Abortions Averted by Sterilization in Korea: 1977-1978

Abstract

tBased on preliminary estimates from J. McCarthy, work in progress; see also: M. Gomez, Female Sterilization in Costa Rica, paper presented at Workshop on Methodological Aspects of Demographic Analysis of Sterilization, Honolulu, Sept. 1979. tC. F. Westoff, N. Goldman, J. McCarthy and M. Choe, see reference 1. According to a recent analysis of the history of contraceptive sterilization in the Republic of 1 81 percent of married couples will be protected by the procedure from the risk of unwanted childbearing by the time they have been married 25 years, if current marriage-duration-specific rates of sterilization continue. These data indicate a rate of sterilization adoption far higher than those found in other countries where sterilization has become popular (see Table 1). 81 percent figure involves a synthetic calculation projecting a recent period when there was a large increase in use of sterilization in Korea; since this rate of increase is unlikely to continue, the ultimate actual prevalence rate will undoubtedly be lower. Nevertheless, even the simple, or actual, percentages sterilized by the time of the 1978 survey indicate that about one-fifth of those married 10 years, and nearly one-quarter of those married 15 years, had already elected contraceptive surgery. * Despite these high sterilization rates, we estimate that only an average of 0.30 births per woman were being averted by contraceptive sterilization during the 1977-1978 period; that is, the total marital fertility rate at 25 years' duration would have been 3.55 rather than the observed 3.25 births per woman. f Why do such high rates of sterilization appear to have such a minimal effect on fertility? As indicated in Table 1, several other countries (Fiji,2 Panama,3 Sri Lanka4) with lower rates of sterilization at the earlier durations than those found in the most recent Korean survey5 showed more births averted. This was the first puzzle posed by these estimates. second puzzle was that in other countries examined, but not in couples who elected sterilization had a history of considerably higher fertility than couples with the same length of exposure to risk of childbearing who were using other methods of contraception or using no method at all (see Table 2, page 61). In there is evidence of only slight selectivity for high fertility among couples choosing sterilization. explanation for both of these puzzles lies in the very high abortion rates in Korea. remainder of this paper describes the interrelations of abortion, sterilization and fertility based on data from the 1978 Korea Fertility Survey. Abortion: Trends and Prevalence There are two possible explanations for the fact that marital fertility has declined sharply in Korea in recent years and that sterilization appears to be making only a minor contribution to this decline: Either more Korean couples are using more effective contraception or the abortion rate has increased. As may be seen in Table 3 (page 61), an increase in use of effective contraception does not seem to have been a major factor, at least for the five years from 1973 to 1978. Following an increase from 18 to 22 percent between Charles F. Westoff is Director of the Office of Population Research and Maurice P. During '22 Professor of Demographic Studies and Sociology at Princeton University. This article is part of a larger analysis of the demographic history of sterilization in the Republic of Korea by Dr. Westoff. Noreen Goldman, Siew-Ean Khoo and Minja Kim Choe, The Recent Demographic History of Sterilization in Korea, to be published in a forthcoming issue of Perspectives. It was prepared partly during the author's visit to the East-West Population Institute in Honolulu and was supported by funds provided by the Office of Population of the U.S. Agency for International Development. author is grateful for the critical comments of Dr. Goldman and to Minja Kim Choe for programming assistance. *See Appendix 1, p. 63, for the formal definitions of simple and synthetic rates.