birth control
Effects of nuptiality and family planning on fertility.

Abou-gamraa H.

PIP: Focus in this discussion is on marriage and marital fertility control factors. It is known that fertility change in response to a change of an intermediate variable varies among variables. The objective here is to assess the effect of the different variables. The effect of each intermediate variable can be studied by using some demographic models or by investigating empirical data. Demographic models can be used either to simulate a real situation or an unreal situation. Models are useful to represent cases which are expected in the future. For the assessment of the effect of nuptiality change on fertility, nuptiality models recently developed by Coale are very useful. It was observed that the 1st marriage frequencies conform to a curve of the same shape in different populations if these frequencies are adjusted to have the same minimum age at marriage, the same pace at which marriage occurs, and the same proportion of the ever married at high ages. Results show that fertility will decline slightly in response to raising the minimum age of marriage. The effect of birth control on fertility is self evident because through birth control one may suspend or stop participation in the reproductive process. The following conclusions have been reached; nuptiality and birth control are the most effective intermediate variables; slowing down the tempo of marriage or raising the minimum age of marriage result in a small reduction in fertility level; the prevalence of celibacy has a significant influence on fertility, but it is not culturally acceptable and has undesired social effects; and the prevalence of contraceptive use is the most influential factor for reducing the fertility level.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12312119&dopt=Abstract birth control



birth control
[The experience of carrying out the technical responsibility system in the birth control of Peng County, Sichuan Province]

[Article in Chinese]

Xin D, Peng ZL.

PIP: Following the establishment of the system of fixed responsibility in production in Peng County, Sichuan Province, the County's Family Planning Office and Public Health Bureau in 1980 broadened the system of technical responsibility in birth control by defining tasks and goals. The commune public health office should guide birth control technology, lower the incidence of unplanned pregnancies and the number of abortions. The number of fertile women using IUDs should be over 80%, and its failure rate should be less then 10%; the failure rate of male ligature should be less than 3%. Commune members should give 1 jiao to the public health office for expenses incurred in birth control technology. If all the goals are reached, then there would be economic rewards outside the total public support system. That is, 1 jiao is awarded for each IUD inserted, 2 jiao for male ligatures and 3 jiao for female ligatures. Infractions such as poor attitude, irresponsibility, or delaying surgery are fined from 1-20 yuan. The following situations resulted from having implemented the system of technical responsibilty for birth control: 1) medical personnel had the authority to initiate action concerning birth control technology; 2) the quality of surgery was raised, while the incidence of errors was lowered; 3) the costs of surgery were lowered; and 4) because abortions are not awarded with economic incentives, medical personnel tended to perform more preventive surgery rather than corrective surgery.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12312488&dopt=Abstract birth control



birth control
[Dynamics of women's marriage and fertility in Beijing]

[Article in Chinese]

Beijing Family Planning Commission; People's University of China. Institute of Population Research.

PIP: Based upon the survey on fertility and marriage conducted by Beijing Municipal Committee on Family Planning and the Population Research Institute of the Chinese People's University, some basic findings can be summarized as follows: 1) the average age for the 1st marriage and fertility has increased gradually. This shows that delayed marriage has been accepted. 2) The average fertility rate has gradually been reduced and this is related to the governmental birth control policy. 3) The period of fertility for women has been shortened, and the total births each year are being reduced gradually. 4) The higher the cultural level, the lower the fertility. There is a close relationship between fertility and the cultural level. 5) The households with a higher economic level in agriculture normally have fewer children, but in large cities, the situation is not so clear. 6) The number of single-child households is getting increasingly higher, and numerous children households are decreasing. This situation is more obvious in the cities than the countryside. 7) The infant mortality rate has declined sharply, and at the same time, the infertility rate for women has also gradually declined. 8) Birth control measures have been taken by numerous women in the past. Many women, however, still do not know about birth control measures, and some of them do not even think about birth control problem. This situation shows there is a need for ideological education in birth control.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12312936&dopt=Abstract birth control



birth control
Birth control techniques in China.

Xiao B, Wang M.

PIP: This article describes the major birth control techniques in use in China, based on data from a contraceptive prevalence study conducted in September, 1982. 118 million of the 170 million married women of child bearing age use birth control. IUD insertion accounts for 50.2% of birth control methods used, tubal ligation accounts for 25.4%, vas deferens ligation 10.0% oral contraceptives (OCs) 8.2%, and condoms 2.0%. A table of clinical data on 9 China made IUDs reveals that pregnancy rates range from 0 (V Cu-300 model) to 5.83% (mixed ring model). A method of IUD insertion immediately after delivery has been researched and adopted, using a silastic Delta IUD with barium added to reduce the high postpartum expulsion rate. fixing the IUD by sutures during Cesarean section has also been developed. Electronmicroscopic studies of the endometrium of women who have used a stainless steel IUD for more than 20 years showes no tendency towards malignancy, nor negative effects on the endocrine functions of the ovaries. 28 million Chinese women have accepted sterilization as of June, 1982. Local anesthesia and the use of acupuncture have reduced complications due to general anesthesia seen previously. Sterilization by means of chemically induced adhesion of Fallopian tube tissue has also been performed successfully; however, this method makes later anastomosis difficult, and is not suitable for young women with only 1 child. Fallopian tube occlusion by means of a silver clip has been performed in 1,128 cases, with a pregnancy rate of only .85%. 10.62 million men have accepted sterilization. While most of the procedures are val ligations, 300,000 men have been sterilized by direct injection of an adhesive agent throuh the skin of the scrotum. No increase in auto immune or vascular disease has been found. 3 low-dose OCs, used since 1969, have proven to be reliable and freer of side effects than higher-dose compounds. In addition, longterm OCs containing quinestrol have been used since 1969 with a success rate of 98.3% women-year. These pills are taken 1x monthly. R and D priority will be given be given to monthly injectable contraceptives; megestrol and norethindrone are the compounds most preferable. In trials so far, the effective rate has been 99.9% with mild side effects. Gossypol, a male contraceptive, has shown an antifertility effect in 99% of 8000 cases studied; however, hypokalemia and irreversibility of spermatogenesis were reported in some cases. Vacuum suction is the most common method for abortion, but Radix Trichosanthis and lilac daphne terpine, traditional abortifacients, anre acceptable for 1st trimester abortions. Prostaglandins are also used.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12312957&dopt=Abstract birth control



birth control
A survey of China's birth control among women of child-bearing age.

Qiu S.

PIP: To further implement China's family planning policy of "prevention first, birth control first," a study of the current family planning situation was conducted. A survey of the birth control methods employed by women of childbearing age and by men was based on a nationwide randomized sampling of 1/1000. In the different age groups, ranging from 15-49 years old, IUD users accounted for over 50%, tubal sterilization 25%, and vasectomy 10%. The main IUD users were women in the 20-24 age group. Tubal sterilization was more prevalent among the women in the 35-39 age group. The use of oral contraceptives (OCs) was more common among younger women but accounted for less than 10% of the total. The survey was based on the replies to questionnaires from 172,788 married women of childbearing age; 120,022 of them practiced contraceptive methods for a birth control rate of 69.46%. The breakdown was as follows: IUD, 34.84%; tubal sterilization, 17.63%; vasectomy, 6.94%; OCs, 5.86%; condom users, 1.39%; and other methods (including chemical suppositories, rhythm, or safe period method and withdrawal before ejaculation), 2.78%. There was a higher percentage of OC users in urban areas, and a marked preference for IUDs in the rural communities. The rural birth control rate was 68.58%; the urban rate was 74.17%. The use of the IUD has priority in all the areas; its percentage approaches the national average level. The use of vasectomy as a birth control method varies considerably according to area as does the use of OCs, condom, and tubal sterilization. Rural minority groups prefer the IUD and OCs; tubal sterilization, the condom, and vasectomy are preferred by the Han nationality. The birth control rate differed according to the different occoupation groups: 77.85%, workers; 76.01%, farmers; 85.15%, cadres; 59.52%, housewives; and 66.67%, others. The birth control rate was higher among those who received a college education than the illiterates, but statistics did not show a significant difference in the rate of those with a high school education and the illiterates. Mothers of 0-1 children generally preferred OCs; tubal sterilization was preferred by mothers with 2-3 children. The nonusers of contraception accounted for 30.54% among married women of childbearing age. A breakdown gives the following figures: menopause and infertility, 6.17%; divorced and widowed, 1.64%; planned parenthood, 10.51%; nonusers who should have practiced contraception, 12.22%. On a national level, the estimated number of nonusers of contraception among those who should be practicing contraception comes to about 20,000,000 women.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12312960&dopt=Abstract birth control



birth control
[World fertility and the women's situation]

[Article in Chinese]

Lin F.

PIP: In 1981, total number of childbearing women in the world reached 9.8 hundred million. Their socioeconomic status and fertility level are very important data for the study of women's liberation and population control. Facing limited natural resources and a constant growing demand, many nations are studying how to control the population growth and achieve a "zero population growth." In nations with a high GNP, such as Switzerland, West Germany, and France, fertility is low. On the contrary, countries in central and south Asia and most parts of Africa are the poorest economically, and their fertility rate has remained very high. Another factor which is related to the fertility level is the degree of women's participation in the labor market. In Europe and North America, the percentage of women's participation in economic activities is high, and fertility is low. In Latin America and Africa, fertility is high, and the percentage of women's participation in economic labor is low. From the above, we may conclude that promotion of women's participation in the labor market and better employment conditions will reduce fertility. Another 2 factors related to fertility are marriage age and birth control rate. Late marriage and the extensive use of birth control measures are effective methods for reducing fertility. All the above mentioned factors are closely related to the woman's educational background. If women receive a better education and find better employment opportunities, delay their marriage age, and take birth control measures, fertility will be reduced and the population growth will be under control.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12313014&dopt=Abstract birth control



birth control
[The family planning work in Yiyang prefecture as suggested by part of the data of the sample fertility survey]

[Article in Chinese]

Li T.

PIP: The National Committee on Family Planning conducted a sample survey of fertility in the Yi-yang area in September 1982. The survey was focused on the marriage and fertility status of women between the ages of 15 and 67. Results from this survey show that early marriage is still very popular. Only 40% of those surveyed delayed their marriage to a later age. There is a need to educate the people on the benefits of late marriage. In addition, statistics show that the average fertility rate for a woman was 6.8 children in 1970 and 2.35 children in 1982. This recent figure is still too high when compared with the under 1.2 figure suggested by the central government. Among the total number surveyed, only 77% have taken birth control measures, and the other 23% still have not taken any birth control measures. The phenomenon shows that popular education on late marriage and having children at a later age is still urgently needed in order to further reduce the fertility rate. Married couples of childbearing age should be taught effective birth control measures and knowledge of eugenics with better education for the next generation. In this way, the masses may participate actively and positively in the national family planning campaign.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12313022&dopt=Abstract birth control