The fertility transition in Cuba and the Federal Republic of Korea: the impact of organised family planning.

ABSTRACT

PIP: It is argued that access to contraception, voluntary sterilization, and safe abortion had a direct impact on fertility decline in two countries (Cuba and Korea) that differed in religion, economic conditions, culture, and attitudes. Both countries achieved below replacement fertility through high rates of contraceptive prevalence and ready access to legal abortion. Family planning services were provided in both countries through the public sector and in Korea through a subsidized private sector. Fertility decline in both countries occurred at the same time as the initiation of family planning programs. Family planning was introduced in Korea in order to reduce population growth and in Cuba in order to reduce the incidence of induced abortion and not for demographic reasons. Both Korea and Cuba had successful family planning programs over the past ten years that combined awareness, accessibility, and perceived quality. Korea adopted legal abortion as a means of reducing high maternal mortality rates and fertility. Cuba adopted legal abortion, during a period when the government lacked hard currency and consumer items such as birth control pills. Even antibiotics were difficult to obtain, particularly for teenagers. Both countries worked to improve services for teenagers. The experiences with family planning in both countries provide support for the theory that socioeconomic forces are not needed to push fertility lower. It is suggested that access to reversible and permanent contraception and safe abortion increases the speed of the transition and permits lower fertility than would otherwise be achieved without formal family planning programs. Fertility decline occurred in Korea under rising incomes and Cuba experienced declines during a period of economic declines. Both countries need to expand options for reducing exposure to pre-union adolescent pregnancies.