and its outcome. Relevant socioeconomic differentials are also identified.

PIP: Data from the 1988 China Two-per-Thousand fertility survey were utilized. The fertility impact of contraceptive failure was analyzed by different contraceptive methods and by selected sociodemographic characteristics of the women. The survey targeted ever-married resident women, 15-57 years old, whose pregnancy and contraceptive use histories were analyzed. The analysis of contraceptive use was restricted to a sample of 40,266 currently married women. This sample had 32,259 spells of contraceptive use, of which there were 2123 failures. The fertility rate resulting from contraceptive failure was calculated by the use prevalence, the contraceptive failure rate, and the live birth rate of contraceptive failures. Overall, 71.1% of married women 15-49 years old were practicing contraception at the time of the survey. The most widely used method was the IUD, accounting for 42% of all contraceptive use. 27.2% used female sterilization, 7.4% used male sterilization, 5% used oral contraceptives, and 3% used condoms. 71.1% and 67.2% of contraceptive failures for male and female sterilization, respectively, led to live births, whereas only 37.7% of IUD failures and less than 17% of the pill, condom, and other failures led to live births. Overall, the failure fertility rate was 73.97 per 10,000 women-years. The general fertility rate in the 3-year reference period was calculated as 104.8 per 1000. This meant that births as a result of contraceptive failure made up 7.1% of the general fertility rate, and IUD failures contributed 72.2% of this failure rate. Contraceptive failure for the different methods was also found to be strongly related to the women's sociodemographic background. Women 25-29 years old had the highest proportion of the age-specific fertility rate resulting from IUD failure. Finally, more educated women had a lower percentage of the general fertility attributable to IUD failure than less educated women. These findings suggest that there is a need for the Chinese Family Planning Program to consider both the theoretical and use effectiveness of the IUD.