The family building life course and contraceptive use: Nang Rong, Thailand

Abstract

This paper incorporates the insights of the life course perspective in an examination of the determinants of contraceptive use. It views decision-making about contraceptive methods in the context of personal history and the broader social setting. Three stages in the reproductive life course of married women are considered. In the early years, timing decisions dominate. Contraception is used to delay the first birth and control the tempo of fertility. Mid-career, the major concern is whether to have a sterilizing operation. Towards the end of the fecund period, couples must decide when to stop using contraception, given that they have not already opted for sterilization. We examine choice among nonpermanent methods, as well as sterilization, in the context of a theoretical model that explicitly recognizes the permanence of the sterilization decision. Our statistical procedures control for unobserved community influences. The data are from Nang Rong district, Thailand, a relatively poor area near the Cambodian border under going substantial socioeconomic change during the 1980s. Our results clearly show variation in method choice over the reproductive life course, and variation in the effects of specific determinants including age of husband and wife, living arrangements, and village location. They also demonstrate gains in the understanding of any particular stage in the life course that accrue from an integrated examination of all of them.

Women and Reproductive Control: The Nexus between Abortion and Contraceptive Use in Madhya Pradesh, India

“…Although this influence has long been understood at a theoretical level, relatively few studies have applied this insight empirically. For the most part, research on contraception and abortion has focused almost exclusively on single indicators of the life-course stage, such as age or parity; fewer studies have taken a holistic approach that fully accounts for the influence of past and present experiences (notable exceptions include Rindfuss et al 1996;Axinn and Barber 2001;Edmeades 2008). The life-course approach implies a much more dynamic conceptualization of the decisionmaking process that lies behind abortion and contraceptive use than has typically been taken in empirical research in this area.…”

“…3 The use of temporary and permanent methods cannot be modeled together for several reasons. Not only do substantial differences exist between these options in terms of the decisionmaking process (sterilization represents a clear intention to limit fertility permanently, whereas use of temporary methods does not), but the two decisions are endogenous (see Rindfuss et al 1996).…”

“…5 Some researchers have argued that parity should not be included in models of contraceptive use because of the potentially endogenous relationship between these two variables (see, for example, Rindfuss et al 1996). Inclusion of parity is less of a concern in this case, because the parity measure (number of sons and number of daughters) refers to the beginning of the interval, prior to the point at which the contraceptive decision is made.…”

“…In recent years, a considerable body of research has emerged focusing on the individual, household, and sociocultural influences on contraceptive and abortion behavior and, to a lesser extent, on the interrelationship between them (Ahmed et al 1998 and1999;Rahman et al 2001;Guillaume and Desgrées du Loû 2002). This research has demonstrated that a key influence on both contraceptive and abortion behavior is a woman's stage in her family formation (Rindfuss et al 1996;Ahmed et al 1998;Bankole et al 1999;Pallikadavath and Stones 2006). Most of the research on abortion and, to a lesser extent on contraceptive use, has not given full consideration at the theoretical or the empirical level to the influential role of life-course experiences on women's behavior.…”

The legacies of context: Past and present influences on contraceptive choice in Nang Rong, Thailand

“…By 2000, virtually all of these women were likely to have married and had children, making fertility control an increasingly important issue, particularly with regard to permanent methods. Research in Nang Rong has found that sterilization is closely related to an individual's remaining years of anticipated need for contraception, which can be proxied by age (Rindfuss et al 1996). In addition, given the age range covered, many of these women would have likely had at least some experience with migration to urban areas, providing an ideal test of the ways in which individual experiences might infl uence the relationship between context and contraceptive behavior.…”