Impact of Family Planning Programs on Fertility: The US Experience.

Abstract

The hypothesis that U.S. family planning programs reduce unwanted fertility among subgroups from which clinic patients are drawn was confirmed. The study divided white and black females within counties into age marital and socioeconomic (SES) subgroups. The coincidence of a decennial census in 1970 and availability of national county-by-county studies of organized family planning programs in 1969 provided the data used for this systematic national evaluation of the demographic impact of U.S. programs. 51 tables and 2 figures show that the overall program effects independent of other factors on the fertility of lower SES women in the U.S. were both statistically and substantively significant suggesting that the programs have the potential to sharply reduce historical class differentials in fertility. The level of program enrollment had a negative impact on fertility of women in all lower SES subgroups and was statistically significant (P < .05) in 28/36 comparisons and only slightly less significant (P < .1) in 2 others. In contrast program enrollment was unrelated to fertility in 19/24 tests involving subgroups of upper SES women. Hence it is recommended a policy to expans the enrollment of lower SES persons in family planning clinics would be the most cost effective means of reducing the class differences in fertility by assisting in avoidance of unwanted and mistimed pregnancies which in recent years have accounted for the remaining class differentials in the U.S.