Abstract
BackgroundUntil recently, premarital examination for both men and women was a legal requirement before marriage in China. Researchers have carried out surveys of attendees' sexual activity, pregnancy and abortion before their marriages, trying to map out reproductive health needs in China, according to this unique population-based data. To systematically identify, appraise and summarise all available studies documenting pregnancy and induced abortion among unmarried Chinese women attending premarital examinations.MethodsWe searched the Chinese Biomedical Literature Index from 1978 to 2002; PUBMED; and EMBASE. Trials were assessed and data extracted by two people independently.ResultsNine studies, of which seven were conducted in the urban areas, one in the rural areas, and one in both urban and rural areas, met the inclusion criteria. In the seven studies in urban areas, the majority of unmarried women had experienced sexual intercourse, with estimates ranging from 54% to 82% in five studies. Estimates of a previous pregnancy ranged from 12% to 32%. Abortion rates were high, ranging between 11 to 55% in 8 studies reporting this, which exclude the one rural study. In the three studies reporting both pregnancy and abortion, most women who had become pregnant had an induced abortion (range 86% to 96%). One large rural study documented a lower low pregnancy rate (20%) and induced abortion rate (0.8%).ConclusionsThere is a large unmet need for temporary methods of contraception in urban areas of China.
Highlights
Until recently, premarital examination for both men and women was a legal requirement before marriage in China
Sexual activity was reported in 5 of the 7 urban studies: this was greater than 54% in all studies; in the one rural study, the level was much lower (20%, n = 5,960); in the study covering both urban and rural Shanghai, 69% of unmarried women had sexual activity before their marriage
We used the unique opportunity of the premarital examinations to obtain population based data on reproductive need of women who were not yet married
Summary
Premarital examination for both men and women was a legal requirement before marriage in China. Appraise and summarise all available studies documenting pregnancy and induced abortion among unmarried Chinese women attending premarital examinations. "Backstreet" abortion, often seen in many other developing countries, has become rare in China, in the urban areas. This is largely because of effective rectification of medical care market by the Chinese government. The current National Family Planning Programme targets married couples and the young people have little access to information or advice about contraception. Against this background, we (page number not for citation purposes)
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