Marital relations and fertility control decisions among lebanese couples

This study examines how marital relations affect fertility control decisions among couples who want no further pregnancies. Marital relations studied include the degree of communication between husbands and wives, the extent that couples report marital tension, conflict, and separation, and the amount of intimacy and mutuality achieved in their sexual relations. Findings are based upon the responses of 530 Middle Eastern women who used the facilities of the University Hospital Family Planning Program of the American University of Beirut, Lebanon; 257 women were interviewed in their homes throughout Lebanon, and the remaining 273 were interviewed at the clinic. Three decisions were studied: (1) IUD/pill use; (2) tubal sterilization use; and (3) consideration of and refusal to use tubal sterilization. Women were interviewed using a standardized questionnaire prepared in colloquial Arabic. The decision to choose a reversible versus a permanent method was primarily sociodemographically determined. Among women who considered a permanent method, however, differences in their decisions were mainly attributable to their marital relations rather than to their demographic characteristics. Wife's attitude toward marriage and educational attainment were important and interactive components in the explanation of the association between marital relations and tubal sterilization use.I appreciate the assistance and critical comments offered by Drs. Joseph Veroff and George Simmons of the University of Michigan, and Dr. Joseph Chamie of Population Division, UN, New York. This article is a modified section of my doctoral dissertation which was recently completed at the University of Michigan. The anonymous reviewers' comments on the organization of this paper are greatly appreciated.