Reproductive preferences and contraceptive use

The level of contraceptive use among Sri Lankan women increased rapidly in the period

following the early 1970s (section 1.4.5). There was increasing awareness of

contraception not only for the purpose of ceasing childbearing but also for spacing. Of currently married, non-pregnant, fecund women interviewed in the 1982 SLOPS, about 70 per cent were currently using contraception for either spacing or termination of childbearing (Table 4.10). Among the users 55 per cent had adopted modem methods while the rest used traditional contraception. Among modem method users the majority were using permanent methods, female sterilization being the most common (Table A4.3). Traditional method users largely relied on rhythm.

Number of living children rather than parity is again used to examine contraceptive behaviour, because it is living children that represent, on the one hand, economic pressure, and on the other hand, the satisfaction afforded by parenthood. Number of living children shows a positive relation with the use of modem contraception but a negative one with the use of traditional contraception (Table 4.10). With an increment in the number of living children from two to three, women’s contraceptive behaviour changed dramatically from traditional to modem methods. This is a clear indication that in Sri Lanka there is genuine interest in terminating reproduction at smaller family sizes. It is perhaps true that many women in Sri Lanka used traditional methods for spacing and modem methods for terminating childbearing.

Table 4.10 Percentage Distributions of Currently Married, Non-pregnant, Fecund

Women by Contraceptive Use by Number of Living Children and Age,

1982 SLCPS Re-interviewed Subsample

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Use status/Method Number of living children

0-1 2 3 4+ Total (N) M o d ern m eth o d s 12.0 29.6 52.7 55.3 38.6 710 Permanent (sterilization) 1.5 11.1 41.0 46.6 26.8 493 Temporary 10.5 18.5 11.7 8.7 11.8 217 T r a d itio n a l M eth o d s 34.8 39.7 29.0 26.0 31.7 582 A ll m eth o d s 46.8 69.3 81.7 81.3 70.3 1292 N o n -u ser 53.2 30.7 18.3 18.7 29.7 547 Total 100.0 100.0 100.0 100.0 100.0 1839 Age of respondent <25 25-34 35+ Total (N) M o d ern m eth o d s 20.3 37.5 48.5 38.6 710 Permanent (sterilization) 5.2 25.8 38.2 26.8 493 Temporary 15.1 11.7 10.3 11.8 217 T ra d itio n a l M eth o d s 36.6 31.0 30.1 31.7 582 A ll m eth o d s 56.9 68.5 78.6 70.3 1292 N o n -u ser 43.1 31.5 21.4 29.7 547 Total 100.0 100.0 100.0 100.0 1839

Source: Longitudinal data tape 1982-85.

Of women aged less than 25 years about 57 per cent used contraception, with a larger proportion using traditional methods than modem methods (second panel of Table 4.10). However, as age increased use of modem contraception increased while use of traditional methods decreased. Among women aged 35 and above female sterilization was by far the most commonly accepted method of contraception, used by almost twice as many women as rhythm (Table A4.4). Modem contraception is overwhelmingly sterilization, which obviously is of no use as a means of spacing births.

One obvious explanation for a relatively higher use of modem contraception, especially sterilization, among older currently married, fecund, non-pregnant women is that many do not want another pregnancy, having already achieved their desired fertility. As mentioned earlier, there is also commonly found in Asian countries a feeling of shame about pregnancy in a woman who has grown-up children, which could also lead to high use of terminal methods of contraception.

4.6.1 Relation between reproductive preferences and contraception

The question to be answered in this section is the extent to which expressed reproductive preferences are related to the pattem of contraceptive use. Women who wanted to have more children and were at the same time contracepting generally wanted to space births, while most women who wanted to have no more children were

contracepting to limit their family sizes. For 11 WFS countries, Palmore and

Concepcion (1981) report a meaningful but small relationship between the desire for additional children and current contraceptive use. In Taiwan, Hermalin et al. (1979) found that desire for additional children was the most important predictor (of a group also comprising marriage duration, education and parity) of contraceptive use.

Women who want to delay or stop childbearing will be inconsistent if they use no contraception to support their expressed desires. In the 1982 SLCPS women who wanted to have no more children were less inconsistent than women who wanted the next child later (Table 4.11). Although about two-thirds of women who wanted then- next child ‘soon’, that is within two years, were using contraception, ‘incongruity’ with their contraceptive behaviour is not unexpected. Some who wanted another child ‘soon’ may have been contracepting to delay the next birth for a short period of time. They were therefore were not considered inconsistent and were excluded from the present analysis.

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Table 4.11 Levels of Inconsistency Between Reproductive Desires and Contraceptive Behaviour by Selected Socio-economic Variables for Currently Married, Non-pregnant,

Fecund Women, 1982 SLCPS Re-interviewed Subsample

V a ria b le a s o f 198 2 P e r c e n t in c o n s is te n t W a n t ‘la t e r ’ b u t n o t c o n tra c e p tin g W a n t n o m o re b u t n o t c o n tra c e p tin g N o . o f liv in g c h ild r e n 0-1 2 9 .6 2 6 .3 2 2 5 .8 16.7 3 2 8 .2 1 0 .6 4 + 74.1 13.9 N o . o f liv in g b o y s N o n e 2 9 .4 15.6 O n e o r m o re 33.1 14.1 A g e < 2 5 30 .3 15 .6 2 5 -3 4 2 8 .3 14.1 3 5 + 5 1 .2 12.7 D u r a tio n o f m a r r ia g e < 5 30.1 19.7 5 -9 3 2 .7 14.1 10+ 4 6 .9 13.9 E d u c a t io n N o s c h o o lin g 6 1 .2 2 0 .3 P r im a r y 3 8 .6 15.9 S e c o n d a ry 24.1 12.6 H ig h e r 2 3 .5 8.9 E t h n ic it y /R e lig io n S in h a le s e /B u d d h is t 2 8 .9 14.0 T a m il/H in d u 4 5 .5 16.9 M o o r /M u s lim 5 4 .5 2 0 .0 C h r is tia n 3 6 .4 12.4 P la c e o f r e s id e n c e U rb a n 3 6 .8 10.5 R u ra l 2 7 .6 15.3 E s ta te 4 7 .8 14.1 H u s b a n d ’s O c c u p a t io n P r im a r y s e c to r 2 9 .8 13.8 N o t in p r im a r y 32 .1 14.5 H u s b a n d ’s a p p r o v a l o f f a m ily p la n n in g A p p r o v e 2 9 .9 10.6 D is a p p ro v e 3 8 .7 3 3 .7 T o t a l (N ) 3 1 .2 (3 5 0 ) 1 4 .2 (1 2 0 2 )

When currently married women were asked in the 1982 SLCPS about current family planning practice, abstinence was not included as a separate contraceptive method, but those who were abstaining from sex for postpartum or any other reasons were included in the ‘other’ traditional method category (Table A4.3). It is likely that only those abstainers who volunteered that they were currently abstaining were actually picked up in the survey; so the true level of current contraception in 1982 was, therefore,

underreported (Gajanayake and Caldwell 1989). Among those who wanted to cease

childbearing and also those who wanted to postpone the next birth for more than two years in the 1982 SLCPS, some would have been in postpartum amenorrhoea and

consequently might have reported no use of contraception at the survey. From

information on when the respondent had her last live birth, and her last menstrual period, women who were in postpartum amenorrhoea were identified and included as there was no risk of immediate pregnancy.8

For those who wanted no more children the level of inconsistency shows a negative association with successive life-cycle stages. Increasing age, duration of marriage and number of living children all show this relationship, while number of living sons shows no appreciable difference in inconsistency levels. Level of education shows a negative relation; being better educated was probably associated with being at the earlier stages of the life-cycle, and yet this is where inconsistency is lowest. More than a quarter of Moor/Muslim and Tamil/Hindu women who wanted no more children were not using contraception. The levels for Christians and Sinhalese/Buddhists were only 12 per cent and 14 per cent respectively. Women residing in the estate sector or in rural Sri Lanka were less inclined to be using contraception to avoid unwanted births than urban women.

8 Variations in the length o f postpartum amenorrhoea may be partly determined by breastfeeding practice (Santow 1987). In many