~!!::%O::?;N&d d ~“~{ 

m EDJTORIALLIBRARY 

FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE � Public Health Service I Number 36 � August 18, 1978 

Contraceptive Utilization in the United States: 1973 and 1976’ 

e 

INTRODUCTION 

The data presented in this report are the 

latest nationwide statistics on contraceptive utilization from the 1976 and 1973 National Surveys of Family Growth conducted by the 

National Center for Health Statistics. The data 

were collected by means of personal interviews 

with a multistage probability sample of women 

15-44 years of age in the noninstitutionalized 

population of the conterminous United States. 

Women were eligible for inclusion’ in the sarnpIe 

if they were currently or previously married or 

were never married but had offspring presently 

living in the household. 

The interview focused on the respondents’ 

marital and pregnancy histories, their use of contraception and the pkirming status of each pregnancy, their intentions regarding number and 

spacing of future births, their use of maternal 

care and family planning services, and on a 

broad range of social and economic characteristics. Between June 1973 amd February 

1974, 3,856 black women and 5,941 women of 

others races were interviewed for Cycle I. 

Between January and September of 1976,2,946 

black women and 5,665 women of other races 

were interviewed for Cycle II. Further discussion 

of the survey design, definition of terms, and 

sampling variability are in the Technical Notes. 

CONTRACEPTIVE STATUS FOR 

CURRENTLY MARRIED WOMEN 

From the 1960’s through the early 1970’s, 

there was increased use of highIy effective con9 traceptive methods by man%d -couples in the 

1This report was prepared by Kathleen Ford, Ph.D., 

Division of VitaI Statistics, 

United States.z YSTables 1, 2, and 3 present preliminary data from 1976 and data from 1973 

representing the contraceptive status of currently married women alI ages 15-44 years, ages 

15-29 years, and ages 30-44, respectively. The 

data show that reliance on nonsurgical methods 

of contraception has decreased while surgical 

sterilization has increased. 

In 1976, 30.2 percent of couples with wives 

aged 15-44 years were considered sterile (table 1). 

This represents a more than 6 percentage point 

increase from 1973 and is due primariIy to a 

dramatic increase in surgical sterilization among 

white couples. There was a corresponding net 

decrease from 1973 in the other categories, most 

notably a decline of almost 5 percentage points 

in the proportion using nonsurgical methods of 

contraception. However, about the same percent 

of women at risk of an unplanned pregnancy 

(those not sterile, pregnant, post partum, or 

seeking pregnancy) were using a method in 1976 

as were in 1973, 86.3 percent and 85.9 percent, 

respectively. 

Of the remaining (69.8 percent) currently 

married women, 48.6 percent were contraceptors using methods other than sterilization; 

13.4 percent were pregnant, post partum, or 

seeking pregnancy; and 7.7 percent were classified as other nonusers of contraception, that is, 

neither sterile nor “pregnant, post partum, or 

seeking pregnancy. ” 

2National Center for Health Statistics: Contraceptive 

utilization among currently married women 15-44 years 

of age: United States, 1973, by Kathleen Ford. Monthly 

Vital Statistics Report, VOL 25-No. 7, Supp. DHEW Pub. 

No. (PHS) 75-1120. Public Health Service. Rockville, 

Md. Oct. 4, 1976. 

3Westoff, C. F. and Jones, E. F.: Contraception and 

Sterilization in the United States, 1965-1975. Fan. 

Plann. Perspect. 9 (4): 153-157, 1977. 
2 achancedata 

Table 1. Number of currently married women aged 15-44 and percent distribution by contraceptive status, according to race and 

Hispanic origin: United States, 1973 and 1976 

COntraceDtive status 

All women .................................................. 

Sterile couples 

All sterile couples ............................................. 

Nonsurgical ................................... ............................. 

Surgical ....................................................................... 

Noncontraceptive .................................................. 

Female ............................................................. 

Male ................................................................. 

tintraceptive ........................................................ 

Female ............................................................. 

Wle ........................... ...................................... 

Fecund cou pies 

Noncont raceptors: 

Pregnant, POSTpartum, seeking pregnancy ............. 

Other nonusers ...................................................... 

Contraceptors: 

All methods .... ........................................... ...... 

Oral contraceptive piIl .......... .................... .................. 

Intrauterine device ..................................................... 

Diaphragm ................... ............................................... 

@ndom ..................................................................... 

Foam .................................... ...................... ................ 

Rhythm ...................................................................... 

Withdrawal ................................................................. 

Douche ........... ............................................................ 

Other .......................................................................... 

1[ncludes white, black, and other races. 

Total’ II White I Black I Hispanic origin2 

1976 1973 1976 1973 1976 1973 1976 1973 

Number in thousands3 

27,185 26,646 I 24,518 24,249 2,144 [ 2,081 I 1,673 I 1,676 ‘ 

Percent d istribtuion 

100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

y 

30.2 -=3 

1.9 0.9 1.9 0.8 2.6 1.9 1.5 *0.7 

28.3 22.9 29.1 23.1 21.7 20.8 19.0 20.9 

9.0 6.5 9.0 6.6 8.8 6.2 7.8 5.2 

8.2 6.3 8.2 6.3 8.7 6.1 7.0 5.2 

0.8 0.2 0.8 0.3 0.0 0.0 *0.9 

19.3 16.4 20.1 16.5 12.9 14.6 11.2 15.7 

9.6 8.6 9.6 8.2 11.0 13.6 7.0 10.7 

9.7 7.8 10.5 8.4 1.9 1.0 4.2 5.0 a 

t 23.8 31.0 24.0 24.3 22.7 I 21.6 

1

II 

13.4 14.2 12.8 14.2 16.6 14.0 20.8 18.9 

7.7 8.7 7.2 7.8 13.5 17.9 10.5 9.7 

46.6 

22.3 25.1 

L

22.5 25.1 22.0 26.3 20.7 22.9 

6.1 6.7 6.1 6.6 6.1 7.6 10.4 8.7 

2.9 2.4 3.0 2.5 1.8 1.2 2.4 *1.8 

7.2 9.4 7.4 9.9 4.5 3.2 6.1 7.0 

3.0 3.5 2.9 3.5 3.8 3.0 3.5 *I .8 

3.4 2.8 3.5 2.9 1.4 0.7 3.1 2.1 

2.0 1.5 2.0 1.6 1.8 0.4 *1.1 2.2 

0.7 0.6 0.5 0.5 2.7 ‘1.8 *0. I *0.6 

0.9 1.3 0.9 1.3 1.2 1.0 “0.5 2.7 

53.2 49.0 54.0 45.4 45.3 48.1 49.8 

J 

Zwomen of Hispanicorigin are included in the figures for white and black women if they were identified as such by the interviewer. 

3 In the 1973 figures, estimates of the number of women included cases for which contraceptive status was not ascertained but was 

imputed. Only those cases in which contraceptive status was ascertained are included in the 1976 figures. See Technical Notes. 

According to preliminary data for 1976, 

changes since 1973 in the distribution of women 

among categories of contraceptive status were 

largely in the same direction in the age groups 

15-29 years (table 2) and 30-44 years (table 3). 

Both groups experienced a net increase in the 

percent sterile and a net decrease in the percent 

using a method other than sterilization. The net 

increase for women 15-29 years of age was 

approximately 2 percentage points. The net increase was approximately 10 percentage points 

for women 30-44 years of age, and the net decrease was approximately 6 percentage points. 

The proportions of women at risk of an un- m 

planned pregnancy who were using a contraceptive method were practically unchanged 
� 

w achmdaa3 

e


within age groups for the 3 years-for women 

15-29 years of age, 91.9 percent in 1973 and 

91.3 percent in 1976; for women 30-44 years of 

age, 80.3 percent in 1973 and 80.7 percent in 

1976. 

The women in the younger age group who 

were not using a contraceptive method were 

more likely to be pregnant, post partum, or 

seeking pregnancy; the older women were more 

likely to be sterile. The totid avoidance of contraception (other nonusers) was greater among 

older women, resulting in a higher percent of 

older women unprotected against an unplanned 

pregnancy. However, it is likely that other 

factors such as lower fecundity and less frequent 

intercourse reduce the risk of pregnancy. 

The percent of wives 30-44 years who were 

pregnant, post partum, or seeking pregnancy increased about 4 percentage points from 1973 

among black wives but did not change among 

white wives. Most of this increase was due to 

black wives reporting that they were seeking pregnancy. 

In 1976 as in 1973, black wives were more 

likely than white wives to fall into the category 

“other nonusers,” although the gap between the 

two groups decreased from 10.1 percentage 

points in 1973 to 6.3 percentage points in 1976. 

The large increase in the percent sterile 

among couples with wives 30 years or older is 

due almost entirely to the increase among white 

couples. The percent sterile among the black 

couples, wife 30 and over, remained essentially 

constant at about 35 percent in the 2 years, 

while the percent sterile for white couples in this 

age group increased about 10 percentage points 

to 46.8 percent in 1976. Among couples, wife 

15-29, the percent sterile increased about the 

same amount in both raciaI groups (2.5 and 2.7 

p e rce ntage points among white and black 

couples, respectively), remaining slightly higher 

among white couples (11.8 percent) than among 

black couples (10.9 percent). 

The net effect of all these changes, in terms 

of exposure to unpkmned pregnancy, is a lessening of differences between the two racial groups. 

In both years, the proportion of women at risk 

of an unpkmned pregnancy who were using a 

contraceptive method was higher for white 

women than for black women, but this percent 

increased for black women between 1973 and 

1976 and remained stable for white women. 

About 87 percent of white women at risk of an 

unplanned pregnancy were using a method in 

1973 and 1976, and the percent of black women 

at risk of an unplanned pregnancy who were 

using a method rose 5.4 percentage points to 

77.1 percent in 1976. Parallel trends can be observed for the younger and older age groups. 

Sterility 

In the 30.2 percent of couples in which one 

spouse was sterile, only 1.9 percent were not 

surgically sterile as shown in table 1. Of the remaining 28.3 percent who were surgically sterilized, 9.0 percent reported this to be for noncontraceptive reasons and 19.3 percent reported 

this to be at least partly for contraceptive 

reasons. 

Although the nonsurgically sterile accounted 

for only 1.9 percent of sterile couples in 1976, 

this was double that proportion for 1973. The 

frequencies are too small for reliable detailed 

study but may reflect better diagnosis of infertility problems. 

The surgically sterile accounted for nearly alI 

of the sterile couples, and the increase of 5.4 

percentage points in this group from 1973 to 

1976 acounted for most of the 27-percent increase in overaU sterility between these years. 

For white couples with women of all ages 

combined, the percent surgically sterile increase 

6 percentage points from 23.1 percent in 1973 

to 29.1 percent in 1976. In contrast to this, very 

little change occurred in the percent of surgically 

sterile black couples, 20.8 percent in 1973 to 

21.7 percent in 1976. 

For couples where the wife was under age 

30, (tabIe 2) the Ievel and trend of surgical sterilization was similar for white and black couples. 

The percent of white couples, wife 15-29 years, 

who were surgically sterile increased 2.0 percentage points to 10.8 percent in 1976. The 

corresponding figure for black couples rose 1.1 

percentage points to 9.2 percent in 1976. 

Among the white couples, wife aged 30-44 

(table 3) the increase, in surgical sterilization in 

the 3 years between the surveys was most 

dramatic. There was an increase of almost 10 

percentage points from 35.0 in 1973 to 44.2 

percent in 1976. In contrast to this, the percent 
* 

4 advancedata 

Table 2, Number of currently married women aged 15-29 and percent distribution by contraceptive status, according to race and 

Hispanic origin: United States, 1973 and 1976 

II I I 

Totall White Black Hispanic Originz 

Contraceptive status 

T 1976	 I ’973 1976 I ’973 1976 I “973 

Number in thousends3 

All wmen .................................................. 12,292 I 12,040 ] 11,063 10,963 I 978 964 I 810 770 

Percent distribution 

Total ................................................................ 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Sterile cowdes 

All aterile couples .. ... . ..... ... . ...... .. .... ... ... . .... ... ... 11.6 9.2 11.8 9.3 10.9 8.2 *5.7 10.6 

m 

Nonsurgiwl ... ... ..... .... . ..... .. .. . ..... .. .. .. ..... . . ....... . .. ..... .. .. . 1.0 ‘0.5 1.0 0.5 1.6 *0. I 

Surgiml .. .. ... . ..... ...... .. .. ..... . ... ....... .. .. ..... .. . .... ... ... ... ... ... 10.6 8.7 10.8 8.8 9.2 8.1 *5.7 10.6 

Noncontraceptive .. ..... ... ... .... ... .. ...... .... .. .. ... ..... ... .. 2.2 *0.8 2.2 ‘0.8 3.8 *1.4 *0.8 

Femle .. ..... .. .... ..... ... . ...... ... ... ..... . .. ..... . .. ..... ... .. 1.9 *0.7 1.8 *0.7 3.8 *1.4 ‘0.8 

Mle . .. ... ...... .. ... ..... . .. . ...... .. . .. ..... .. . ...... ... . .... ... .. *0.3 *0. I ‘0.4 *0. I 

@ntraceptive .. .... .. ..... ... . ....... . ... .... ... .. ... ... .. . .... ... .. 8.3 7.9 8.6 8.0 5.4 6.7 ‘4.9 10.6 -0 

Female . .. .... ... . ...... ... .. .... .. .... .... .. .. .. .... .. .. ..... ... .. 4.4 4.1 4.3 4.0 5.3 6.2 *2.8 *7.1 

Mle .. .... ...... .. .. ...... ... .. ..... . .... ..... . ... .... ... .. ..... . ... 3.9 3.7 4.3 4.0 ++0.2 “0.4 *2.1 *3.6 

Fecund cou pies 

Noncontreceptors: 

Pregnant, post parturn, seeking pregnancy .. . ..... . .... 22.5 23.0 22.0 23.0 24.3 22.8 31.7 26.1 

Other nonusers ... ... .. .... .. .. ..... .. . .. ..... .. .. .... .... . .... . .. .. . 5.7 5.5 5.2 4.9 9.7 12.0 *4.2 *6.2 

Contraceptors: 

All methods .. ... .. .... .. .. . .... ... ... .... .. . .. ... ... .. ..... .. ... 60.2 62.3 61.0 62.7 55.1 57.0 58.4 57.0 

I


t


Oral contraceptive pill .. .... .. .. ...... .. .. ...... .. ....... . .. ..... .. ... 35.1 37,6 35.4 37.4 33.8 40.7 31.2 33.0 

Intrauterine device ... .... .... .. .. . .... .. .. .. ..... . ... ... .. . .. ..... . ... . 6.9 8.4 7.0 8.4 5.4 8.4 10.9 10.8 

Diaphragm ... .. ..... ... .. .. .. .... .... ... .... . .. . .... .. .. ..... ... . ..... . .. .. 2.7 1.7 2.9 1.8 ‘0.8 ‘0.8 *2.3 *1 .3 

tindom ...... .. ... ..... .... . ..... .. .. . ...... .. . .. .. ... . ... .... .. .. .... .. .. .. 6.5 7.0 6.7 7.4 5.0 *1.9 *6.8 *4.9 

Foam .... . ..... ... .. ....... .. .. .. ... ... ... ..... . ... ..... . .. .... .... . .... ... .. . 3.3 3.6 3.4 3.8 3.0 2.2 *3.4 *1.2 

Rhythm ..... ... ... ...... .. .. . ..... ... . ..... .. .... ... .. .. .. .... ... . .... .. ... .. 2.6 1.4 2.6 1.4 *1 .9 *1 .0 ‘2.0 *1 .1 

Mthdrawl .. ... .. .... .... . .. ..... .. ... .... .. .. ..... .. ... .... .. .. ..... .. .. .. 1.7 1.0 1.7 1.1 *1.6 “0.3 *I .5 *2.6 

Douche ... .. .... .. ...... .. .... .... .. .... ... ... .. ... ... . ... .... .. .. ...... ... .. *0.4 *0.3 *0.3 *0.2 2.4 *1.3 ++0.7 

~her ......................................................................... *0.9 1.1 J_L *0.9 1.2 *I .0 *0.3 *0.3 *1 .4 

1Includes white, black, and other races.


2 W. men of Hispanic ~rig~ me ~cluded in the figures for white and black women if they were identified as such by the interviewer,


3 In the 1973 figures, estimates of the number of women included 

inputed. Only those cases in which contraceptive status was ascertained 

of surgically sterile black couples, wife aged 

30-44, was stable at about 32 percent both in 

1973 and 1976 and was 12 percentage points 

below that for white couples in 1976. 

The percent of sterilizing operations performed on the male partners remained at about 

cases for which contraceptive status was not ascertained but was 

are included in the 1976 fiiures. See Technical Notes. 

38 percent for white coupIes over the 3 years 

but was very small for black couples both in 

1973 and 1976. a The majority of sterilizing operations were 

reported as contraceptive in intent (table 1). The 

proportion of couples who reported a sterilizing 
a&mdata5 

Table 3. Number of currently married women aged 30-44 and percent distribution by contraceptive status, according to race and 

Hispanic origin: United States, 1973 and 1976 

Total’ White Black Hispanic origin2 

Contraceptive status 

1976 1973 1976 1973 1976 1973 1976 1973 

Number in thousands3 

All woman .................................................. 14,882 14,606 13,454 13,286 1,167 1,117 862 I 806 

Percent distribution 

Total ................................................................ 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Sterile couples 

* 

All sterile couples ...... ................... ................... 45.7 36.0 46.8 36.1 35.6 30.9 

+ 

Nonsurgical ........... ........................... .......................... 2.6 1.3 2.6 1.1 3.4 3.4 *3.O 1.3 

Surgiml ......................... ........................... .................. 43.0 34.6 44.2 35.0 32.2 31.8 31.5 28.6 

Mncontraceptive ................................................. 14.6 11.3 14.6 11.4 13.0 10.3 14.4 9.6 

Femle .................................. ............ .............. 13.5 10.9 13.4 11.0 12.9 10.2 12.7 9.6 

~le ................................................................ 1.1 *0.4 1.2 *0.4 *0.1 �0. I �1.7 

Contraceptive ..................... ............................ ...... 28.4 23.4 29.6 23.6 19.2 21.5 17.1 20.0 

Female ............. .......................... ..................... 14.0 12.2 14.0 11.6 15.9 20.0 10.9 13.8 

Male ...................................... ........... ............... 14.5 11.1 15.5 12.0 3.4 *1.5 *6.1 �6.2 

Fecund couples 

Noncontraceptors: 

Pregnant, post partum, seeking pregnancy ............ 5.9 7.0 5.3 6.9 10.2 6.4 10.6 12.8 

Other nonusers ... .... .. .. .... . .. ... .. ... .. .. . ... . ... .... . .. .... . ... 9.3 11.3 8.8 10.2 16.8 23.1 16.5 12.5 

COntraceptors: 

All methods .................................................... 39.1 45.7 39.1 46.8 37.4 35.3 38.4 43.7 1 

Oral contraceptive pill ............... ........ ....................... 11.8 14.8 11.9 14.9 12.2 13.8 11.0 14.4 

Intrauterine device .................................................... 5.4 5.2 5.3 5.2 6.6 7.0 9.8 *6.9 

Diaphragm ................................................................. 3.1 2.9 3.1 3.1 2.5 �1.6 �2.6 *2.2 

Condom ..................................................................... 7.7 11.4 8.0 120 4.1 4.3 �5.5 8.7 

Foam ......................................................................... 28 3.4 2.6 3.3 4.5 3.7 * 3.6 *2.3 

Rhythm ..................................................................... 4.0 3.9 4.2 4.1 �I .0 *0.5 *4.2 �2.9 

Wthdraml ................................................................ 2.3 1.8 2.3 2.0 2.0 �0.5 “0.8 *1 .9 

Douche ...................................................................... *0.9 *0.8 *0.8 *0.7 3.0 2.2 ‘0.2 *o .5 

~her ......... .................................. ................... ........... *0.9 1.4 ‘0.9 1.5 �1.4 �1.5 ‘0.6 *3.7 

l~cl~des white. black. and other races.
 2W0men of ~spanic ~~ig~ are ~cluded in the fiwwes for white and black women if they were ident fled as such by the interviewer.


31n ~973 figures, estimates of the number of women included cases for which contraceptive status Ins not ascertained but 

was imputed. Only those cases in which contrricept ive status was ascertained are included in the 1976 figures. See Technical Notes. 

operation performed for noncontracep tive rea- Sterilizing operations were classified as consons, however, increased 2.5 percentage points traceptive or noncontraceptive according to a 

from 1973 to 9.0 percent in 1976. The pro- question regarding the contraceptive intent of 

e portion of couples who reported a sterilizing the operation. The wording of this question 

operation for contraceptive reasons increased differed for the 2 data years. This wording 

2.9 percentage points to 19.3 percent in 1976. change affected response to the question, in 
--

e 

6 &ncedata 

most cases, lowering the percent of operations 

reported as contraceptive in 1976 relative to 

1973. If the assumption is made that the percent 

of women having a surgical sterilization operation solely for medical (noncontraceptive) reasons should not change for the two surveys, then 

the percent of total women contraceptively 

sterile would be 2 to 3 percent higher in 1976 if 

the 1973 figures are taken as the standard. Conversely, if the percent of surgical sterilization for 

noncontraceptive reasons in 1976 is taken as the 

standard, the percent contraceptively sterile 

would be 2 to 3 percent lower in 1973. The 

motivation behind a sterilizing operation is a complex topic which is presently being studied. A 

more detailed report on contraceptive practices in 

the United States will examine this topic more 

closely. 

Oral Contraceptive Pill 

The increase in the use of oral contraceptives 

observed from the 1960’s through, 1973 has 

come to a halt. However, for couples in which 

one partner was not sterile, no other method 

comes close to it in popularity. 

The percent of married women aged 15-44 

using the oral contraceptive pill in 1976 was 

22.3 percent compared with 25.1 percent in 

1973 (table 1). Although this represents a net 

decrease of almost 3 percentage points, the percent of contraceptors using the pill remained 

relatively stable, 46 percent for 1976 and 47 

percent for 1973 (table 4). 

Among the younger wives (15-29 years) in the 

sample, a 2-3 percentage point decline from 

about 37 percent to about 35 percent occurred 

among the totaI sampled and white women 

(tabIe 2). A larger decline, about 8 percentage 

points, occurred among the young black wives 

from 40.7 percent in 1973 to 33.8 percent in 

1976. As a share of all contraceptive method use 

other than sterilization for wives under 30, this 

represents about a 2 percentage point decline 

from about 60 to about 58 percent for white 

women and total women (table 5) and a 10 percentage point decline from 71.4 percent in 1973 

to 61.4 percent in 1976 for black women. 

Table 4. Number of currently married women aged 15-44 using contraceptives other than sterilization and percent distribution by 

method of contraception, according to race and Hispanic origin: United States, 1973 and 1976 

Contraceptive status 

All wmen .................................................. 

Total ................................................................ 

Oral contraceptive pill .................................. .............. 

Intrauterine device ..................................................... 

Diaphragm .................................................................. 

@ndom ........................................................... .......... 

Withdraml ................................................................. 

Foam .......................................................................... 

Rhythm ................ ................................................... ... 

Douche ....................................................................... 

~her .......................................................................... 

—— 

,, 1 

Total’ White Black Hispanic origin2 

I I I I 

I “73I 1’76 1976 I 1973 * I 1’76 I 1’73 

Number in thousands3 

13,225 \ 14,183 12,005 13,094 975 944 ] 804 835 

Percent distribution 

100.0 100.0 100.0 100.0 100.0 100.0 

T1.5 1.1 1.1

46.0 47.2 45.9 

12.5 12.5 12.4 

6.0 4.5 6.2 

14.8 17.6 15.1 

4.2 2.8 4.2 

6.2 6.5 6.0 

6.9 5.3 7.1 

1.9 2.4 1.9

—— —— 

46.5 48.5 57.9 

12.3 13.4 16,9 

4.7 3.9 2.7 

18.4 9.9 7.1 

2.9 4.0 ‘0.9 

6.5 8.4 6.7 

5.4 3.1 *1.7 

“0.9 6.0 4.0 

2.5 2.7 2.1 

100.0 100<0 

43.2 46.0 

21.5 17.4 

*5.1 *3.6 

12.8 14.0 

*7.3 *3.6 

*6.5 *4.2 

*2.4 *4.5 

‘0.2 *1 .2 

*1.O *5.3 

l~ncludes ~hjte, black, and other races.. 

.2women of Hi~p~ni~ origin are i~~luded in the figures for white and black wo men if they were identified as such by the interviewer. 

31n ~973 figure5, estimates of the number of women in~luded cases for which contraceptive status was not ascertained but 

was imputed. Only those cases in which contraceptive status was ascertained are included in the 1976 figures. See Technical Notes. 
Table 5. Number of currently married women aged 15-29 using contraceptives other than sterilization and percent distribution by 

method of contraception, according to race and Hispanic origin: United States, 1973 and 1976 

Total’ White Black Hispanic origin2 

Contraceptive status 

1976 1973 1976 1973 1976 1973 1976 1973 

I Number in thousands3 

All women .................................................. 7,405 7,501 I 6,7441 6,879 538 ] 549 I 474 I 439 

I Percent distribution 

Total . .. .. .... ... .. .... .. . .... ... . .. ... . ..... .. . ..... .. .. . ... .. . ..... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 

Oral contraceptive pill .. ... .. ... . .... . . ... .. ... . ... ... .. .... . .. ..... .. 58.3 60.4 58.0 59.6 61.4 71.4 53.3 57.9 

Intrauterine device . ..... .. .. .... . . .... . ... ... .. .. .... .. ... .... . .. .... .. 11.5 13.5 11.5 13.4 �9.8 14.7 18.7 18.9 

Diaphragm . .. .... .. .. . ..... .. .. ... ... .. .. .. .. ... .. .. ... .. ... . .... . .. ..... . . 4.5 2.8 4.8 2.9 �1 .5 *1.4 �3.9 *2.2 

Condom ... . .. .. ... .. .. ..... . .. .... ... . .... .. .... .. .. .... ... .. ..... . . .... . ... 10.9 11.2 11.0 11.8 *9.1 *3.4 ‘d 1.7 �8.7 

Withdrawal . .... .. .... .. .. . . ..... . .. .. .. .. .. .... .. .. ... . .. .. .... . . ..... . .. .. 2.8 1.6 2.9 1.7 �2.9 ‘0.5 *5.8 �2.2 

Foam . ... .... ...... .. ... ... ... . .... .. ... ... .. .. .. .. . ..... ... . ...... .. ... ... ... . 5.5 5.8 5.5 6.0 �5.4 *3.9 �3.4 �1 .9 

RhWhm .. . ... .... . .. .... .. .... ... . . ...... . . ... ... . .... . .... ... ... . ..... .. .... 4.3 2.3 4.3 2.3 �3.4 *1 .8 *2.6 *4.6 

Douche .. ... .... .. .. ..... .. . ...... . .. ... . .. .... . .. ..... . ... ... .... . ... .. ... ... ‘0.7 �0.5 ‘0.4 �0.3 �4.4 *2.3 - �1.2 

~her ... ... .... . .. .. .... .. .. .... ... . .... .. .. .. . .. .. .... .. . ..... ... . ... .. .. .... . 1.5 1.8 1.4 1.9 *1 .9 * 0.6 *0.6 *2.4 

� lIncludes white, black, and otherraces.


.3womenof HlsPanic origin are included in the fkrgres for white and black women if they were identified as such by the interviewer.


31n 1973 figures, estimates of the number of women included cases for which contraceptive status was not ascertained but 

was imputed. Only those cases in which contraceptive status was ascertained are included in the 1976 figures. See Technical Notes.. 

e 

For those wives ages 30-44, pill use declined 

about 3 percentage points from about 15 percent in 1973 to 12 percent in 1976 for white 

women and total women (table 3). Pill use 

among older black women declined from 13.8 

percent to 12.2 percent. 

As a proportion of contraceptive method use 

other than sterilization for older women, pill use 

declined only about 2 percentage points for 

white women and total women from about 32 

to about 30 percent (table 6). Among older 

black women, however, the share of contraceptive use other than sterilization for the pilI 

declined about 7 percentage points from 39.2 

percent to 32.6 percent. 

intrauterine Device 

AIthough it is a highly effective method, the 

intrauterine device (IUD) remained much lower 

in popuku-ity than the pill. In 1973, 6.7 percent 

of wives 15-44 years of age were using the IUD, 

and in 1976 about the same proportion, 6.1 percent, were using this method (table 1). The share 

of method use other than sterilization for the 

IUD remained at 12.5 percent for both years 

(table 4). This method became less popular 

among black wives 15-29 years of age over the 

3-year period, 8.4 percent used the IUD in 1973 

and 5.4 percent in 1976 (table 2). 

Condom 

Between 1973 and 1976, use of the condom 

declined about 2 percentage points reducing its 

portion of contraceptive use other than sterilization fkom 17.6 percent to 14.8 percent 

(table 4). This small decline is present in the 

white and total groups but some increase in condom use is present among black couples in 

which the wife is under age 30 (1.9 percent in 

1973 and 5.0 percent in 1976) (table 2). 

Other Methods 

Use of all methods other than the pill, IUD, 

or condom continued to be very small. Any increase or decrease in the use of individual 

methods should be interpreted with caution 

because of the small number of sample cases involved. As shown in table 1, there was littIe 

difference between the 2 years in the percent 
8 aduancedata 

Table 6. Number of currently married women aged 30-44 using contraceptives other than sterilization and percent distribution by 

method of contraception, according to race and Hispanic origin: United States, 1973 and 1976 

Totall White Black Hispanic origin2 

Contraceptive stat us 

1976 1973 1976 I 1973 1976 1973 1976 1973 

—— 

I Number in thousands3 

All women .................................................. 5,8191 6,682 II 5,260 I 6,2151 436 I 394 I 331 ] 396 

I Percent distribution 

Tota I. .... .. .. .... ... ..... . .... ..... . .... .. ... .. ...... .. .. .... .. .. .. . I 100.0, 100.0 100.0 I oo.a mo.a 100.0 , 

I * 

Oral contraceptive pill ................................................ 30.3 32.4 30.4 37.9 32.6 39.2 28.6 33.0 

Intrauterine device ..................................................... 13.8 11.5 13.6 11.1 17.1 19.9 25.6 15.8 

Diaphragm .................................................................. 7.9 6.4 8.0 6.6 +6.8 *4.5 *6.8 *5.1 

Condom ........................................ ............................. 19.8 24.8 20.4 25.7 �10s �12.1 �14.4 20.0 

Withdrawal ................................................................. 6.0 4.0 5.9 4.2 *5.3 �1.5 *9.4 *5.2 

Foam ......................................................................... 7.1 7.4 6.6 7.1 *1 2.1 *I 0.6 *10.9 *6.7 

Rhythm ..................................................................... 10.2 8.6 10.7 8.8 “2.7 �1.4 *2.1 *4.3 

buche ........................................... ........................... 2.4 1.8 2.0 1.5 “8.0 *6.4 *0.6 *1.3 

Other ......................................................................... 2.4 3.1 2.3 3.1 *3.8 *4.3 1

�1.6 *8.6 I I 

.2wo 

Irnc]udes 

men of 

white, 

~5Panic 

black, 

~risin 

and 

are 

other 

in~lud 

races. 

ed in the figures for white and black women if they were identit%d as such by the interviewer. � 3 In 1973 figure5, estimates of the number of women included cases for which contraceptive .StatUS WS not ascertained but 

was imputed. Only those cases in which contraceptive status was ascertained are included in the 1976 figures. See Technical Notes. 

using methods other than the pill, IUD, and condom among white couples (12.4 percent in 1973 

compared with 13.0 percent in 1976). However, 

the percent of black wives using other methods 

increased from 8.2 percent in 1973 to 12.8 percent in 1976. 

Hispanic Origin 

The Iarge increase in surgicaI sterilization observed between 1973 and 1976 among the white 

couples in the sample was not present among 

couples of Hispanic origin. Among couples with 

wives reporting Hispanic origin, 21.6 percent 

were surgically sterile in 1973 compared with 

20.5 percent in 1976 (table 1). For 1973 and 

TECHNICAL 

The Survey Design 

The NationaI Survey of Family Growth 

(NSFG) is designed to provide data on fertility, 

family planning, and related aspects of maternal 

and child health. Field work for Cycle I was 

carried out by the National Opinion Research 

1976, about one quarter of the male paxtners 

among these coupIes were sterile. 

Use of contraceptives by Hispanic couples 

declined from 22.9 percent in 1973 to 20.7 percent in 1976 (table 1). The IUD was more 

popular among women of Hispanic origin than 

all other women in 1973 and in 1976. In 1976, 

10.4 percent of wives of Hispanic origin were 

using an IUD, and in 1973, 8.7 percent of wives 

of Hkpanic origin were using an IUD. 

Of those women of Hispanic origin exposed 

to risk of au unplanned pregnancy (not sterile, 

pregnan~ post partum, or seeking pregnancy), 

82.1 percent were using a contraceptive method 

in 1976, compared with 83.7 percent in 1973. 

NOTES 

Center between June 1973 and February 1974. 

Field work for Cycle II was carried out by 

Westat, Inc., between January and September of 

1976. 

A multistage probability sample of women e 

in the noninstitutiondized population of the 

conterminous United States was used in both 
� 

cycles. Each time, approximately 33,000 households were screened to identify fie sample of 

women who wouId be eligible for NSFG, i.e., 

women between the ages of 15 to 44 years, inclusive, who were currentiy married or previously mamied or who were never married but 

had offspring presently Iiving in the household. 

In households with more than one eIigible 

woman, a random procedure was used to select 

only one to be interviewed. Since the interviews . were always conducted with the sample person, 

the term “respondent” is used as synonymous 

with sample person. For Cycle I, interviews were 

completed with 3,856 black women and 5,941 

women of other races. For Cycle II, interviews 

were completed with 2,946 black women and 

5,665 women of other races. A detailed description of the sample design for Cycle I is 

presented in “NationaI Survey of Family 

Growth, CycIe I: Sample Design, Estimation 

Procedures, and Variance Estimation,” Series 2, 

Number 76, in the Vital and Health Statz.ktics 

series. A similar report is in preparation for 

Cycle II. 

� 

The interview was focused on the respondent’s maritil and pregnancy histories, on 

the use of contraception and the planning status 

of each pregnancy, on the respondent’s intentions regarding the number and spacing of 

future births, on maternal and family planning 

services, and on a broad range of socizd and 

economic characteristics. While the interviews 

varied greatly in the time required for their completion, they averaged about 70 minutes for 

Cycle I and about 58 minutes for Cycle IL 

Qualky control procedures were appIied at 

all stages of the survey. These incIuded a verification of Ming completeness with unlisted 

dwelling units being brought into the sample, a 

preliminary field review of completed questionnaires for possible missing data or inaccurate 

administration, a 10-percent sample recheck of 

all households to be screened in the survey, obsemation of interviews in the field, and an independent recoding of a 5-percent subsarnple of 

completed interviews. 

e Reliability of Estimates 

Since the statistics presented in this report 

are based on a sample, they may differ somedmcedda9 

what from the figures that would have been 

obtained if a complete census had been taken 

using the same questionnaires, instructions, interviewing personnelj and fieId procedures. This 

chance difference between sampIe results and a 

complete count is referred to as sampfing error. 

Jn addition, the results are also subject to nonsampliig error due to respondent misreporting, 

data processing mistakes, and nonresponse. It is 

very difficuh, if not impossible, to obtain accurate measures of nonsampling errors. These 

types of error were kept to a minimum by the 

quality control procedures and other methods 

incorporated into the survey design and administration. 

Sampling error, or the extent to which 

samples may differ by chance from a complete 

count, is measured by a statistic calIed the standard error of estimate. Approximate standard 

errors for estimated numbers and percentages 

from Cycle I are shown in tables I and II for the 

totzd and white populations and in tables III and 

IV for the black population. Provisiomd estimates for standard errors for Cycle II for total 

and white women can be obtained by multiplying the standard errors for these women from 

Cycle I by a factor of 1.1. SimiIarly, provisional 

estimates of standard errors for Cycle II for 

black women can be obtained by multiplying 

the standard errors for these women from Cycle 

I by a factor of 1.2. 

The chances are about 68 out of 100 that an 

estimate from the sample would differ from a 

complete census by less than the standard error. 

The chances are about 95 out of 100 that the 

differences between the sample estimate and a 

Table 1. Approximate standard errors for estimated numbers for 

white and total women: 1973 National Survey of Family Growth 

Relative Size of etandard Standard 

estimate error error 

50,000. ................................. 30,0 15,000 

100,000................................ 21,2 21,000 

200,000................................ 15.0 30,000 

500,000 ................................ 9.5 47,000 

1,000,000 ............................. 6.7 67,000 

2,000,000 ............................. 4,8 95,000 

5,000,000 ............................. 3.0 151,000 

10,000,000 ........................... 2.2 216,000 

20,000,000 ........................... 1.5 311,000 
10 admncedata � 

Table 11. Approximate standard errors for estimated percentages standard error. The relative standard error is the 

expressed in percentage points for white and total women: ratio of the standard error to the statistic being 1973 National Survey of Family Growth. 

estimated. In this report, numbers and percentages which have a standard error that is 

Estimated percentage more than 25 percent of the estimate itself are 

Base of —. 

percentage 2or 5or O or 20 or 10 or $0 or 50 considered “unreliable.” They are marked with 

98 95 90 80 70 60 an asterisk to caution the user but may be combined to make other types of comparisons of 

100,000 ........... 3.0 4.6 6.4 8.5 9.7 10.4 10.6 greater precision.


500,000 .......... 1.3 2.1 2.8 3.8 4.3 4.6 4.7 In this report, terms such as “similar” and


1,000,000 ........ 0.9 1,5 2.0 2.7 3.1 3.3 3.3 “the same” mean that any observed difference


3,000,000 ........ 0.5 0.8 1.2 1.5 1.8 1.9 1.9


5,000,000 ........ 0.4 0.6 0.9 1.2 1.4 1.5 1.5 between two estimates being compared is not


7,000,000 ........ 0.3 0.5 0.8 1.0 1.2 1.2 1.3 statistically significant. Similarly, terms such as 

10,000,000 ...... T0.3 0.5 0.6 0.8 1.0 1,0 1.1 T “greater,” “less,” “larger,” and “smaller” indicate that the observed differences are statistically significant. The normal deviate test with a 

.05 level of significance was used to test all comparisons which are discussed in the text. A statisTable I I 1. Approximate standard errors for estimated numbers tically significant difference is one large enough for black women: 1973 National Survey of Family Growth that in repeated samples of the same size and 

type as this one such a large difference would be 

Sizeof Relative Standard expected to be found in less than 5 percent of 

standard estimate error error the samples. Lack of comment in the text �

between any two statistics does not mean the 

differences was tested and found not to be 

25,000 .................................. 25.3 6,000


50,000 .................................. 17.9 9,000 significant. 

100,000 ................................ 12.7 13,000 Adjustment for nonsampling error due to 

150,000 ................................ 10.3 16,000 nonresponse was made in two ways. Nonre250,000 ................................ 8.0 20,000 spondent cases, as distinct from missing data 

500,000 ................................ 5.7 28,000 items, were imputed by weighting for non750,000 ................................ 4.7 35,000 response within each PSU, stratum, and age-race 1,000,000..., ......................... 4.0 40,000 category. In the 1973 survey, codes for missing 

items were imputed using a “hot deck” procedure. In the 1976 survey, imputation for missing 

data items has not been performed and the figures in the tables are based only on those inter350,000 ................................ 6.8 24,000


Table IV. Approximate standard errors for estimated percentages 

expressed in percentage points for black women: 1973 views where enough information was obtained 

National Survey of Family Growth from the respondent to determine contraceptive — status. As a result, in the 1976 figures, about 

I 

I Estimated percentage 1,061,000 women out of an estimated 

Base of , 3i,847;ooo total ever-married women are not 

percentage 2 or 5 or Oor 200r represented. 98 95 90 80 

5,000 ............... 7.9 12.3 T22.6 25.9 27.7 28.3 

DE FIN TIONS OF TERMS 

17.0 

10,000 ............. 5.6 8.7 12.0 16.0 18.3 19.6 20.0 Sterile Couples 

50,000...........<.
2.5 3.9 5.4 7.1 8.2 8.8 8.9 

100,000 ........... 1.8 2.7 3.8 5.1 5.8 6.2 6.3 Sterile.–A woman (or couple) was classified 

300,000 ........... 1,0 1.6 2.2 2.9 3.3 3.6 3.6 as sterile if she reported that it was impossible 500,000,.......... 0.8 1.2 1.7 2.3 2.6 2.8 2.8 

700,000 ........... 0.7 1.0 1.4 1.9 2.2 2.3 2.4 for her to have a baby. a 

1,000,000 ........ 0.6 (3.9 1.2 1.6 1.8 2.0 2.0 iVonsurgical.-A ‘woman (or couple) was 

1 II I classified as nonsurgicaHy sterile if she reported 
admcecw 11 

that it was impossible for her to have a baby for 

any reason other than a sterilizing operation. Reported nonsurgical reasons for sterility included 

menopause and steriIity due to accident, illness, 

or congenital causes. 

Surgz”caL–A women (or coupIe) was classified as surgically sterde if she or her husband 

were completely sterile due to an operation. 

Since sterilizing operations are very frequently obtained exclusively or partly as 

methods of contraception, i.e., because of their 

complete effectiveness against conception rather 

than for purely therapeutic reasons, they have 

been further classified as contraceptive and noncontraceptive. In Cycle I, a sterilizing operation 

was contraceptive if the respondent answered 

“yes” to the question ‘Was the operation done 

at Ieast partly so that you would not have any 

more children?” Since the avoidance of more 

children (conceptions) couId itself be for therapeutic reasons, the question was reworded in 

Cycle II to ‘Was one reason for the operation 

because you had all the chiIdren you wanted?” 

This change in wording was expected to yield a 

lower percent of operations reported for contraceptive reasons than would have been reported previously. As a result, the percents of 

coup 1es with contraceptive and noncontraceptive sterilization shown in this report are not 

completely comparable between the two surveys. Also, there is evidence that sterilizing 

operations classified as noncontraceptive may inCIude some that actually were at Ieast partly 

contraceptive in intent. The percent classified as 

contraceptive should therefore be regarded as a 

minimum estimate. Because of these Imitations 

on the data, sterilizations for contraceptive reasons are reported with other causes or sterility 

and not, as formerIy, with other methods of 

contraception. 

Fecund Couples–Noncontraceptors 

Pre~ant.–A woman (or couple) was classified as pregnant if she replied affirmatively to 

the question “Are you pregnant now?” or for 

those in doubt, “Do you think you probably are 

pregnant or not?” A woman who reported that 

the onset of her last menstrual period was within 

the 30 days prior to the interview was automaticzdly considered not pregnant. 

Seeking pregnancy.–A woman (or couple) 

was classified as seeking pregnancy if she reported she was not using a method at the time 

of interview because she wanted to become 

pregnant. 

Post partum.–A woman (or couple) was 

classified as post partum if she reported she was 

not currently using a method, was not seeking a 

pregnancy, and her last pregnancy had terminated within 2 months before the date she 

was interviewed. 

Other nonusem.-Women (or couples) who 

reported they were currently using no contraceptive method and could not be classified in 

any of the preceding categories of noncontraceptors were ck.ssified here. Among these are 

women who were indifferent to the chances of 

pregnancy, had a very low risk of pregnancy due 

to some fecundity impairment, or objected to 

contraceptive methods for personal or religious 

reasons. Women who used the douche following 

intercourse, but who did not report this as a 

method of contraception, were zdso ckssified 

here although such douching practice is known 

to have a very modest contraceptive effect when 

done very soon after intercourse. 

Fecund Couples – Contraceptors 

Method usem.-A woman (or couple) who 

reported use of a contraceptive method other 

than a surgical sterilization at the date of interview was classified according to the specific 

method used. Methods used by extremely small 

proportions of the population such as jeIIy, 

cream suppositories, or abstinence, not in combination with any other methods, were grouped 

in the category “Other.” Where more than one 

method was reported in current use, the method 

generally considered the most effective was used 

for classification purposes. 

Demographic Terms 

Age.–In this report, age is classified by the 

age of the respondent at her Iast birthday before 

the date of interview. 

Race. –Classification by race, based on interviewer observation, was reported as black, white, 

or other. Race refers to the race of the woman 

interviewed. 

Hispanic orzgin.-A respondent was classified 

as being of Hispanic origin if she reported her 

origin or descent as Mexicano, Chicano, Mex-
---------------------------------------- ---

12 acklncedata


ican American, Puerto Rican, Cuban, or other 

Spanish. 

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 identified as such by the interviewer. 

Man.tal status. –Persons are classified by 

marital status as married, widowed, divorced, 

separated, or never married or as informally 

married, such as living with a partner or common-law spouse. Persons who are temporarily 

separated for reasons other than marital discord, 

such as vacation, illness, or Armed Forces, are 

classified as married. Divorced persons are those 

whose most recent marriage has been legally dissolved and who are free to remarry. Women with 

an annulled marriage, while having the legal 

status of never having been married, are classifle~ +nma+k=v..r; +l- J:..-.--A ..,~-~~ TLa S.+S ,U LU~VLll L1 VVIL1l UIVUILLU VVV1ll L1l. A llG LCtLCgory “separated” includes those who are legally 

or informality separated for their most recent 

spouse due to marital discord. The “never 

married “ include those who have never had a 

formaI marriage and do not consider themselves 

in any of the preceding categories. However, in 

NSFG, only single women with offspring living 

in the household are incIuded and separately 

classified. 

I I 

SYMBOLS I I I Data.riot available I 

I Category not applicable ------------------------------ . . . I 

I Quantity zero ---------------------------------------------- - I 

I Quantity more-than Obutks than o.o&---- O.O / 

Figure does not meet standards of 

* reliability or precision ---------------------------

1 

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