Feature Articles

While Hong Kong’s fertility rate remains low but the trend is leveling off, delayed childbearing warrants concern, according to findings of the Survey of Family Planning Knowledge, Attitude and Practice in Hong Kong 2007 released by the Family Planning Association of Hong Kong (FPAHK) on 4 November 2008.

The Association has been monitoring local people’s pattern of family planning and related issues through the survey, which is conducted every 5 years since 1967. The ninth in the series, the 2007 survey successfully interviewed 1,510 married or cohabitated women aged between 15 and 49, and 770 of their spouses between December 2007 and April this year by home visits. The response rate was 66% for female respondents and 51% for male respondents.

Parity

Presenting the survey results, Dr Siu Yat Ming, member of the FPAHK Research Sub-committee, said there was a continuous drop in the actual parity of Hong Kong couples over the past 20 years. The mean actual parity declined from 3.3 in 1977 to 1.5 in 2007. While low fertility persisted, the declining trend was leveling off. As for ideal parity, nearly 50% of the women polled still desired two children, a decrease of 10% from 60% in 1992. On the other hand, the proportion of those whose ideal parity is one child had risen from about 10% in 1992 to 26% in 2007. Respondents who desired no children also rose from 13% in 2007 from 5% in 1992.

In comparing actual and ideal parity, it was found that over 65% of the women polled had the same number of children as they desired, representing a considerable increase of almost 20 percentage points from about 45% five years ago. Less than 10% had more children than they desired, representing a substantial drop of almost 20 percentage points from 30% five years ago. Dr Siu said the reasons may include: (1) better family planning; (2) better contraceptive methods; (3) late marriage resulting in less likelihood to have more children or greater ease in achieving one's fertility goal.

Family Planning and Fertility

The current pregnancy rate at the time of the survey was only 0.9%. Among the fertile women polled in 2007, only about 13% desired to have a child or another child while over 80% did not. 40% of women married for 4-5 years still had no children. Those aged 35-39 and still childless were also on the rise, accounting for 15% of the fertile women in 2007 as compared with 11% in 2002.

Professor Paul Yip, Chairman of FPAHK Research Sub-committee, said the findings showed the trend for late pregnancy among local women. In the 35-39 year old group, 31% had fewer children than they desired, indicating that about 30% of women in this age group still desired to give birth. However, women’s fertility declined from after 35 years of age, accompanied by greater risks during conception and pregnancy.

Respondents not desiring to have a child or another child cited heavy financial burden of raising children, being too old, and too much responsibility in raising children as their main concerns. The proportion of women who thought themselves too old and did not want to have late pregnancy rose from 5% in 2002 to 37% in 2007, indicating that age had become an increasingly significant factor affecting Hong Kong people’s fertility.

The survey also reflected an increasing level of education and full-time employment among Hong Kong women. In 2007, 87% of the female respondents had attained secondary or post-secondary education and 51% worked full time. High education attainment and long working hours are associated with women deferring pregnancy and even affect their desire to have children.

On policies to encourage childbearing, respondents said they would most likely be encouraged by: financial incentives including education and healthcare subsidies; parental support such as flexible working hours and increase in nurseries and child-care services; education policies including free pre-school education, better quality of education and small-class teaching, etc. However, the survey indicated that such incentives were more attractive to respondents with one child or no children, but less meaningful for those who already had two or more children.

Contraceptive Practice

The male condom was the most popular current method of contraception, being used by more than 60% of the 1,078 female respondents practicing contraception at the time of the survey. Its usage had increased continuously from 20% in 1982 to 63% in 2007. By contrast, the usage of female sterilization and oral contraceptive pill, the most popular methods in the past, had declined. In 2007, female sterilization registered a usage of 9%, compared with 28% in 1982. During the same period, the usage of oral contraceptive pill also dropped from nearly 27% to about 8%. Usage of intrauterine contraceptive device (IUCD) at 12% in 2007 was double of the level at about 6% in 1992 and 1997. The increase is believed to be due to more women coming from the Mainland to reside in Hong Kong.

Induced Abortion

The survey found 21% of the female respondents had ever had induced abortion, down from 26% five years ago and showing a departure from the upward trend over the past 15 years. There were no significant changes in the proportions of those who had had one, two, three, four or more induced abortions.

About half (51%) of the female respondents who had ever had induced abortions said they were practicing contraception before the induced abortion, 22% said they had skipped contraception at that time, and 27% did not practice contraception. This indicated that contraception failure and failure to use contraception consistently every time were the significant causes of unplanned pregnancies. Among the respondents who were practicing contraception before the induced abortion (including those who skipped contraception at that time), 62% were using male condoms. Dr Susan Fan, Executive Director of FPAHK, pointed out that the contraceptive reliability of the male condom was lower than that of other methods such as oral contraceptive pill, IUCD and injectable contraceptives. She suggested that couples could use a combination of male condom together with another contraceptive method to achieve dual protection against sexually transmissible diseases and unwanted pregnancy.

Concluding the survey results, Dr Fan said that in recent years, Hong Kong’s concern over fertility issues and efforts by various sectors of society to reduce the barriers to childbearing were positive and deserved recognition. She stressed that the choice and decision on parenthood is every couple’s responsibility and should be made in a timely way. Those who wished to have children should prepare well and early. With modern society’s preoccupation on career achievements and freedom in lifestyle, many couples over-emphasized the ‘costs’ and ‘sacrifices’ of parenthood including money, time and effort. In reminding everyone to cherish the ‘value’ and ‘meaning’ of nurturing the next generation and the satisfaction of parenthood, she wished Hong Kong people all the best in building happy, healthy and harmonious families.