Guilty whether contraception in reducing fertility?
Is the use of modern methods of contraception leads to a reduction in fertility? Or is it a myth? What really affects the reproductive behavior of the Russians? Your opinion on this issue expressed director of the Center for Demography and Human Ecology, Institute of Economic Forecasting RAS, Doctor of Economics, Academy of Natural Sciences Anatoly Vishnevsky.
Russia's population is not reproducing itself for 40 years
In Russia, the birth rate began to fall in the late 1920s and dropped to a very low point - below replacement rate - in 1964, earlier than in most developed countries. Since then, the net reproduction rate (see Fig.) Remains below this critical level, except for a short period of 1986-1988. This level of fertility makes the inevitable decline in population that began in Russia in 1992.
For simple replacement of generations, it is necessary that women account for about 2, 2 was born, and we have the figure is 1 and 3. Even if the mortality rate in our country was not so high, extremely low birth rate can not hope that the decline in the population will be able to stop in the near future.
Model few children of the family has become a priority
Installation on having a small family is characterized by today for most Russians, there is almost no social or regional differentiation. Businessman, engineer, teacher, worker, janitor have about the same number of children, regardless of where they live - in the center or the outback. Significant differences are observed only at the level of ethnic differentiation, for example, in the North Caucasus, where the birth rate is traditionally high.
Even the improved economic conditions (high wages, good housing and so on.) Is not always pushes women to the decision to have another child. Additional material capabilities of people today are primarily aimed at improving the quality of education - providing better education, comprehensive development of the child, etc. And benefits affect more on the "calendar" the appearance of children in the family, than a finite number of them.
The demographic situation in Russia is developing in line with the processes occurring in all developed countries. These processes are associated with a new type of reproduction of the population, due to changes in the social and economic life, which in particular led to the democratization of family relations, the emancipation of women, opened more opportunities for self-fulfillment and human needs.
It would be naive to believe that contraception itself causes changes in reproductive behavior. On the contrary, these changes have generated demand for contraceptives. Their widespread - only a consequence of the changes taking place. Solution - how many children to have determined a way of life, mentality, life values of modern man. Model family with fewer children, alas, has become a priority for the majority of people in the developed countries.
Restricting access to modern contraception is unlikely to stimulate the birth rate. If a woman wants to have more children than planned, she would rather go to an abortion than dare to give birth.
On the threshold of the contraceptive revolution
Unfortunately, abortion remain in Russia is very common method of birth control, although in recent years their number has been steadily shrinking. In 1995, 100 202 live births abortion, in 2002 - 139. The total abortion rate dropped from 3, 4, abortion on average per woman of reproductive age in 1991 to 1, 8 in 2002
The situation is improving in all age groups. The number of abortions per 1,000 women aged 35 years and older: in 1991 it was - 51, and in 2002 was - 21. In the youngest age group - from 15 to 19 years - there were 69 abortions, and was 33.
Number of abortions reduced with sustained growth in the number of women using modern contraceptive methods. According to the Ministry of Health, at the end of 2001 15, 6% of all women of reproductive age use intrauterine devices and 7, 8% - hormonal agents.
While the level of use of modern contraceptives in Russia remains relatively low. Contraceptive revolution that Western countries have experienced in the 60's - 70's, we have only just begun. Nevertheless, Russia is moving from a situation where the primary means of birth control was an abortion, to make greater use of modern family planning methods. And this entails a reduction in maternal mortality reduction of secondary infertility, improving women's reproductive health, which in turn has a positive effect on the demographic situation.
Contraception prevents abortion, not childbirth
Population scientists are skeptical about the claims that increased access to contraception leads to a decrease in fertility. This is a very primitive, superficial view of the problem. Contraception prevents abortion, not childbirth.
There are many developed countries where contraception is much more prevalent than in Russia, and the birth rate - much higher. For example, in France informed policies in the area of family planning, through insurance programs paid for consulting services for contraceptive use. Public awareness of family planning methods is much greater than in Russia, and the birth rate in this one and a half times higher. Abortion same per hundred births - five times less.
If we want to achieve at least that the birth rate, as in France, - 1, 9 births per woman - should not impede access to contraception and abortion ban does not require - all this creates a semblance of fight for increasing the birth rate. The center of gravity of public efforts should be moved to create a social climate conducive to the emergence of children and their education, which is done in France for decades. Of course, we need serious measures in support of motherhood, the state and society. But sensible policy of family planning is also necessary to create a favorable social climate. If it does not, there will be no conditions that allow to do civilized choices about birth control and apply safe and effective methods of contraception.
"Pharmaceutical Bulletin" prepared N.Maskina