The everlasting outmoded contraceptive method mix in Brazil and its legacy

Abstract Fertility transition occurred in a short period of time in Brazilian the absence of family planning programs, and most noticeable, in a context of illegality in the provision of means of fertility self-regulation. These events did not happen without consequences. Based in the literature and facts registered during that time, the paper first discusses how the resistance to the implementation of family planning programs from the 1960s to the 1980s have contributed to the unbalanced contraceptive method mix in the 1990’s. Secondly, the paper will discuss problems around contraceptive data collection in the National Health Survey, and, performing an adjustment of the data, we analyze trends in the use of contraceptive methods from 1986 to 2013, showing that method mix continues to be very concentrated in the same two methods, an even more outdated scheme, with the daily pill exchanging first place with female sterilization. Finally, the paper discusses some fertility characteristics associated with the outdated contraceptive mix, still prevailing at the end of fertility transition, arguing that this could be avoided or minimized if policies and laws are based in reproductive rights of all people only.摘要：在缺乏计划生育项目的背景下，巴西的生育率转型在短时间内完成，且尤为值得关注的是，当时提供生育自我调节手段的行为属于非法范畴。此类变迁并非毫无影响。基于同期文献与登记记录，本文首先探讨了1960至1980年代对计划生育项目实施的抵制，如何导致1990年代避孕方法结构失衡。其次，本文将探讨全国健康调查（National Health Survey）中避孕数据采集存在的问题，并在对数据进行校准修正后，分析1986至2013年避孕方法使用趋势，结果显示避孕方法结构仍高度集中于两种方案，且结构更为陈旧——短效口服避孕药与女性绝育术互换了首位。最后，本文探讨了生育率转型末期仍占主导地位的陈旧避孕方法结构所关联的若干生育特征，并提出若政策与法律仅以全体民众的生殖权利为依据，此类情况本可避免或得到缓解。