Using a Reproductive Life Course Approach to Understand Contraceptive Method Use in Australia

Abstract

This paper examines contraceptive method use at different stages of the reproductive life course. Previous research on contraceptive practice in developed countries typically applies age as a proxy for reproductive history. While age is an essential and useful life course measure for understanding contraceptive use, investigations of contraceptive practice should also consider parity and fertility intentions, as they may be more accurate measures of reproductive life course stage. Analysis is based on data collected in the 2005 Household, Income and Labour Dynamics in Australia (HILDA) survey, a nationally representative sample of women of reproductive age (18-44). For women at risk of pregnancy, the most commonly used methods are easily reversed methods such as the oral contraceptive pill (30%) and condom (23%), medium-term methods such as the intrauterine device and implantation (5%) and permanent methods (7% tubal ligation and 9% vasectomy of partner). Logistic regression models are used to investigate the use of four popular contraceptive methods by parity, age and fertility intentions controlling for socio-demographic factors. The main findings indicate that the use of these methods varies substantially by the stage of a woman's reproductive life course: age, parity and fertility intentions are all associated with method use.

The contribution of increases in family benefits to Australia’s early 21st-century fertility increase: An empirical analysis

“…The fertility increase has occurred despite an ongoing, if slower, decrease in the prevalence of marriage in the reproductive age groups and slight improvements in the availability and use of contraceptive methods (Birrell, Rapson, and Hourigan 2004;Parr and Siedlecky 2007;Heard 2008;Gray and McDonald 2010). The effect of the decrease in marriage on rates of partnership has been offset partially by increases in the percentages of females in unmarried cohabitation.…”

The perplexing links between contraceptive sterilization and (dis)advantage in ten low-fertility countries

“…In these latter countries, married and cohabiting female contraceptors were most likely to rely on highly-effective reversible (HER) methods, such as pills and IUDs (see Table 2). Lower use of HER methods (particularly IUDs) in the United States and Australia (Eeckhaut, Sweeney, and Gipson 2014) may be related to the poor reputation and subsequent distrust of IUDs after reports of serious safety concerns with the Dalkon Shield IUD in the 1970s (Hubacher and Cheng 2004; Gray and McDonald 2010). As the Dalkon Shield was seldom used in Europe, the safety scare associated with this device likely had less of an impact on contraceptive use patterns in Europe (Sonfield 2007).…”

“…In the United States, limited evidence suggests that socioeconomic differentials in parity contribute to, but do not fully explain, associations between the prevalence of surgical sterilization and education or income at the time of interview (e.g., Chandra 1998; Eisenberg et al 2009; Anderson et al 2012). In Australia, Gray and McDonald (2010) found the negative link between a woman’s education and her reliance on contraceptive sterilization (male or female methods, combined) to become non-significant when adding controls for factors such as parity and relationship status. In Northern Belgium (Flanders), Lodewijckx (2002) found that relatively lower levels of sterilization (again, male or female methods combined) among couples where at least one partner had completed higher education persist even after controlling for background factors such as parity and age at last birth.…”

“…Moreover, most studies examining the links with socioeconomic status have failed to make the distinction between female and male sterilization, often combining the two methods together in a single ‘sterilization’ category. For example, studies report a negative association between women’s education and the likelihood of relying on either male or female sterilization (combined into a single category) for Australia in the mid-2000s (Gray and McDonald 2010), and for France, Great Britain, Spain and West-Germany in the mid-1980s (Riphagen and Lehert 1989). Lodewijckx (2000, 2002) reported the odds for female or male sterilization (again, combined into a single category) to be lowest among couples where at least one partner had completed higher education in Northern Belgium (Flanders) in the mid-1990s.…”

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