Effects of Sex Preference on Contraceptive Use, Abortion and Fertility in Matlab, Bangladesh

Abstract

Data from the Matlab Demographic Surveillance System were used to investigate the effects of son preference on contraceptive use abortion and fertility and trends in these effects over time in the Matlab maternal and child health and family planning project area and in a comparison area. A modified Arnold Index was used to estimate the increase or decrease in contraceptive prevalence abortion or fertility that would occur in the population in the absence of sex preference. The level of sex-selective abortion was measured by the deviation from the expected ratio of males to females at birth. Between the early 1980s and the middle 1990s contraceptive use and recourse to abortion increased in Matlab while fertility declined. Method use rose with parity in the project area. (Adequate data were not available for the comparison area). At low parities method use increased with the number of sons; among women with 3 or more children however it stabilized or decreased among those who had at least 2 sons. In the absence of sex preference contraceptive use in the project area would have risen by 9% in 1983 by 8% in 1988 and by 6% in 1993. The abortion ratio increased with parity; within parities it was generally lowest for women with no sons and was often highest for those with at least 2 sons and a daughter. In the absence of sex preference the abortion ratio would have increased by 27% in 1982-86 by 36% in 1987-91 and by 55% in 1992-95 in the project area and by 36% 37% and 38% respectively in the comparison area. The percentage of women giving birth declined as parity rose and within parities was highest for women without sons. Among women with more than 2 children fertility was lowest for those who had sons and a daughter. In the absence of sex preference fertility would have decreased by 9% in 1984-86 by 10% in 1989-91 and by 12% in 1994-95 in the project area and by 7% 8% and 9% respectively in the comparison area. There was no evidence of sex-selective abortion in Matlab. Sex preference does not have a strong effect on contraceptive use in Matlab. Its absence however would probably increase recourse to abortion which is used to limit fertility once couples have the number of sons they desire. The effect of sex preference on childbearing is becoming stronger as fertility declines because couples must achieve their desired number of sons within a smaller overall number of children. (authors)