In Bangladesh, Couples' Method Use Increases As Number of Sons Rises

Abstract

Longitudinal data derived from the Matlab population register were examined to test the hypothesis that the sex composition of a couples surviving children strongly influences the couples subsequent contraceptive use. The sample consisted of 3145 women who had had a singleton live birth in 1982; their contraceptive history was examined over the 5 years subsequent to birth. 51% of the women started to use contraceptives after birth. By the end of the study period 27% of these women were still practicing contraception; about one-quarter of them had undergone sterilization. Having at least one living son strongly influenced a couples decision to initiate contraception. 24% of four-child and 8% of five-child families with no sons adopted a method compared with more than 50% of those with at least one son. High-parity and older women with no sons were less likely to practice contraception than were younger lower parity women. Among couples with 3 children 43% of those with no sons accepted a method compared to 57% of those with one and 58% of those with 2. Method acceptance rose among four-child families from 24% of those with all daughters to 54% of those with one son 62% of those with 2 sons and 65% of those with no sons to have practiced contraception. A multiple regression analysis with variables of no surviving sons no surviving daughters and the number of surviving sons showed that all these variables were significantly associated with contraceptive acceptance. It was calculated that elimination of gender preference would raise contraceptive acceptance in Matlab by 10% and would increase continuation by 15% thereby increasing current contraceptive prevalence of 50% of about 8% a change that would avert nearly one-half birth per woman. Although contraceptive prevalence is rising in Bangladesh gender preference will likely limit the impact of the national family planning program effort.