Davis Jason, Bilsborrow Richard, Gray Clark
Postdoctoral scholar, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA,
Int Perspect Sex Reprod Health. 2015 Mar;41(1):1-10. doi: 10.1363/4100115.
Communities indigenous to the Amazon are among the few remaining worldwide still practicing near-natural fertility, without the use of modern contraceptives. Given the large proportion of women desiring no more births, information on the challenges women there face in limiting fertility would be useful.
Samples of women of reproductive age from five indigenous ethnic groups in the Northern Ecuadorian Amazon were surveyed in 2001 and 2012. Cross-sectional and longitudinal analyses examined married women's desire for another child at both times and modern contraceptive use in 2012, as well as determinants of a change in women's desire to have more children and of the number of children born during the study period.
In 2001, 48% of married women desired another child, 2% used a modern contraceptive and 50% had an unmet need for limiting; in 2012, the proportions were 40%, 19% and 47%, respectively. The total fertility rate was 7.9 births per woman in 2001 and 7.0 births per woman in 2012. Characteristics associated with wanting another child in 2001 and 2012 included parity (odds ratios, 0.6 and 0.4, respectively) and experience of a child death (2.0 each); characteristics associated with contraceptive use in 2012 included desire for another child, experience of a child death and presence of a community health worker (0.3-0.5). Number of children born was positively associated, and the square of the term negatively associated, with no longer wanting more children in 2012 among women who wanted more in 2001 (2.1 and 0.9, respectively).
Indigenous women in the Northern Ecuadorian Amazon appear to be making the transition to lower fertility. Insufficient access to credible information about the safety and efficacy of modern contraceptives, however, may slow the transition.
亚马逊地区的原住民社区是世界上少数仍在近乎自然生育状态下生活、不使用现代避孕措施的群体。鉴于很大一部分女性不想再生育，了解当地女性在限制生育方面所面临的挑战将很有帮助。
2001年和2012年对厄瓜多尔北部亚马逊地区五个原住民族群的育龄妇女样本进行了调查。横断面分析和纵向分析考察了已婚妇女在这两个时间点生育意愿以及2012年现代避孕措施的使用情况，同时分析了妇女想要更多孩子的意愿变化以及研究期间生育子女数量的决定因素。
2001年，48%的已婚妇女想要再生育一个孩子，2%使用现代避孕措施，50%有未满足的限制生育需求；2012年，这些比例分别为40%、19%和47%。2001年每名妇女的总生育率为7.9胎，2012年为7.0胎。2001年和2012年与想要再生育一个孩子相关的特征包括胎次（比值比分别为0.6和0.4）以及子女死亡经历（均为2.0）；2012年与使用避孕措施相关的特征包括想要再生育一个孩子、子女死亡经历以及社区卫生工作者的存在（0.3 - 0.5）。在2001年想要更多孩子的妇女中，2012年生育的子女数量与之呈正相关，而该变量的平方与之呈负相关（分别为2.1和0.9）。
厄瓜多尔北部亚马逊地区的原住民妇女似乎正在向较低生育率转变。然而，获取关于现代避孕措施安全性和有效性的可靠信息不足，可能会减缓这一转变。
