From Vital and Health Statistics of the National Center for Health Statistics December 20, 1984. Number 103 

4 

.+ 

PROPERW OF = -

PtlBUCAmO}4: %?ANCH 

EtM’fORIALLIBRARY 

Use of Services for Family Planning and Infertility: 

United States, 1982 

by Marjorie C. Horn, M.A., and William D. Mosher, Ph. D., Division of Vital Statistics 

o 

* 

In 1982, the annual rate of visits for family pltig services 

was 1,077 visits per 1,000 nonsterile women. Never married 

women made greater use of family planning services in that 

year than did women who had been married (1,227 visits compared with 1,010 visits per 1,000 women, respectively). Many 

oviders of family planning services also offer services or make 

ferrals for infertile couples. Over 6 million ever married 

women in 1982 had used infertili~ services at some time during 

their reproductive years. 

These and related statistics on the use of family planning 

and infertility services presented in this report for 1982 are 

preliminary results from Cycle III of the National Survey of 

Family Growth (NSFG), conducted by the National Center 

for Health Statistics. Comparative data for 1973 and 1976 are 

from Cycles I and II, respectively, of the NSFG.1,2 For Cycle 

III, data were collected through personal interviews with a multistage area probability sample of 7,969 women aged 15–44 

years in the noninstitutional population of the conterminous 

United States. Between August 1982 and February 1983, interviews were conducted with 3,201 black women and 4,768 

women of other races. Because the estimates of statistics in this 

report are based on a sample, they are subject to sampling 

variability. Sampling variability, the design of the survey, and 

definitions of terms used in this report are discussed in the 

Technical notes. 

Use of family planning services by 

currently married women 

In the 1982 survey, a detailed series of questions was asked 

to obtain relatively complete estimates of the extent and type of 

“lyplanning services received. The specific services included 

these questions are listed in the Technical notes. Statistics 

on family planning services are limited to women who were 

able to conceive 3 years before the interview date. A woman 

was classifkd as not able to conceive (sterile) if she reported 

that it w% impossible for her or her husband to conceive as a 

result of(1) an operation that occurred more than 3 years before 

the interview or (2) nonsurgical factors known to the respondent 

3 years or more before the interview. All other women were 

assumed to be able to conceive at the beginning of the period 

for which use of family planning services was reported. These 

women are referred to as “nonsterile,” although some will have 

become sterile because of an operation or nonsurgical conditions during the 3 years before the interview. 

Table 1 shows the number of currently married, nonsterile 

women 15–44 years of age by race, Hispanic origin, and poverty level income, and the percent who used family planning 

services in the 3 years before the survey. Overall, 79 percent of 

currently married nonsterile women reported using some type 

of family planning service during the previous 3 years. Although 

white wives may have been more Iiiely to have used family 

planning services (79 percent) than black (75 percent) or Hispanic (77 percent) wives, neither of these diiTerences was statistically signitlcant. There were no significant differences between the two income groups. 

In previous cycles of the survey, use of family planning 

services was measured by the single question “During the past 

3 years, has a doctor or other trained person prescribed, or 

talked with you about a method for delaying or preventing pregnancy?” This was found to be an inadequate question because 

respondents apparently felt it excluded services other than formal discussions about contraception. In 1982, many women 

who answered “no” to the above question (the old question) 

nonetheless reported in response to the new series of questions 

using other family planning services, including pregnancy tests, 

and getting or renewing a method of contraception. 

As a result, the older measure seriously underestimated 

use of family planning services, which is demonstrated by comparing the estimates based on the old and new questions. As 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 
2 

Table 1. Number of currently married women 15-44 yeers.of age who were not sterile 3 years before the dete of interview, percent who used 

family planning servicee in the last 3 years, and percent who talked to a doctor or other trained person about contraception in the last 3 years,/ 

by rece, Hispanic origin, and poverty level income: United Stetes, 1973, 1976, and 1982 

[Statiatica are based on a sample of the household population of the conterm(nous Unmed States. See Technical notes for estimates of sampling variability and 

definitiona of terms. Data for 1982 are preliminary] 

Used family Talked about 

planning sewices contra cep tion 

Currently married in last 3 years in last 3 years 

Race, Hispanic origin, and 

poverty level income 1982 1976 1973 1982 1982 1976 1973 

Number in thousands Percent 

Allwomenl . . . . . . . . . . . . . . . . . 220,813 222,923 

Rece’ 

White, . . . . . . . . . . . . . . . . . . . . . . 18,489 20,553 

Black . . . . . . . . . . . . . . . . . . . . . . . . . .,, . . . 1,639 1,896 

Hispanic origin 

Hispanic, . . . . . . . . . . . . . . . . . . . . . 1,847 1,519 

Non- Hispanic . . . . . . . . . . . . . . . . . 18,386 21,357 

Poverty level income 

Less than 150 percent . . . . . . . . . . 3,095 3,001 

150percant or more . . . . . . . . . . . 15,029 17,513 

llncludes white, black, and other races.


‘Includes Hispanic origin and poverty level income not stated.


shown in table 1, in 1982, only about 50 percent of the women 

had discussed contraception with a medical professional according to the old question, compared with 79 percent of the 

women who used family planning services according to the 

new, more comprehensive questions. 

Despite the inadequacies of the old question, it was retained 

in Cycle III to permit examination of changes over time. Thus, 

table 1 also shows the percents of women in 1973, 1976, and 

1982 who reported a discussion about contraception in the 3 

years before the surveys. In 1982, approximately 10 million 

women reported a discussion about contraception, a decrease 

of about 3 million women since 1976. One-third of this difference resulted from a reduction in the number of currently married nonsterile women, and two-thirds from a decline in the 

percent of women who had discussed contraception. (The decrease in the number of currently married, nonsterile women 

results almost entirely from an increase in contraceptive sterility 

between the 1976 and 1982 surveys. Preliminary findings on 

contraception and on reproductive impairments, which will include data on sterility, will be reported in other Advance Data 

reports.) 

The change between 1976 and 1982 in the percent of wives 

reporting a family planning discussion appears to be due primarily to changes among white wives, who reported a decline 

of almost 10 percentage points. The percents of black and Hispanic wives reporting a discussion about contraception may have 

declined as well, but the differences between 1976 and 1982 

were not statistically significant. The decreases from 1976 to 

1982 for white and non-Hispanic wives were about the same 

size as the increases between 1973 and 1976. A similar pattern 

was found for black and Hispanic women. As a result, there 

were no significant changes between 1973 and 1982 in the 

percent of white, black, Hispanic, or non-Hispanic women who 

23,863 278.8 249.5 258.6 51.2 

-d ! 

21,711 79.2 50.0 59.9 -51.9 

1,868 74.9 44.4 46.9 44.1 

1,504 77.0 42.6 51.8 48.1 

22,359 78.7 50.3 59.0 51.3 

3,693 82,0 47.6 58.3 52.6 

20,170 78.7 50.7 60.4 50.9 

had a discussion about contraception. The same applies to income groups: the percents increased from 1973 to 1976 an ‘ 

decreased between 1976 and 1982. T 

Given the limitations of the older measure of family planning services, the changes over time are difficult to interpret. 

They may represent real changes, or be artifacts of reporting 

errors. Specifically, it cannot be assumed that a similar trend 

over time characterized by a sharp peak in 1976 would have 

been found with the new measure. However, the proportions 

receiving family planning services were probably higher in 1973 

and 1976 than is indicated by the old measure. 

In all three survey years, white wives appeared more likely 

than black or Hispanic wives to have talked with a medical 

professional about contraception, as did wives with higher incomes compared with those with lower incomes. However, the 

differences between white women (50 percent) and black 

women (44 percent) were not statistically significant in 1982, 

while those between white and Hispanic wives were significant 

only in 1976. The percents in the income groups did not differ 

significantly in any of the three surveys. 

Annual family planning visit rates 

In addition to information on use of family planning services in the past 3 years, data were collected in Cycle III on 

use of services in the 12 months before the survey, to produce 

annual rates of family planning visits. Further, the inclusion of 

never married childless women made it possible to comput” 

these rates for all women who had ever had intercourse. r 

Table 2 presents rates per 1,000 women for family plaming 

visits made during the 12 months before the interview by source 

of service, race, age, and marital status. As in table 1, statistics 

in table 2 also refer to women who were not sterile 3 years or 
admceMa3 

Table 2. Number of women 15-44 years of age who ever had sexual intercourse and were not sterile 3 yeers before the date of interview and 

~number ‘f family Plannin9 viaits in the last 12 months, by race, age. and marital status, and number of family planning viaits in the last 12 

months per 1,000 women, by source of service, race, age, and marital statua: United States, 1982 

relim inary data based on a sample of the household population of the conterminous U“lted States, See Technical notes for estimates of sampling var!abtlity and 

de finmons of terms] 

Source of services 

Privete 

All medical 

Race, age, and marital status Women Visits sources services Clinics Counselors 

Number in 

ALL WOMEN I thousands Visits per 1,000 wOmen 

15–44 years,,...,,..,,....,,,., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,,. 37,488 40,369 1,077 656 385 36 

15-24 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,.. 13,452 19,462 1,447 702 673 71 

15-19 years, . ., ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,. 4,465 7,059 1,581 609 867 105 

25–34 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,639 17,362 1,043 743 280 “21 

35-44 yesrs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,397 3,545 479 377 95 *7 

~ MARITAL STATUS 

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Currently married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Widowed, divorced, orseparated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1Includes white, black, and other races 

more before interview, however, unlike table 1, which includes 

only currently married women, table 2 refers to all women who 

ever had intercourse regardless of marital status. A family planning visit means that a woman went to a clinic, private medical 

source, or counselor to obtain one or more family planning 

services. (Family planning services and sources are defined in 

the Technical notes). 

Differences in family planning visit rates by age, race, and 

marital status reflect the different distributions of contraceptive 

methods used in these groups, which are described in another 

NSFG report.J For example, the oral contraceptive pill is the 

leading method among young and never married women, and it 

requires repeated visits to a doctor or clinic to renew the prescription and check for side effects. Sterilization, the leading 

method among older married women, requires fewer visits. Contracepting black women rely more on methods requiring medical services (except the diaphragm) than white women, and 

this’is reflected in the visit rates by race. 

Nonsterile women aged 15–44 who had ever had sexual 

r ~ercourse used family planning services of all types at the rate 

of 1,077 visits per 1,000 women per year. Teenagers had the 

highest annual visit rate (1,5 81 per thousand) of any age group 

for all sources of family planning services combined. Visit rates 

declined sharply with age, from 1,447 at 15–24 years to 479 at 

31,111 32,125 1,033 670 323 39 

10,912 15,192 1,392 738 573 81 

3,512 5,352 1,524 661 736 127 

14,009 14,024 1,001 746 232 *21 

6,190 2,909 470 375 88 ‘8 

5,277 7,039 1,334 556 754 *24 

2,192 3,791 1,729 530 1,162 *37 

833 1,555 1,867 451 1,387 *29 

2,128 2,671 1,255 632 604 *19 

956 577 * 603 *444 153 *6 

11,529 14,143 1,227 534 636 *56 

20,806 21,212 1,020 741 251 27 

5,153 5,014 973 586 361 *26 

ages 35–44. Similar declines with age also were found in the visit 

rates for white and black women separately. Nevertheless, the 

annual visit rate for black women (1,334 per 1,000 women) 

was significantly higher than the rate for white women (1,033). 

Visit rates for black women also were higher than those for 

white women within each age group (although for ages 35–44 

the difference is not significant). The highest overall visit rate 

in table 2 was for black women 15– 19 years of age (1,867 per 

1,000 women). 

The visit rate of 1,227 per 1,000 never married women 

was higher than that for either currently married or previously 

married women (1,020 and 973, respectively). This suggests 

that the observed differences in visit rates by age may reflect, 

in part, the effects of marital status, because a large majority 

of the youngest age group has never been married. It also may 

be the case that visit rates are higher among never married 

women because they are younger, as a group, than ever married 

women. 

Nearly two-thirds of all family planning visits were to private 

medical sources. Teenagers of all races had higher family planning service visit rates to clinics than to private medical services, 

as did black women aged 15-24 years. White teenagers also 

may have been more likely to obtain services from clinics than 

from private medical services (736 compared with 661 visits 
4 ackincedata 

per 1,000), but the difference was not significant. White women 

aged 20 years and older had higher visit rates to private medical 

services than to clinics. 

Visit rates to private medical services were higher among 

women aged 25 –34 than among women 15– 19 years and 

35–44 years old. Visit rates to clinics were highest among 

15–1 9 year olds. A similar pattern was found when rates by 

age were examined separately for white and black women, but 

not every difference was statistically significant. 

Never married women had higher visit rates to clinics than 

currently or formerly married women. Currently married women 

were more likely than either never or previously married women 

to obtain family planning services from private medical sources. 

In each age and race category, women were least likely to 

obtain family planning services from counselors, who are not 

able to offer as wide a range of services as doctors and clinics. 

The highest visit rates to counselors were found for teenagers, 

perhaps because teenage women may be more likely than other 

women to turn to nonmedical counselors for information about 

family planning methods. 

Overall, white women had higher visit rates to private medical services than black women (at the 0.10 level of signii3cance), 

while black women had higher visit rates to clinics. These differences by race were statistically significant for teenagers separately and for women aged 15–24. In addition, clinic visit 

rates for black women were higher than rates for white women 

among women 25–34 years of age. 

Infertility services 

Family planning includes infertility services as well as services for limiting the number and planning the spacing of births. 

Data also were collected in 1982 on use of medical services for 

infertility by women who had dii%culty in conceiving or in carrying a pregnancy to term. About 1 million ever married women 

had one or more infertility visits in the 12 months before the 

interview; about 825,000 of these were to private medical services. During the 3 years before interview, about 1.9 million 

women had infertility visits, 1.5 million of which were to private medical services. Table 3 shows the percent of ever married women who had used services for infertility at any time, 

according to the most recent source of those services, race, 

Hispanic origin, and age. The statistics include infertility visits 

made at any time in the past because there were not enough 

cases to make statistically reliable estimates of infertility visits 

in the last 12 months or 3 years for the subgroups of the population shown in table 3. 

About 6.3 million ever married women 15–44 years of age 

had used infertility services at some time. The percents ever 

using sewices were higher for women aged 25 –34 years and 

35–44 years compared with younger women. The same pattern 

is reflected when white women are considered separately. A 

higher proportion of white women ( 19 percent) than black women 

Table 3. Number of ever married women 15-44 years of age, 

percent who ever used services for infertility, and percent 

distribution by most recant source of services, according to race, 

Hispanic origin, and age: United States, 1982 

o [Preliminary data based on a sample of the household population of the 

conterminous United States. See Technical notes for estimates of sampling 

variability and definitions of terms] 

Most recent source of 

services 

Ever Private 

Race, age, and married All medical


Hispanic origin women sources services Clinics


Number in 

ALL WOMEN1 thousands Percent 

15-44 yeara . . . . . . . . . 34,937 18.1 14.9 3.2 

15-24 years . . . . . . . . . 5,500 10.7 ‘7.0 “3.8 

15-19 years . . . . . . . 682 “3.1 “1.4 “1.8 

25-34 years . . . . . . . . . 15,998 18.9 15.4 3.5 

35–44 years . . . . . . . . . 13,439 20.2 17.7 *2.5 

White 

15-44 years . . . . . . . . . 30,419 18.6 15.7 2.9 

15-24 years . . . . . . . . . 4,975 10.5 “7.0 *3.6 

15-19 years . . . . . . . 621 *3.4 “1,5 *1.9 

25–34 years . . . . . . . . . 13,819 19.2 16.3 *2.9 

35-44 years . . . . . . . . . 11,626 21.3 18.8 *2.5 

Black 

15-44 years, . . . . . . . . 3,442 13.5 9.0 4.5 

15–24 years . . . . . . . . . 427 “10.7 *3.9 *6.9 

15-19 years . . . . . . . 39 0.0 0.0 o. 

25–34 years . . . . . . . . . 1,630 14.8 8.7 6. 

35–44 years . . . . . . . . . 1,385 12.8 10.9 *1.8a 

HISPANIC ORIGIN 

Hispanic 

15–44 years, . . . . . . . . 2,790 “13.6 *9.7 *3.9 

15-29 years . . . . . . . . . 1,240 “11.8 “7.0 *4.8 

30-44 years . . . . . . . . . 1,550 “1 5.0 ‘12.0 *3.1 

Non-Hispanic 

15–44 years . . . . . . . . . 31,191 18.5 15.4 3.1 

15–29 years . . . . . . . . . 11,525 14.9 11.6 “3.3 

30-44 years . . . . . . . . . 19,666 20.7 17.7 2.9 

Ilncludes white, black, and other races; alao includes origin not stated. 

(14 percent) had ever used infertility services. This difference 

is due primarily to the high percent of white women aged 35–44 

who had used infertility sewices; comparisons between other 

age groups yield no significant differences. Although non-Hispanic women appeared more likely than Hispanic women to 

have used infertility services, none of the comparisons yielded 

significant dhTerences. For all ever married women, as well as 

for white and black women separately, infertility services were 

much more likely to be secured from private medical sources 

than from clinics. 
References 

ational Center for Health Statistics, G. Hendershoti Use of family 

*	 laming serviceq by currently married women 15-44 years of age, 

United States: 1973 and 1976. Advance Data From Vital and Health 

Statistics. No. 45. DHEW Pub. No. (PHS) 79-1250. Public Health 

Service. Washington. U.S. Government Printing Oflice, Feb. 1979. 

‘National Center for Health Statistics, G. Hendershot and K, Baumam 

Use of services for family planning and infertility, United States. Vital 

and Health Statistics. Series 23, No. 8. DHHS Pub. No. (PHS) 

82–1 984. Public Health Service. Washington. U.S. Government Printing Office, Dec. 1981. 

3Nationrd Center for Health Statistics, C. A. Bachrach and W. D. 

Mosher: Use of contraception in the United States, 1982. Advance 

Data From Vital and Health Statistics. No. 102. DHHS Pub. No. 

(PHS) 85-1250. Public Health Service. Hyattsville, Md, In preparation. 

4National Center for Health Statistics, D. French National Survey of 

Family Grow@ Cycle I: Sample design, estimation procedures, and 

variance estimation. Vital and Health Statistics. Series 2, No. 76. 

DHEW Pub. No. (PHS) 78-1350. Public Health Service. Washington. 

U.S. Government Printing Oftice, Jan. 1978. 

5National Center for Health Statistics, W. Grady National Survey of 

Family Growth, Cycle Ik Sample design, estimation procedures, and 

variance estimation. Vital and Health Statistics. Series 2, No. 87. 

DHHS Pub. No. (PHS) 81-1 361. Public Health Service. Washington. 

U.S. Government Printing Ofice, Feb. 1981. 

6U.S. Bureau of the Census Money income and poverty status of 

ilies and persons in the United States 1982. Current Population 

ports, table A-1. Series P-60, No. 140. Washington. U.S. Govern- e ment Printing OffIce, July 1983. 

Technical notes 

Survey design 

The National Survey of Family Growth (NSFG) is conducted periodically by the National Center for Herdth Statistics 

to collect data on fertility, family planning, and related aspects 

of maternal and child health. Field work for Cycle I was conducted under contract in 1973 by the National Opinion Research Center. Field work for Cycles II and III was conducted 

by Westat, Inc., in 1976 and 1982, respectively. 

In all cycles, personal interviews were conducted with a 

multistage area probability sample of women 15–44 years of 

age in the noninstitutional population of the conterminous 

United States. In Cycles I and II, ever married wornen and 

never married women with offspring living in the household 

were eligible for the survey. In Cycle III, all women aged 15–44 

years were eligible regardless of marital status or the presence of 

offspring. Women living in group quarters (such as college 

dormitories) were excluded from the samples in Cycles I and 

, but included in Cycle III. Interviews were conducted with 

,797 women in Cycle I, 8,611 women in Cycle II, and 7,969 

@ women in Cycle III. The sample designs of Cycles I and II are 

described in more detail in other NCHS reports.4~5 

NOTE: A list of referencesfollowsthe text. 

ackmecM5 

7U. S. Bureau of the Census Characteristics of the population below 

tie poverty level, 1975. Current Population Reports, table A-3. Series 

P-60, No. 106. Washington. U.S. Government Printing OffIce, June 

1977. 

‘U.S. Bureau of the Censux Characteristics of the low-income populatioxx 1973. Current Population Reports, table A–3. Series P-60, 

No. 98. Washington. U.S. Government Printing Ofllce, Jan. 1975. 

9NationaJ Center for Health Statistics, B. Hudsom Basic data on visits 

to family planning service sites, United States, 1980. Vital and Health 

Statistics. Series 13, No. 68. DHHS Pub. No. (PHS) 82-1729. Public 

Health Service. Washington. U.S. Government Printing Office, July 

1982. 

10National Center for Health Statistics, B. K. Cypresx Patterns of 

ambulatory care in general and family practice, The National Ambulatory Medical Care Survey, United States, January 1980-December 1981. Vital and Health Statistics. Series 13, No. 73. DHHS Pub. 

No. (PHS) 83–1734. Public Health Service. Washington.U.S. Government Printing Office, Sept. 1983. 

1lNational Center for Health Statistics, B. K. Cypresx Patterns of 

ambulatory care in obstetrics and gynecology The National Ambulatory Medical Care Survey, United States, January 1980-December 

1981. Vital and Health Statistics. Series 13, No. 76. DHHS Pub. 

No. (PHS) 84-1737. Public Health Service. Washington. U.S. Government Printing Office, Feb. 1984. 

12S. O. Aral and W. Cates, Jr.: The increasing concern with infertilim 

why now? JAMA 250(17):2327-2331, 1983. 

Field work for Cycle HI was conducted between August 

1982 and February 1983. Black women and women aged 

15–19 years were oversarnpled. Interviews were conducted by 

trained female interviewers and lasted an average of 1 hour. 

The interview focused on a woman’s pregnancy history; use of 

contraceptives in each pregnancy interval, ability to bear childreq future childbearing expectations; use of family planning 

and infertili~ servicey marital histo~ labor force participation and a wide range of socialj economic, and demographic 

characteristics. 

Reliabil-kyof estimates 

Because the statistics presented in flis report are based on 

a sample, they may differ from the statistics that would result if 

all 54 million women represented by the NSFG had been interviewed. The standard error of an estimate is a measure of such 

differences. The standard error of an estimated number or percent presented in this report may be calculated by using the 

appropriate values of A and 1?from table I in the equations 

112 

A+= SE(N) = () B .N 
6 

Table 1. Parameters used to compute astimeted standard errors 

and relative standard errora of numbers and percents of women, 

by marital status, age, and race: Netional Survey of Family Growth 

Yaar, race, marital status, 

and age 

1982 

White; all rsce~: 

All marital statuses. ., . . . . . . . . 

Ever married, . . . . . . . . . . . . . . . 

Never married............,,, 

15-19 years . . . . . . . . . . . . . . . . 

81ack: 

All marital statuses; aver 

married; naver married. . . . . . 

15-19 years . . . . . . . . . . . . . . . . 

1976 

Currently married: 

All races . . . . . . . . . . . . . . . . . . . 

White . . . . . . . . . . . . . . . . . . . . . 

black . . . . . . . . . . . . . . . . . . . . . . 

1973 

Currently marriad: 

Allraces; white . . . . . . . . . . . . . . 

Black . . . . . . . . . . . . . . . . . . . . . . 

and 

Parameter 

A B 

-0.0003935957 21306.4134 

-0.0010973290 39809.1677 

-0.0009351043 17608.8833 

-0.0014564930 13862,1044 

-0.0009086323 6346.0484 

-0.0033223630 4727.0569 

-0.0001858989 6751.0619 

-0.0002056235 7021.1665 

-O.OOO631O4OO 2798.6440 

0.0000176730 4493.7916 

0.0000402190 1600.4393 

SE(P)= (B+100X;P’)1’2 

wttere N is the number of women, P’ is the percent, and X is 

the number ofwomen in the denominator ofthepercent. Ap 

proximate standard errors for estimated percents of women of 

all races in Cycle III are shown in table II. 

The chances are about 68 in 100 that a sample estimate 

would fall witiinonestindard error, andabout95 in 100that 

it would fall within two standard errors of a statistic based on a 

complete count of thepopulation represented by tie NSFG. 

Differences between percents discussed in this report were found 

to be statistically significant at the 95-percent cotildence level 

using atw&ailedt- testwiti39 degrees of freedom. l%is means 

that in repeated samples of the same type and size, a difference 

as large as the one observed would occur in only 5 percent of 

Table Il. Approximate standard errors for estimated parcenta 

expressed in percentage pointa for women of all racea: National 

Survey of Family Growth, Cycle Ill 

Estimated percent 

2 or 5 or 10 or 20 or 300r 400r 

Base of percent 98 95 90 80 70 60 50 

100,000 ...,,. 6.4 10.0 13,8 18.4 21.1 22.6 23.0 

500,000 ... 2.9 4,5 6,2 8,2 9.4 10.1 10.3 

1,000,000 . 2.0 3.2 4.4 5.8 6.7 7.1 7,3 

5,000,000 . . . . 0.9 1.4 2.0 2.6 3,0 3.2 3.3 

10,000,000 . . . 0.6 1.0 1.4 1.8 2.1 2.3 2.3 

30,000,000 ... 0,4 0.6 0.8 1.1 1.2 1.3 1.3 

50,000,000, 0.3 0.4 0,6 0.8 0.9 1.0 1.0 

samples, if there were in fact no difference between the percents 

in the population. P 

The relative standard error of a statistic is the ratio of the 

standard error to the statistic and is usually expressed as a 

percent of the estimate. In this report, statistics with relative 

standard errors of 30 percent or larger are indicated with an 

asterisk (*). These estimates are considered unreliable by themselves, but may be combined with other estimates to make comparisons of greater precision. 

Statistics in this report also maybe subject to nonsampling 

error, that is, errors or omissions in responding to the interview, recording answers, and processing data. The data have 

been adjusted for nonsampling error due to nonresponse by 

means of adjustments to the sample weights assigned to each 

case. Other types of nonsampling error were minimized by a 

series of stringent quality control measures similar to those 

used in Cycles I and 11.4.5 

Definitions of terms 

Family planning services-In Cycle III, to obtain more 

complete estimates of the extent and types of family planning 

services, women were asked a series of questions about their 

use of specific services. These included the following (1) advice 

or counseling about any problems or worries about sexual intercourse, an unwanted pregnancy or one that occurred at a bad 

time, having a sterilization operation, or birth control; (2) checkup or medical test to check for correct use, fit, or position of am 

birth control meth~ health problems from using a birth control ~ method; or pregnancy; and (3) visit to a doctor or clinic to 

renew a method of birth control the woman was already using 

or to obtain a new method of birth control. Women who reported 

receiving one or more of these services were classified as having 

used family planning services. This is the basis for the statistics 

on use of family planning services reported in table 1 and for 

the visit rates in table 2. The new family planning use measure 

based on these services will be retained in future cycles. 

Talked about contraception in the last 3 years-In Cycles 

II and III, women were asked, “During the past 3 years, has a 

doctor or other trained person prescribed, or talked with you 

about a method for delaying or preventing a pregnancy?” In 

Cycle I, women were asked the same question except that a 

period of 5 years was specified rather than 3 years. Women 

who answered that question affhmatively also were asked, 

“When was the last time you talked about methods of family 

planning with a doctor or trained person?” Women who answered that question with a date less than 3 years before the 

interview were considered to have made a family planning visit 

in the last 3 years. This measure was retained in 1982 to pr~ 

duce time series data between 1973 and 1982. It will be replaced in future cycles by the measure based on the full range 

of family planning services. 

Source of family planning services-Women who had received family planning services in the last 12 months were shown 

a card containing the following list of types of places: “Clinics” T 

included hospital, family planning, community health center, 

public health department, military health service, and student 

NOTE: A list of references follows the text. 
_ health service clinics; “private medical sources” included visits 

o private doctors, private group practices, c~ops, or privately 

[’	 +wned clinics; service providers classified as “counselors” included minister, priest, religious counselor, school counselor, 

family and social service agency, and youth center. 

Age—Age is classified by the age of the respondent at her 

last birthday before the date of interview. 

Race—Race refers to the race of the woman interviewed 

and is reported as black, white, or other. In Cycle III, race was 

classified according to the woman’s report of the race that best 

described her. In Cycles I and II, race was classified by the 

observation of the interviewer. Cycle III data indicated that 

results using either method of classification were found to be 

very similar. 

Hispanic orzgin-In Cycle III, a respondent was classified 

as being of Hispanic origin if she reported that her only or 

principal national origin was Puerto Rican, Cubm~ Mexican 

American, Central or South American, or other Spanish. In 

Cycles I and II, if a respondent repofied her origin or descent 

as Puerto Rican, Cuban, Mexican American, Central or South 

American, or other Spanish, she was classified as being of Hispanic origin, whether or not it was her principal origin. In tables 

where data are presented for women according to race and 

Hispanic origin, women of Hispanic origin are included in the 

statistics for white and black women if they were classified as 

—,

such by race. 

For a small number of respondents (O. 1 percent in Cycles 

and II and 3 percent in Cycle III), origin was not ascertained. ‘I 

In Cycle I, values were imputed where missing, using a known 

value of another similar, randomly selected responden~ in Cycle 

II and in this report for Cycle III, however, missing values of 

Hispanic origin were not imputed, and only cases with known 

values are included in statistics on Hispanic origin. 

Man”tal status—Persons were classified by marital status 

as married, widowed, divorced, separated, or never married. In 

Cycles I and II, informally married women—women who volunteered that they were sharing living quarters with their sexual 

partner-were classified as currently married. These women 

constituted about 2 percent of currently married respondents in 

Cycle I and 3 percent in Cycle II. In Cycle III, such women 

were classified according to their legal marital status. Thus, 

statistics on currently married women for 1982 shown in this 

report are not strictly comparable to those for 1973 and 1976. 

However, reclassifying women in the 1973 and 1976 surveys 

according to the 1982 definition of marital status makes little 

difference in the distributions of currently married women by 

other characteristics for these years. 

In all cycles, women who were married but separated from 

their spouse were classified as separated if the reason for the 

separation was marital discord, and as currently married otherwise. 

fVen”/i~—For this report, use of family planning services 

n the last 3 years was considered inapplicable if a woman was 

r ierile 3 years or more before the interview; that is, she 

reported it was impossible for her and her husband to conceive 

as a result of an operation, accident, or illness that occurred 

more than 3 years before the interview-before January 1970 

for Cycle I, before January 1973 for Cycle II, or before January 

ackweMa7 

1979 for Cycle III. All other women were classified as able to 

conceive at the beginning of the period for which their use of 

family planning services was reported. 

Poverty level income—The poverty level index was calculated by dividing the total family income by the weighted 

average threshold income of families with the head of the family 

under 65 years of age based on the poverty levels published by 

the U.S. Bureau of the Census. G-g This definition takes into 

account the sex of the family head and the number of persons in 

the family. Total family income includes income from all sources 

for all members of the respondent’s family. For substantial numbers of respondents (7 percent in Cycle I, 16 percent in Cycle 

II, and 22 percent in Cycle III), total family income was not 

ascertained. In Cycle I, values were imputed where missing, 

using a known value of another similar, randomly selected responden~ in Cycle II and in this report for Cycle III, however, 

missing values of family income were not imputed, and only 

cases with known values are included in statistics on poverty 

income level. Because of these high levels of missing data, small 

differences by poverty level income should be interpreted with 

caution. 

Infertility services-A woman was classified as having used 

infertility services if she answered either of the following questions aflkmatively: “Have you (or your husband) ever been to 

a doctor or clinic to talk about ways to help you become pregnant?” or “(Not counting routine care or advice about a pregnancy), have you (or your husband) ever been to a doctor or 

clinic to talk about ways to help you prevent a miscarriage?” 

Such women may not be currently infertile; for example, if the 

advice or treatment was successful. 

Related data 

Data on family planning services also are available from 

two other surveys conducted by NCHS. Data from the National 

Reporting System for Family Planning Services were collected 

annually from 1972 through 1980 from a sample of medical 

organizations that provide family planning services. These data 

excluded family plaming visits to private physicians’ offices, 

visits for pregnancy tests only, and visits the sole purpose of 

which was to obtain contraceptive supplies or counseling.$’ The 

National Ambulatory Medical Care Survey obtains data on 

visits for family planning services from reports from a sample 

of otllce-based physicians. 10,11Both data systems use information from the providers of family plaming services, in contrast 

to the NSFG, which uses information from recipients of services. Because of this difference and differences in collection 

procedures and definitions of terms, data from these sources 

may differ but they do provide complementary perspectives on 

family planning visits. Recent estimates of annual numbers of 

visits to private physician’s o!%ces for infertility were published 

in an article in the Journal of the American Medical Association. ]2 The data in the cited article may differ from the statistics in this report because they refer to a different period of 

time; because they refer to visits, and women may have more 

than one visit in a yeaq and because both estimates, being 

based on samples, are subject to sampling variability. 

NOTE: A list of references follows the text. 
---

8 advancedata 

Recent Issues d Advance Data From Wtal and Health Statistics 

No. 102. Use of Contraception in the United States: 1982 (Issued No. 99. Health Care of Adolescents by OfTice-Based Physician


Dec. 4, 1984) National Ambulatory Medical Care Survey, 1980-81 (Issued Sept.e


No. 101. 1983 Summary National Hospital Discharge Survey 28, 1984)


(Issued Sept. 28, 1984) No. 98. Diagnosis-Related Groups Using Data From the National


No. 100. CAT Scan Use in Shofi-Stsy Non-Federal Hospitals: Hospital Discharge Survey United States, 1981 (Issued July 20,


1984) United States, 1979-82 (Issued Sept. 28, 1984) 

. . . 

0.0 

z 

* 

Suggested Citation 

National Center for Health Statistics, M. C. Horn 

and W. D. Moshec Use of services for family 

planning and infertility, United States, 1982. 

Advance Data From Vital and Health Statistics, 

No. 103. DHHS Pub. No. (PHS) 85-1250. Public 

Health Service. Hyattsville, Md., Dec. 20, 1984. 

U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Public Health Service 

National Center for Health Statistics 

3700 East-West Highway 

Hyattsville, Maryland 20782 

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more relative standard error) 

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