The End of Babies? Probably Not.

This weekend's NYTimes included a widely-read opinion article titled "The End of Babies," which lamented the low birth rate in the richer countries. As of this writing, the article had almost 1,400 comments (and I admit that I have read only a few of them). The writer, Anna Louie Sussman, dives into the issues surrounding the Second Demographic Transition without seeming to know that this is what she is doing. 

As of yet, no one has come up with a single answer as to why so many countries now have below-replacement level fertility, and this is largely due to the unprecedented demographic situation in which we find ourselves. Never before in human history have death rates been so low, nor have women (and men) had such control over reproduction. Both of those phenomena have become associated with greater gender equality than ever before. Yes, we still have a long way to go, but things are moving in the right direction. It is easy to forget that Margaret Sanger started a world-wide movement for female reproductive rights because of the unwanted pregnancies (and attempted abortions) that she saw so often in the slums of New York City a hundred years ago.

In other words, we need to relish the fact that childbearing is now a choice. It is not something that societies demand of couples in order to counter the high death. And, increasingly it is not something that a man can foist on a woman whether she wants it or not. Furthermore, as the writer herself notes, it is not something that any longer requires having sexual intercourse with a man! These are genuinely revolutionary times in which we live. We are not living in a time associated with the end of babies (remember that there are still about a million more babies born each year in the U.S. than there are people dying). We are living in a time of choices, and that's a good thing.

The combination of lower mortality and lower fertility has, of course, altered the age structures of all modern societies. In particular, the populations of most countries are aging. But, rather than lament that fact and long for the days of higher birth rates (which the world really cannot afford), we need to adjust to these new realities of changing age dynamics, and gain a better understanding of how age structures influence politics and the economy. A good place to start getting your head around this is with the work of political demographer Richard Cincotta.

Would China's Population Be Even Smaller Had There Been No One-Child Policy?

For many years, the accepted wisdom in the world has been that China's one-child policy was the reason for the rapid decline in that country's birthrate. In the last several editions of my Population text, I have questioned that assumption, noting the incredible similarity between the fertility trajectories in China and its geographically and culturally close neighbor Taiwan (indeed, close enough that China claims it as its own). Here is my graph from the 13th edition of Population, which will be out very soon:

Given my history with this issue, I was very interested to read a paper by Stuart Gietel-Basten and his colleagues that was published just this week in PLOS/ONE: "Assessing the impact of the “one-child policy” in China: A synthetic control approach." They use a set of sophisticated demographic techniques to make the case that fertility might have declined even more quickly in the absence of the one-child policy--albeit in the continued presence of the wan xi shao ("later, longer, fewer") campaign launched a few years prior to the one-child policy. Here is their summary graph:

The implication of their findings is, of course, that a faster decline in fertility would actually have produced fewer people in China than there are now. Their results also help to explain why fertility has not risen in China despite the official end of the one-child policy. This is an important article regarding population policy, and I strongly recommend it to you.

The Northern Triangle Countries Are NOT Falling Off a Demographic Cliff

Thanks to my son and co-author Greg Weeks for pointing me to a recent online commentary from the Center for Global Development, a "think-and-do-tank" in Washington, DC. Michael Clemens and Jimmy Graham posted "Three Facts You Haven't Heard Much About Are Keys to Better Policy Toward Central America." The first one they discuss is that "Central America is falling off a demographic cliff—so migration will slow." They argue that UN demographic data show that the youthful populations in the Northern Triangle countries of El Salvador, Honduras, and Guatemala are about to decline dramatically and that will slow down migration from those countries, just as it has from Mexico--as a result of declining fertility--as I discuss in the forthcoming 13th Edition of my text.

The problem with their analysis is that the data simply don't show what they say. The United Nations demographers' medium projections show that the youthful, migration-age populations in Guatemala and Honduras will continue to increase in number for at least another decade, and after that we will see only a gradual slowdown. It is true that the number of youths in El Salvador will be a bit smaller in 2030 than now, but the change is not dramatic. There is no current evidence that any of the three Northern Triangle countries are falling off a demographic cliff. As much as I would have liked for their story to be true, the data simply don't paint the picture they have put out there.

Mothers Are Increasingly Working Full-Time

Yes, I get it, mothers have always been working full-time, but this story is about paid work out in the labor force. Juliana Menasce Horowitz of Pew Research has just posted an analysis that combines data for the U.S. from Current Population Surveys with Pew Research survey data. The results are not necessarily surprising, but they nicely illustrate what we can see going on around us. 

First, the shift in mothers with children under age 18 who are working full-time:

You can see that there has been a substantial increase in the percentage of mothers who are working in the last half century, and all of that increase has been among women employed full time. Some of this is obviously related to the decline in fertility over that time. Fertility was already on its way down in the U.S. in 1968, but the total fertility rate was still well above replacement, whereas it is now below replacement.

The second part of the story, drawing on Pew Research survey data, is that attitudes toward mixing work and parenthood are generally positive. To be sure, there are downsides, especially among mothers compared to fathers (for whom working and being a parent has, of course, long been the norm). Children can slow down promotions at work, and work can lead parents to feel guilty about not spending enough time with their kids. The survey results also exhibit a lot of variability among respondents in attitudes toward women combining work and parenthood, but the employment patterns among mothers--as shown in the above graph--tell us what mothers themselves must be thinking.

Pregnancy is dangerous; abortion can be lifesaving

The recent passage of an incredibly repressive and regressive anti-abortion piece of legislation in Alabama has sparked outrage everywhere. This is genuinely an example of patriarchy at its very worst. If Americans really value the health of women--which is massively important to the health of society at large--it will pay attention to the message of Dr. Warren Hern's Op-Ed in today's New York Times.

As I have been saying for a long time in my book, the most dangerous thing a woman can do in life is to get pregnant. We need to protect women as much as we can for their good and for the good of their children, and thus for the future of humanity.

Hispanic Fertility is Dropping in the U.S.

I have not blogged for a while because I am working very hard to finish up the 13th edition of POPULATION, which should be available this Fall. However, I had to say something today because so many of you sent me a link to the New York Times story on the fertility decline among Hispanics in the U.S. The NYT story is based largely on a report just out from the National Research Center on Hispanic Children & Families in Bethesda, Maryland, and their report is based on data compiled by the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention. Here's the bottom line:

Between 2006 and 2017, the Hispanic fertility rate fell by 31 percent, compared with just 5 percent for white women and 11 percent for black women. The especially large decline among Hispanic women is likely driven, in part, by recent changes in the composition of the U.S. Hispanic population. The share of U.S. Latinos who are foreign-born is getting smaller, and foreign-born Hispanic women generally have higher fertility than U.S.-born Hispanic women.

Continued fertility declines among Hispanics will help push the total fertility rate in the U.S. even further below replacement level.

Fertility rates are dropping among all race/ethnic groups in the United States, and although the drop has been highest for Hispanic women, they do still have the highest birth rates of any group. I agree with the assessment that the higher percentage of U.S.-born Hispanics is very influential in these trends, but keep in mind that this is largely because of the recent steep drop in migration from Mexico, which is closely related to the precipitous drop in fertility within Mexico.

Back in January I was on TV here in San Diego talking about the decline in the birth rate in the United States, and if you'd like to check that out, follow this link to KUSI-TV, and go in about 15 minutes--I was the third guest on the "San Diego People" program.

OK--back to the 13th edition...

Pakistan's Supreme Court Drops "Population Bomb"

The Supreme Court of Pakistan yesterday produced a genuine "wow" moment when they urged the country to strive for a two child per family norm. The Times of India reports that:

Describing Pakistan's rapidly growing population as a "ticking timebomb", the Supreme Court Tuesday urged religious scholars, the civil society and the government to back population control measures, including a two children per family norm, in the Muslim-majority country.

A three-member bench led by Chief Justice Saqib Nisar made the observations during a hearing in a case related to population control in Pakistan, now the world's fifth most populous.

"The increasing population is a burden on the country's resources. It is about the future of the next generation. It would be unfortunate if the population is not controlled. Two children per home will help to control the population. There is a need for a campaign on the matter," the apex court was quoted as saying by the report. "The entire nation needs to stand together to control the population," the chief justice said.

The Pakistan Medical Association (PMA) has also voiced its concern at the rapid increase of population in the country, calling it a looming disaster.

In a recent press statement, the PMA said the birth of 15,000 babies in Pakistan on the 1st day of 2019 was alarming. The PMA thinks that it is a distressing situation as at the moment as 60 per cent of the national population stands below the age of 25 years; 25 million children are not going to school and 90 per cent the population is not being provided with clean drinking water. Malnutrition is another big issue and food scarcity is a big problem, the association said. 

The PMA said it believes that the unchecked rise in the population is a looming disaster, and concrete steps should be taken to implement family planning and make people-friendly economic policies to overcome these difficulties and save the coming generations.

Pakistan has wrestled with the question of family planning for most of its history. During the 1950s and 1960s there were concerted efforts to organize government-sponsored programs, but political instability has undermined their efficacy over time. With any luck, this time will be different. 

Set it and Forget it: Reducing Unwanted Pregnancy

Thanks to one of my readers, Du Elium Kayali Araujo, for the link to a story closely related to my recent post on the dangers of getting pregnancy in the United States. Yesterday the NYTimes Upshot writer Margot Sanger-Katz posted a story about how better contraception could be a key to reducing poverty. If you've followed my blog over time, you know that in my opinion this is not speculative ("could") but is definitive ("will").

Unplanned pregnancies remain astoundingly common. According to the Guttmacher Institute, they represented 45 percent of all pregnancies in the United States in 2011. The majority of abortions, which numbered more than 900,000 in 2014, are in response to unplanned pregnancy, and there are signs that the new program has pushed down Delaware’s abortion rate.

The new program referenced in the article is in Delaware and is a collaboration with a national organization called Upstream. The goal is to reduce unplanned pregnancies by providing women with a one-stop shop for contraception, with a particular emphasis on long-acting reversible contraceptives (LARC).

Without a LARC, preventing pregnancy means taking steps like filling prescriptions and remembering to take a pill every day. With one, a woman won’t become pregnant until she takes the step of removing it.

“Set it and forget it,” said Venus Jones, an Upstream trainer. “We call it the Crock-Pot method.”

The program has the very positive impact of reducing abortions, and it has the strong potential to improve the lives of women and their children:

Children whose births are unplanned are likelier to have health complications, to be born into poverty, to stop their education sooner and to earn less. Mothers of unplanned children tend to give birth when they are younger, leave school earlier and earn less when older.

Isabel Sawhill, a senior fellow at the Brookings Institution, has measured the wide gulfs in outcomes between young women with unintended children and those with planned pregnancies later on. She has written extensively in support of expanded LARC access.
“It’s very expensive and very hard to reduce poverty,” Ms. Sawhill said. “Reducing unplanned births is easy by comparison.”

I first made reference to Sawhill's book Generation Unbound more than four years ago, and I've commented on it in several other blog posts since then. If you haven't read her book, you should do so. 

Age at First Birth is Steadily Rising

A couple of weeks ago, I mentioned that data from the Current Population Survey show that the age at marriage in the United States has been been steadily rising. This week a closely related analysis shows that the age at first birth has also been going up. Indeed, between 1970 and 2017 it went from 21.4 years to 26.8 years. These data were put together by Karen Guzzo and Krista Payne at Bowling Green State University's National Center for Family & Marriage Research. 

The results are especially interesting because they show that there are clear geographic differences in the delay in first birth. Thus, while the age at first birth has been going up everywhere, it is going up much more in some states than in others, as you can see in the map below.

The increases have been greatest along the west coast and in the northeast. Two southern states--Arkansas and Mississippi--share the honors of having the lowest age at first birth in both 1970 and 2017. By contrast, Massachusetts, Connecticut, and New Jersey were all consistently at the older ages with respect to first births in both 1970 and 2017. However, in 1970 the difference between the youngest and oldest was considerably less (22.5 - 20.2 = 2.3) than it was in 2017 (29.7 - 24.1 = 5.6). 

These results suggest yet another way in which the population of the United States is growing more diverse, since the differences in delaying the first birth are both a cause and a consequence of a wide array of changes that are taking place all over the country. 

Laws Threatening Immigrants Can Affect Birth Outcomes

My thanks to Professor Rubén Rumbaut for linking me to a paper just accepted for publication (and now available online) in the American Journal of Epidemiology. The paper is titled "Restrictive Immigration Law and Birth Outcomes of Immigrant Women," and its authors--Florencia Torche and Catherine Sirois--are at Stanford University. The paper examines what happened to pregnant women in Arizona when that state passed a very aggressive anti-immigration law (SB 1070) back in 2010. The short answer is that the probability increased that an undocumented woman would give birth to a low-weight baby.

Prenatal exposure to the bill resulted in lower birthweight among Latina immigrant women, but not among US-born white, black, or Latina women. The decline in birthweight resulted from exposure to the bill being signed into law, rather than from its (limited) implementation. The findings indicate that the threat of a punitive law, even in the absence of implementation, can have a harmful effect on the birth outcomes of the next generation.

The low birthweight data are especially noteworthy because many of us have over time demonstrated that Hispanic women in the United States tend to have better outcomes than non-Hispanic Whites. To be sure, Professor Rumbaut and I published research on this more than 20 years ago:Rubén G. Rumbaut and John R. Weeks, "Unraveling a Public Health Enigma: Why do Immigrants Experience Superior Perinatal Health Outcomes?" Research in the Sociology of Health Care, 13(B): 337-391, 1996. So, when the results show that birth outcomes are worse, not better, we know that something is going on. This is a case where correlation is apt to be showing causation.

As the authors point out, these children are now U.S. citizens and will be tomorrow's workers and voters. It was reckless and pointless to have harmed their health during pregnancy. These are among the many, many reasons why Congress needs to get together and craft a genuine immigration reform bill.

The Second Demographic Transition Comes to America

The Washington Post recently published a widely retweeted story (at least among demographers!) about the continued decline in fertility in the U.S., focusing on the fact that every demographic group has experienced the drop. 

The CDC said Wednesday that the total fertility rate — a theoretical figure that estimates the number of births a woman will have in her lifetime — fell by 18 percent from 2007 to 2017 in large metropolitan areas, 16 percent in smaller metro areas and 12 percent in rural areas. A similar downward trend holds for white, black and Hispanic women.

Low fertility in the U.S. is not, in and of itself, news. I last blogged about this only three months ago. But this new analysis of the birth data takes us into the comparisons among groups that we hadn't seen before. So, what's going on? The Washington Post sought answers from demographers:

The University of Pennsylvania’s Hans-Peter Kohler, who studies fertility and birthrates, said the data indicated that many shifts affecting fertility are occurring “in the transition to adulthood.” The biggest recent drops in birthrate have been among teenagers as well as people in their 20s. In 2016, the teen birthrate hit at an all-time low after peaking in 1991.

“The declining total fertility rates are children not born in the moment, but the hope is that they are delayed, not forgone,” Kohler said. “The exact details we won’t know until the young adults who are currently delaying having children are in their 30s or 40s.”

William H. Frey, a demographer with the Brookings Institution, said that what struck him about the new report is the figures on Hispanic women, who have traditionally had high fertility rates. From 2007 to 2017, Hispanic women experienced a 26 percent drop in fertility rates in rural areas, a 29 percent drop in smaller metro areas and a 30 percent decline in large metro areas.

The reality is that the Second Demographic Transition--the decline of fertility to below replacement levels in rich countries--has finally caught up with America. It seemed for awhile as though we might somehow avoid it, but these new data illustrate the amazing changes in family demography that have been taking place over the past couple of decades. Women are delaying marriage and child-bearing--or avoiding one or both altogether at levels that are historically unprecedented. They are living for themselves, not just for their husbands and children. As in Europe, the percent of births that are out-of-wedlock is historically high, as Bloomberg reported a few days ago, building on data from the United Nations Population Fund (UNFPA). 

The data show such births in the U.S. and EU are predominantly to unmarried couples living together rather than to single mothers, the report says. The data suggest that societal and religious norms about marriage, childbearing and women in the workforce have changed, said Kelly Jones, the director for the Center on the Economics of Reproductive Health at the Institute for Women’s Policy Research.

Welcome, America, to the Second Demographic Transition. We don't know how this is going to turn out, but we're clearly in the middle of it. 

Tanzania Expels Pregnant Girls From Schools

Scarcely more than a month ago I blogged about the President of Tanzania telling women that they should stop using birth control. Their job was to have babies and, presumably, not try to compete with men in society. Another approach to this extreme level of gender inequality is to expel girls from school if they become pregnant. CNN reports that:

It happens twice a year at Arusha Secondary School. Each one of the school's 800 female students is accompanied into a toilet and told to pee in a jar. Outside the cubicle, a teacher waits to make sure the samples are not swapped. The girls are taking compulsory pregnancy tests. And if they come back positive, the student is expelled immediately. The tests have been happening at this school, for students from grades eight and up, for three years.

Tanzania uses a morality clause in a 2002 education law to give schools the legal framework needed to expel students -- the practice originally dates back to the 1960s. The law has been more widely applied since President John Pombe Magufuli took office in 2015.

Last June, Magufuli, dubbed "The Bulldozer," went a step further, announcing that pregnant students would not be allowed to return to school after giving birth. "In my administration as the President no pregnant girl will go back to school... she has chosen that of kind life, let her take care of the child," he said at a public rally in 2017. His speech removed any discretion schools had over how they enforced the morality rule.

Expelling a pregnant girl from school sets her life on a different course than if she were able to continue her education even while having to care for her child. Furthermore, the schools do not teach sex education nor are contraceptives available. If her parents don't teach her about sex, the CNN writers suggest that many of these girls will not be aware that sexual intercourse can lead to pregnancy. So, if the whole idea is to scare girls into not getting pregnant while in school, a little bit of education along those lines would clearly be beneficial. In theory, any male who impregnates a schoolgirl could be sent to prison, but the CNN report does not indicate that this has ever happened.

The CNN report also summarizes the situation in Tanzania with respect to teenage pregnancies:

Around a quarter of Tanzanian girls aged between 15 and 19 are mothers or pregnant. Child marriage is still prevalent in the country -- 37% of women aged 20 to 24 having been married before they turned 18, according to official data from 2010, the latest available. More than a quarter of girls married before the age of 19 have husbands who are 10 or more years older, according to the same survey.

I should note that the 2010 data are not the most recent. The results of the 2015-16 DHS in Tanzania are available online at DHSProgram.com. Sadly, they show that teenage pregnancy has increased slightly since 2010, rather than declined.

Is China's Birth Rate Even Lower Than We Thought?

A few days ago I noted that the fertility rate in South Korea may have dropped to less than one child per woman. A paper just out by Stuart Gietel-Basten and associates has results from China's 2015 1% mini-census that suggests similarly very low levels of fertility--although probably not any lower than in South Korea.

In this paper, we produced a simple analysis of the 2015 mini-census of China without any statistical manipulation. Given the recent decision by the National Bureau of Statistics to cease publishing age-specific fertility rates, this data source represents one of the few means to calculate national and disaggregated measures of fertility in contemporary China. Our exercise found a national TFR of just above one, and very low TFRs in both urban and rural areas, and especially among migrant women. Our analysis of the contribution of changing trends in marriage lends credence to the idea that the postponement effect is being strongly felt in China.

The authors are careful to note that these results are tentative. The intercensal mini-census covered about 14 million people, so the sample is very large numerically, but census data are not necessarily as precise as information from vital statistics registration systems. Nonetheless, the results are consistent with various other sources, as the authors note. Although the results come from a date just prior to the government's lifting of the one-child policy, it seems pretty clear that China's road back to replacement-level fertility will probably be a long one.

Tanzania's President Urges Women to STOP Using Birth Control!

CNN has just reported that the President of Tanzania, John Magufuli, has called on women in his country to stop using birth control because the country needs more people. 

"Those going for family planning are lazy ... they are afraid they will not be able to feed their children. They do not want to work hard to feed a large family and that is why they opt for birth controls and end up with one or two children only," he said at a public rally on Sunday. He was quoted in a local newspaper, The Citizen, as saying that those advocating for birth control were foreign and had sinister motives.

Magufuli urged citizens to keep reproducing as the government was investing in maternal health and opening new district hospitals.

Now, for the record, the latest PRB World Population Data Sheet show that the average woman in Tanzania is having 5.2 children. To be sure, this is down from 6 children 20 years ago, but it still means that Tanzania is one of the top 8 countries in the world in terms of population growth over the next several decades. They are projected to increase from the current 59 million to 84 million by 2030 and 138 million by 2050--more than a doubling in scarcely more than three decades! And these projections assume that fertility will drop to about 3.5 children by the middle of this century.

So, the need for women to stop using birth control is obviously bogus. Magufuli argued that:

"You have cattle. You are big farmers. You can feed your children. Why then resort to birth control?" he asked. "This is my opinion, I see no reason to control births in Tanzania," Magufuli, who has two children, said.

The CNN reporter, Stephanie Busari, hints at the real issue--sexism. Males seem to be feeling threatened by increasing control of women over their own bodies and lives. In the meantime, the future of Tanzania almost certainly depends upon women using more birth control, not less.

South Korea's Fertility May Drop Below 1 Child Per Woman

Thanks to both Todd Gardner and Stuart Gietel-Basten for almost simultaneously pointing me to a story in yesterday's Guardian suggesting that the fertility rate in South Korea may soon drop to less than one child per woman. This is low-low fertility of nearly unheard of proportions even in what has become a very low fertility region of the world (and check out the brand new 2018 PRB World Population Data Sheet to make those comparisons for yourself!):

The average number of babies born per woman of reproductive age is due to be as low as 0.96 this year, falling below one for the first time in history, according to a study commissioned by the Chosun Ilbo newspaper [that article is in Korean, btw].

Such a low fertility rate is normally only seen during wartime, said Lee Chul-hee, an economics professor at Seoul National University and one of the authors of the study.

“There’s definitely going to be a psychological shock among the Korean people,” he said. “It will likely influence what is considered to be an ideal number of children, and could lead to the rate dropping even further.”

At the end of the Korean War, UN demographers estimate that the TFR in South Korea was above 6 children per woman, but a rapid drop in fertility after that (not unlike the one in Taiwan) brought fertility down to below replacement in the mid-1980s and it has stayed below replacement since then. This has, of course, generated the almost ideal demographic dividend that has helped the country leap into prosperity in a relatively short period of time. 

As is also true in Southern Europe, the birth rate is so low in South Korea at least in part because of the strings that are still tied around the lives of women:

The status of women in South Korea, a deeply patriarchal society, is a major driver of the trend, along with worsening job prospects for young people and rising property prices. Women are getting married and having children later in life, if at all, for fear of being denied promotions and facing discrimination at work.

The average age for South Korean women marrying for the first time is 30.2, according to figures from the ministry of gender equality and family, up from 24.8 in 1990. On average, women have their first child at 31.6.

There are going to have to be some decisive cultural changes--not just simple government policies--if the birth rate is going to get back up closer to replacement level. It can happen, of course, but it won't be easy.

Max Roser and Our World in Data

Over time I have regularly given shout-outs to the great work that Max Roser and his team at Oxford University do in assembling and presenting data for the world around us--focusing heavily on demographically-related themes (remember, indeed, that nearly everything is connected to demography!). There is no time like the start of the Fall term to go online and access these resources. You could start with the graphs of world population growth, such as:

Or, you may want to start with a YouTube video sponsored by Bill Gates, focusing on the important demographic work that the Bill and Melinda Gates Foundation does around the world:

And there's lots more. Browsing these resources is a great way to start the term.

China Now Pushes For More Children

A story this weekend in the NYTimes discusses new moves by the Chinese government to encourage a rise in the birth rate, since the continued low birth rate is leading to a rapidly aging and eventually declining population. The one-child policy has been scrapped in favor of a two-child ideal, but Chinese couples are not hopping on the baby wagon in great numbers.

Now, keep in mind that fertility was already declining pretty rapidly in China before the implementation of the one-child policy back in the late 1970s, so the government may have helped to lower the birth rate, but its nasty, repressive policies were not the underlying cause of the low birth rate. This is at least one reason why lifting the one-child policy hasn't yet encouraged an increase in the birth rate. So, it may be that the government is going to get nasty again.

The new campaign has raised fear that China may go from one invasive extreme to another in getting women to have more children. Some provinces are already tightening access to abortion or making it more difficult to get divorced. 

“To put it bluntly, the birth of a baby is not only a matter of the family itself, but also a state affair,” the official newspaper People’s Daily said in an editorial this week, prompting widespread criticism and debate online.

A plan to end the two-child limit was floated during the legislative session in Beijing last spring and now appears to be under consideration with other measures, the National Health Commission said in a statement.

Experts say the government has little choice but to encourage more births. China — the world’s most populous nation with more than 1.4 billion people — is aging quickly, with a smaller work force left to support a growing elderly population that is living longer. Some provinces have already reported difficulties meeting pension payments.

It is unclear whether lifting the two-child limit now will make much of a difference. As in many countries, educated women in Chinese cities are postponing childbirth as they pursue careers. Young couples are also struggling with economic pressures, including rising housing and education costs.

It is my hope that these and related issues are being discussed among demographers attending this year's American Sociological Association meetings in Philadelphia. I'm sorry I can't be there to contribute. 

Good Contraceptive Approved/Not so Good Contraceptive App Exposed--UPDATED

Yesterday the U.S. Food and Drug Administration approved a new vaginal ring that provides a year of birth control for women who use it. The method was developed by the Population Council in New York City, and I first became aware of it eight years ago. The FDA describes it this way:

Annovera is a reusable donut-shaped (ring), non-biodegradable, flexible vaginal system that is placed in the vagina for three weeks followed by one week out of the vagina, at which time women may experience a period (a withdrawal bleed). This schedule is repeated every four weeks for one year (thirteen 28-day menstrual cycles).

The efficacy and safety of Annovera were studied in three, open label clinical trials with healthy women ranging from 18 to 40 years of age. Based on the results, about two to four women out of 100 women may get pregnant during the first year they use Annovera.

That is a very good use-effectiveness rate, as you can see if you look at Table 6.2 in my book. 

On the other hand, a widely used Swedish phone app called "Natural Cycles" designed to help women avoid pregnancy through fertility awareness methods (natural family planning) is not so good, as a recent story in The Guardian points out. Indeed, it is now being investigated in the UK by the Advertising Standards Authority:

The Advertising Standards Authority has launched a formal investigation into marketing for a Swedish app that claims to be an effective method of contraception, after reports that women have become pregnant while using it. An ASA spokesman said it had received three complaints about Natural Cycles and its paid advertising on Facebook, which describes the app as highly accurate contraception that has been clinically tested. “We would require robust substantiation from any company to support such a claim,” he said.

The app was developed by two scientists from Sweden and Austria: Elina Berglund, who worked at the Cern laboratory in Geneva on the discovery of the Higgs Boson particle, and Raoul Scherwitzl. The married couple originally devised the algorithm for their own family planning, and now both work full time for the company they founded. They claim to have 600,000 users worldwide, who pay an annual subscription.

Users monitor their fertility with the app by taking their temperature each morning. It tracks the results to detect ovulation, and advises which days are safe or unsafe to have unprotected sex without the risk of conception. The app relies on users taking their temperature at around the same time every morning, and cautions: “Remember that you must always measure as soon as you wake up before you snooze, sit/get up, or check your phone.”

Like all methods of natural family planning, there is a lot of room for error--which leads to unintended pregnancies and possibly then to abortions. 

UPDATE:

CNN today published an op-ed piece by Caroline Criado Perez that gives us more background into the Natural Cycles app, and how suspicious its claims are. She argues that since getting pregnant is one of the most dangerous things a woman can do in her life, governments should make it harder to market birth control methods that aren't very effective.

Poor Health Behaviors Increase Risk of Poor Birth Outcomes

My hope is that anyone reading this blog post will know immediately that if you engage in risky health behaviors before or during pregnancy you increase the chance that your baby will be born with health problems that may indeed last a lifetime. Still, additional research findings along these lines never hurt to keep driving home the point. For this reason I was very interested to read the summary of an article forwarded to me by Professor Rumbaut at UC, Irvine, demonstrating that the behavior of mothers matters for their baby's health. More specifically, mothers who smoked as teens are more likely to deliver smaller babies.

The article was recently published in the journal Social Science & Medicine by Jennifer Kane--a colleague of Professor Rumbaut at UCI, Kathleen Mullan Harris at the Carolina Population Center (UNC, Chapel Hill), and Anna Maria Siega-Riz, also at the Carolina Population Center. There are two interesting aspects to this paper: (1) the data and analysis are importantly connected to Past PAA Presidents; and (2) the whole subject matter takes me and Professor Rumbaut back to our collaborative research many years ago.

The data in this paper come from the National Longitudinal Study of Adolescent to Adult Health or Add-Health as it is popularly known. This project was put together by Kathleen Mullen Harris (PAA President in 2009) and Dick Dry (PAA President in 1994). It was highly controversial at the time, as you can read about in my interview with Professor Udry as part of the PAA Oral History Project. The paper also references the work of Past PAA President Greg Duncan at UC, Irvine, whose interview has just been posted to the PAA website.

Professor Rumbaut and I collaborated on research aimed at understanding the differential birth outcomes among immigrants to San Diego from Indochina and also from Mexico. You can get a feel for our research in this paper, in which we found that infant death rates among Indochinese refugees was lower in San Diego in the 1980s than among Hispanics, Whites, and Blacks. One of the reasons was that they were less likely to smoke. Yes, their husbands were quite likely to smoke (and that's not good, of course), but very few women smoked. Furthermore, babies were conceived almost entirely to women older than the teens who were married. These are all predictors of better birth outcomes, a topic I recently discussed.

Age at First Birth Tells Us a Lot about the Status of Women and Their Children

The New York Times today led with an interesting demographic story on the average age at first birth in America, and thanks to my good friend, Professor Rubén Rumbaut for sending me the link to it last night. The story is about starting families and my wife and I have been "vacationing" at home with the family we started several decades ago when we were ourselves married college graduates.

Becoming a mother used to be seen as a unifying milestone for women in the United States. But a new analysis of four decades of births shows that the age that women become mothers varies significantly by geography and education. The result is that children are born into very different family lives, heading for diverging economic futures.

[The analysis] was of all birth certificates in the United States since 1985 and nearly all for the five years prior. It was conducted for The New York Times by Caitlin Myers, an economist who studies reproductive policy at Middlebury College, using data from the National Center for Health Statistics.

The results are not necessarily surprising, but they reinforce other research findings showing that women who have their first baby at a young age tend to be disproportionately unmarried, not a college graduate, and more likely from a rural area. By contrast, the later ages at first birth tend to occur among college educated women, who are also more likely to be married and to live in urban areas. This matters more now than in the past because the growing inequality in income and wealth makes it ever more difficult to launch children in the direction you, as a parent, want them to go.

There has long been an age gap for first-time mothers, which has narrowed a bit in recent years, driven largely by fewer teenage births, Ms. Myers said. Yet the gap may be more meaningful today. Researchers say the differences in when women start families are a symptom of the nation's inequality -- and as moving up the economic ladder has become harder, mothers' circumstances could have a bigger effect on their children’s futures.

“These education patterns do help drive inequality, because well-educated women are really pulling ahead of the pack by waiting to have kids,” said Caroline Hartnett, a sociologist and demographer studying fertility and families at the University of South Carolina. “But if going to college and achieving an upper-middle-class lifestyle seems unattainable, then having a family might seem like the most accessible source of meaning to you.”

The law professors June Carbone and Naomi Cahn described in a 2010 book how red and blue families were living different lives. The biggest differentiating factor, they said, was the age that mothers had children. Young mothers are more likely to be conservative and religious, to value traditional gender roles and to reject abortion. Older mothers tend to be liberal, and to split breadwinning and caregiving responsibilities more equally with men, they found.

You can see, then, that the age at first birth is a key indicator of how a woman's life is going, and at the same time is a key predictor of how her children's lives are apt to turn out.