Contraceptive use before and after marriage in Shanghai.
Data from a cohort study of 7,336 newly married fertile couples conducted between 1987 and 1995 were used to analyze contraceptive method choice, switching, and discontinuation in two districts of Shanghai. Twelve percent of couples reported that they had had sexual intercourse before marriage. Only one-third of those exposed to premarital risk of conception were protected by some form of contraception, mostly by withdrawal and periodic abstinence. As a consequence, a majority of these couples conceived, prompting rapid marriage in most cases and induced abortion among one-fourth of them. After marriage, about half of the couples used contraceptives to postpone the birth of their first child, but of these, 40 percent experienced an unintended pregnancy. Method choice was dominated by condoms, withdrawal, and abstinence. After the birth of their first child, almost all couples (98 percent) adopted contraceptives, but one-third of them used ineffective methods. Failure and discontinuation rates were high, giving rise to a high incidence of induced abortion. Increasing numbers of couples switched to the IUD, and this was the preferred method for the majority by the third year following childbirth. These results suggest that wider method choice that includes hormonal contraceptives should be provided to meet couples' needs in Shanghai and that the family planning program's attention should be focused specifically on sexually active unmarried individuals and on the availability of postpartum services.
Che
Yan
Y
Shanghai Institute of Planned Parenthood Research, 2140 Xie Tu Road, Shanghai 200032, China. yan_che2002@hotmail.com
Cleland
John
J
D000328:Adult; D001721:Birth Intervals; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007086:Illegitimacy / Q000706:statistics & numerical data; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012725:Sexual Behavior / Q000706:statistics & numerical data