THE COST OF IUD FAILURE IN CHINA

By 1988, 71% of the 206 million married Chinese women of reproductive age were using a modern method of contraception. About 60 million women were using IUDs (41%), and 38% relied on tubal ligation, the main methods promoted by the national family planning (FP) program. During several trips to China between May 1990 and October 1991, some serious problems with the use of IUDs in China were discussed with Chinese FP officials. The main IUD produced and used in China is the single-ring, stainless steel IUD, which is made in several sizes (20-23 mm). There are 10 IUD factories in China, most of which manufacture the single ring, the Copper V-200, a uterine-shaped, steel-ring IUD; and several others. The failure and expulsion rates of the single ring are much higher than those of other IUDs. One study, conducted in 1983-84 in 13 provinces, compared 3 IUDs available in China: the single ring, the Copper T-220, and the Copper V-200. The single ring had a 12-month failure (pregnancy) rate of 10.6%, compared with a rate of 1.7% for the Copper T and 2.1% for the Copper V. The 1982 One per Thousand Fertility Survey reported that 34.11% of all abortions obtained by the women surveyed were the result of IUD failure. In abortions obtained by the women surveyed were the result of IUD failure. In a 1987 study, in one county where 32% of the women were using IUDs, 80% of the abortions were obtained after the failure of a contraceptive method, usually the stainless steel IUD. In 1987, there were more than 10 million reported abortions in China that cost the government about $45 million. China's FP program has been criticized for its heavy reliance on abortion. Reducing reliance on the single-ring IUD, by inserting better devices in first-time users and in those women experiencing single-ring failures, may help improve the image of China's FP program.