Leridon Henri
Inserm, U569, F-94276 Le Kremlin-Bicêtre, INED, F-75020 Paris France.
Hum Reprod Update. 2006 Sep-Oct;12(5):603-16. doi: 10.1093/humupd/dml025. Epub 2006 Jun 14.
The use of the contraceptive pill increased very rapidly in the 1970s in many developed countries, and fertility almost simultaneously started to decline. We discuss here the possibility of a causal link between these two major changes. We first provide evidence for a relationship between the spread of oral contraceptive use and the change in fertility in many European countries over the last three or four decades. The situation of specific countries is examined more in depth on the basis of available literature. We then review the various theories attempting to explain these trends and see how the family planning variables are treated in these approaches. At the country level, the conclusion is unambiguous: within individual countries, there is no systematic negative correlation between fertility and contraceptive pill use. The development of hormonal contraception cannot be considered as responsible for either starting or the size of the fertility decline. A more subtle chain of causality must be considered, but there is no agreement on a general theory of fertility changes. Most authors, however, agree that the diffusion of modern contraception has certainly contributed to the reduction in the number of unwanted pregnancies and has also facilitated and favoured the adoption of new (more restrictive) norms for the ideal family size.
20世纪70年代，避孕药在许多发达国家的使用迅速增加，生育率几乎同时开始下降。我们在此讨论这两个重大变化之间存在因果关系的可能性。我们首先提供证据，证明过去三四十年中许多欧洲国家口服避孕药的普及与生育率变化之间的关系。根据现有文献，对特定国家的情况进行了更深入的研究。然后，我们回顾了试图解释这些趋势的各种理论，并考察了这些方法中对计划生育变量的处理方式。在国家层面，结论是明确的：在各个国家内部，生育率与避孕药使用之间不存在系统性的负相关。激素避孕的发展不能被视为生育率下降的起始原因或下降幅度的原因。必须考虑一个更微妙的因果链，但对于生育率变化的一般理论尚未达成共识。然而，大多数作者一致认为，现代避孕方法的普及无疑有助于减少意外怀孕的数量，也促进并有利于采用关于理想家庭规模的新（更具限制性）规范。
