Fertility decline in the Dominican Republic : past determinants and future prospects

However, increased contraceptive use was accompanied by a swing toward female sterilization as the method of choice, so that by 1983 sterilization accounted for 60% of contraceptive practice. This paper argues that concern for increasing the use of methods other than sterilization should be translated into well thought out policies and initiatives on birthspacing. Using existing survey data, relations among breastfeeding, contraception, health services usage, child survival, and birth intervals should be analyzed and targets set for breastfeeding and birth interval increases. Target realization will depend on increasing IUD acceptance and improving maternal child health care services; integrating family planning with such services is recommended.