Academic journal article International Perspectives on Sexual and Reproductive Health

The Role of Abortion in the Last Stage of Fertility Decline in Vietnam

Academic journal article International Perspectives on Sexual and Reproductive Health

The Role of Abortion in the Last Stage of Fertility Decline in Vietnam

Article excerpt

CONTEXT: Vietnam has experienced a rapid fertility decline over the last three decades, yet fertility rates vary considerably across the country's 54 ethnic groups.

METHODS: Data were drawn from the 2001 Vietnam National Health Survey, which collected information from 27,097 currently married women aged 15-49 on their birth and abortion history over the preceding five years, as well as their current contraceptive use. Multivariate regression analyses identified associations between individual, household and community characteristics and women's contraceptive use and abortion history, and examined ethnic differences in the types of methods used and in abortion incidence.

RESULTS: Vietnam's total fertility rate was 1.6 children per woman, whereas the rate among ethnic minorities in the northern uplands and central highlands was 2.6 and 2.8, respectively. These groups also had a lower abortion rate than the national average (0.3-0.5 vs. 0.7), and were less likely than the group comprising the Kinh majority and the Chinese minority to have used either a modern or traditional contraceptive (odds ratios, 0.4-0.7) or to have had an abortion (0.2-0.6). The likelihood of having had an abortion was elevated among older (5.6-21.2) and better educated women (1.4-1.7), as well as among those with one or two children and those from socioeconomically advantaged ethnic groups (1.2-1.4). Finally, abortion rates were higher among women who practiced traditional methods than among those who used modern ones.

CONCLUSIONS: Because better access to abortion is unlikely by itself to reduce fertility among high-fertility minority groups, programs that provide supportive reproductive health services and that target young, low-parity and less educated women may help to lower fertility among these groups.

International Perspectives on Sexual and Reproductive Health, 2010, 36(2): 80-89

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Vietnam's total fertility rate dropped from 5.7 births per woman in 1979 and 3.8 births in 1989 (1) to 2.0 for the period 1998-2002, according to the 2002 Demographic and Health Survey, (2) yet despite this rapid decline, rates vary considerably across the country's 54 ethnic groups. The Kinh, who account for 84% of the country's population of 86 million, have completed the transition to replacement-level fertility. (3) Some ethnic minority groups, such as the Chinese, Tay, Thai, Muong and Nung, have also achieved low levels of fertility, whereas minorities in the northern uplands and central highlands--who tend to be poor and account for three-fourths of Vietnam's ethnic minority population of 14 million people--have not. For example, the Dao and the Hmong--the two most populous minority groups in the northern uplands--had total fertility rates of 3.6 and 7.1, respectively, according to the 1999 census. (4) While 2006-2008 fertility estimates based on the Population Change and Family Planning Surveys conducted by Vietnam's General Statistics Office suggest that fertility is declining among women in the northern uplands and central highlands, their rates remain well above replacement and are higher than those for women in the lowlands, such as the Red River Delta, who tend to be of Kinh ethnicity. (3) Furthermore, some minority groups report a significantly higher prevalence of unmet need for family planning than do the Kinh. (2), (5) Therefore, before the last stage of fertility decline in Vietnam is attained, the reproductive health and family planning needs of ethnic minorities must be addressed.

Vietnam's rapid fertility decline has been associated with high rates of both contraceptive use and induced abortion. (1) The latter is primarily provided by the government, free of charge or for a minimal fee, and is available to married women on request at most public health facilities. According to official statistics, the total abortion rate averaged 2.5 procedures per woman in the mid-1990s. …

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