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PIP: This paper studies the attitudes of Aboriginal people to family planning and family planning services, and the actual practices of health personnel in the communities, to examine the mechanism of decline in Aboriginal birth rates. The Aboriginal attitudinal data was obtained from surveys conducted of 251 women (aged 15-50) in 5 communities in New South Wales, South Australia, Western Australia, and Queensland. Results are complex: 1) Aboriginal women are more likely to approve of birth control for spacing children than for any other reason, 2) they are somewhat less likely to approve its use to stop having children, and 3) they are strongly opposed to people using contraception to delay the births of their 1st children. 64% approved of birth control for at least 1 reason. The large proportion of women who claimed no knowledge of family planning or expressed no opinion about particular questions is strong evidence of sensitivity about the subject of family planning. Women rarely discuss family planning with their husbands. Aboriginal women show a marked preference for receiving family planning advice from a doctor; most did not indicate a preference for Aboriginal health Workers. Usually, Aboriginal people have little choice in the matter of health services since they usually have access to only 1 channel of health care delivery. The main mechanisms of fertility control used in the various communities were IUDs, tubal ligation, and injectable contraceptives. Aboriginal women frequently reject the pill. Few Aboriginal men use condoms. Aboriginal birth rates have remained at a plateau level since the late 1970s. It is likely in the future there will be a gradual downward trend in birth rates but the main variable in this assessment is the extent to which the approval of Aboriginal women of more spacing between births will be translated into effect though the activities of more informed health service personnel and the opportunity for women to make informed choices.
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