Social and Psychological Factors Affecting Fertility. XX. The Use, Effectiveness, and Acceptability of Methods of Fertility Control

Abstract

This report is based upon information supplied by 1977 wives, in response to detailed questions about their pregnancies and contraceptive histories which ranged over a married period of 12-15 yrs. Requirements for inclusion in the intensive interview study were the same as those set up for previous reports in this series. All couples represented were native white, Protestant, at least 8th grade graduates, married during the period between 1927 and 1929, never previously married, residents of a large city during most of their life together, and with the husbands under 40 and the wives younger than 30 at the time of their marriage. A consideration of fecundity and economic class showed no evidence of relation between the two but there was a wide difference between rates of non-contraceptive pregnancies in the various economic classes. In the period of exposure to the risk of conception before the 1st pregnancy there is direct correlation between economic class and the period covered by contraceptive practices. After the 1st pregnancy this correlation is absent. Definite evidence is shown that there is an inverse association between economic class and the regularity of the use of contraceptive practices. This is reflected in the inverse relation seen (in the pregnancy rates of couples practicing contraception) between family income and number of pregnancies. The condom is used by about 72% of couples, either alone or supplemented by some other means. Diaphragm and jelly, which was used in only 7% of all contraceptive exposures, tends to be used later in the married period, although 35% of all couples were using comparatively ineffective methods after 13 to 15 years of married life. For relatively fecund couples who reported using contraception the general effectiveness is 92%, from the point of view in reduction of uncontrolled fertility. Highly effective techniques include the diaphragm and jelly, the condom, and the condom and douches. Least effective methods included the safe periods, suppositories and douches.