birth control
On the spatial diffusion of fertility decline: the distance-to-clinic variable in a Chilean community.

Fuller G.

PIP: Survey data collected in San Gregorio, Chile during 1967 were selected for an investigation of the importance of residence distance-from-clinic in the pattern of contraceptive acceptance. Data were obtained through interviews conducted with women of fertile age who resided in every 4th house in the community. 1163 household reports could be employed. This number included a total of 1612 women in their fertile years. The 1612 women could be divided into users of some means of contraception and non-users. Once the basic binary classification procedure has been applied, each available socioeconomic variable for users and non-users may then be compared to determine if a significant difference exists among the distribution of the variables for each group. The variables of abortions, recent births, and aspiration level were the most potent discriminators between users and non-users of birth control. The more conventional socioeconomic variables showed little discriminatory power. Distance was found to be a fairly powerful discriminator between the group of users and non-users. Several variables other than distance are correlated with birth control practice, but once the influence of the spatial variation of these correlates has been extracted, distance emerges as the single most powerful discriminator between users and non-users of contraceptive techniques. There thus appears to be a need to emphasize the distribution of contraceptive supply in order to reduce the distance which women must travel to obtain birth control information or devices.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12309958&dopt=Abstract birth control



birth control
Birth control technology: today and tomorrow.

Standley CC.

PIP: Compared to 25 years ago, birth control technology for women has vastly improved. The oral contraceptive, the IUD, and improved techniques for abortion and sterilization have presented better prospects for safe, effective birth control than have ever before existed. The side effects of these methods can have political significance when the method is distributed by the state. No one would blame a complicated or failed pregnancy on officaldom, but they would blame a death from a state-distributed method on the government. New IUDs slowly release a steroid, thus avoiding excessive menstrual blood loss. Devices being tested have a life span of 3-5 years. Depo-Provera, an injectable contraceptive, is being used by between 1-2 million women, despite its controversial status. A number of new injectables are being studied in animals and should become available in the second half of the decade. Because the testing of contraceptive drugs is stricter than that of all other drugs, it takes many years to develop a new drug to the stage where it can be marketed. Another method being tested is an implant just under the skin that slowly releases a contraceptive. For men, there has been little or no progress in development of new birth control methods. A shortage of funds mitigates against research and development of new methods.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12310011&dopt=Abstract birth control



birth control
[The population growth in the city of Beijing and our present tasks (author's transl)]

[Article in Chinese]

Qian LJ, Xu B, Huang SY.

PIP: Concern for the rapid population growth since 1949 of China's second largest city, Beijing, is discussed in terms of population control, migration, and rises in the productive development of the city. From 1949 to 1963 the natural rate of population increased from 7.5 to 35.3%; however, after the introduction of a birth control program in 1971, the natural increase of population declined to 4.02% in 1977. From 1949-1978, the average birth rate was 145,000/year while the average death rate was 46,500/year, leaving the annual average increase in population at 98,000. The natural population increased by 2,340,000 from 1949-1978. The massive population growth since 1949 affected the economic development of the city as well as the country. Cultivated land near Beijing increased from 1949-1952, but because of urban development the land for cultivation decreased by 1,527,000 market acres from that available in 1949 (7,965,000 market acres). Population density increased from 430 persons/ square kilometer in 1962 to 506 persons/ square kilometer in 1978. From 1953 to 1978, production and consumption rates fluctuated with a net balance of only 2020 million catties in the 26 years, causing the need for products to be imported from other areas of the country. Unemployment is exacerbated by the lack of jobs and increasing numbers of people. Transportation problems also have developed. New efforts are being made to inform people of population control by the Beijing Population Association begun in 1979, because Beijing's population will continue to increase until 1989 due to the baby boom years during the fifties which created a 2nd boom in the late 1970s as well as the lack of education on population control. Other programs are being developed to, 1) educate people on economical measures of reducing the population, 2) promote governmental departments to improve birth control programs by means of social security services, child health agencies, and nursing schools, 3) propagandize eugenics and genetic education to enhance the population, and 4) reinforce the propaganda on birth control and technical guidance.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12311025&dopt=Abstract birth control



birth control
[Why is it difficult to carry out birth control work in Wenzhou?]

[No authors listed]

PIP: Some leading cadres in Wenzhou Municipaity, Zhejian refuse to practice birth control instead of supporting this effort. The wife of Comrade Lin Xiannen, a member of the Standing Committee of the party municipal committee, gave birth to a 3rd child last March. Up to now, they have refused to practice birth control. Wang Danwen, a member of the provincial revolutionary committee and deputy director of the municipal posts and telecommunications bureau, did not break the news that she was pregnant with her 3rd child until the 8th month of her pregnancy. Following the example of these leading cadres, Lin Xiaohua, a cadre of the Wenzhou prefectural intermediate court of justice, and Sun Lianfang (a party member and cadre) gave birth to their 3rd child. These cases have been reported many times to the municpal committee leadership. In Wenzhou Municipality at this time, many young people got married too early and many young women are pregnant too early. The actions that were subsequently taken against the cadres who refused to practice birth control and were having too many children are outlined. The fundamental reason why birth control work in Wenzhou is lagging behind is that some cadres fail to practice family planning and urge their sons and daughters to marry too early. According to an investigation, 496 of the 728 cadres, or 68.1%, in 6 areas in Ruian County have 3 or more children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12311445&dopt=Abstract birth control



birth control
Impact of contraceptive practice on child spacing. A life table analysis of birth intervals of urban and rural Thai women, 1979.

Orapin Singhadej, Keller T, Palmore JA.

PIP: The effect of contraceptive utilization on the interval of time elapsing between births (childspacing) for urban and rural married women in Thailand is revealed using a life table analysis. The analysis also computed the childspacing pattern of both samples in 2 periods of time, before (1955-69) and after (1970-78) the beginning of Thailand's National Family Planning Program (NFPP). A sample of 1104 urban and 678 rural women of reproductive age were interviewed between 1978 and 1980. In addition to demographic information, the questionnaire collected data on pregnancy histories, including duration of lactation, and contraceptive practices. The age distribution of the women in both samples is almost identical, and the demographic characteristics follow established urban and rural patterns: urban populations have smaller families, a smaller percentage of live births, and a higher percentage currently practicing birth control. The life table analysis demonstrated that the probability of terminating all birth intervals (i.e., the 1st 6 months after a birth and every 6 months after, up to 60 months exposure) was less for the urban sample than for the rural sample. This is explained in part by the earlier introduction of birth control methods into the urban areas and the more frequent choice of permanent methods, e.g., sterilization, on the part of urban populations. The urban women who practiced contraception showed almost an identical pattern of terminating birth intervals before and after the beginning of NFPP. Compared to urban contraceptors, the percentage of women who delayed terminations was smaller in the subsample of urban women who did not use birth control.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12311581&dopt=Abstract birth control



birth control
A comparison of efficiency of birth control input between China and India.

Liang J, Wang H.

PIP: Global world population in mid-1991 would have been 6.9% higher (an additional 366 million births) without the effective birth control programs in India and China. 260 million births in China and 110 million births in India were averted. These averted births relieved population pressure on the food supply. Without birth control, output would have decreased by 20% in China to 302 kg in 1991 and by 12% in India to 189 kg in 1991. Both India and China have between 1000 and 2000 married and fertile women per birth control worker. The manpower-input efficiency is higher by 2 times in China than in India, but the gap is closing. In China, public expenses for birth control include family planning operating expenses, family planning workers, and bonuses for single child families. World Bank estimation has determined the ratio of government to grassroots investment to be 1:2. Total investment in 1980 was RMB 1.4596 billion or about $10.00 per person. In 1980 the allowance was RMB 60.00 per year per single child family, and in 1989 the allowance should have been RMB 120.00 per year per family but was actually RMB 48.00 due to local poverty areas and low economic performance. Data were provided annually between 1971 and 1991 on total revenue, grassroots revenue, bonuses, foreign aid, and expenses per person. The expenses per person increased from RMB 2.46 in 1971 to 5.23 in 1991 or US $6.53 in 1990. Investment in birth control totaled over 21 years RMB 50.10186 billion (US $16.6557 billion), which included RMB 49.9696 from China and $40 million in foreign aid. The cost of preventing 259.585 births over this period was RMB 193.01 or US $64.16 per birth. Savings would also accrue from child rearing costs. Government savings would have amounted to RMB 3,461 billion in rural and urban areas, or 2 times China's gross national product in 1988. State costs amount to 36.5% and family costs amount to 63.5% of child rearing until 16 years of age in urban areas; the proportion in rural areas would be 20.03% and 79.97%. The prevention of 260 million births would have saved RMB 932.1 billion for the state and collectives and RMB 2,528.9 billion for families. Over 21 years, savings were RMB 50.1 billion by the state and RMB 932.1 billion by collectives. The efficiency yield would be 1:18.60 and including family savings 1:69.08. The ratio was computed for shadow prices and with a discount factor. For India, the efficiency yield was 1:57.37.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12288641&dopt=Abstract birth control



birth control
Birth control over 30.

Asnes M.

PIP: Among 30-40 year old women, 40% of pregnancies are unplanned, which is indicative of the unreliability of the birth control methods they are using. The 1992 Ortho Birth Control Study interviewed almost 7000 women, of whom 8% listed withdrawal and 4% listed the rhythm method. These two methods have failure rates of 24% and 19%, respectively. Birth control methods often disappoint the users and increasingly they turn to sterilization. 48% of married women aged 15-44 had themselves been sterilized or had a sterilized partner in the Ortho survey. Although reversal of tubal ligation succeeds in 43-88% of cases, conception cannot be guaranteed. For women over the age of 30 who are healthy and do not smoke, low-estrogen or no-estrogen oral contraceptive pills are considered safe. Taking the pill also helps prevent ovarian and endometrial cancer. The failure rate is 6%. Barrier methods also offer protection from sexually transmitted diseases including HIV. Condoms are favored by 33% of unmarried women and 19% of married women. Sexually active 40-44 year old unmarried women run a 14-19% risk of contracting a sexually transmitted disease (STD) in a 12-month period. Diaphragms offer some protection against STDs, but their failure rate is 18%. IUDs are regaining popularity, but only 1% of women use them (ParaGard T380A or Progestasert). Pelvic inflammatory disease is the reason: a 1992 study showed that 0.97% of women developed it within 20 days of use. Norplant is a long-term implant containing levonorgestrel with a failure rate of 0.5%. A 1993 study followed 1253 implant users over 12 months and found a very low rate of pregnancy, but 75% experienced some side effects during the first year. About half of the women using Norplant removed it after 2.5 years because of irregular bleeding. Depo-Provera is an injectable administered every 3 months, but after removal it can take up to a year for ovulation to return. Side effects may include hair loss and weight gain; and links to breast cancer have also been suggested.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12291485&dopt=Abstract birth control