A model of fertility control in a Puerto Rican community.

ABSTRACT

PIP This article examines the fertility control decision making of Puerto Rican women in Hartford, Connecticut a city that has a high sterilization rate among Puerto Rican heads or co-heads of households. Decisions regarding fertility are conceptualized as a result of a complex interaction among individual needs of women, factors influencing the family, the impact of religious institutions, accessibility of medical services, and socioeconomic resources of the household and the local community. A survey of 153 female household heads in Hartford conducted in 1978-79 by the Hispanic Health Council found that 79 (51.6%) had been sterilized. Further analysis was aimed at identifying the factors linked to sterilization in a subsample of the original respondents that included 3 categories those using no birth control, those using the IUD or oral contraception, and those sterilized. The results indicate that Puerto Rican women begin their sexual activity with limited use of birth control, accept reversible methods primarily after the 2nd and 3rd births, become sterilized in significant numbers after their 3rd child, and have generally attaned sterilization after 5 births. Sterilization is the fertility control method most frequently selected at the point where women feel they have reached their desired family size. Since optimal family size is achieved quickly, many Puerto Rican women seek sterilization in their 20s. This widespread acceptance of sterilization in part reflects the effects of recent sterilization campaigns in Puerto Rico. It further reflects health care providers' expectation that Puerto Rican women will not be successful in their use of reversible methods. The major difference between higher and lower socioeconomic groups centers around the point in family size at which sterilization takes place, with women of higher socioeconomic status terminating childbearing after fewer births. It is concluded that interventions should aim to increase use of reversible methods of birth control, both for birth spacing and family size limitation, among Puerto Rican women of higher socioeconomic status and that a comprehensive approach, involving both socioeconomic factors and fertility control, should be directed toward those of lower socioeconomic status.^ieng