family planning in israel

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Family Planning in Israel: Irrationality and IgnoranceAuthor(s): Dov FriedlanderSource: Journal of Marriage and Family, Vol. 35, No. 1 (Feb., 1973), pp. 117-124Published by: National Council on Family RelationsStable URL: http://www.jstor.org/stable/351104Accessed: 20-02-2016 07:55 UTC

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2/9

Family Planning

in

Israel:

Irrationality

and

Ignorance*

DOV

FRIEDLANDER

TheEliezer

Kaplan

School

of

Economics

and

Social

Sciences,

The Hebrew

University,

Jerusalem

The concern

over

the

population

growth

among

the Jewish

population

in Israel

is

not

new.

Attempts

to achieve

fast

population growth,

mainly

or

political

ends,

have

been

made

for

several

decades.

This

may

explain why

Israel's

otherwise

extensive

public

health services

exclude

family

planning. Consequently,

here is

much

public

ignorance

concerning

amily planning

issues,

and,

in

turn,

a low

usage

of efficient

contraceptives

among many families

wishing

to

control

the number

of

their

children,

as is

shown

by

a

sample

survey

of

the

urban

population.

Nevertheless,

amily

size is

generally

small

or

else

in

the

process

of

decline

which

is

achieved

through

the

use

of primitive

contraceptive

methods and

also

through

extensive

use

of

induced

abortions. It is

concluded

that

family

planning

programs

are neither a

necessary

nor

a

sufficient

condition for achieving small family size, and that such programsare efficient in

affecting

ertility

behavior

only

when

applied

in

a

socioeconomic

context.

An inverse

relationship

between

fertility

and

contraceptive

usage

exists for

most

countries:if

fertility

is

high,

contraceptive

usage

is

low;

if

fertility

is

low,

contraceptive usage

is

high.

Israel

represents

an

exception

to

this

relation-

ship: fertility

levels are

relatively

ow

but

usage

of

efficient

contraception

is also

low.

General

public

health

services

are

availableand

utilized

by

the

majority

of

Israel's

population

and

indeed almost the entire range of medical

assistance;

amily

planning

services are

conspic-

uously

absent.

The

neglect

of

family

planning

within an

otherwise

extensive

public

health

service

is

longstanding.

For

decades one of

the

more

important

aspects

of

Zionist

ideology

has

been

to

maximize

population

growth,

and

this

was

pursued

by

activities of

the

Jewish

internal

authorities

before the

foundation of

the

State,

and

by

the State of

Israel

after

its

establish-

ment. In

the

past,

such action

was

mainly

in

terms

of

maximizing

Jewish

immigration,

al-

though

the

importance

of

increased

natality

was advocatedfrequently.Attempts to achieve

substantial

growth

of

the

Jewish

population

in

Israel

through

immigration

and/or

through

natality

had

clear and

specific political

objec-

tives.

Of

less

importance,

there was

the

influ-

ence

of

the

various

religious

groups

n

Israel.In

addition

to

political objectives,

rapid

growth

of

the Jewish

population

was

part

of the

religious

values

of these

groups

(e.g.,

"Be fruitful

and

multiply,

and

replenish

he

earth").'

These

political

and

religious

considerations

have

not

led to a

deliberate

and

conscious

governmental

policy

against

the

provision

of

family

planning

services

in Israel.

However,

it

may

be

argued

that

one

consequence

of

political and religious factors is that no Minis-

try,

governmental

gency

or

public organization

of

any

significance

has considered

it of

suffi-

cient

importance

to take initiatives

to

change

the status

quo.

What

are

the

consequences

of

the lack

of

public

family

planning

services

in Israel?

It

is

certainly

not that families

cannot

or do

not

control

the size

of their families.

Indeed,

the

Jewish

population

in Israel

may

be divided

nto

two

major

subgroups.

Those

people

of

Euro-

pean

origins

have

had low

fertility

and

small

family

size for

many

years.

In the

second

group,namelyJewish

mmigrants

of Afro-Asian

origins,

there

has been

a

significant

reduction

n

family

size of about

35

per

cent

since the

early

1950's.

This transition

has taken

place

despite

the lack

of

easily

accessible

family

planning

services.

It was

one element

accompanying

he

socioeconomic

transformationof

a

traditionally

*The

research

reported

in

this

paper

was

carried out

during

1971.

This

study

was

supported by

Grant No.

D

71059C

provided

by

the

Population

Council,

New

York,

for

which

the

author

is

grateful.

I

am

grateful

also

to

Calvin

Goldscheider for

his

critical

reading

of

the

manuscript

and to

Ruhama

Izhaki

for

her

assis-

tance

in

the

analysis.

1The

Jewish

religion

contains

pro-natal

elements

and the

preference

for

large

families

is

clearly

ex-

pressed

in

the

Bible on

several

occasions. For

a

discussion

of these

and other

religious

values

on

birth

control

see

Feldman,

1968.

February

1973

JOURNAL

OF

MARRIAGEAND

THE

FAMILY

117


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3/9

high

fertility

subgroup

in

the

process

of

their

absorption

within Israeli

society.

However,

this

transition

from

high

to

low

fertility

would

have

been

more effective

(and

this is

still

true

at

the

present

time)

if

free and

publicized

family

planning

services were available.

It is

precisely

because

of

the

lack

of

family planning

services

in Israel that there is much public ignorance

(some

aspects

of

which are illustrated

n

what

follows)

about matters

concerning

family

plan-

ning.

One

consequence

s

that a

high

proportion

of

women

using

contraceptives

do not use

effective

contraceptive

methods. At the

same

time,

a

family

limitation method

which

is used

extensively

is

induced

abortions,

apparently

because the

contraceptives

hat are

in

common

use

(because

of

ignorance)

are

so

ineffective.2

A

more

detailed

account

of the

political

background

of

the

family

planning

issue

in

Israel

has been

presented

elsewhere

(Fried-

lander,

1971).

It has been demonstrated here

that

even if

official

pro-natalist

attitudes

would

result in

the

increase

n

family

size

(for

instance

by

not

providing

an

easy

accessible

amily-plan-

ning

advice,

or

by

reducing

the

frequency

of

induced

abortions,

or

through

any

other

means)

this would still

make

no

positive

contribution

(in

the

relatively

short

run-20

to

30

years)

to

political

or

other

national

goals.

Therefore,

he

nonavailability

of

public

family

planning

ser-

vices

has resulted

in

various

costs:

for

example,

a slower

fertility

transition

amonghigh fertility

immigrant ubgroupsand the use of inefficient

means of

family

size

control and induced

abortion.

Moreover,

the

expected

national-

political

benefits

are

nonexistent in

the short-

run.

In

the

present

paper,

some

data

pertaining

o

family

planning

and

family

size control

in

the

Jewish

urban

population

are discussed.

These

data are based

on

a

sample survey

that was

carried

out in

1971.

THE

ACCESSIBILITY F

FAMILY

PLANNING

SERVICE

Generally,the entire rangeof contraceptives

are

available

in

Israel.

These

include

conven-

tional

and oral

contraceptives

as well as

intrauterine devices. Pills

can

be

purchased

legally only

on

a

physician's prescription.

However,

the

availability

and use of modern

contraceptives

require

the

services

of

medical

personnel

which

are

not

readily

available

on a

non-profit

basis,

although

there,

are

several

types

of

health service

systems

that could

provide

such

services. For

example,

there

is

a

network of over 700

public

clinics

(Tepat

Halav)

providing prenatal

and

postnatal

care

under

the

supervision

of the

Ministry

of

Health.

The

policy

of that

Ministry

s to avoid

providing

medicaladviceaboutfamilyplanningwithin the

context of these clinics. In

addition,

there

is the

overall health service

organization

of the

labor

movement,

Kupat-Holim,

that covers well

over

70

per

cent

of the

population.

There

are

over

one

thousand

Kupat

Holim

clinics

throughout

Israel,

most staffed

regularlyby

a

gynecologist.

Yet,

these

clinics

provide

neither

contraceptives

nor

family

planning

advice.

The

same

is

true for

the

outpatient

units of

public hospitals.

Thus,

family

planning

advice

in

Israel

is

obtainable

almost

exclusively

on a

private

basis.

Hence,

given

the

general ignorance

of

many peoplewith

respect

to

family

planning,

and the fact

that

private

consultations

are

relatively costly,

family planning

advice

is not

open

to

all.

In

particular,

t is not

open

to those who need

it

most,

that

is,

the

population

of

Afro-Asian

origins

who

are

in

the midst

of

their

fertility

transition.

Even for the more

affluent section

of the

population,

the

inaccessibility

of

family

planning

advice

through

public

channels has

implications.

First,

a

significant

proportion

use

unsophisticated

means

of

contraception

and

as

a

result resort

frequently

to

induced abortions.

This is an importantelement in the establish-

ment of

abortions as an

acceptable

means

of

family

limitation.

Although

abortions

in

Israel

are

legally

prohibited,

except

for

health rea-

sons,

in

practice,

induced

abortions

are

readily

obtainable

for those who

can afford them. This

has

been

since 1952 when the

Attorney

General

recommended

that

no

prosecutions

should

be

made

on

charges involving

induced abortions

except

in

special

circumstances,

such

as abor-

tions

terminating

n

the

death

of

the

woman.

Against

this

background,

t

is of interest to

examine

the

extent

of

family

planning

utiliza-

tion in Israel; the level of family planning

compared

to other

countries;

and

differential

family

planning

among

various

population

subgroups.

These and related

questions

can

be

investigated

with

data

obtained from

a

survey

undertaken

in

1971.

The

survey

consisted

of

a

probability

sample

of the

Jewish urban

popula-

tion

in

Israel. Several

amily

planningquestions

were

incorporated

in

the

continuous

sample

survey

obtained

by

Israeli Institute of

Applied

Social Research.

In

addition to these

special

questions,

a

range

of

social, economic,

and

demographicbackground

variablesare

regularly

2Although

there are no

direct

figures

on

the

frequency

of

induced

abortions,

it has been estimated

that

nearly

half the women

aged

40 or over

had

experienced

at least one

abortion

(Bachi,

1968).

118

JOURNAL

OF

MARRIAGEAND THE FAMILY

February

1973




4/9

TABLE

1.

AVERAGE

FAMILY SIZE IN

JEWISH

URBAN POPULATION

IN ISRAEL

1971,

BY

PLANNING

UTILIZATION PATTERNS

AND

OTHER

POPULATION CHARACTERISTICS

(N=1402)

Average

Number of

Children

Total Actual Future

Expected

To Date

Expected

All

Respondents

3.3

2.1 1.2

100

Family

Planners 3.3 2.0 1.3

43

Nonplanners

3.4

2.2

1.2

57

Respondents

willing

to use

a

free

public

family

planning

service 3.3 2.1 1.2 48

Respondents

not

willing

to use

a

free

public

family

planning

service 3.4 2.1 1.3

52

Age

of Women

Less

than 30

years

3.3

1.2

2.1 32

35-45

years

3.3

2.6 0.7

39

Continent

of

Origin

Afro-Asian

Born 3.9

2.7 1.2

31

Israeli

Born

Father

Afro-Asian Born 3.7

2.1 1.6 8

Father Israeli

Born 3.6

2.3 1.3

5

Father

European

Born

3.1

1.7

1.4

21

European

Born

2.9 1.7 1.2

33

Education

Elementary

or less

2.5

1.6

0.9

35

Secondary

3.1 1.7 1.4 43

University

or

other 3.2 1.7

1.5 22

Occupation

Manual

Workers

3.6

2.3 1.3

22

White

Collar 3.1 1.8

1.3

60

Family's

Income

Less

than IL800

per

month

3.3 1.9 1.4

29

IL

1250

per

month or

more

3.1

1.9

1.2

36

Religiosity

Observing 4.4 2.2 2.2 23

Nonobserving

3.1 1.7 1.4

77

included.

The

sample

consisted

of

approxi-

mately

1400

respondents.

Only

respondents

who

were

marriedwomen

under

age

45

or men

whose wives were under

that

age

were

asked the

questions

concerning

family

planning.

For

example,

they

were

asked whether or

not

they

have

ever

used

birth

control

measures,

and

if

not,

why

not. The

analysis

was

divided

nto two

groups, planners

and

nonplanners,

the

former

defined

as

those

who ever-used

any

means

of

birth control. Planners using "conventional

methods"

(e.g.,

coitus

interruptus,

condom)

were

asked to

state the

reason for not

using

more

effective methods

(such

as the

pill

or

I.U.D.).

Respondents

were

also

asked whether

the

existence

of

a free

public family

planning

service

in

the

past

or in

the

future

would

alter

their

family

planning

behavior

and/or

would

affect

family

size.

THE EXTENTOF

FAMILY

PLANNING

UTILIZATION N

ISRAEL

Clearly,

contraceptive

usage

is

a means

to

achieve

desired

family

size.

Therefore,

the

use

of

contraceptives

s

a function

of

the number

of

children

desired

and,

in

turn,

dependent

on

socioeconomic

characteristics.

Hence,

the

use

of

contraception

should be

high among

popula-

tions

where

family

size

desires

are

low

and that

are

predominately

urban

and

industrial with

relatively

high

income

and

high

levels of

consumption.

The

Jewish

population

of

Israel

clearly belongs

in

these

categories

(nearly

90

per cent of its population reside in urban

places,

and

the

national

income is

over

$1300

per capita per

annum).

It

is

quite

understand-

able

therefore

that

in three

different

surveys

taken

between

1960

and

1971,

the

ultimate

family

size

expected among

urban Jewish

women

was

relatively

small,

that

is,

around

three

children.3

Given these

family

size

desires,

3The first

of

these

surveys

was

taken

in

1959/60

by

Bachi

and

Matras

(Bachi

and

Matras,

1962).

The

second

was taken

in

1968

(Peled, 1969).

The

survey

is

the

one

described

in the

present paper.

February

1973

JOURNAL OF

MARRIAGEAND THE

FAMILY

119




5/9

it is

reasonable

to

assume that a

high

propor-

tion

of

families

in

Israel

use methods of

family

limitation

so

as to

attain

their

family

size

desires.

Data

presented

in

Tables

1

and 2

reveal

the

inconsistencies

between

expected

family

size,

family

size

desires,

and use

of

contraceptives.

Thesedataarepresentedseparately or planners

and

nonplanners

and

for

various

subpopulations

within

Israel.

Table

1 refers

to

the

total

Jewish urban

population

(i.e.,

to

all

respondents)

whose

family

planning

characteristicswill

be

consid-

ered

first.

The

table

shows

mean values

of

expected family

size

and

actual

family

size.

The

difference between these two

represents,

here-

fore,

average

expected

family

growth

in the

future. It

can be seen

that the

difference

between

actual and

expected family

size is

1.2

among

women

within the

childbearing

ages

in

Israel. In view of suchsmall valuesfor

expected

family

size

and

particularly

expected

family

growth,

it

is

surprising

o

find

that

only

43

per

cent

of

families

in

urban Israel

report having

ever

used

any

method

of

family

limitation. It

is

worthwhile

noting

that 35

per

cent of all

families

expect

no

more

additional children

according

to the

survey

No

less

surprising

s

the fact that

since

the first

family

planning

survey

(1959-60),

the

percentage

"ever

plan-

ners"

has remained more

or

less

unchanged

(compare

with

Bachi and

Matras,

1962,

Table

2).

This

stability

is

exceptional

given

the

greater

availability

of

contraceptive

echnology

and

the

greater

use of these new means

for

timing

as

well as

planning

for ultimate

family

size.

For

example, in contrast to the Israeli case, the

percentage

of "ever-users"

among

the

white

population

of

the United States

has

increased

by

14

per

cent

during

the decade

1955-65.

(Westoff

and

Ryder, 1969).

This increase

took

place

despite

the

higher

level of

overalluse

of

contraceptives

n the United

States.

Generally

speaking,

the

percentage

of

"planners"

n

Israel

is

roughly

half that of

developed

countries.

In

comparison

with some

developing

countries,

it

is

lower;

for

example,

in

Hong

Kong

the

proportion

is 51

per

cent;

it is about

equal

to

two

other

developing

countries,

South

Korea

(42

per

cent)

and Taiwan

(44

per

cent)

(Nortman, 1971).

The

percentage

of

planners

n

Israel

is

of

course

higher

when

compared

to

most

underdeveloped

countries but in

these

countries there

remain,

in

contrast to

Israel,

preferences

or

relatively arge

families.

What kind of

contraceptives

do

family

planners

n Israel use? It can be seen

in Table

2

that

just

over half

(54

per cent)

of the

planners

TABLE

2.

CONTRACEPTIVE USAGE PATTERNS

OF

FAMILY

PLANNERS BY

POPULATION

CHARAC-

TERISTICS

Percentage

of

Total

Respondents

In

Group

Using

Family

Planning

Pills or

IUD's

All Others

%

%

%

All

Family

Planners

54

46

Age

of Women

Less than

30

years

45

65

35

35-45

years

29

46

54

Continent

of

Origin

Afro-Asian

Born 38

46

54

Israeli

Born

Father

Afro-Asiain

Born

22

50

50

Father

Israeli

Born

44

36

64

Father European Born 51 55 45

European

Born 46

63

37

Education

Elementary

or

less

26

39

61

Secondary

45

55

45

University

or

other

64

64

36

Occupation

Manual

Workers

33

50

50

White

Collar

56

55

45

Family's

Income

Less

than

IL800

per

month

35

53

47

IL

1250

per

month

or

more

56

53

47

Religiosity

Observing

29

49

51

Nonobserving

54

64

36

120

JOURNAL

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6/9

use

modern

contraceptives,

that

is,

either

pills

or

I.U.D.

This

seems

to be

a

fairly

high

percentage

compared

to

developed

countries

where

it

is,

roughly

speaking,

around

30

per

cent,

but lower

than in

some

developing

countries such as

South

Korea

(74

per

cent)

and

Taiwan

(64

per

cent) (no

figures

on

the

types of contraceptivesused are available for

Hong

Kong).

Those

planners

who

currently

use

conventional

contraceptive

methods

were

also

asked what were

the reasons

or

not

using

more

modern

methods

such

as

pills

or

the

I.U.D.

More

detailed

data not

shown here

reveal

that

about 60

per

cent

replied

that the reason

was

"medical"

while

the

remainder

quoted

a

variety

of

other

reasons. This is not

uncommon

in

other

developed

countries. For

example,

over

half

of

the women

not

using

oral

contraceptives

in

a

sample

survey

in

Canada

replied

that

they

would

not

use

oral

contraceptives

n

the future

because of "health hazards"or "side effects"

and

similar

findings

have

been

recorded

or

the

United

States

(Allingham,

1970).

Examining

the

nonplanners,

the data

in

Table

3

show

the distribution

of reasons

given

by

nonplanners

or

not

using

contraceptives.

A

logically prior question,

however,

is the

family

size

desires

of

nonplanners.

If

this

group

is

characterized

by preferences

or

large

families,

then their

present family planning

behavior

would

appear

consistent

and rational.

Detailed

data

from the

survey

show

that

the number

of

additional children

expected

by

nonplanning

families in the future

was

relatively

small.

In

fact,

37

per

cent of this

group

wanted

no

additional

children,

21

per

cent

wanted

just

one

additional

child, and,

on the

average,nonplan-

ners expected 1.25 additional children in the

future.

Thus,

it

is

evident

that

nonplanners,

reporting

not

having

ever used

any

method

of

family

limitation,

have

in fact small

family

size

preferences.

In

turn,

family planning

behavior

of this

group appears

irrational

and

inconsis-

tent.

As for

the reasons

given

for

nonuse,

the

responses

of

at least

half of

the

nonplanners

were

unspecified

and lacked clear

justification.

Fourteen

per

cent cited

religious

reasons

for

not

using

contraceptive

methods,

and

another

13

per

cent stated

that

they

wanted

many

children

and, therefore,

the behavior of

these

respondents

seems rational. Less than 20

per

cent

replied

that

they

eitherdid not know

how

to

use

contraceptives

or

that these were

too

costly

or

that

their use is

inconvenient.

But,

it

can be seen that the remainder

54

per

cent)

attributed

nonplanning

to

unspecified

"other

reasons."What

might

"other

reasons"be if not

religious,

not

a

desire for

many

children,

not

because

contraceptives

are

costly,

or

inconve-

nient,

and not because

of

a lack

of

knowledge?

TABLE

3.

REASONS LISTED BY

NONPLANNERS FOR NOT

USING

CONTRACEPTIVES

Want

many

Don't know Too

All

Other

Religious

Children

how

to

plan

Costly

Inconvenient

Reasons

Total

Non-Planners

14

13

2 2

15 54

Age

of Women

Less

than 30

years

8 17

6 3 10

56

35-45

years

15

5

2 2

13

63

Continent

of

Origin

Afro-Asian Born 17

18 4 4 12

45

Israeli Born

Father

Afro-Asian Born 8 18

5

0

21

48

Father

Israeli Born 14 19

0

5 5

58

Father

European

Born

21

9

0

0 12

57

European Born 11 9 0 1 19 60

Education

Elementary

or less

15

12

3

3

13

54

Secondary

14

15 0 0

17

54

University

or

other

24

17

0 0 8

51

Occupation

Manual Workers 21

10 3 3 13

50

White Collar 12

13

0 0

15

60

Family's

Income

Less

than IL 800

per

month

25

14

5

4 12

40

IL

1250

per

month

or

more

5

16 1

0 21

57

Religiosity

Observing

66

6 0

0 5

23

Nonobserving

1

16 1 2

18

62

February

1973

JOURNAL

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THE

FAMILY

121




7/9

In view of the

relatively

small

number of

additional children

expected

by

this

group,

it

may

be

hypothesized

that a

proportion

(un-

known)

of

these

self-declared

nonplanners

are

in

fact

planners,

but

probably

do not use

mechanical

or

oral

contraceptives.

In

fact,

data

not shown reveal that

fully

44

per

cent

of

nonplannersgiving unspecifiedreasons or their

behavior

desireno more children.

However,

the

irrationality

n

family planning

in

Israel

becomes

even more

apparent

n

Table

4

which

shows that

52

per

cent

of

respondents

(who

have,

on

the

whole,

small

family

size

preferences-see

Table

1),

think

they

would

not

use a free

public

family

planning

service

if it

were

available as a

matter of

social

policy.

In

fact,

according

to

more detailed

results not

shown

here,

only

43

per

cent

of

nonplanners,

59

per

cent

of

planners

who use

conventional

contraceptives,

and 63

per

cent of

planners

who

use modern

contraceptives (pills

or

I.U.D.)

replied

that

they

would use such a

service.

Thus,

one

inference

that

may

be

drawn

from

these

data

is

that

on

the

whole the

family

planning

behavior

of

the

Jewish urban

popula-

tion

in Israel

is

inconsistent with

family

size

preferences

and

expectations.

An

equally

im-

portant

inference

is that

a small

proportion

see

the

need for

public

family

planning

ervicesand

this

may

in

large

part

reflect

family

planning

ignorance

and fear.

The

questions

of

why

family

size

is small and how

changes

occur in

actual

family

size

despite

the relative

high

proportion

of nonuse of

family

planning

meth-

ods is more difficult to answer

conclusively.

It

is

probably

true that small

family

size in Israel

is

achieved

by many couples

(some

of whom

may

define themselves as

nonplanners)

hrough

the use of traditional methods and apparently

(but

not

independently)

also

through

induced

abortions.

Let us now

focus on variations in

family

planning

behavior

patterns among

specific

sub-

groups.

Data

in

Table

2

revealvariations n

the

extent of

family

planning.

It

is not

surprising

o

note that

the

subgroups

employing

family

planning

methods

tend to be

young

rather han

old,

of

European

origin

rather

than of Afro-

Asian

origin,

the more

educated rather

han the

less

educated,

those

in white

collar

occupations

rather

than manual

workers,

those

earning

higher

incomes ratherthan lower incomes, and

the

less

religious

rather than the

religiously

observant.

What

is

exceptional

is

that

for

each

of these

subgroups

there

are

inconsistencies

between

family

planning

behavior

on the

one

hand,

and

the

number

of

children

expected

in

the future

(Table

1).

Consistent

behavior

could

be

expected

to

reveal a

negative

relationship

between the number of

additional children

expected by

families in the future

and

the

percentage

using

any

method

of

family

limita-

TABLE 4.

PERCENT

OF NONPLANNERS BY POPULATION CHARACTERISTICS

Unwilling

to

Use

Nonplanners

Public

Service

Total

Respondents

43

52

Age

of Women

Less

than 30

years

55

47

35-45

years

71

61

Continent of

Origin

Afro-Asian

Born

62 44

Israeli Born

Father

Afro-Asian Born

78 42

Father Israeli

Born

56 47

Father European Born 49 67

European

Born

54

52

Education

'Elementary

or less 74

50

Secondary

55

53

University

or other 36

55

Occupation

Manual

Workers

67

49

White

Collar

44

52

Family's

Income

Less

than IL 800

per

month

65

45

IL

1250

per

month or more

44

59

Religiosity

Observing

71

72

Nonobserving

46

52

122

JOURNAL OF

MARRIAGEAND

THE

FAMILY

February

1973




8/9

tion. The

data, however,

reveal

no

such

relationship.

Moreover,

while

there

is

very

little

variation in

expected

family

growth

among

subgroups,

there

is substantial variation n the

percentage

of

family

planners.

For

instance,

it

can

be seen that

"origin"

groups

show

very

little variation

in

expected

family growth,

rangingbetween 1.2 and 1.6 children.However,

the

percentage

of

family

planners

vary

between

22

per

cent

and

51

per

cent.

Similarly,

the data

show

that

there

is a

difference

of

just

over half

a

child

on

the

average

in

expected

family

growth

between the lowest and

highest

educa-

tional

level,

while

the

variation n the extent

of

family

planning

s

very

substantial:

only

26

per

cent of those

with

at

most an

elementary

evel

education

are

family planners

compared

to 64

per

cent

of

those

having

some

higher

education.

It

is

perhaps

worthwhile

to

note that

among

the

groups

not

practicing family planning

exten-

sively,

there is

only

one

group

whose behavior

can

be considered "rational." This

is

the

religiously

observant

group

whose

expected

family

size

growth

s

high

and, therefore,

whose

use

of

family

planning

is low.

Similarly,

the

religiously

observantare

the least

likely

to

have

positive

attitudes toward

the use

of

public

family planning

services

if

they

were

made

available.

Except

for

the

general

pattern

that those

in

lower

socioeconomic

groups

(i.e.,

Afro-Asians,

less

educated,

manual

workers,

lower income

groups) tend to have positive attitudes toward

the

use

of

a

free

public

family planning

ervice

if

it

were

available

(Table 4),

no

significant

associations

between

the extent

of

family

planning,

the

use of modern

contraceptive

methods,

or

the

willingness

o

use

public

family

planning

servicesare

apparent.

CONCLUSIONS

It

has been

argued

that

political,

ideological,

and

religious

factors are the

major

elements

in

Israel's thrust for

rapid

population

growth.

It is

only against

this

background

hat

the total lack

of accessiblepublic familyplanning ervicescan

be

understood.

Family

planning

ervicesare one

of the few

programs

absent

from

an

otherwise

extensive

public

medical

system.

The nonavail-

ability

of

family

planning

programsexplains

in

part

the

inconsistencies noted

between

family

size

expectations,

desires,

and use

of

modern

contraceptive

methods.

The

family

planning

patterns

that

emerge

from

the

data

clearly

are

irrational

given

the

relatively

ow level of

family

growth

expectations

and desires.

Nevertheless,

despite

the low

level of

contraceptive

usage,

small

family

size is

attained

by

about half

of

Israel'spopulation,

i.e.,

by

those

of

European

origins,

and

the transition

toward small

family

size

among

Afro-Asians

is in

rapid

progress.

This

may

be

compared

to

some

developing

nations,

where

KAP studies

have shown

that

high

proportions

of

couples

desire

relatively

small families where a

rapid spread

of

family

planning services and utilization have been

recorded,

but

fertility

and

family

size

remainas

yet

almost

unchanged.

Thus,

in the

contempo-

rary

world small

family

size

can

be

achieved

without

family

planning

programs

and

family

planning programs

do

not

necessarily

result

in

fertility

reductions.

Nevertheless,

two

points

must

be

emphasized:

first,

family planning

services

may

be of

great importance

from the

point

of view

of

social-medical

policies;

second,

family planning

programs

are most

efficient in

affecting fertility

behavior

only

when

applied

n

a

socioeconomic context.

REFERENCES

Allingham,

J.

D.,

T. R.

Balakrishnan,

and

J.

F.

Kantner

1970 "The end of

rapid

ncrease n

the

use

of

oral

anovulants:

some

problems

n

the

interpre-

tation of

time

series of

oral use

among

married

women."

Demography

7

(Febru-

ary).

Bachi,

R.

1968

"Induced

abortions

in Israel."

Paper pre-

sented to the InternationalConference

of

the

Association or

the

Study

of

Abortions,

Hotspring.

Bachi,

R.

and

J. Matras

1962

"Contraception

and

induced

abortions

among

Jewish

maternity

cases

in

IsraeL"

MilbankMemorialFund

Quarterly

April).

Feldman,

D.

M.

1968 Birth

Control

in

Jewish

Law.

New

York

University

Press.

Friedlander,

D.

1971

"Israel:

towards

a

population policy-a

re-

view

of

its

background,

problems

and

ikeli-

hood

of

success."

Presented

at the

Confer-

ence

on

Population

and

Political Science

held

at

the

Population

Council

New

York

(October).

Kantner,

. F.

1968

"Oral

contraception

and

fertility

decline

in

Canada,

1958-1968:

a first look at a crucial

component

in the

argument."

Report,

On-

tario.

Langford,

C. M.

1969

"The use

of

contraception

n

Britain." A

preliminary

eport.

Nortman,

Dorothy

1971

"Population

and

family

planning

programs:

a factbook."

Reports

on

Population

and

Family

Planning.

The

Population

Council

(June).

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1973

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Peled,

Z.

1969 "Problems

and

attitudes

in

family

plan-

ning." (Mimeographed)

Jerusalem:The Israel

Institute of

Applied

Social Research.

Westoff,

C. and N.

Ryder

1969

"Family

limitation

in

the

United

States." A

paper

presented

at

the

International

Popula-

tion

Conference,

London.

124

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AND THE

FAMILY

February

1973

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