Changing reproductive patterns in rural China : The influence of policy and gender

Detta är en avhandling från Stockholm : Karolinska Institutet, Department of Public Health Sciences

Sammanfattning: Background: In 1949, at the time for the foundation of the People's Republic of China, PRC, China had a Total Fertility Rate (TFR) of 5-6 children per woman, and it remained at that level throughout the 1950s and 1960s. In the beginning of the 1970s, the problems of rapid population growth began to receive serious attention and family planning programs were implemented. The TFR of around 6 births per woman in the early 1970s dropped to 2.8 in 1978. The one-child policy was introduced in 1979, and the fertility continued to drop, and in year 2000, it was estimated to be 1.8 children per woman. Paralleling this fertility decline, economic reforms were implemented with a de-collectivisation and return to family farming. China has been much criticized for its targetdriven population control programs, and for failing to take into account women's own perceptions of their health needs. It has also been argued that the family planning programs have resulted in undesirable social and economic consequences, such as increased discrimination against girls due to the strong preference for sons. Objectives: The overall aim was to analyse the reproductive patterns among women of different birth groups in one rural county, Yunnan Province, in context of successive birth policies and economic reforms and discuss these in relation to gender relationships. Methods: A cluster random sample of aged 15-64 at the time of the survey (2000) was selected in Huaning, one poor rural county in Yunnan province. The study population was women aged 15 to 64 years at the time of the survey in 2000. Thus, the older women in the study population entered reproductive age at the time of the foundation of the People's Republic of China in 1949. The total data set consists of 1336 women. Pre-coded questionnaires were used including background data, details on marriage, pregnancy histories, abortion, and contraceptive use. Quantitative analysis, such as life-table technique and causation analysis have been made. Main Findings: The childbearing patterns have changed in the direction of postponement of first marriage, a decreased interval between first marriage and first birth, a significant lengthening of birth intervals between first and second child, and a dramatic decline of third and higher birth orders. Abortion had become virtually universal for women with two children, regardless the sex of previous children. During the period 1988-2000, the reported sex ratio at birth rose to an average of 110 for all parities combined, which is considerably above the normal ratio. The IUD was the far most common method of family planning also after the birth of the second child, regardless the sex of the previous child. Conclusions: The timing and magnitude of the transformation of child bearing patterns and adoption of small family size follow closely the requirements of the successive family planning policies, especially from the mid 1980s and onwards. The family planning policies have, in demographic terms, successfully limited population growth, at the same time has the sex ratio at birth increased gradually since the implementation of these policies.

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