Can work influence women's contraceptive behavior?

Responsible researcher: Silvio da Rosa Paula

Article title: EMPLOYMENT STATUS AND CONTRACEPTIVE CHOICES OF

WOMEN WITH YOUNG CHILDREN IN TURKEY

Article author: Didem Pekkurnaz

Location of intervention: Turkey

Sample size: 2,608 women

Big theme: Gender

Type of Intervention: Analyze the impact of the employment situation of women with young children on the use of a contraceptive method

Variable of Main Interest: Contraceptive methods

Assessment method: Others (Conditional Mixed Process (CMP), simultaneous equations, Probit)

Assessment Context

According to Hacettepe University's Institute of Population Studies, between 2003 and 2013, contraceptive use in Türkiye rose from 71% to 73.5%. During the same period, the use of modern contraceptive methods also increased from 42.5% to 47.4%, while the use of traditional methods reduced from 28.5% to 26%. Furthermore, participation in the labor force of women aged 15 to 64 increased from 28.1% to 33.7%, causing the female employment rate to reach 29.6% in 2013. Despite showing a trend increasing participation of women in the labor market, this trend has generally been lower than for men and well below the averages observed in the Organization for Economic Cooperation and Development (OECD) countries. Among the main reasons that explain women's low participation rates in the labor market in Turkey is the burden of childcare.

Methodology Details

In several studies, researchers are interested in establishing a cause and effect relationship. To achieve this objective, regression models are generally used. In this study, the authors, using regressions, seek to establish a relationship between contraceptive methods and the women's labor market. However, when endogeneity exists, it is not possible to establish a direct relationship between cause and effect, and it is necessary to resort to other regression methods to correctly establish this relationship, avoiding inappropriate inferences.

In the context of this study, the authors highlight a potential endogeneity problem between women's work variables and the choice of contraceptives, given that it is reasonable to assume that women with above-average skills may be more likely to be employed. Furthermore, factors related to employment, such as higher pay, can affect contraceptive behavior, causing women to postpone the decision to have children. Consequently, it is not possible to establish a direct cause and effect relationship, since the choice of contraceptives can affect women's work and work can affect the choice of contraceptives, characterizing endogeneity through simultaneity.

Given these considerations, the authors resort to the estimator proposed by David Roodman (2011), conditional mixed process (CMP), which will allow identifying the causal relationship through simultaneous equations, using variables that only affect the employment situation of women, but not has an effect on contraceptive decision-making. The variables used for this purpose were province-level employment rates and percentage of women employed in a given sector (agriculture and manufacturing). Therefore, with the use of these instruments, the authors hope to correctly identify the cause and effect relationship.

Intervention Details

To carry out the study, data from the 2013 Turkish Demographic and Health Survey was used, which collects information on various aspects of women's lives such as fertility, family planning, child health, maternal health and employment status of families who are chosen randomly. In total there are 9,746 women in the 2013 survey. However, only information from 2,608 women is used, excluding pregnant women, infertile women, women who were sterilized before the year of the research, with sterilized partners and with children under 6 years of age.

The information from the selected women was divided into two main groups. The group of women who use traditional contraceptive methods (periodic abstinence, coitus interruptus and any other folk method), and the group who use modern methods (pill, IUD, injections, diaphragms, condoms, female and male sterilization, implants and LAM). Furthermore, other information is used, such as the number of children under 6 years old, between 6 and 13 years old and between 14 and 17 years old, the presence of adults other than the husband, the woman's level of education, the husband's level of education, ideal fertility, wealth index, whether you live in an urban or rural region, whether you are a public servant, informal or other jobs and availability of daycare centers in the municipality.

Results

The results indicate that women who work are more likely to use a contraceptive method than women who do not work. This result corroborates the hypothesis that women who are more focused on the labor market have a higher opportunity cost of raising children when compared to women who do not work. This way, they would be more inclined to use a contraceptive method to avoid an unintended pregnancy. Furthermore, employed women are more likely to use modern contraceptive methods instead of traditional ones, when compared to women who do not work. One of the explanations concerns the ability to pay for more modern contraceptive methods.

Furthermore, the results indicate that an increase in the public provision of daycare centers and
preschool institutions increases the probability of employment for women with young children. On the other hand, a higher proportion of private childcare services leads to a lower probability of employment, as they are not affordable for many families. Finally, comparing women based on work category, in particular, women in the public service and women in other paid work conditions, the results indicate that public servants are more likely to use modern methods compared to traditional ones, corroborating the hypothesis that access to modern methods is easy for women working in high-status, better-paying jobs.

Public Policy Lessons

In the present study, the authors investigate the impact of the employment status of women with children under primary school age on the use of contraceptive methods. Although there are differences between Brazil and Turkey regarding public policies on access to contraceptive methods, the results are interesting for understanding the factors that influence women's inclusion in the job market.

Another important result of the study that converges with the Brazilian reality would be the importance of the availability of public daycare centers. According to a study by the Brazilian Institute of Geography and Statistics ( IBGE ), based on data from the 2010 Census, the employment level of women with children up to three years of age who attended daycare was 65.4%, higher than that of those whose children did not attend daycare, which was 41.2%. Given this reality, achieving the goals established in the National Education Plan (PNE), of ensuring that at least 50% of children between 0 and 3 years old are enrolled in daycare centers by 2024, would be an important factor in promoting greater participation of women in job market in Brazil.

Reference

PEKKURNAZ, Didem. Employment Status and Contraceptive Choices of Women With Young Children in Turkey. Feminist Economics , vol. 26, no. 1, p. 98-120, 2020.