Family Planning

People have consciously or unconsciously engaged in family planning throughout history. Abstinence, either lifelong or temporary, and prohibitions forbidding intercourse during certain times of the year or during certain festivals effectively curtail the fertility rate (the number of live births for each women during her lifetime). Separation of husbands and wives for long periods of time by war or business trips also curtails the fertility rate.

Abortion has often been used to limit family size, and descriptions of abortifacients, or agents that cause abortion, can be found in the herbal and other folklore of women and midwives of most societies. The deliberate abandonment of infants and young children, even killing of newborns, has not been uncommon in the past or even in some areas of the world today. Although the early Christian Church outlawed infanticide, it emphasized the stigma of illegitimacy, which meant that out-of-wedlock infants were brought to overcrowded orphanages and monasteries, where the majority of them died of starvation or disease within a few months.

Prolonged lactation is also a factor in spacing births. Lactation and the stimulus of the infant sucking ordinarily suppresses ovulation and menstruation, but it is highly effective as a birth control mechanism only when the infant consumes nothing but breast milk or when couples normally abstain from intercourse during lactation. As partial weaning takes place—as early as four to six months—the menstrual cycle returns in most women who are adequately nourished, and pregnancy is again possible.

Numerous devices such as condoms and IUDS (intrauterine devices) have been and still are used in family planning. Alternate methods of intercourse, including withdrawal and anal intercourse, also lessen the chance of pregnancy. One of the earliest results of the use of broad-scale methods sufficient to affect national fertility was the decline in the French birth rate from the end of the eighteenth century, a decline attributed to the widespread use of coitus interruptus (Van de Walle 1978). The continuing search for means of controlling contraception emphasizes an almost universal desire for humans to gain some control over the number and spacing of births.

The effectiveness of family planning is measured by the fertility rate, the total number of live births a woman at age fifty would have had. The replacement rate for a stable population is over two and under three. In the twentieth century, many countries had fertility rates below the replacement ratio but still gained population because people were living longer and several generations of a family were alive at the same time. In determining potential rates of increase without any family planning, demographers traditionally have used Hutterite women as their maximum standard for potential. The Hutterites are members of a religious denomination (in the northern United States and Southern Canada) who in the past did not use any method of family planning, although evidence suggests that this is changing. Their living standard is not luxurious, but their food supply is more than adequate, and they are regarded as very healthy. Hutterite women bore an average of twelve children in the early part of the twentieth century (Coale 1971), and this has been considered the maximum for a totally uninhibited rate of fertility that only could reached under the best possible conditions. Current fertility rates in some countries of the Third World, such as Saudi Arabia, Malawi, and Rwanda, were between seven and eight at the beginning of the 1990s, but even these had dropped to between six and seven at the end of the decade (International Planned Parenthood Federation 2002), indicating the growing influence of family planning.