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  • Title: Determinants of contraceptive use among women of reproductive age in Great Britain and Germany. I: Demographic factors.
    Author: Oddens BJ, Lehert P.
    Journal: J Biosoc Sci; 1997 Oct; 29(4):415-35. PubMed ID: 9881145.
    Abstract:
    Multifactorial analyses of data from representative British and German national contraception surveys were used to examine the principal demographic determinants of contraceptive use by women. Contraceptive use appeared to be determined mainly by reference to 'reproductive status' (the combined impact of age, marital status, parity and future child wish). Women who were postponing pregnancies were using oral contraceptives, whereas those who wanted no more children relied more on intrauterine devices or sterilisation. Differences between the countries suggested that the choice of contraceptive method was influenced by health care policy, the organisation of the relevant services and differential provider preferences. The contraceptive method used was also related to having occasional rather than steady sexual partners (more condom use), lower educational level (less oral contraceptive use) and frequent church attendance (greater use of condoms and periodic abstinence). Contraception decisions appeared to follow a fixed pattern, based more on a couple's demographic situation (reproductive status, country, educational level and religious beliefs) than on the characteristics of the contraceptive methods. This resulted in an unnecessarily restricted choice of methods. This study examines the demographic determinants of contraceptive use in Great Britain and Germany. The author conducted two nationally representative population surveys in 1992 among a sample of 967 women 15-45 years old in Great Britain and 1064 same-age women in Germany. The data for both countries were statistically weighted to correspond to national demographic characteristics. 646 British women and 1023 German women used contraception. Analysis included multiple logistic regression techniques and principal components and segmentation techniques. Contraceptive use patterns differed between East Germany, West Germany, and Great Britain. Oral contraceptive (OC) use and periodic abstinence rates were higher in West and East Germany. Sterilization rates were lower in Great Britain. In the analysis of reunified Germany compared to Great Britain, OC use declined with increasing age in both countries. IUD use and sterilization increased with an increase in age. Only in Great Britain was OC use greater in urban areas compared to rural areas. Both countries had higher periodic abstinence in larger cities. IUD use and sterilization rates were higher, and OC use rates were lower among married women compared to never married women. The association between employment status and use was unclear. Increased church attendance was associated with higher use of condoms and periodic abstinence and lower use of OCs. Having occasional partners was associated with a higher condom use rate. Multivariate findings on differential use by country suggest that choice of contraceptive method was related to health care policy, service provision, and differences in provider preferences. Contraceptive decisions were primarily based on reproductive status, country, educational level, and religious beliefs rather than on the characteristics of the method.
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