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Provincial patterns of contraceptive use in China.


 This examination of provincial contraceptive use in China finds that patterns are similar in the least and most developed provinces. The pattern has been dominated by use of the IUD and other user-controlled methods rather than sterilization. Provinces midway in the level of socioeconomic development are characterized by high sterilization use followed by IUD use and low use of other methods. Persons in the most developed provinces choose contraceptives based on personal preferences. In the least developed provinces flexible methods are selected due to the tradition among ethnic minorities for larger families. Contraceptive use patterns are obtained from a 10% subsample randomly drawn from 467,162 women 15-57 years old responding to the 1988 Two Per Thousand Fertility and Birth Control Survey of China, conducted by the Family Planning Commission. The study period is 1979-88, and the sample includes only currently married women who had at least one child since 1979 (12,296 women). The study period begins with the one child family planning policy and economic reform. Population policies and regulations shifted from stringent centralized implementation to decentralized units. Local areas adopted their own regulations. 14 out of 29 provinces required couples to use an IUD after the birth of their first child and sterilization after their second child. The policy that requires "all pregnant women without a birth quota (permit) to end their pregnancies by means of abortion" is in force in Liaoning, Hebei, Henan, Hunan, Shanxi, Gansu, Ningxia, Yunnan, and Guizhou provinces. Abortion is a "should" rather than a "requirement" in 14 other provinces. Mass mobilization campaigns were an alternative measure to achieve change. National rates of use indicate that about 50% of contraceptive users were sterilized, and 40% depended on IUDs. It is considered unlikely that socioeconomic development would have such an immediate and marked effect on contraceptive use patterns in a short period of time.
