Contraception failure and abortion in China

Contraception failure is common in China.  Abortion is often used as a backup method when contraception fails.  Abortions, in particular repeated and unsafe abortions, are damaging to women’s physical and psychological health. Do national family planning programmes affect a woman’s decision on whether to terminate the pregnancy? 

Almost 1 in 5 women in China willbecome pregnant within the first year of using condoms, and 1 in 10 will bepregnant within a year of relying on the intrauterine device (IUD). 4 percentwill be pregnant in the year following their husbands’ sterilization. But whatdo women do when they discover they have an unplanned pregnancy? 

The London School of Hygieneand Tropical Medicine, together with Xian JiaotongUniversity, China, looked at over 6,000 unplanned pregnancies that occurred inthe 1970s and 1980s, and how the women responded.  The four methods of contraception covered bythe study are sterilization, IUD, condoms and the pill.  The information is taken from the NationalSurvey of Fertility and Contraceptive Prevalence, conducted in 1988. The surveyis based on data from women aged between 15 and 57 from every province in theChinese mainland.

The study found that 57percent of contraceptive failure led to an abortion. 40 percent resulted in alive birth and the remaining 3 percent were still births and spontaneousabortions.  The study found that abortionrates varied with a woman’s age, the number of children they have, and the typeof contraception used:

• A woman with only one child was almost certain tohave an abortion when her method of contraception failed. 96 percent ofthese women terminated the pregnancy.
• Women who had already experienced abortion wouldalmost certainly use it again when contraception failed.
• The abortion rate for women over the age of 34 washigher than in younger women.
• Only 33 percent of sterilization failures led toabortion.  When IUD failed, 50percent of foetuses were aborted. With condom failures the abortion rate was 75 percent, and with thepill the rate was 80 percent.
• The likelihood of a woman with two or morechildren having an abortion when her reversible contraception failed istiny in comparison to women with one or no children: between two and fourpercent.

Many women have more than oneunplanned pregnancy.  One woman surveyed hadnine unplanned pregnancies following contraception failure.  A number of reasons may explain high rates ofabortion in China:

• The Chinese family planning programme recommendsabortion when contraception fails.  Accordingto the programme, Chinese families in urban areas are only supposed tohave one child with some exceptions such as national minorities and thosefamilies with more than one child would be penalised.
• Some women who have repeated abortions may notuse the contraceptives, such as the pill, correctly.
• Poor family planning services may also be toblame with inexperienced doctors and limited contraceptive supplies,particularly in rural areas.
• Staff may put pressure on women to have anabortion when an unplanned pregnancy occurs. 
• Older women do not want to have any morechildren.

While the data is taking froma survey in the 1980s, the findings are still relevant today.  Abortion is used as a backup whencontraception fails in China despite the fact that repeated and unsafeabortions are a danger to women’s health.