Lack of Contraceptive USE: Childbearing Preferences among Balinese Women

BACKGROUND: The freedom of women to choose how many children to bear is a fundamental human right. A multitude of demographic and socioeconomic factors influence childbearing decisions. However, improved socioeconomic conditions often lead smaller family size norms and higher contraceptive rates. Although the total fertility rate in Indonesia has decreased dramatically, family size norms are still high in many rural communities. Assessing the degree to which desired numbers of children are related to subsequent reproductive behavior under various conditions is important to the understanding of the determinants of fertility and may help lower fertility rates.

METHODS: This longitudinal study was conducted in an isolated community in East Bali with high fertility and infant mortality rates and low contraceptive rates. 745 women reporting the desire for more children or unsure fertility intentions were followed over a five year period.

RESULTS: Based on the literature and Bongaarts' model, ten independent variables were forced into a multivariate logistic regression model to determine the predictors of fertility during the study period. Five variables remained significant. The age of mother, contraceptive use and the number of living children had a negative association with additional fertility. Interestingly, having one living son or more than one living sons were both positively associated with the outcome.

RECOMMENDATIONS: A strong son preference exists in this patrilineal, agrarian community. Increased socioeconomic development may lead to smaller family size norms and less reliance on sons for economic security. Improving reproductive rights should include development and improvements in women's status.