Premarital Sexual Activity and Contraceptive Use in Santiago, Chile

Author(s): Joan M. Herold, Maria Solange Valenzuela and Leo Morris

Source: Studies in Family Planning, Vol. 23, No. 2 (Mar. - Apr., 1992), pp. 128-136
Published by: Population Council
Stable URL: http://www.jstor.org/stable/1966542
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 PremaritalSexual Activityand
ContraceptiveUse in Santiago,Chile
JoanM. Herold, Maria Solange Valenzuela, and Leo Morris

TheSantiagoYoungAdultReproductive HealthSurveywas conducted in 1988 toexaminethe

sexualbehavior ofand contraceptive
useamongyoungadultsin Chile.Thesurveywas basedon
multistage household probability
samplesof865 womenand 800 menaged15-24 whowere
livingin Santiagoin 1988.Findingsshowthat35 percentoffemales and 65 percentofmaleshad
hadpremarital intercourse.
Amongthosewhohaddoneso,themedianageatfirstexperience
was 18.4 yearsforwomenand 16.4 yearsformen.Only20 percent offemales and 19 percentof
malesusedcontraceptives atfirstpremarital
intercourse.Use ofcontraceptives increased
with
age at thetimeofthatevent.Fertilitydatarevealthat70 percent births
offirst werepremaritally
conceived, and morethanone-third ofthesewerebornpriortounion.Thehighratesofpremari-
taland unintended pregnancy amongyoungwomenand thelowprevalence ofeffectivecontra-
ceptiveuse indicatea needforgreateremphasison sexeducationandfamilyplanningservices
directedat adolescentsand unmarried youngadultsin Santiago.(STUDIES IN FAMILY PLANNING
1992;22,3:128-136)

In recentyears,therehas been much interestin teenageciallydevastatingin LatinAmericansocieties,whereop-

fertilityin Latin America, including concernabout the
portunitiesto advance socioeconomicallyare alreadyex-
early initiationof childbearingand the levels of unin-
tremelylimited.
tended pregnancyand premaritalconception(Darabi et In addition to socioeconomic considerations,there
al., 1979; Edmunds and Paxman, 1984; Morris, 1986; is a growing concernabout the health consequences of
Senderowitzand Paxman, 1985). This interestis linkedadolescent pregnancy.Evidence fromsurveysconfirms
to evidence thatwomen who have theirfirstbirthat a thatbabies bornto adolescentwomen have a lowerprob-
youngage have shorterbirthintervals,moreunintended abilityof survivinginfancyand childhood than do ba-
pregnancies,and more birthsoutside of marriagethan bies born to older women (Rutstein,1983). Accordingto
do women who startchildbearingat later ages (Send- Molina and Romero (1985), studies of Latin American
erowitz and Paxman, 1985). Also associated with ado-populations have shown an association of early age at
lescent childbearingare low incomes, low educationalpregnancywith increased rates of infantmortalityand
levels,and disadvantaged social and economicpositions
healthrisksto themother.
laterin life(Liskinet al., 1985;Senderowitzand Paxman, Concern foradolescent pregnancyin Chile, specifi-
1985). Such social and economic consequences are espe-
cally, has been expressed by various writersin recent
years(see Molina and Romero,1985;Viel,1986).Viel and
Campos (1987) have pointedout thatwhereasoverallfer-
tilityrateshave declinedin recentdecades, littleprogress
has been made withtherateamong 15-19-year-olds, and
JoanM. Herold,Ph.D.isAssistant
Professor,
Emory the proportionof out-of-wedlockbirthsamong young
SchoolofPublicHealth,1599Clifton
University Road,NE, women has been on theincrease.
Atlanta,GA30329;MariaSolangeValenzuela, M.P.H.is Between 1960 and 1980, the total fertilityrate for
Instructor,
Department ofPublicHealth,SchoolofMedi- Chile declined significantly-from 4.7 children per
cine,University
ofChile;andLeoMorris,Ph.D.is Chief, woman to 2.4. However, the dramaticdrop in age-spe-
Behavioral
EpidemiologyandDemographic Research cificrates over thatperiod did not occur among 15-19-
Branch,DivisionofReproductive
Health,CenterforChronic year-olds.In 1960,the fertilityrateamong women aged
DiseasePreventionandHealthPromotion,Centersfor 15-19 was 72.6 birthsper 1,000women; in 1980, it had
DiseaseControl,
Atlanta,GA30333. declined slightlyto 61.5, and in 1984 it was 64.0. These

128 StudiesinFamilyPlanning
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fairlystableratescontrastsharplywithdeclinesbetween tended pregnancyamong the population aged 15-24 in
1960 and 1984 of 47 percent and 56 percent among Santiago,Chile, and what are some of thesocial and de-
women aged 25-29 and 30-34, respectively(Viel and mographiccharacteristicsassociated withtheselevels?
Campos, 1987; Taucher, 1986). During this period, the
moresignificant changeamong youngwomen was a pro- Results
nounced increase in birthsto unmarriedteenagers.In
1960, 31 percentof birthsamong women under age 20 RespondentCharacteristics
occurred outside of marriage;since that time,the pro-
The majorityof respondentswere single: 79 percentof
portionhas steadilyincreased,to 55 percentin 1984 (Viel,
the femalesand 89 percentof the males had neverbeen
1986).
married;' only 18 percentof females and 9 percentof
These figures,as well as thosefromsmall clinicstud-
males were currentlyin a union. Membersofboth sexes
ies, indicate a need forinformationon sexual develop-
had attained similarlevels of education-40 percentof
mentand use offamilyplanningamong thispopulation;
femalesand 41 percentof males had completedsecond-
however,therehas been no data set available fromChile
ary school (12thgrade), and 11 percentand 14 percent,
in recentyears to document the onset of sexual activity
respectively,reported having more than a secondary
or theuse of contraceptivesand otherrelatedeventsfor
school education. Males were more likelythan females
the young population. Chile has never had a national
to be currentlyattendingschool (60 percentvs. 50 per-
familyplanning survey,and no survey on such topics
cent,respectively);and femaleswere much more likely
has been conductedin Santiago since the 1960s.Further,
than males to be neitherattendingschool nor working
Chile did not participatein the World FertilitySurvey.
(31 percentvs. 8 percent,respectively).With regard to
Given thesecircumstances, Chilean public healthprofes-
morefemales(74 percent)thanmales
religiousaffiliation,
sionals identifiedSantiago as a cityin need of a young
(62 percent) reported themselves to be Catholics, al-
adult reproductivehealthsurvey.
thoughamong Catholics of both sexes, fewerthan one-
half attended churchas oftenas once a month.Fifteen
The Survey percentof the females and 13 percentof the males be-
longed to a non-Catholicreligion,and 11 percentof fe-
The Santiago Young Adult ReproductiveHealth Survey males and 26 percentofmales reportedno religion.
was developed to obtainfurther information about sexual
knowledge and behavior in the 15-24-year-oldpopula- Sexual Experience
tionofthecapitalcityofChile.The surveywas conducted The data in Table 1 show that 35.4 percent of young
fromSeptemberto November 1988 by the Department women in thesurveyand 65.0 percentofyoung men re-
of Public Health, WesternCampus School of Medicine, ported having had premaritalsexual intercourse.Pre-
Universityof Chile, with technicalassistance fromthe maritalsexual experienceincreasedwithage: Among fe-
Division ofReproductiveHealth,CenterforChronicDis- males, 19.1 percentofthose aged 15-19 and 56.5 percent
ease Preventionand Health Promotion,US Centersfor of those aged 20-24 reportedpremaritalsexual experi-
Disease Control.The questionnaireand sample design ence; among males,thecorrespondingproportionswere
were patternedaftersimilarsurveysthathad been car- 47.6 percentof 15-19-year-oldsand 85.7 percentof 20-
ried out in Mexico, Guatemala, Jamaica, and Brazil 24-year-olds.
(Morris,1990). The questionnairecollected information
on sexual activity,contraceptiveuse, fertility,sex edu- TableI Percentage ofyoungadultsaged 15-24whohavehad
cation, attitudestoward sex roles and sexual behavior, sexualintercourse,
premarital byage group, togender
according
knowledge of contraceptionand AIDS, smokingbehav- status,Santiago,Chile,1988
andmarital
ior, and basic demographicand socioeconomic charac- Never-married Ever-married Total
teristics.The survey was based on independent, self- Agegroup % (N) % (N) % (N)
weightingprobabilitysamples offemalesand males aged Females
15-24 22.3 (683) 84.6 (182) 35.4 (865)
15-24 who lived in greaterSantiago.Response rateswere 15-19 13.1 (451) 91.9 (37) 19.1 (488)
88 percentforfemalesand 84 percentformales; 865 com- 20-24 40.1 (232) 82.8 (145) 56.5 (377)
pleted femaleinterviewsand 800 completedmale inter- Males
15-24 61.0 (708) 95.7 (92) 65.0 (800)a
views were obtained.Details ofthesurveymethodology 15-19 45.8 (421) - (14) 47.6 (435)
have been discussed elsewhere(Valenzuela et al., 1989). 20-24 83.2 (286) 94.9 (78) 85.7 (364)
This reportaddresses the principal study question (N)indicates
Note:Inthisandallsubsequenttables, baseofpercentage.
unweighted
refers
"Married" tobothlegalandconsensualunions. fewer
Dash(-) indicates
underlyingthesurvey.Thatis,what are thelevels ofpre- than25 cases.
marital sexual activity,contraceptive use, and unin- a Total
includesonemalewhoseage wasunknown.

Volume 23 Number2 March/April1992 129

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 Thetableclearlyillustrates genderdifferences inthe littlebetweenCatholicsand non-Catholics; but among
associationof premarital sex withmarriage.Only22.3 men who regularlyattendedreligiousservices,being
percentof never-married women,comparedwith84.6 non-Catholic was a greaterdeterrentto premarital sex
percent ofever-married womenreported havinghadpre- thanwas beingCatholic.
maritalintercourse. The difference was notas greatfor Age atfirst
sexualintercoursealso differedbetween
males(61.0percentofnever-married and95.7percentof the sexes. Table 3 presentsresultsusing a life-table
ever-married malesreportedhavinghad premarital in- methodto calculateage at firstpremarital sexualinter-
tercourse).Thedifference bymaritalstatusis due inpart course.Allowingallyoungadultstocontribute exposure
toan ageeffect.Whenagewas controlled, however, there timetothelifetable(boththosewhodid and thosewho
remaineda strongpositiveassociationbetweenbeing did nothavesexualintercourse), we findthatalmost20
marriedand havingreportedpremaritalsexual inter- percentofwomenaged 15-24had had premarital inter-
courseforwomen.Formen,theassociationwas much coursebyage 18,and almost50 percenthad doneso by
weakerafterage was controlled. age 21.Amongyoungmen,50percenthad had premari-
It would appear thatsexual intercourse is not as tal intercourseby 17.5yearsof age, and morethan80
likelytobe a precursor to marriageformalesas itis for percenthad done so by age 21. Considering onlythose
females.Thatis,youngwomenareprobablymorelikely youngpersonswhodidactuallyengageinpremarital in-
to participatein premarital intercoursewhentheyfeel tercourse,themedianage atfirst intercoursediffered by
relativelycertainofmarrying theircurrentsexualpart- twoyearsbetweenwomenand men(18.4yearsofage
ner.Or, premarital intercourse, and subsequentpreg- forwomenand 16.4yearsof age formen).Bothsexes
nancy,maybringabout marriage.Theremay also be tendedto have firstpartners who wereolderthanthey
some underreporting of premarital sexual intercourse (onaverage,firstpartners ofwomenwere3.5yearsolder
amongunmarriedwomen,althoughthesurveymeth- and firstpartnersof menwere2.5 yearsolder),which
odologyattempts tokeepsuchunderreporting ata mini- suggeststhata sexuallyexperienced partner at firstpre-
mum.Nevertheless, itis clearthatretrospectivereport- maritalintercourse is thenorm.
ing by marriedwomenprovidesvaluableinformation As Table4 shows,theoverwhelming majority (80.5
concerning thebehaviorofunmarried women. percent)of sexuallyexperiencedwomenreportedthat
Table2 illustratestheassociationbetweenreligious theirfirstpartnerhad been theirsteadyboyfriend. For
valuesandpremarital sexualactivity.BeingCatholicdid males, both and
steadygirlfriends friends had beenfre-
nothavea significant impacton premarital intercourse; quentfirstpartners(41.5percentand 48.8 percent,re-
instead,religiouscommitment, as measuredby atten- Only4.2percentofmalesreported
spectively). thattheir
dance at religiousservices,2producedthegreatestdif- firstpartnerhad been a prostitute.A mildassociation
ferencein prevalenceofpremarital intercourse.Young existedbetweenage atfirst intercourse
and degreeofre-
adults of both sexes who identifiedwith a religion lationshipwiththepartner. Forexample,as age at first
(Catholicor non-Catholic) butdid notregularly attend intercourseincreased,morewomenreportedthattheir
servicesreported premarital sexualexperience at a level firstpartnerhad beena fianceor a spouse.Theassocia-
closerto thatof thosewithno religionthanto thatof tionwas weakerformenbecauseoftheincreasedfre-
membersoftheirownreligionwho reported greaterre-
ligiouscommitment. Additionally, whenfrequency of
churchattendancewas controlled,the percentageof Table3 Probability
ofhaving
hadfirstpremarital
intercourse
by
womenhavingpremaritalsexual experiencediffered a givenage,amongyoungadultsaged 15-24,Santiago,Chile,
1988
Respondents who had
Table2 Percentage ofyoungadultsaged 15-24whohavehad Ageatfirst All respondents premaritalintercourse
sexualintercourse,
premarital byreligion, togender,
according premarital
intercourse Females Males Females Males
Santiago,Chile,1988
14 .012 .085 .033 .131
Females Males
15 .024 .171 .069 .263
Religion % (N) % (N) 16 .070 .280 .191 .423
17 .117 .426 .304 .610
Catholic,attendsservicesa 25.8 (310) 58.6 (222)
18 .191 .565 .452 .763
Non-Catholic,attendsservicesa 29.1 (86) 45.5 (55)
19 .270 .666 .588 .855
Catholic,does notattendservicesb 40.1 (332) 70.1 (271)
does notattendservicesb 48.8 76.1 20 .373 .744 .733 .915
Non-Catholic, (43) (46)
21 .475 .816 .845 .961
No religion 50.0 (94) 68.0 (206)
22 .580 .860 .931 .985
Total 35.4 (865) 65.0 (800) 23 .653 .886 .970 .994
a "Attends
services"
isdefined
as attending
religious
services
atleastoncea month. 24 .732 .903 .997 .998
b"Doesnotattend
services"
is defined
as attendance
at religious
serviceslessthan
Medianage (years) 21.2 17.5 18.4 16.4
oncea month.

130 StudiesinFamilyPlanning

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Table 4 Percentagedistributionofyoungadultsaged 15-24 The tablealso presentsthedistribution ofmethods
totheirpartner
accordingto theirrelationship at first
intercourse, usedbyyoungadultsattheirfirst premarital intercourse.
byage at first
intercourseand gender,Santiago,Chile,1988
In theaggregate, therhythm method(used by 6.3 per-
Age at firstintercourse
centof femalesand 5.2 percentof males),and thepill
<18 18-19 20-24 Total
Relationship
(usedby4.3percent offemalesand4.2percent ofmales),
Females
Spouse 4.9 10.5 12.0 8.4
were thetwo most prevalent methods of contraception
Fiance 6.9 5.3 10.9 7.8 reportedby bothsexes.Use ofthecondomwas also of
Steady boyfriend 82.6
2.1
82.1
2.1
76.1
0.0
80.5
1.5
someimportance forfemales: Infact,itsuse was reported
Friend
Rapist 2.8 0.0 1.1 1.5 morefrequently byfemales thanbymales.Amongmales,
Other 0.7 0.0 0.0 0.3 withdrawal was reported at a relativelyhighfrequency;
Total 100.0 100.0 100.0 100.0
(N) (144) (95) (92) (334)a it was the most common method used (8.1 percent)
Males amongmenaged 18-24at firstintercourse. Thesedata
Spouse
Fiancee
0.0
0.8
2.5
0.0
2.2
2.2
0.6
0.8
shouldbe viewedwithcaution,however.Some males
Steady girlfriend 39.4 49.4 46.7 41.5 may nothaveknownwhether theirpartner was usinga
Friend 52.0 39.5 35.6 48.8 method,suchas thepillor rhythm, at thetimeofinter-
Prostitute 3.0 6.2 11.1 4.2
Casual acquaintance 3.0 2.5 2.2 2.9 course.
Other 1.8 0.0 0.0 1.3 As Table 6 shows,mostrespondents who did not
Total 100.0 100.0 100.0 100.0
(N) (396) (81) (45) (523)a practicecontraceptionat firstpremarital intercoursere-
aThe totalincludesthreefemalesand one maleforwhomage atfirst intercoursewas
ported thatthey had notexpected to have intercourseat
unknown. the time(48.1 percentof femalesand 58.6 percentof
males).Lackofknowledgeofcontraception was another
frequentlycitedexplanation fornonuse,especiallywhen
quencyofhavinghad a prostitute as a firstpartneras
firstintercourseoccurredbeforeage 18. Of noteis that
age atfirst intercourse increased.
10 percentofwomensaid theyhad wantedto become
pregnantat firstpremaritalintercourse. This finding
Contraceptive Use
lends some supportto our earlierstatementthatfor
As Table 5 indicates,only20.3 percentof femalesand women,premarital intercoursemayprecipitate marriage.
18.7percentof males reportedusingcontraceptives at Amongunmarried youngadultswhoreported ever
firstpremarital intercourse. The use of contraceptives havinghad sexualintercourse, 36.9percentof females
doubledwithageatfirst premarital intercourse, from13.5 and 29.3 percentof males said theywere currently
percentamong females and 15.2 percent among males sexuallyactive (had had intercoursein the previous
aged under18 to 26.1percentamongfemalesand 30.1 month)(not shown).Sexualactivity amongyoungadults
percentamongmalesaged 18-24.

ofyoungadultsaged 15-24
Table 5 Percentagedistribution Table6 Percentage ofyoungadultsaged 15-24
distribution
accordingto whether
they used and which
contraceptives accordingtotheirreasonsfornot atfirst
usingcontraceptives
methodtheyused at first byage at first
intercourse,
premarital intercourse,
premarital intercourse,
bygenderandage atfirst
and gender,Santiago,Chile,1988
intercourse Santiago,Chile,1988
Females Males
Females Males
Reason <18 18-24 Total <18 18-24 Total
Contraceptiveuse <18 18-24 Total <18 18-24 Total
Did notexpectto
Used a method 13.5 26.1 20.3 15.2 30.1 18.7 have intercourse 40.9 56.2 48.1 56.2 69.2 58.6
Rhythm 3.8 8.5 6.3 4.8 6.5 5.2
Didnotknowof
Pill 2.3 6.1 4.3 3.5 6.5 4.2 a method 20.9 13.2 17.2 16.5 3.8 14.2
Condom 3.0 4.2 3.7 1.3 4.1 1.9 Didnotthink
pregnancy
Vaginals 0.0 4.2 2.3 0.0 0.8 0.2 wouldresult 8.7 12.4 10.5 9.0 11.5 9.5
Withdrawal 3.0 1.8 2.3 2.5 8.1 3.8 Wanted pregnancy 11.3 9.1 10.0 0.9 0.0 0.8
IUD 0.8 0.6 0.7 1.3 1.6 1.3 Believed contraceptives
Injection 0.8 0.6 0.7 0.5 0.0 0.4 arebadforhealth 10.4 7.4 9.2 1.9 1.3 1.8
Other 0.0 0.0 0.0 0.5 0.0 0.4 Couldnotobtain a method 1.7 0.0 0.8 2.5 1.3 2.2
Unknown 0.0 0.0 0.0 0.8 2.4 1.2 Believed itwas partner's
responsibility 0.0 0.0 0.4 8.7 5.1 8.0
Did not use a method 86.5 73.3 79.4 81.3 63.4 77.1 Hada religiousobjection 0.0 0.0 0.0 0.3 0.0 0.3
Unknown 0.0 0.6 0.3 3.5 6.5 4.2 Wastooembarrassed to
Total 100.0 100.0 100.0 100.0 100.0 100.0 obtaina method 0.0 0.0 0.0 0.9 1.3 1.0
(N) (133) (165) (301)a (395) (123) (519)a Other 6.1 1.7 3.8 3.1 6.4 3.7
Total 100.0 100.0 100.0 100.0 100.0 100.0
Note: Fivefemaleswhoreported first
their to havebeena rapeare
intercourse (N) (115) (121) (239)a (322) (78) (401)a
from
excluded thetable.
aThetotals three
include andonemalefor
females whomage atfirst was
intercourse aThetotalsinclude three
femalesandonemalefor was
intercourse
whomage atfirst
unknown. unknown.

1992 131
Volume23 Number2 March/April

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was sporadic:One-thirdofsexuallyactiveunmarried fe- Table 8 revealsthata substantialnumberof first
males and malesreportedhavinghad sexualrelations birthsoccurred outsideofmarriage. Overone-third (36.5
onlyoncein thepreviousmonth.Fewerthan25 percent percent)offirstbirthsto womenaged 15-24wereborn
ofbothsexeshad hadsexualrelations fourormoretimes outsideofunion.Anotherone-third (33.2percent)were
inthepreviousmonth.Noneofthefemalesand only7.6 bornwithinthefirst sevenmonthsafterentry intounion,
percentofthemalesreported havingmorethanonepart- producinga totalof69.7percentoffirst birthsthatwere
ner(notshown). premaritally conceived.The percentageof premarital
Table7 indicatesthatcurrentcontraceptiveuse was conceptions was higheramongwomenaged 15-19than
somewhathigher(butnottoa statistically de-
significant amongwomenaged20-24,although thedifferenceis not
gree)amongunmarried femalesthanamongunmarried statistically Premarital
significant. conceptions appeared
males(65.2percentvs.59.5percent, Among
respectively). to be moreprevalentamongwomenwithmorethana
females,contraceptiveuse was associatedwithage:Un- gradeschooleducation, althoughthisassociationis con-
married womenaged 15-19werelesslikelythanunmar- foundedbytheage ofrespondents atinterview.Father's
riedwomenaged 20-24to have used a methodat their education,a socioeconomic measureless susceptibleto
mostrecentsexualintercourse (48.3percentcompared age bias,did nothave a statistically associa-
significant
with78.4percent, Amongmales,therate
respectively). tionwithpremarital conceptions.3
did notdiffer betweenthetwoage groups.
significantly We did find,however, thattherespondents'parents'
The table,whichalso showsthecontraceptive methods educationallevelwasassociated withwhether thebirth oc-
used by sexuallyactiveunmarried females and males, curred of
outside marriage. Women whosefathers hadonly
indicatesthatthemostprevalent methodsforbothsexes a primary education
werealmosttwiceas likelyas women
were,onceagain,thepill(usedby25.8percent offemales whosefathers werehighschoolgraduates tohavea birth
and 10.7percentofmales)andrhythm (usedby15.2per- outsideofunion.Thisassociation is reversedforinfants
centoffemalesand 16.8percent ofmales).Thethirdmost bornin thefirstsevenmonths ofunion,wherewomenof
popularmethodamongfemaleswas theIUD; butamong highersocioeconomic statushavetwicetheproportion of
males,thecondom,withdrawal, and theIUD all closely infantsbornduringthatperiodas womenoflowerstatus
followedthepill. backgrounds. Sucha patternwas also observedforthe
woman'seducational level,and age was notdetermined
PremaritalConceptions tobe a confoundingvariableinthisrelationship.
Approximately one-fourth (24.3percent)ofthewomen
interviewed had everbeen pregnant(notshown).For Table8 Percentage offirstlivebirths conceivedpremaritally
amongwomenaged 15-24,byselecteddemographic
thosewithsexualexperience, theproportion was 62.6 characteristics
andtiming ofbirth,Santiago,Chile,1988
percent,and formarriedwomenitreached80.8percent,
Premaritalconceptions
whichmayindicatea highsocialvalue attachedeither
Born
to havingchildrensoon afterentering intomarriageor duringfirst
tomarrying as a resultofpremaritalpregnancy. Born outside 7 months
Characteristic of union of union Total (N)
Total 36.5 33.2 69.7 (178)
Age
15-19 47.5 30.0 77.5 (40)
Table7 Percentage ofunmarried
distribution youngadultsa 20-24 33.3 34.1 67.4 (138)
aged 15-24according use andmethod
tocontraceptive used Level ofeducation
duringmostrecent bygenderandage,
sexualintercourse, (years)
0-8 39.6 22.6 62.3 (53)
Santiago,Chile,1988 9-11 41.4 34.5 75.9 (58)
Females Males 12+ 29.9 40.3 70.1 (67)
Father'seducation
Reason 15-19 20-24 Total 15-19 20-24 Total (years)
Used a method 48.3 78.4 65.2 57.1 60.7 59.5 Unknown 36.4 30.3 66.7 (33)
Pill 10.3 37.8 25.8 2.4 14.6 10.7 0-6 41.8 26.9 68.7 (67)
Rhythm 17.2 13.5 15.2 16.7 16.9 16.8 7-11 37.0 32.6 69.6 (46)
IUD 6.9 13.5 10.6 7.1 7.9 7.6 12+ 25.0 50.0 75.0 (32)
Injection 3.4 5.4 4.5 0.0 2.2 1.5 Age at first
intercourse
Withdrawal 6.9 5.4 6.1 11.9 6.7 8.4 <16 43.6 23.1 66.7 (39)
Condom 0.0 2.7 1.5 14.3 6.7 9.2 16-17 40.0 38.0 78.0 (50)
Billings 3.4 0.0 1.5 0.0 3.4 2.3 18-19 37.5 31.3 68.8 (48)
Vaginals 0.0 0.0 0.0 4.8 2.2 3.1 20-24 26.3 42.1 68.4 (38)
Didnotuse a method 51.7 21.6 34.8 42.9 39.3 40.5 Age at first
birth
Total 100.0 100.0 100.0 100.0 100.0 100.0 <18 45.7 28.3 73.9 (46)
(N) (29) (37) (66) (42) (89) (131) 18-19 35.1 36.8 71.9 (57)
20-24 32.0 33.3 65.3 (75)
onlythosepersonswhohadintercourse
a Includes during month.
theprevious

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 The probabilityofhavinga birthoutsideofmarriage than among women who were younger,less educated,
was higheramong women whose firstintercourseor first and oflower parity.
birthtook place at a young age. It is strikingthatalmost
one-half(45.7 percent)of firstbirthsamong women un-
der 18 yearsofage were outside ofmarriage. Discussionand Conclusion
As Table 9 shows, almost 40 percentof all firstlive
birthswere reportedlyunintended. Unintended preg- The Santiagosurveywas one of 11 surveysconductedin
nancyincreasedwiththerespondent'seducationallevel, LatinAmericathatcontaindata on youngadults.The pro-
but notwithherfather'seducation.No relationshipwas portionofyoungmalesin Santiagowho have experienced
found between unintended pregnancyand age at first premaritalsexual activityis similarto thatin Mexico City
intercourseor age at firstbirth. and low compared with proportionsfoundin the other
Young women withtwo or morechildrenwere more countriesforwhich thereare data (see Table 10). On the
likely to report an unintended firstbirth than were otherhand, thelevel of premaritalsexual activityamong
women who had only one child. This relationshipwas femalesin Santiagois higherthanthatin theotherpopula-
also found between the planning status of the most re- tionsshown in Table 10 exceptforJamaica.Moreover,the
centbirthand thenumberof children.A higherpropor- age at firstpremaritalintercourseforboth males and fe-
tionof women with two or more children(47.2 percent) males in Santiagois higherthanthatin otherLatinAmeri-
reportedan unintendedpregnancythatled to the most can locations.The differences observedmaybe attributable
recentbirththan did women with one child (36.6 per- to thedifferent levelsofeconomicdevelopmentofthespe-
cent) (notshown). cificcountriesinvolvedor to socialand culturalfactors, be-
Among the women surveyed, the overwhelming cause there is great variationin both of thesedimensions
majorityofunintendedpregnancies(89 percent)resulted acrosstheLatinAmericancontinent.
frompremaritalconceptions.Consequently,forwomen Chile is more developed than the other countries
who experienced premarital conceptions, we see the shown in thetable,and itspopulation has a correspond-
same relationshipwith othervariables as was observed inglyhigherlevel of educational attainment.One effect
forall women.Thatis,unintendedpregnancywas higher of highereducational levels can be thepostponementof
among women aged 20-24, who had more than a pri- sexual activityresultingfromhigheraspirationsand the
mary school education and had two or more children, availabilityof more alternativesto early marriageand
childbearing(Singh and Wulf,1990). At the same time,
Table9 Percentageoffirst andpremarital
livebirths increasingeducational levels can cause the age at mar-
thatwereunintended
conceptions amongwomenaged 15-24,
Santiago,Chile,1988 riage to rise to a point where it is difficultfor young
characteristics,
byselecteddemographic
people to desist fromsexual activityprior to marriage
All Premarital
Characteristic firstbirths (N) conceptions (N) (Liskinet al., 1985). This situationmay explain the large
Total 39.9 (178) 50.8 (124) increasein premaritalsexual activityamong Santiaguans
Age fromages 15-19 to ages 20-24 and, consequently,the
15-19 35.0 (40) 41.9 (31)
20-24 41.3 (138) 53.8 (93) higherage at firstpremaritalintercoursethanis observed
Levelofeducation in theotherLatinAmericancountries.
(years)
0-8 28.3 (53) 33.3 (33) At the same time,theremay also be culturalfactors
9-11 46.6 (58) 56.8 (44) influencingdifferences in adolescent sexual activity.For
12+ 43.3 (67) 57.4 (47)
Father'seducation example, the practiceof bringingyoung boys to prosti-
(years) tutesas a formof initiationinto manhood has the effect
Unknown 42.4 (33) - (22)
0-6 37.3 (67) 52.2 (46) ofincreasingsexual intercourseat youngages. This prac-
7-11 45.7 (46) 53.1 (32) tice has been noted in Guatemala and Ecuador, where
12+ 34.4 (32) - (24)
Age at first
intercourse age at firstintercourseis relativelyyoung formales, and
<16 35.9 (39) 50.0 (26) where a substantialproportionof firstsexual partners
16-17 40.0 (50) 48.7 (39)
18-19 37.5 (48) 45.5 (33)
ofyoung men are prostitutes(Herold et al., 1988;Centro
20-24 47.4 (38) 61.5 (26) de Estudios de Poblacion y Paternidad Responsable,
Age at first
birth 1989). In Chile, such a practiceis notnormative,and this
<18 41.3 (46) 50.0 (34)
18-19 38.6 (57) 46.3 (41) may be part of the explanationforlower ratesof sexual
20-24 40.0 (75) 55.1 (49) experienceamong 15-19-year-oldmales in Santiago. (In-
Numberoflivebirths
1 36.6 (142) 47.4 (97) deed, the data show thatonly 4 percentof the Santiago
2+ 52.8 (36) 63.0 (27) males stated that theirfirstsexual partnerhad been a
than25 cases.
fewer
Note: Dashes(-) represent prostitute.)

Volume 23 Number 2 March/April1992 133

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All use subject to JSTOR Terms and Conditions
 Table 10 Percentageofyoungadultsaged 15-24 reporting
premarital
sexual intercourse,
bygender
and age, selected surveysinLatinAmerica

Country Yearof 15-19 20-24 Meanage atfirst

andcity survey % (N) % (N) intercourse
(years)
Females
Jamaica 1987 55.4 (1,046) 90.5 (892) 15.6
Mexico
MexicoCity 1985 13.4 (876) 39.1 (705) 17.0
Guatemala
Guatemala City 1986 12.4 (405) 35.7 (294) 16.7
ElSalvadora 1988 15.7 (753) 32.3 (765) 16.4
CostaRicaa 1986 18.1 (702) 40.6 (677) 16.6
Panamaa 1984 14.2 (1,648) 37.4 (1,604) 16.7
Ecuador
Quito 1988 11.9 (404) 33.8 (399) 17.4
Guayaquil 1988 18.4 (474) 42.7 (379) 16.7
Brazil 1986 13.9 (1,318) 36.5 (1,168) 16.6
Salvador 1987 20.1 (508) 54.7 (448) 17.2
Sao Paulo 1988 25.7 (443) 53.5 (361) 16.8
Paraguaya 1987 21.2 (388) 48.7 (493) 16.9
Chile
Santiago 1988 19.1 (488) 56.5 (377) 17.9b
Males
Jamaica 1987 78.1 (1,090) 96.8 (786) 12.7
Mexico
MexicoCity 1985 43.5 (793) 85.7 (609) 15.7
Guatemala
Guatemala City 1986 64.5 (327) 87.3 (244) 14.8
Ecuador
Quito 1988 58.5 (412) 97.1 (350) 15.1
Guayaquil 1988 63.9 (449) 94.0 (349) 14.8
Brazil
Salvador 1987 73.2 (500) 93.8 (371) 14.8
Sao Paulo 1988 72.6 (398) 93.2 (352) 14.7
Chile
Santiago 1988 47.6 (435) 85.7 (364) 16.0b
a Malesnotincluded
inthesesurveys. b
Meanage doesnotagreewith
medianinTable3 as thelatter
useda life-table
method
not
usedinthecurrent
table.
Source: Morris
(1990),Tables3Aand3B.

The pattern of differences between females in in theotherLatinAmericansettings forwhichwe have

Santiago and femalesin the otherLatin Americancities data. Furtherevidenceof sexual freedomforChilean
surveyedis not the same as thatformales. The effectof womenis thatfewofthem(16.2percent)reportedthat
economicdevelopmenton premaritalsexual activityfor theirfirst
sexualexperience was witha spouseora fiance.
women can be, as with males, both positive and nega- Thesewomendo notdemonstrate promiscuity,
however,
tive. Certainly,women can experience the same nega- as four-fifths
reported thattheirfirst
partnerhad beena
tive effectas men in termsof increasingeducation rais- steadyboyfriend.
ing aspirationsamong theyoungand reducing(typically InSantiagoas wellas inothercountries,
therelation-
unprotected)sexual activity.At thesame time,however, shipwiththefirst sexualpartneris morecommitted and
because women in Latin Americansocietieshave tradi- contraception is morelikelytobe used whenfirst inter-
tionallybeen prohibitedfromparticipatingin premari- courseoccursat olderages (de Monterroso et al., 1988;
tal sex,thedissolutionoftraditionalvalues thatoftenac- Powell et al., 1988;Centrode Estudiosde Poblaciony
companies economic development and higher PaternidadResponsable,1989;Sakamotoet al., 1991).
educational attainmentwould tend to increase female Thus,the laterage at firstintercourseamongyoung
premaritalsexual activity.This situationwould be espe- Santiaguansmayhelpto preventmoreunintended and
cially true in a societythat has a late age at firstmar- out-of-wedlock birthsthanmightotherwise resultifin-
riage. In Santiago, it appears that the positive effectof tercoursebeganatearlierages.
economic development on women's premaritalsexual Nonetheless, thereremainsa veryhighproportion
activityoutweighs the negative effectof raised aspira- ofpremarital conceptions andbirthsoutsideofmarriage
tions, yielding higher rates of premaritalsex than are amongyoungadultsin Santiago.The levelofpremari-
foundin less developed countriesofLatinAmerica. tal conceptionswas 70 percent,and one-third of first
These resultssuggest somewhat more sexual free- birthsto womenaged 15-24wereoutsideofmarriage.
dom forwomen and a consequently greaterparityin Almostone-half ofthewomenwhobecamemothers be-
sexual mattersbetween the sexes in Chile than is found foreage 18hadtheirfirst childoutsideofmarriage.These

134 StudiesinFamilyPlanning

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figuresare comparable to the figureof 33 percentof all and even to increases in out-of-wedlockand unwanted
livebirthsbeingout ofwedlock in Chile in 1984and 1987, birthsamong young people in recentyears (Viel and
as reportedbyViel and Campos (1987and undated).Also Campos, 1987;Viel, 1989).
worth noting,and similar to the findingsof Viel and The implicationsof thefindingsof theSantiago sur-
Campos' studies,are thehigherproportionsofbirthsout- vey are thatefforts to reduce premaritaland unintended
side ofmarriageamong 15-19-year-oldscompared with pregnancyamong women under the age of 25 must fo-
20-24-year-olds.As has been pointed out, out-of-wed- cus on the provision of contraceptiveinformationand
lock birthsat theseages are ofgreaterconcernthanthose services.However,sinceChile has had a well-established
among women over age 20, insofar as the former are familyplanning programforseveral decades, the need
morelikelyto involvean absentfather;women aged 20- may not necessarilybe one forgreateroverall inputinto
24 are more likelyto live with the father,even though generalfamilyplanningservices;rather,specialized ser-
he may notbe a legal spouse (Viel and Campos, 1987). vices are needed to reachsexuallyactiveadolescentsand
We need also be concernedabout the association of young adults who are some years away frommarriage
the timingof firstbirthswith socioeconomic status,in and planned childbearing.Sex education and programs
thiscase measured by both the father'sand the respon- orientedtowardyoung,unmarriedwomen and men are
dent's education. Bothvariables indicatethatfirstbirths essentialrequirementsto achieve a reductionin untimely
born outside of marriageare farmore prevalentamong birthsamong thissubgroup ofthepopulation.
women oflower socioeconomicstatus.Women ofhigher
status seem to marryor entera consensual union soon
aftertheoccurrenceofa premaritalconception.Thus,the Acknowledgments
women who can least affordto care fora child on their
Fieldworkforthissurveywas fundedby theUnitedNations
own are theones experiencingtheburden.
Fund forPopulationActivitiesthroughthe Pan American
The highproportion(40 percent)ofunintendedfirst HealthOrganization. Seedmoneyfortheproject was provided
pregnanciesreportedby theyoung women in thisstudy bytheCenterforPopulationOptions.Theauthorswould es-
was primarilyattributableto premaritalconception.Al- pecially like to acknowledgethe contributions of Steven
most90 percentofunintendedfirstpregnancieshad been Kinchen, Computer Specialistat the Centers forDisease Con-
premaritally conceived.We feelconfidentthatifthelevel trol,as well as Ilse Lopez, Statistician, and Nelson Vargas, Di-
rector, Department ofPublicHealth,University ofChile.They
of premaritalpregnancyin Santiago were substantially fortyp-
aregrateful to SharonSiegmundofEmoryUniversity
reduced,thelevel ofunintendedpregnancieswould also ingthemanuscript.
decline significantly.
The levels of premaritaland unintendedpregnancy
among 15-24-year-oldsin Santiago appear to be a func- Notes
tionofbothpremaritalsexual activityand theinadequate
use of contraceptivesat premaritalintercourse.Contra- 1 Theterm"married"inthistextreferstobothlegaland consensual
ceptiveuse at firstintercoursewas low, and whereas the unions.
prevalenceofcurrentcontraceptive use was muchhigher, 2 Attendance is dichotomized intoattending servicesat leastoncea
the high proportionsof both sexes using rhythm and of month and attending serviceslessthan once a month.
males usingwithdrawalindicatesdependence on less ef- 3 We assumethatthe33 unknownvalueson father's educationdo
fectivemethods.4The prevalence rate forcurrentuse of notaffect theassociationof thehighestcategory of thisvariable
withpremaritalconception.All 33 cases have values forthe
the more effectivemethods of contraception(pill, IUD,
woman'sownlevelofeducation thatarebelowthemedianfortheir
injection,and condom) was only42.4 percentforunmar- agegroup,suggesting thatthesecasescomefromfamilies withlow
ried sexuallyactivewomen and 29.0 percentforunmar- educationallevels.It therefore maybe assumedthatthefather's
ried sexuallyactivemen. educational level,ifknown,wouldbe lessthan12years.
The use of less effectivemethods among the sexu- 4 Elsewhere inthequestionnaire respondents wereaskedtoidentify
ally activeyoung adults ofSantiago may reflect poor ac- the time during the menstrual cycle when a womanwas mostat
cessibilityof contraceptiveinformationand servicesfor riskof becoming pregnant.Only halfof theyoung adultswhore-
portedcurrent use oftherhythm methodcorrectly answeredthis
Chilean youths. According to Viel (1989), government
question.
supportforfamilyplanningprogramshas been less vo-
cal and therehas been less advertisingsince 1980, pre-
sumablycausing a decline in theuse of familyplanning
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