Birth Control Practice in the USA

In 1924, Margaret Sanger wrote the following to argue on behalf of birth control practice: 

Everywhere we look, we see poverty and large families going hand in hand. We see hordes of children whose parents cannot feed, clothe, or educate even one half of the number born to them. We see sick, harassed, broken mothers whose health and nerves cannot bear the strain of further child-bearing. We see fathers growing despondent and desperate, because their labor cannot bring the necessary wage to keep their growing families. We see that those parents who are least fit to reproduce the race are having the largest number of children; while people of wealth, leisure, and education are having small families.

It is generally conceded by sociologists and scientists that a nation cannot go on indefinitely multiplying without eventually reaching the point when population presses upon means of subsistence. While in this country there is perhaps no need for immediate alarm on this account, there are many other reasons for demanding birth control. At present, for the poor mother, there is only one alternative to the necessity of bearing children year after year, regardless of her health, of the welfare of the children she already has, and of the income of the family. This alternative is abortion, which is so common as to be almost universal, especially where there are rigid laws against imparting information for the prevention of conception. It has been estimated that there are about one million abortions in the United States each year.

To force poor mothers to resort to this dangerous and health destroying method of curtailing their families is cruel, wicked, and heartless, and it is often the mothers who care most about the welfare of their children who are willing to undergo any pain or risk to prevent the coming of infants for whom they cannot properly care.

In the 1968 papal encyclical Humanae Vitae, Pope Paul VI reiterated the Roman Catholic Church's position against birth control practice:

In conformity with these landmarks in the human and Christian vision of marriage, we must once again declare that the direct interruption of the generative process already begun, and, above all, directly willed and procured abortion, even for therapeutic reasons, are to be absolutely excluded as a licit means of regulating birth. Equally to be excluded, as the direct teaching authority of the Church has frequently declared, is direct sterilization, whether perpetual or temporary, whether of the man or of the woman. Similarly excluded is every action which, either in anticipation of the conjugal act, or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end of as a means, to render procreation impossible.

Birth control practice is still a controversial subject in the USA, even though it is thought to be quite prevalent.  How prevalent is it?  We will cite some survey data from the MARS OTC/DTC Pharmaceutical Study.  The relevant portion of the data comes from 15,472 females between the ages of 18 and 49 who filled out mail questionnaires in 2001 and 2002.  Among these survey respondents, 19.1% indicated that they were practicing some form of birth/fertility control, such as taking contraceptive pills and using other products such as diaphragms, cervical caps, intra-uterine devices, morning after pill, Norplant and so on.  This projects to around 12.5 million persons.  This will be an understatement of the incidence of birth control practice in total, since the number does not include vasectomy, sterilization, coitus interruptus, condom use, etc. 

In the following chart, we show the incidences by age, race/ethnicity and marital status.  From these frequency distributions, the most likely profile is that of a young and single white woman.

In that next chart, we show the incidences by education, employment and annual household income.  The most likely profile would be that of an educated working middle-class female.  We note that the incidences are low among those who have low household income and who have not graduated from high school.  

In the final chart, we show the incidences by the presence of children in the households of the respondents.  The highest incidence is among those households in which a child was just born within the past year.  This decision is clearly tied in to a desire to avoid having multiple children immediately.

(posted by Roland Soong, 11/21/2002)