Desired Numbers of Children, Fertility Preferences and Related Factors among Couples Who Referred to Pre-Marriage Counseling in Alborz Province, Iran

Background

The Islamic Republic of Iran has experienced a dramatic decrease in fertility rates in the past three decades. One of the main issues in the field of fertility is the couple's preferences and the desire to bear children. This study aimed to determine desired number of children, fertility preference, and related factors among people referring pre-marriage counseling to clarify their presumed behavior in case of fertility.

MATERIALS AND METHODS

This study was a descriptive analytic cross-sectional survey, conducted during 8 months. The participants were 300 couples came to pre-marriage counseling centers of two health centers of Karaj and asked to complete a 22 items questionnaire about of demographic characteristics, participants' interest, preference about fertility, and economic situation.

RESULTS

Majority of the males were between the ages of 20-30 years (66.6%) while majority of the females were below 25 years of age (57%). About 17 percent of men and 22.3 percent of women stated that they want to have 1 child and equally 52.7 percent of men and 52.7 percent of women wanted to have 2 children. The only factor that contributed to the female participant's decision for a desirable number of children was the number of siblings that they have. In male participants with an increasing age at marriage and aspiration for higher educational level, the time interval between marriage and the birth of the first child has increased. There was a convergence in desired number of children in male and female participants.

CONCLUSION

Majority of the participants express their desire to have only one or two children in future but in considering the fact that what one desires does not always come into reality, the risk of reduced fertility is generally present in the community. Appropriate policies should be implemented in order to create a favorable environment for children.

Are husbands a barrier to women's family planning use? The case of Morocco

Little is known about men's role in the adoption of family planning. Recent studies suggest that men may be a barrier to women's use of family planning. However, it is not clear whether husbands represent a true or a perceived barrier. Using the 1992 Morocco Demographic and Health Survey data, this study examines (1) whether women and men report concordant fertility desires, discussions, and contraceptive use; (2) the accuracy of women's perceptions of their husbands' fertility desires; and (3) whether husbands are a barrier to women's family planning use. The results demonstrate that, controlling for women's own fertility desires, husbands' true fertility desires are associated with family planning use. Likewise, women who perceive their husbands to want fewer children than they want are more likely to use family planning. Future fertility and family planning programs need to include men to reduce their role as both perceived and true barriers to family planning use.

Potential effects on fertility and child health and survival of birth-spacing preferences in sub-Saharan Africa

Using Demographic and Health Survey data from 20 sub-Saharan African countries, this article compares the actual lengths of birth intervals to women's reported preferred lengths, and assesses the implications of the difference between the two for selected demographic and health indicators. The results show a clear pattern. In Comoros, Ghana, Kenya, Rwanda, and Zimbabwe, women prefer much longer birth intervals than those they actually have, compared with women in the other 15 countries studied. As a consequence, the potential effects of spacing preferences on the level of fertility and on the prevalences of short (less than 24 months) birth intervals and child malnutrition are greatest in the same five countries. The covariates of preferred birth-interval lengths are also examined. An explanation is offered for this pattern, based on the observed sharp decline in fertility recently experienced by these five "forerunners." In general, women who know, approve of, discuss, and use family planning prefer longer intervals than do their counterparts. The policy and program relevance of these results is discussed.

The effects of family planning workers' contact on fertility preferences: evidence from Bangladesh

Should family planning programs put more effort into persuading couples to want smaller families or into helping women achieve their reproductive goals? Indeed, can family planning programs affect fertility preferences? Longitudinal data from Bangladesh collected from 1982 to 1993 show that women's desired family sizes have declined dramatically. This study examines how the decline in desired family size is related to visits from family planning workers for three intervals: 1982-85, 1985-90, and 1990-93. By use of logistic-regression analysis, the number of rounds during which women received visits from family planning workers is found to have no statistically significant effect on the probability that women altered their preference from wanting more children at the beginning of an interval to wanting no more at the end of the interval.

Determinants of contraceptive discontinuation in six developing countries

This analysis investigates the determinants of contraceptive discontinuation in six developing countries, using data from Phase I surveys of the DHS programme. Cumulative probabilities of discontinuation at 24 months for reasons other than the desire for another child were examined. By this time, typically about 40% of couples have stopped use and most are subsequently at risk of an unwanted conception. Discontinuation of IUD use was found to be less common than for other methods, partly perhaps because cessation of use requires a deliberate decision to have the device removed. The most important results are negative ones. Neither the schooling of couples nor their type of residence exerted appreciable influence on discontinuation. The policy and programme implications are discussed. Prior use of a method, fertility preferences and the related demographic factors of age and family size emerged as pervasive predictors of discontinuation.

Women's fears and men's anxieties: the impact of family planning on gender relations in northern Ghana

The Navrongo experiment, a family planning and health project in northern Ghana, has demonstrated that an appropriately designed, community-based family planning program can produce a change in contraceptive practice that had been considered unattainable in such a setting. Simultaneously, however, evidence suggests that newly introduced family planning services and contraceptive availability can activate tension in gender relations. In this society, where payment of bridewealth signifies a woman's requirement to bear children, there are deeply ingrained expectations about women's reproductive obligations. Physical abuse and reprisals from the extended family pose substantial threats to women; men are anxious that women who practice contraception might be unfaithful. Data from focus-group discussions with men and women are examined in this report and highlight the strains on gender relations resulting from contraceptive use. The measures taken to address this problem and methods of minimizing the risk of adverse social consequences are discussed.

The consistency and validity of reproductive attitudes: evidence from Morocco

Information on reproductive attitudes is now routinely collected in fertility surveys in developing countries, and has become very important for understanding fertility behaviour. The quality of this information, however, is rarely assessed, partly due to lack of necessary data. In this paper, the recently completed panel survey in Morocco by the Demographic and Health Surveys (DHS) was used to investigate the consistency of reporting of ideal number of children, reproductive intentions and the planning status of the last birth. The validity of reproductive intentions for subsequent fertility behaviour was also examined. The findings indicate that the three measures of reproductive attitudes are subject to different degrees of measurement error. The measure of reproductive intentions is the most consistent of the three, followed by ideal number of children. The latter is much more consistent at the aggregate level than at the individual level. The reliability of the planning status of the last birth is marred, mainly by an unwanted child being reclassified as 'wanted' with time since the birth of the child. The reproductive intentions of women were also found to be positively related to their subsequent fertility.

Comparison of two question sequences for assessing pregnancy intentions

Unintended pregnancies can have serious health, social, and economic consequences. Such pregnancies may be unwanted (a baby is not wanted at any time) or mistimed, yet wanted (a baby is wanted eventually). Intended pregnancies are those conceived when desired. Reproductive health survey respondents' understanding of these concepts and validity of survey results may be affected by question order and wording. Using a randomized crossover design, National Survey of Family Growth (NSFG) and Demographic and Health Survey (DHS) intendedness questions were asked in a 1993 survey of Arizona women aged 18-44 years. Of 2,352 ever-pregnant respondents, 25% gave discordant responses to DHS and NSFG questions about the most recent pregnancy. Age, marital status, household income, education, parity, time since pregnancy, and outcome of pregnancy were significantly predictive of discordant responses. DHS and NSFG questions yielded similar prevalence estimates of intendedness and wantedness; but young, unmarried respondents gave more "mistimed" responses on whichever question was asked later. Classifying pregnancies as intended, mistimed, or unwanted may be a problem for women who have not decided on lifetime reproductive preferences. Approaches to improving survey validity include addressing ambivalence, clarifying the definition of "unwanted," and, for young, unmarried women, not attempting to classify unintended pregnancies as mistimed or unwanted.

Family size and sex preferences and eventual fertility in Botswana

Botswana is one of the sub-Saharan countries where actual fertility has declined. This study examines the fertility preferences of both men and women and shows that fertility intentions have a significant influence on future fertility behaviour. Fertility preferences are relatively low and there is no significant difference between those of men and women. Men's preference for sons influences desired family size and eventual fertility. For women as well as men, child survival is an important factor. Women's income is also influential.

Do family planning programs affect fertility preferences? A literature review

A literature review finds few studies about whether family planning programs have reduced fertility preferences. The strong and surprising evidence from Matlab, Bangladesh, demonstrated that this intensive program did not decrease preferences; however, it did crystallize latent demand for fewer children, resulting in a demand for contraception. One cross-national multivariate study was consistent with this finding. A few intracountry multivariate studies found small program effects, decreasing the number of children that couples want. An intensive multimethod study in India found plausible larger effects. Most studies of program media effects are flawed by possible selection bias, but one longitudinal study avoids this pitfall and finds large effects for one country. Program feedback effects are plausible but not yet demonstrated empirically. The effects of a coercive program are plausible, at least in China, but not definitively demonstrated. Several promising unpublished studies may strengthen the case for program effects in reducing fertility preferences, now often based on plausible but not conclusive evidence. Stronger generalizations require better studies of a wider range of locations.

A conversation with Richard Easterlin

"After an introduction touching on various biographical highlights, this paper summarizes a wide-ranging discussion with Richard Easterlin which occurred in the Autumn of 1996. We considered the Easterlin Hypothesis--its genesis and current status, together with Easterlin's views on attempts to develop measures of relative income--and then moved on to ¿The Fertility Revolution' and questions regarding the applicability of the theory of household choice in modernizing societies. This was followed by a discussion of his early career development and influences on him at that time, ending with ruminations regarding the current state of economics, and the validity of training given to young economists today."

Unmet need for contraception in Vietnam: who needs what and when

The Vietnam 1988 survey established the first national estimates for reproductive preferences and behavior. It created a unique baseline for levels and differentials, both for the marked differences between North and South, and for various social and demographic categories. It also provided the first national data for program guidance, including information on unmet need. Unmet need for contraception has been extensively documented for much of the developing world, but its structure is not yet well understood. This study differentiates unmet-need couples by several demographic characteristics, by time since the last birth, and by features identified through a computer search program. Past investigations have emphasized the per cent with unmet need within various population subgroups, but some of those subgroups are small, whereas the national family planning program must be oriented to subgroups with large absolute numbers of unmet need couples. Unmet-need couples are selective, whether by reference to the married population or by reference to other couples who also wish to avoid pregnancy but are using a method. Most unmet-need couples are younger than users, have fewer children and, especially, are closer to their last birth. Surprisingly, most have never used a contraceptive method before, even though Vietnam has had a vigorous family planning program and 49 per cent of all couples in the survey reported some experience with a modern contraceptive method. In terms of sheer numbers, those in need are distributed very widely throughout the country. The most disadvantaged segments of the population have both high percentages and large numbers in need, but the concentration of the national program upon a single contraceptive method restricts their options.

Men, women and the trouble with condoms: problems associated with condom use by migrant workers in rural Zambia

Understanding cultural attitudes to condoms is of the utmost importance in promoting their use as a means of protection against HIV transmission. This article examines condom use in relation to what people see as the purpose of sex, what good sex entails and how this relates to ideas of being a proper woman or man. It seems that the underlying and pervasive ideal is that sex is essentially a procreative act, since an emphasis on male potency and male and female fertility often overrides anxieties about contracting HIV and other sexually transmitted diseases. Hence condom use is usually only negotiated within some short-term relationships and then not consistently. Whilst both men and women have negative attitudes to condoms, women because of their economic and ideological dependence on men are in a much weaker position to negotiate condom use.

Ideal-family-size and sex-composition preferences among wives and husbands in Nepal

This study tests the hypothesis that, in Nepal, measures of ideal family size mask an underlying preference for sons, making some people willing to have families larger than their ideal. Existing evidence suggests that men are likely to have stronger preferences for sons than are women. This research uses empirical evidence to examine the hypothesis that husbands are more willing than their wives to pursue the birth of sons at the cost of an increasingly large completed family size. A Multiple-response Fertility Preference Scale was developed to test these propositions among a sample of couples. The methodology was successful in demonstrating differential patterns of decisionmaking between husbands and wives that are otherwise obscured by more simplistic, single-response measures (for example, ideal family size). The results indicate that husbands are consistently more willing than their wives to pursue the birth of sons at the expense of larger family sizes, and that the birth of daughters is not pursued to a similar degree by wives or husbands.

The male versus female perspective on family planning: kinshasa, zaire

Males have often been neglected in both family planning programmes and in surveys used to design and evaluate such programmes. A 1988 study on fertility, family planning and AIDS in Kinshasa, Zaire, provides comparable data on 3140 men and 3485 women of reproductive age which served as the basis for analysing male/female differences. The study indicated a fair degree of similarity in the attitudes, beliefs, knowledge levels and practices of men and women regarding fertility and family planning. Where they differed (e.g. on expected or ideal number of children, the desire for more children at parity 7 or above), men tended to be more pronatalist than women. The implications of the findings for future family planning programmes are discussed. Programmes should target males because of their role as decision makers within Zairian society.

Endogenous fertility, multiple growth paths, and economic convergence

"This paper extends the Cass-Koopmans optimal growth model to allow for endogenous fertility choice. It is shown that if agents choose their fertility rate, then the net rate of return on capital (marginal product of capital minus the population growth rate) may not be monotonically decreasing in capital. In this case, multiple steady states and growth paths may emerge, which can explain the persistent differentials in income between poor and rich countries, as well as the existence of development miracles and disasters. The paper provides also empirical evidence which supports the existence of multiple convergence groups and is consistent with the theoretical model."

How does childbearing affect fertility motivations and desires?

In this study we assume that fertility decisions are made one birth at a time and use longitudinal data collected from 401 married couples over a two-year period to explore how having a child affects two types of fertility motivation and three types of fertility desires. Using a series of five constrained multiple regression analyses, we tested the effects of two childbearing variables on these five types of motivation and desires in the context of a large set of control variables also hypothesized to affect fertility motivation and desires. The results demonstrate that the childbearing variables have a substantial effect in all five regression models. Specific findings indicate that childbearing stimulates greater positive motivation for childbearing and an increase in the number of children desired. Although this situation would appear to create a positive feedback loop in which each child born further increases the motivation and desire for children, the findings also suggest three different mechanisms whereby childbearing causes a counterbalancing regulation of that loop. These mechanisms include a negative motivation mechanism, a satiation mechanism, and a delay mechanism. The effect of these mechanisms on the termination of childbearing is considered in conjunction with a fourth mechanism, the achievement of desired family size.

Son and daughter preferences in Benighat, Nepal: implications for fertility transition

Married women in Benighat, Nepal stressed old age security and continuity of lineage as prominent reasons for wanting sons. In addition, women clearly desired daughters too--an important finding that is less often stressed. Religious reasons and help with household chores were the most common reasons reported for wanting a daughter. Strong desires for sons could increase fertility in settings where fertility is controlled. Additional desires for daughters could have an additional pronatalist influence. For Benighat we document a pervasive desire for at least two sons and at least one daughter. If realized, these sex composition preferences would increase fertility by 50 per cent. Actual effects are no doubt smaller, but the effects of sex preference on the desire for more children and on contraceptive use are clearly visible.

The effects of HIV and AIDS on fertility in East and Central Africa

Concern has been expressed about the fertility of people infected with HIV: the worry has been that on learning of their condition, HIV-affected individuals may attempt to accomplish unmet reproductive goals knowing that they will not live a normal life span. This article addresses the potential effects of AIDS on fertility and reproductive decisions in East and Central Africa. The problem is seen in terms of a tightly knit continuum of biological, epidemiologic and cultural contexts, and the prevailing conditions of response to the epidemic. AIDS can influence fertility among individuals and groups regardless of any awareness of serostatus by increasing death rates among reproductive populations, and damaging the physical capacities of infected men and women to reproduce. In much of the region, high prevalence of STDs may simultaneously impair the fertility of men and women and increase their risk of contracting HIV. These biological conditions are compounded among those for whom fertility is a highly valued marker of adult status, where the social and economic marginality of young women contributes to reliance on commercialized sex, where the mobility of young men leads to instability in sexual partnerships and frequent partner change, or where women lack the ability to negotiate their fertility with spouses. It appears that even focused programs of testing and counselling with HIV-positive women in Europe and in Africa have not motivated a significant change in reproductive action. Were there a demonstrable effect of counselling on the fertility choices of infected persons, there are numerous practical limitations on the role that interventions can play in affecting the fertility of HIV-positive people.

[Fertility behavior in Quebec, family allowances, and taxes: results and simulations with a discrete choice model for the years 1975-1987]

"We suppose that women (couples), who are less than 40 years old, are faced with three types of sequential decisions: the fertility decision, the decision relative to the number of children to have and the decision concerning labour force participation.... We use a nested polychotomous discrete choice model to estimate the responsiveness of the behaviour of 'married' women in Quebec to variations in the expected flow of revenue resulting from changes in the parameters of the personal income tax and in the level of public monetary transfers conditional on the number of children. The model is estimated with micro-data from 9 repeated cross-sections for the years 1975 to 1987 with a full information maximum likelihood method.... This empirical setting is used to simulate the effects of changes made to the fiscal and transfer policies in favor of families with dependent children on fertility, [women's] labor force participation and the importance of spending costs for the two levels of government." (SUMMARY IN ENG)

Abortion in Vietnam: measurements, puzzles, and concerns

This report summarizes current knowledge about abortion in Vietnam, drawing upon government statistics, survey data, and fieldwork undertaken by the author in Vietnam throughout 1993 and part of 1994. The official total abortion rate in Vietnam in 1992 was about 2.5 per woman, the highest in Asia and worrisome for a country with a still-high total fertility rate of 3.7 children per woman. Vietnamese provinces exhibited substantial variation in both the rate of abortion and the type of procedures performed. Among the hypotheses explored to explain Vietnam's high rate of abortion are the borrowing of family planning strategies from other poor socialist states where abortion is common; current antinatal population policies that interact with a lack of contraceptive alternatives; and a rise in pregnancies among young and unmarried women in the wake of recent free-market reforms. Because family-size preferences are still declining, abortion rates may continue to increase unless the incidence of unwanted pregnancy can be reduced, a goal that Vietnamese population specialists are seeking to achieve.

Family context and adolescents' fertility expectations

Data from the National Longitudinal Surveys of Labor Market Experience of Youth are used to examine and contrast the effects of family context and individual characteristics on adolescents' expectations about adolescent fertility, nonmarital childbearing, family size, and childlessness. The findings indicate that family structure has modest but specific effects on adolescents' fertility expectations. Living with mothers only increases expectations for nonmarital childbearing, and living with fathers (without biological mother) lowers the total number of children expected. Larger subsize raises expectations for nonmarital childbearing and family size. Poverty raises expectations for adolescent childbearing but does not affect other fertility expectations. Adolescent women are less likely than men to expect nonmarital childbearing, and overall, expect fewer children. Blacks are more likely than Whites to expect adolescent and nonmarital fertility and Hispanics are significantly less likely than non-Hispanic Whites to expect childlessness.

Do fertility intentions predict subsequent behavior? Evidence from Peninsular Malaysia

Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.