Topic Area: Fertility Control

Geographic Area: Mexico

Focal Question: Does Government Promotion of Contraception Lead to a Decrease in Fertility?

(1) Chen J. A., Hicks W. W., Johnson S. R., Rodriquez R.C. (1990) "Economic Development, Contraception and Fertility Decline in Mexico." Journal of Development Studies 26 (17) 408-424.

(2) Potter, Joseph A. (1999) "The Persistence of Outmoded Contraceptive Regimes." Population and Development Review 25 i4 p703.

Reviewer: Scott T. Laliberte, Colby College ’01

Between 1950 and 1970 the population of Mexico nearly doubled, growing annually at a rate of 3.2 percent, one of the highest growth rates in the world. Increased fertility occurred at a time of sustained economic growth, increase in urbanization, and mortality decline. The simultaneous increase in population and per capita income ran counter to the belief that economic development leads to a decrease in fertility. The unusual demographic situation came to be known as ‘the Mexican Paradox’. However, by the late 1970’s fertility in Mexico was rapidly on the decline. By 1995 fertility rates for rural Mexico had fallen below 4, and contraceptive use by married women was close to 53%.

In 1973 Government pro-nationalist sponsored family planning programs increased the availability of contraception. Between the years 1976 and 1982 the administration under President Lopez Portillo launched several health programs targeting rural residence, namely the Rural Health Program (SSA) and the Mexican Institute of Social Security (IMSS). During this period over 3,000 rural health clinics, and 73 regional hospitals were constructed to aid regions with less than 2,500 inhabitants.

In the rural programs, SSA and IMSS each emphasized family planning by teaching women the benefits of having a small family, and promoting the use of contraceptives. The most encouraged contraceptive methods were, inter uterary devices (IUD), and female sterilization. These services were provided at no cost to most women, and were encouraged heavily shortly after the woman had just given birth. Hospitals and clinics were assigned monthly targets for implementing the above methods of contraception. To elevate the fear that 90 to 93% of the surveyed patients had of such methods, doctors and nurses pointed to other members of the community that were seemingly having success with these methods of birth control.

Between 1975 and 1980 average fertility in Mexico dropped from 6.0% to 4.5%. The prevalence of birth control use in rural areas increased from 14% in 1976 to 27% in 1981 and 33% in 1987. The figures suggest that family planning programs were responsible for lifting Mexico from ‘natural fertility’ environment where social and economic factors determine the number of children, to one where couples limit their number of children by using pre-modern and/or modern methods of contraception. However, an empirical study conducted by Chen, Hicks, Johnson and Rodreguez found that fertility rates were already on the decline when the government implemented family planning polices. The increased standard of living in Mexico was discovered to be more responsible for the decrease in population growth rates than the heavy-handed methods of birth control, encouraged by the government.

The study uses an estimated three-equation simultaneous model to estimate contraceptive use, and the number of children born. The number of desired children is estimated to be a function of socioeconomic variables including: region of residence, size of population of residence, labor force status of the wife before marriage, occupation of the husband during marriage, education of the wife and education of the husband, and a proxy variable for child quality of life (VAC). The VAC variable is assigned a value of one if the child receives necessary vaccinations shortly after birth. Researchers were unclear as what signs should be assigned to different regions of residence, but accumulated evidence suggests that in urbanized areas desired fertility should be less.

The supply equation is the number of children born. It is based on intermediate variables, specifically, duration of marriage, the first birth interval, the second birth interval, a fecundity indicator, length of breast feeding, pregnancy wastage or spontaneous abortion, child mortality, and use of contraception. The choice equation for contraception usage includes two critical variables: (1) motivation (the difference between the potential number of children born, and the number of children actually born) (2) the number of contraceptive methods the female could name in the survey without being prompted. Socioeconomic variables in the choice equation include, male and female education, region, urbanization, occupation of the male and work status of the female before marriage, and two proxies that indicate the availability of contraceptives. The proxies are VAC, and PRE-NAT (did the mother receive prenatal care prior to the birth of her last child).

This case study was based on a survey conducted in Mexico in 1976. Of the 7,310 surveyed, 959 the women between the ages of 35-44 whom had two or more children and had been married only once were appropriate for the analysis. Of the population studied, the average number of children these women gave birth to was 7.2. About half of them used some sort of contraception. For those that regulated the number of children they had, the average number of live births was 6.7. Those that did not regulate themselves with pre-modern and/or modern methods of contraception gave 7.6 live births on average. 89% of the regulators could mention at least one method of contraception without prompting, compared to 44% for non-regulators. The average level of education for the women was 3.4 years. Regulators had received on average 4.8 years of school, where as non-regulators completed only 2.0. Husbands of regulators received 6.0 years of education versus 2.5 for non-regulators. The regulators were most likely to come from urban regions, and were less likely to have worked, or have husbands that worked in agriculture.

Empirical results from the three-equation simultaneous model found that contraception had a negative and statistically significant effect on the number of children born. Holding all other variables constant, contraception has reduced the number of children born by about 40% compared to the sample average. The education level of the husband and wife, the number of contraceptive devices known by the individual, and motivation were the most important variables in determining whether contraception was used.

The motivation to use contraception was found to be more dependent on socioeconomic development than the government’s family planning policy. Increased knowledge of contraception methods available lead to a decrease in fertility rates, however simply encouraging less educated women living in rural Mexico to use birth control had little effect on fertility. The evidence provided by the simultaneous model suggests that modernization and education were the most important factors in encouraging the use of contraceptive devices Mexico. Government sponsored programs likely were responsible for part of the decline in fertility, but were not found to be the main force. These results support the belief that a nation’s fertility rate and per capita income are inversely related. It just took time for this transition to occur in Mexico.