An Imperfect Contraceptive Society: Fertility and Contraception in Italy

Abstract

Italy represents an unexpected and in some ways paradoxical outcome in terms of fertility control: a drop to one of the lowest birth rates in the world has been accompanied by the preponderant use of “traditional” methods despite the availability of “modern” contraception. Using data from 349 interviews conducted in 2005–2006 in four Italian cities, we argue that Italian women achieve “unplanned” AND desired conceptions through the use of withdrawal and natural methods. While data from other countries reveal similar notions of ambivalence surrounding pregnancy intentions and contraceptive use, Italy stands out for the surprising correlation between highly “managing” the conditions under which children are born and the socially commended approach of “letting births happen”. Such results suggest the need to rethink theoretical understandings of low fertility. Through the use of non-technological methods individuals manipulate culturally produced norms and beliefs about the appropriate moment to have a child; simultaneously, their actions are embedded in larger cultural, economic, and political processes.

Gender inequality and the ‘East-West’ divide in contraception: An analysis at the individual, the couple, and the country level

“…Likewise, when we focused on the sterilized respondents, we found that women living in a country with lower levels of gender inequality were more likely to rely on vasectomy than tubal ligation. Although the first set of results about contraceptive use indicate that efficacy, unsurprisingly, is a primary factor in women's contraceptive choices, these findings add that the assumption that contraceptive behavior advances linearly-from irrational, ineffective, or traditional methods to rational, effective, or modern methods (Gribaldo et al 2009)-should be nuanced. We argue that neither H2a (higher levels of gender inequality lead women to retain female contraceptives) nor H2b (higher levels of gender inequality lead women to transfer this task to their partner) can be confirmed or rejected.…”

“…First, we combine data from two survey programs (DHS 2005-2009, GGP Data Archive 2016 to enable multilevel analysis. Methodological strategies to handle possible differences between the GGS and DHS (e.g., adding a survey dummy) assume that both include a representative set of countries, but the latter only contains CEE countries.…”

“…We tried to take this multilayered character into account by paying attention to multiple measurements of women's social position at the individual, household, and country level. Finally, it would be worthwhile to take other parts of Europe-for instance the Southern region-into account, as this region shows similarly high rates of traditional method use than CEE (UN 2013), despite the introduction of more effective methods (Dalla Zuanna et al 2005,Gribaldo et al 2009). Unfortunately, neither the GSS nor DHS include key information concerning contraceptive use for these regions.…”

“…For instance, dissatisfaction with female hormonal contraceptives is identified as a common motivation for practicing less-effective male barrier methods (Grady et al 2002), and the prevalence of female sterilization exceeds that of male sterilization, although both are similarly effective, and the first entails higher physical and financial costs (Shih et al 2011). This suggests that contraceptive behavior is also a social practice, shaped by complex interactions between (gendered) roles and responsibilities (Gribaldo et al 2009).…”

“…On the other hand, men may define their participation in contraceptive responsibility-both in terms of actually using a male method or engaging in decision-making-as part of their role as a responsible man and as a way of taking care of their partner (Fennell 2011). In line, performing withdrawal successfully is a source of pride and masculinity in some CEE and Southern European countries, and is perceived as a sign of commitment, trust, and intimacy (IPPF 2012, Gribaldo et al 2009). …”