The family building life course and contraceptive use: Nang Rong, Thailand

This paper incorporates the insights of the life course perspective in an examination of the determinants of contraceptive use. It views decision-making about contraceptive methods in the context of personal history and the broader social setting. Three stages in the reproductive life course of married women are considered. In the early years, timing decisions dominate. Contraception is used to delay the first birth and control the tempo of fertility. Mid-career, the major concern is whether to have a sterilizing operation. Towards the end of the fecund period, couples must decide when to stop using contraception, given that they have not already opted for sterilization. We examine choice among nonpermanent methods, as well as sterilization, in the context of a theoretical model that explicitly recognizes the permanence of the sterilization decision. Our statistical procedures control for unobserved community influences. The data are from Nang Rong district, Thailand, a relatively poor area near the Cambodian border under going substantial socioeconomic change during the 1980s. Our results clearly show variation in method choice over the reproductive life course, and variation in the effects of specific determinants including age of husband and wife, living arrangements, and village location. They also demonstrate gains in the understanding of any particular stage in the life course that accrue from an integrated examination of all of them.