178 CHAPTER 7 Human Population Change and the Environment
Family Planning Services
Socioeconomic factors may encourage people to want
smaller families, but fertility reduction won’t become a
reality without the availability of health and family plan-
ning services. The governments of most countries rec-
ognize the importance of educating people about basic
maternal and child health care. Developing countries
that have significantly lowered their TFRs credit many
of these results to effective family planning programs.
Prenatal care and proper birth spacing make women
healthier. In turn, healthier women give birth to health-
ier babies, leading to fewer infant deaths.
Family planning services provide information on
reproductive physiology and contraceptives, as well as
on the actual contraceptive devices available, to people
who wish to control the number of children they have
or to space out their children’s births. Family planning
programs are most effective when they are designed with
sensitivity to local social and cultural beliefs. Family plan-
ning services don’t try to force people to limit their family
sizes; rather, they attempt to convince people that small
families (and the contraceptives that promote small fami-
lies) are acceptable and desirable.
Contraceptive use is strongly linked to lower TFRs.
Research has shown that 90 percent of the decrease in
fertility in 31 developing countries was a direct result
of increased knowledge and availability of contracep-
tives (Figure 7.19; see also the example of India in the
chapter opener). In highly developed countries, where
TFRs are at replacement levels or lower, an average of
72 percent of married women of reproductive age useIn nearly all societies, women with more education
tend to marry later and have fewer children (Figure
7.18). Providing women with educational opportunities
delays their first childbirth, thereby reducing the num-
ber of childbearing years and increasing the amount of
time between generations. Education provides greater
career opportunities and may change women’s lifetime
aspirations. The What a Scientist Sees feature on the fol-
lowing page discusses this. In the United States, it isn’t
uncommon for a woman to give birth to her first child in
her thirties or forties, after establishing a career.
Education increases the probability that women will
know how to control their fertility. It also provides knowl-
edge to improve the health of the women’s families,
which results in a decrease in infant and child mortality.
A study in Kenya showed that 10.9 percent of children
born to women with no education died by age 5, as com-
pared with 7.2 percent of children born to women with
a primary education, and 6.4 percent of children born
to women with a secondary education. Education also
increases women’s career options and provides ways of
achieving status besides having babies.
Education may also have an indirect effect on TFR.
Children who are educated have a greater chance of
improving their living standards, partly because they have
more employment opportunities. Parents who recognize
this may be more willing to invest in the education of a few
children than in the birth of many children whom they
can’t afford to educate. The ability of better- educated
people to earn more money may be one reason smaller
family size is associated with increased family income.
Guatemala
012345678Average number of childrenborn per womanYemenLess than primary
Primary completed
Secondary completed
Kenya PhilippinesAdapted from E. Murphy, and D. Carr,PowerfulPartners: Adolescent Girls' Education and Delayed Childbearing. Population Reference
Bureau (2007).ÕV>ÌÊ>ÊviÀÌÌÞÊUÊ}ÕÀiÊÇ°£nÊ
The amount of education a
women receives affects the
total number of children she
has (TFR). The graph shows
TFRs for women with
different levels of
education in several
developing countries.