Priestley S R
Department of Sociology, Psychology and Social Work, Faculty of Social Sciences, The University of The West Indies, Kingston 7, Jamaica.
West Indian Med J. 2012 Oct;61(7):716-25.
It has been a long held belief that increased contraceptive use is primarily responsible for lowered fertility in Jamaica since the 1970s. However, historically, subfecundity has played a major role in suppressing fertility rates. In order to reveal the prevalence and trend in fertility impairment, a study was conducted using data from the 1989, 1993, 1997 and 2002 reproductive health surveys.
Bivariate analysis was used to highlight women lack of childbearing in the five-year period prior to the survey and the reasons they provide for their inability to become pregnant. Using the impairment typology of Chandra and Stephen (1998), cross-tabulations were used to present the sociodemographic background of women determined to experience fertility impairment.
The data reveal that 28 per cent of sexually experienced women aged 15-49 years in 1989 and 31 per cent in 2002 reported some form of fecundity impairment. Impairment is largely due to subfecundity resulting from miscarriage or abortion, rather than failure to conceive. Women with impairment were predominantly found in married and common-law unions, were mothers, were 30 years or older, had experienced fetal loss, were working, and did not want an additional child.
As childbearing and increasing age raise the prevalence of impairment, many women are unlikely to meet their family building goals. We therefore recommend that health screening for conditions related to infertility be introduced.
长期以来人们一直认为，自20世纪70年代以来，避孕药具使用的增加是牙买加生育率下降的主要原因。然而，从历史上看，生育力低下在抑制生育率方面发挥了重要作用。为了揭示生育障碍的患病率和趋势，利用1989年、1993年、1997年和2002年生殖健康调查的数据进行了一项研究。
采用双变量分析来突出调查前五年内妇女未生育的情况以及她们无法怀孕的原因。根据钱德拉和斯蒂芬（1998年）的障碍类型，使用交叉列表来呈现被确定为有生育障碍的妇女的社会人口背景。
数据显示，1989年15至49岁有性经历的妇女中有28%，2002年有31%报告了某种形式的生育力障碍。障碍主要是由于流产或堕胎导致的生育力低下，而非无法受孕。有障碍的妇女主要存在于已婚和事实婚姻关系中，是母亲，年龄在30岁及以上，有过胎儿丢失经历，有工作，并且不想要更多孩子。
由于生育和年龄增长会提高障碍的患病率，许多妇女不太可能实现其生育目标。因此，我们建议引入与不孕症相关疾病的健康筛查。
