One specific mechanism by which contraceptive access can improve women’s economic outcomes is the effect of contraception on fertility. Early birth can disrupt secondary schooling or college attainment, lowering a woman’s future earning potential; each additional birth can have additional financial consequences, particularly in low-income households; and unexpected late births can impact a woman’s career trajectory during her prime earning years.
Many countries’ increased use of contraception is not because more women want to postpone pregnancy or have no more children. It is instead because contraception is assisting more women in achieving their childbearing goals. This is the overwhelming conclusion of a global survey of national survey data from 59 low- and middle-income countries.
According to the findings, 85-90% of the change in contraception use is due to meeting the prevalent demand for reproductive control, while only 10-15% is due to an increase in the proportion of women who want to avoid pregnancy.
“Contraception use is increasing because women are more successfully carrying through on their preferences, achieving what they want. It’s not due to large increases in the proportion of women who want to avoid pregnancy,” said Mobolaji Ibitoye, lead author of the study and postdoctoral scholar at The Ohio State University’s Institute for Population Research.
Contraception use is increasing because women are more successfully carrying through on their preferences, achieving what they want. It’s not due to large increases in the proportion of women who want to avoid pregnancy.
Mobolaji Ibitoye
According to John Casterline, co-author of the study and professor of sociology at Ohio State’s IPR, the rise in use of modern contraceptives in low- and middle-income countries over the last few decades has sparked a long-running debate about whether the increase is due to women wanting fewer children or not.
One of the most surprising aspects of this new study, according to Casterline, is how definitively it answered that question.
“The results are overwhelming; there is no contest. It is a clear denial of the notion that decreased demand for children has been the primary driver of contraceptive use “He stated. The findings were reported in the journal Studies in Family Planning.
The researchers analyzed five decades of data (1970s through 2020) from five major survey programs that involved women of reproductive age in 59 low- and middle-income countries. The surveys, which included the World Fertility Surveys and the Demographic Health Surveys, were done in countries in Africa, Latin America and the Caribbean, and Asia.
The study used at least two surveys from each country conducted at least eight years apart, which asked women about their contraceptive use and whether they wanted a child or another child.
The majority of the surveys asked women who wanted to have children how long they wanted to wait before becoming pregnant. This enabled the researchers to categorize women as wanting a child soon, wanting one later, or not wanting another child at all.
The researchers used statistical analyses to determine how women’s use of contraception changed over time in relation to their preferences to have (or not have) children. If changes in women’s desire for children were the cause of the increase in contraception use, then increases in contraception use should be linked to increases in the number of women who say they no longer want children over time. But that is not what the researchers discovered.
With few exceptions, similar results were found in countries all over the world. The researchers also took into account the number of children women in the surveys already had to see how that fact affected the link between contraception use and desire for more children. Results showed it did not have major effects.
“About 10-15% of the increase in contraception was actually in women who said they wanted to have children soon, in the next two years,” Ibitoye said. “This is another piece of evidence refuting the claim that contraception use is increasing due to decreased desire for children.”
According to Casterline, researchers frequently discuss the “contraceptive revolution” that occurred with the introduction of new contraceptive technology in the 1960s, including the birth control pill and the inter-uterine device or IUD. This research contributes to defining what that revolution was all about.
“The revolution is that women can now do what they want because of modern contraception,” he explained. “The proportion of women who want to avoid pregnancy has remained stable. Instead, it is greater control over when and how many children they have. It is a significant achievement in global health.”
