Limit Family Size Research Articles

Reproductive Decision Making and the HIV/AIDS Epidemic in Zimbabwe

The fertility-stimulating effect of high rates of child mortality on reproductive decision making (RDM) is a central tenet of population studies, yet the effects of the HIV/AIDS epidemic on RDM have not been thoroughly explored in the literature. This paper investigates how RDM is articulated in the context of high HIV/AIDS prevalence in Zimbabwe. Using qualitative methods (35 focus groups and 46 in-depth interviews), we found that childbearing is extremely important in the lives of adult Zimbabweans and that children are needed to cement the couple's relationship, whether it is the first or subsequent marriage. Most respondents said that rates of both adult and child mortality were greatly increasing due to the AIDS epidemic. However, contrary to expectations based upon the insurance strategy, most respondents said that they would have fewer children as a result of the perceived increase in child mortality. They were also hesitant to continue childbearing after a child death, indicating only weak replacement motivation. Instead, many respondents expressed the desire to limit family size due to concerns about their own mortality and its negative effects on their children. Furthermore, new reproductive strategies seem to be emerging, which focus upon the health of parents and child and are based upon perceptions of 100 per cent maternal-infant HIV transmission. Adult HIV status is linked to child survival as respondents explained that having a healthy child who survives to age five indicates that the parents are also free of the virus and, at this point, they can safely continue childbearing. Additionally, couples who have experienced the death of a child are hesitant to give birth again because they believe future children would die. Finally, there was some talk of having children early in an attempt to avoid contracting HIV. This study presents evidence that Zimbabweans are altering their reproductive strategies in order to protect both parents and children from the threat of AIDS.

Untangling the myths and realities of fertility and mortality in the Pacific islands

Norma McArthur of the Department of Demography at the Australian National University conducted a region-wide project to study the population dynamics of the South Pacific islands. One of the purposes of McArthurs work was to discredit the theory that the post-contact decline of population was due to “psychological causes.” This paper clarifies myths and realities of fertility and mortality in the Pacific islands. Results of the study indicate that fertility is still very high in many Pacific island countries but in others fertility has shown to change within a relative short time. However despite the positive fertility trend most island countries have adopted family planning with reluctance. Only pressure from aid donors has moved most governments to adopt programs or enact policies aimed at limiting family size. Moreover Pacific Island women have been slow to accept family planning because they did not find the method satisfactory. However this situation is now changing and contraceptive technology is currently showing some dramatic improvement.

Struggling to Survive: Soviet Women in the Postwar Years

Based on propaganda, archival sources, and interviews, this article argues that under conditions of extreme material hardship, traditional Russian culture and Soviet values united to place unrealistic expectations on women who bore the brunt of post-World War II production and reproduction goals. As women faced the conflicting responsibilities of rebuilding the economy and repopulating the Soviet Union, the press bombarded them with images of women who successfully fulfilled all the demands placed upon them. In the absence of adequate support facilities, economic reality shaped women's lives more profoundly than state demands, and most women attempted to balance their duties by privileging domestic concerns over professional advancement, limiting family size, and developing strategies to deal with the difficulties of postwar life.

The Contraceptive Revolution in Israel: Changing Family Planning Practices among Ethnoimmigrant Groups

This paper uses data from the 1974–1975 Israel Fertility Survey and the 1987–1988 Study of Fertility and Family Formation to examine trends in fertility control among ethnoimmigrant groups in Israel. From 1974 to 1988, Israel underwent extremely rapid economic growth and there occurred what might be considered a contraceptive revolution in the realm of family planning. Specifically, the nonuse of family planning and reliance on less effective techniques of fertility control (withdrawal and abortion) were largely replaced by more efficient modes (e.g., pill, IUD) of family size limitation. In addition, ethnic differences in patterns of fertility control diminished. Meanwhile, socioeconomic and cultural variables such as religiosity and income maintained their importance as determinants of variation in family planning practices among Israeli women.

Late-blooming societies can be stimulated by information technology

About 50 societies in the world have been unable to make significant progress toward development over the last several decades, despite various kinds of assistance. Information technology is a powerful new tool that has not yet been applied. It can strongly reinforce and redirect more familiar programs, and expedite others, such as education, micro-enterprise formation, community-oriented non-government organizations, family size limitation, social communications, financial management and stabilization of politics. Introducing much more information makes possible efficient consumption. A good, sustainable quality of life, with minimal consumption of natural resources, seems to be a superior goal for development. Here it is proposed that the target conditions should be ‘happiness’, ranging from serenity (achieving order, internal calm to delight) to spontaneous, infectious forms (well-being, fun and joy). Sociologists have developed quite robust measures over the last several decades. Happiness comes cheaply, because it need not involve massive infrastructure, fuel or other expensive inputs. Accelerated progress will require some new institutions using information appropriately. The outlook for funding from foundations created by the information technology billionaire entrepreneurs is promising after current risks of loss have diminished. The same technology would enable affluent people to adopt lives of voluntary simplicity. Consumption at a quarter of Euro–American levels requires only a little planning, and a tenth of those levels seems possible with careful organization and discipline. Then people would be able to move easily to late-blooming societies which accelerated progress through their choice of the happiness path to development. Simultaneously, some talented, energetic individuals who started poor could use the Internet to gain entry into the circle of world servers within a lifetime.

Sibship Size and Intellectual Development: Is the Relationship Causal?

Previous research has consistently found a negative statistical relationship between sibship size and children's intellectual development. Two explanations have been offered for this finding. The prevailing explanation is that the relationship is causal, suggesting that limiting family size would lead to more intelligent children. A second explanation maintains that the relationship is spurious—that one or more undetermined factors correlated with family size are causally related to intellectual development. Using data on children from the National Longitudinal Survey of Youth, we reexamine the issue using change models. These change models allow us to control for such unmeasured effects as family intellectual climate, family value system, and family genetic heritage. We begin by replicating in these data the negative statistical relationship between three cognitive measures and sibship size. We then apply the change models to siblings measured at two points in time and to repeated measures of the same individuals. By considering sibship size as an individual trait that changes over time, we control for effects that are shared across siblings and over time. When these shared effects are controlled, the negative relationship between sibship size and intellectual development disappears, casting doubt on the causal interpretation of the negative relationship conventionally found.

Sex ratio in relation to fathers' occupations.

OBJECTIVE: To investigate whether the sex ratio of children varies between fathers of different occupations. METHODS: The sex ratio (the ratio of the number of boys to the number of...

The Right Incentive: How Perceived Scarcity May Stop Population Growth in Time

Contrary to the views of Ken Smail humanity need not take action to slow rapid human population growth. People must instead be motivated to limit family size. Such motivation will come from the sense that economic opportunity is contracting is less than expected or is less than enjoyed by some significant reference group. Controlled comparisons within a culture area and among ethnic groups in a single society as well as chronological studies consistently show that contracting economic opportunity is followed by declining fertility. Both historically and cross-culturally adaptive responses including delayed marriage and birth spacing appear spontaneously when individuals perceive increasing environmental and economic constraints. Such motivation and response probably caused the large fertility declines observed in countries such as Sudan and Burma (Myanmar) where neither introduced contraceptive programs nor economic development are possible explanations. The author cites examples of low fertility in Italy Spain and Portugal and the cases of former East Germany Malawi Malaysia the West Indies and China.

An evaluation of the Filshie clip for postpartum sterilization in Austria

Voluntary sterilization is a popular method of family size limitation. Among other techniques for surgical induction of female sterility, the application of various kinds of clips to the Fallopian tubes has been introduced. The Filshie clips consist of rubber-lined titanium and their use for interval sterilization has been repeatedly published. So far, there are only a few reports regarding the use of Filshie clips during the postpartum period, when tubes are edematous and more friable. Therefore, 300 women voluntarily requesting postpartum surgical sterilization for the purpose of family size limitation were enrolled into a prospective trial. Within 72 h of delivery, 282 women were sterilized under general anesthesia using a subumbilical minilaparotomy approach and Filshie clip application. Of these women, 251 were available for follow-up examination at 6 weeks, 240 at 6 months, 234 at 12 months, and 209 at 24 months after the sterilization procedure. Complication rates were low, and there were no pregnancies during the follow-up period. These results indicate that the application of Filshie clips is a safe and efficacious method of surgical female sterilization in the postpartum period.

Women's Lives in Transition: A Qualitative Analysis of the Fertility Decline in Bangladesh

The fertility decline that began in Bangladesh in the late 1980s and continues has prompted diverse theories to explain it. In this qualitative analysis of 21 focus-group sessions with rural women ranging in age from the teens to late 40s and living in the villages of the Matlab area, the women's perceptions of their changing society and of the influence of the family planning program are examined. The women's statements reveal their awareness of the social and economic transition they are undergoing and their interest in family-size limitation, which is bolstered by a strong family planning program. Although the shifts in economic and social circumstances are not large, in conjunction with the strong family planning program they constitute a powerful force for change in attitudes, ideas, and behavior among these women.

The regulation of fertility in pre-industrial populations: a local study from eighteenth century Finland

The crude birth rate in Finland in the eighteenth century was more than 40 per thousand. At the same time there was considerable regional diversity. This study of a coastal population in southwestern Finland reveals that the fertility was well below that of the country as a whole and as low or even lower that that recorded for neighboring countries. A more detailed study of families in Houtskiir indicates that the pattern of fertility varied according to the socioeconomic standing of the family head. Differences in age at first marriage were a critical determinant of these variations but other important factors were birth spacing and the timing of the last birth. A conscious attempt was made to limit family size.

The Social Context of Family Planning In a South Indian Village

A quasi-anthropological approach was employed to collect information between June and October 1987 through questions and participant observation in a village with 196 currently married women in the state of Tamil Nadu India. The cigarette and brick industries had a strong influence on the lives of the local population. More than 90% of couples were aware of at least 1 contraceptive method. All knew about sterilization but only 6% knew the condom and the IUD and 2% knew about the oral contraceptive pill. 57% of husbands approved family planning (FP). 58% of wage laborers and 68% of the self-employed salaried people and businessmen approved it. Family size limitation was practiced even before the advent of modern contraceptives to fulfill social and cultural expectations and improve the health of mothers and children. Only 26% of the women with at least 2 children were practicing FP all of whom were sterilized. 36 women had undergone sterilization and one husband had had vasectomy. No one used the IUD the pill or the condom. During 1985-86 the national sterilization acceptance rate was 35% compared to 41% in Tamil Nadu. Just 10% of acceptors had 2 living children; 43% had 3 children; and 46% had at least 4 children. The acceptance rate was 35% among women whose husbands were landless vs. 19% among those who owned land. The acceptance of sterilization amounted to 21% among wives of farmers 27% among wives of wage laborers and 36% among the wives of self-employed salaried and businessmen. 2/3 of eligible women did not intend to use FP in the future mainly because of health reasons. Some opted for coitus interruptus which was not associated with adverse health effects. The unequal relationship between husband and wife also discouraged the practice of contraception. Men usually did not consent to the use of condoms or undergo vasectomies.

Houses, Fertility, and the Nigerian Land Use Act

The case study in one rural Ekiti Yoruba village (3500 total population) in Ondo state Nigeria illustrated that fertility was affected by house plot exchanges traditions in housing tenancy and ownership local household composition and federal land tenure policies. Houseplots consisted of family owned land which was passed on to kin. Recent house exchanges were made on a more impersonal cash basis. It was argued that the Land Use Act weakened village land claims and weakened the security of houseplot ownership. Thus the need for children increased and federal family planning programs were undermined. The emerging tendency to limit family size was being thwarted. Communities were changing within a cash economy and status was associated with a large family and the possession of expensive consumer goods. Among young men and women aged 20-24 years the median desired fertility was 5 children while the total village fertility rate was 6.3 children per woman. Housing was not considered a substitute for children but as an additional form of security. A census and interviews among 70 women aged 15-39 years and 66 men aged 20-44 years were conducted during June 1991 and April 1992. Findings revealed that 87% of village women aged 15-19 years had attained some secondary school education. The village was off a main transportation route and modern improvements such as electricity and piped water were available. The interest in building and maintaining a family house with kin buried close by was very strong. Only 13% of the 333 houseplot transactions recorded between 1910-89 were cash payments of which 75% occurred since 1970. 49% were transactions involving division of family land. Cash transfers of land usually involved plots located on the fringes of town. Family land involved no transfer of cash or in-kind gifts. Family plots could be transferred to non-family members of another patrilineal group; 38% were transactions of this kind and involved considerable transfer of goods to secure the deal. In addition to cash transfers for land other practices such as rental housing on cash-transferred plots and surveyed boundary markers were being introduced. After 1978 land was nationalized; rural land transfers slowed and few transactions were recorded. The act was passed to promote equitable distribution of rural land but instead promoted land insecurity.

Contraceptive Policy and Ethics Illustrations from American History

While the technology of long-term contraceptives is relatively new, many of the ethical and policy dilemmas surrounding their use are not. The history of the birth control movement in this country over the past 125 years provides clear examples of the tensions that have always existed between empowering women to control their fertility and promoting limitations on fertility for the disadvantaged. While this is not an exhaustive survey, several important developments in the history of the American birth control movement have been chosen to illustrate these tensions. In the late nineteenth century, Victorian opinion tolerated promiscuity among men and promoted sexual self-control among women. Prostitutes were a common and accepted solution to this dichotomy. Despite the view that female sexuality was to serve the end of reproduction rather than the woman's pleasure, contraception was widely practiced among all social classes. The methods employed varied by class, however, due to cost and availability. The upper classes were more likely to use relatively expensive methods of contraception such as condoms, spermicides, and douches. They might also have had access to diaphragms and cervical caps, which were smuggled in from Europe at a high cost. Withdrawal and rhythm were often the only methods available to the poor. In an era when menstrual cycles were poorly understood, pregnancies often resulted. Abortion, often self-induced and always dangerous, was resorted to frequently. It is estimated that by the 1850s one out of every five to six pregnancies in America ended with an abortion.[1] Mortality from septic abortions was extremely high. In 1888, death from abortion was estimated to be fifteen times greater than maternal mortality.[2] During this era, American feminists supported the concept of motherhood.[3] Far from empowering women and providing them with sexual freedom, however, voluntary motherhood sustained traditional family roles for women. According to this concept, limiting family size enhanced women's ability to fulfill their societal roles as wives and mothers. Feminists were joined by moral reformers, who were concerned about excessive breeding among the lower classes, particularly immigrants. Targeting the lower class and members of minority groups in the effort to reduce fertility has strong historical roots in the late nineteenth century. Although contraception was widely practiced in private, many were not willing to risk public expressions of support for it or admit to its use. This reluctance influenced public policy. Abortion was declared illegal for the first time in the United States in 1830. A majority of states had declared it so by 1970.[4] A great legal blow was dealt to contraception in 1873 with the passage of what came to be known as the Comstock laws - a federal statute that made it illegal to transport obscene materials through the mail. Contraceptive devices such as condoms and diaphragms, as well as sexually explicit literature, were confiscated under this law. It took the work of one of birth control's leading proponents, Margaret Sanger, to weaken its effects. Margaret Sanger and the Movement for Planned Parenthood Perhaps no name is more closely associated with birth control, family planning, and reproductive freedom for women than Margaret Sanger. The daughter of Irish immigrants, Sanger was born in 1879 and played a strong role in the birth control movement in the United States and abroad until her death in 1966. While she promoted access to birth control for all women, she focused particularly on the poor, as upper-class women had some access to contraception from their private physicians. Poor women did not. Sanger believed that uncontrolled fertility and large families were inextricably linked to poverty. Her efforts to empower poor women, however, had affinities with the eugenics movement. Many eugenicists supported the idea of limiting population growth, particularly among those they viewed as undesirable. …

The value and use of different contraceptive methods*

Reductions in the rates of maternal and child mortality as well as in demographic growth are directly linked to contraceptive usage. The development and availability of safer, improved contraceptives which are convenient to use could be expected to be used by a larger group of individuals and thus make an impact on reproductive health as well as on population growth rates. Such arguments have been used to support contraceptive research. This article deals with some of the developments that have occurred as a consequence of such efforts.

Impact of migration on fertility in sub‐Saharan Africa

Much lower levels of fertility in urban than rural areas throughout sub-Saharan Africa imply that fertility decline in the region may be facilitated by rapid urbanization and rural-to-urban migration. The present study uses data from Demographic and Health Surveys in six countries--Ghana, Kenya, Mali, Senegal, Togo and Uganda--to assess the impact of long-term rural-urban female migration on fertility. Results of logit analyses indicate that in most countries women who leave the countryside represent the higher fertility segment of the rural population in the years before migration. Migrants' risk of conception declines dramatically in all countries around the time of migration and remains lower in the long run among most migrant groups than among rural and urban nonmigrants. Descriptive analyses suggest that the decline in migrant fertility is related to the rapid and pronounced improvement in standard of living experienced by migrants after settling in the urban area and may be due in part to temporary spousal separation.

Population Communications International: Its role in family planning soap operas

In order to motivate people to use available family planning (FP) services Population Communications International (PCI) uses entertainment mass media to promote the small family ideal open family communications and enhance the status for women (to bolster their ability to decide to use FP). In this work PCI emphasizes the importance of understanding and working with the cultural context in which family size decisions are made. In order to reach large numbers of people social marketing campaigns must emphasize the personal benefits of limiting family size and of child spacing as well as the relative safety of modern contraceptive methods as compared to frequent childbearing. PCIs Mass Media Communications Program trains television producers and writers in developing countries in the Miguel Sabido methodology for promoting social development through entertainment serial dramas (soap operas). This methodology based on the theory that people learn new attitudes and behaviors by observing them and their consequences in others and then by trying them involves the development of fictional characters who are "good" and are always rewarded who are "bad" and are always punished who are "uncertain" and act as identification characters for the audience and who evolve from "bad" or "uncertain" to "good." Members of the audience bond with these characters and follow a clearly understood process of vicarious identification. A secondary effect occurs as the audience is stimulated to discuss the dramas with friends and neighbors. The use of serial dramas to combine motivation and information has led to significant impacts in such social development areas as literacy reproductive health family communications and family planning in Mexico Kenya and India. The essential components of such a program are to 1) attract a large audience 2) emphasize cultural archetypes and stereotypes 3) represent emotions 4) promote socially desirable values and 5) promote a vehicle for social learning. PCI has longterm plans for programs in India Latin America Pakistan the Philippines Kenya Nigeria Tanzania and China. Unless people are motivated to adopt small family norms humanity will be faced with the traditional methods of limiting population: war starvation and the maltreatment of women and children.

Attitude towards family planning in Dharan, east Nepal: implications for the family planning programme

A survey of the knowledge, attitude and practice of family planning was conducted in Dharan, Nepal. The town offers a full range of family planning services free of charge. There was a strong desire to limit family size; 52·5% of couples were currently using some modern method of family planning. Of the current users, 62·3% had been sterilized, including 92·3% of those in the lowest socioeconomic group. Health risks and incompleteness of the family were the most common reasons for non-use of contraception, the latter reason reflecting ignorance of the temporary nature of some methods. There was a strong preference for male children and couples rarely used contraception until at least one son had been born. Even in this prosperous town where couples were highly motivated towards family planning and all methods were readily available, there was heavy reliance on sterilization. This is typical of Nepal and has largely been responsible for the failure of the family planning programme—as most couples choosing sterilization are in the older age group and have completed a relatively large family. If Nepal is to succeed in meeting its target of reducing the total fertility rate (i.e., births per woman) from the current 5·8 to 4 by the year 2000 it will need not only to expand services but actively to promote temporary methods of contraception, particularly the more reliable longer acting reversible methods such as Depo-Provera ®, Norplant ® and intrauterine contraceptive devices.

Using the Newspaper to Disseminate Vasectomy Information in Kenya

Recent research in Kenya shows that, although there is still a high population growth rate, there is increasing interest among men as well as women in family planning and in limiting family size. Vasectomy, however, is little known and practiced in Kenya. A major reason for this is a general lack of knowledge about the procedure and where it may be obtained. Little effort has been put into addressing the barriers to vasectomy acceptance in Kenya, partly because of the commonly held assumption that Kenyan men would not be interested in the method. Innovative Communication Systems, with the support of the Association for Voluntary Surgical Contraception, implemented a study using the print media to examine this perception. Advertisements providing information about the method were placed in newspapers and a magazine. An unexpectedly large response was received-over 800 written requests for information from all parts of the country. The majority of inquiries were from rural areas, and there was a high proportion of requests from the coastal district, a Muslim area generally considered to be extremely resistant to family planning. A large proportion of inquiries came through a Kiswahili newspaper appealing to lower socioeconomic groups.

Reproductive health: A global perspective: Presidential address

Reproductive health is the ability 1) to regulate and control fertility (family planning and infertility) 2) for all women to have a safe pregnancy and childbirth and 3) for the newborn to experience a healthy infancy and freedom from sexually transmitted diseases (STDs). Modern medicine which increased life expectancy and reduced the death rate and an increase in births have resulted in rapid global population growth. Urbanization in developing countries adds to the burden of rapid population growth. In the 1970s social scientists and governments confronted rapid population growth by focusing on family planning but by the 1980s they learned that contraceptive technology alone did not slow population growth. Thus they integrated maternal and child health with family planning and focused on maternal and child health. In 1987 various groups formed the Safe Motherhood Initiative to reduce maternal mortality. The Initiative incorporates adequate primary health care and family planning comprehensive prenatal care help of trained delivery personnel for all women in childbirth and effective access to maternity hospital services for women with high-risk pregnancies and for women in dire emergencies. Many of the problem of and obvious solutions to maternal mortality are social or cultural (e.g. lack of transportation). Family planning programs strive to prevent unwanted pregnancies help achieve birth spacing and help couples limit family size so as to reduce maternal mortality. Infertility is highest in those areas of the world where fertility is also highest (e.g. sub-Saharan Africa) due to the high incidence of STDs which cause infertility. Further HIV infection is also highest in these same areas. Improved education and condom use prevent the spread of both STDs and HIV. Womens status must be raised worldwide so the comprehensive reproductive health programs can succeed. All the worlds obstetrician-gynecologists should actively promote improvement of womens status and support the concept of reproductive health.