Imagem: VERIDIANA SCARPELLIAccording to demographic projections announced last year by the UN, Brazilian soccer fans at the 2050 World Soccer Cup Games will have to be content singing “222 million people in action, hurray for the national team” instead of the expected “300 million people in action.” This might sound like good news to those who warn of the dangers of a “demographic explosion” in the country. However, the real situation in the last few decades has been quite different yet equally worrying. The female fertility rate has been rapidly declining; in 1960, the rate was 6.3 children per woman. This number dropped to 5.6 (1970), 2.9 (1991), 2.4 (2000) and 1.9 in 2010. “The fertility rate of the Brazilian population has achieved a level that is below the replacement level. This decline has been noticed in all age groups and regions in Brazil. Another aspect that should be highlighted is that the drop in the fertility rate shows a pattern of rejuvenation; i.e., from 1991 onwards, women from the ages of 20 to 24 had the highest specific fertility rate, which in previous years would have corresponded to women from the ages of 25 to 29. The percentage of adolescents from the ages of 15 to 19 in the total fertility rate, corresponding to the entire reproductive period, went up from 9% in 1980 to 23% in 2006,” explains demographer Elza Berquó, from the Brazilian Analysis and Planning Center (Cebrap). At Cebrap, Elza Berquó coordinates a research project that focuses on Reproduction in Young People and after the Age of Thirty.
According to Elza Berquó and Sandra Garcia, who is also a researcher at Cebrap, the main objective of this research work is to show that demographic shift in Brazil has specific characteristics. On one hand is the aforementioned rejuvenation of fertility, and on the other hand is the fact that child-bearing has been to a great extent postponed until after the age of 30. The concurrent existence of these two fertility regimes will shape the country´s near future. “This shift can be positive or negative, depending on how society will deal with these changes. As the fertility rate has fallen significantly, the population is aging, and life expectancy has risen, in the future between 2030 and 2035, we will have a serious lack of a young workforce, as is happening in the more developed countries, where for decades the population has been made up of more elderly people than young people. This fact has placed an increasingly heavy burden on the economically active population,” the researchers state. “However, there is a new element in Brazil – the rejuvenation of the fertility rate – which has not been seen in the developed countries. In 1980, the peak of fertility was between the ages of 25 and 29 years. Nowadays, the fertility rate is highest among young people from the ages of 20 to 24 years. This shows that there is still some leeway, even though very soon young people will carry less weight while older people will carry more weight.”
Imagem: FONTE: PESQUISA NACIONAL DE DEMOGRAFIA E SAÚDE - 2006When analyzing the factors that have influenced the shrinking of families in Brazil, Elza says that in the past families had many children because they were affected by high infant mortality rates. These had to be offset so that the survivors would be available to take care of their parents as they aged. With the advent of Social Security, the State took on this role, in principle. At the same time, consumer credit policies in the 1970s drove people to consume more and to think about adjusting their desires of consumption with the number of children. The big change in the field of communication, especially television, which came into many homes and places, also influenced – especially through soap operas – small family values and life styles. Another factor was the arrival of the birth control pill, which provided women with the opportunity of controlling their fertility.
“We will have an aging population until the middle of the 21st century. However, in the case of Brazil, there is still time to take advantage of this as a `demographic bonus,´ which is no longer feasible in the case of Europe. In terms of education, for example, the drop in population growth, coupled with the aging of the population, can be a bonus, as this will provide an opportunity to improve education coverage and quality. In addition, there will be less pressure put on natural resources and on the environment,” the demographer points out. “However, this window of opportunity will close very quickly – around 2030, allowing for development to take off and for quality of life to improve, provided that this bonus is taken advantage of in an intelligent manner,” says demographer José Eustáquio Diniz, coordinator of post-graduate programs at the Brazilian Institute of Geography and Statistics (IBGE). “If we miss this opportunity and focus only on the disadvantages of an aging population, this could lead to declining economic growth because of a crisis in the labor market and the burden that the aged will place on the young people.”
However, aging is not the only factor that will shape this demographic transition. “This research study has confirmed that sexual intercourse begins at an increasingly earlier age – the result of a more liberal world where virginity is no longer a value. However, this did not happen together with more knowledge about and more extensive use of birth control methods,” says Elza. Even though young people under the age of 20 know nearly everything about birth control methods, only 60% of the sexually active youngsters resorted to any birth control method. Of the non-users, 40% did not know where to obtain them and of these, one out of every five young girls got pregnant when they had sexual intercourse for the first time. In relation to adolescents from the D and E social classes, 68% did not know where to obtain birth control methods; this percentage figure drops to 70% in the case of less well-educated adolescents. Of the adolescents who got pregnant before the age of 20 years, 78% had no idea about the physiology of reproduction or of the fertile period during the ovulation cycle,” says the researcher. The study suggests that sexual and reproductive behaviors are shaped by structural possibilities and by cultural rules. Thus, the poorer and less educated adolescents use less contraceptive methods, by percentage, which shows the direct link between pregnancy before the age of 20 years, poverty and little or no education.
Imagem: Veridiana Scarpelli
“An amazing 96.2% of the adolescents have a highly positive perception of the implications of pregnancy on their emotional lives and on their self-esteem. This is in contrast with the view of people who link teenage pregnancy to the absence of a life project. The data seems to indicate that, in the absence of a good education, of better life conditions and of better opportunities, an unexpected pregnancy is actually a life project rather than the absence of such a project,” says Sandra. “For the majority of society, teenage pregnancy is a huge problem, a total lack of responsibility, almost a national tragedy, as the normal expectation for young people is that they go to school and get ready to enter the market. This ideal view fails to take into account that opportunities are not equally offered to everybody in Brazilian society,” points out Maria Luiza Heilborn, a professor at the Social Medicine Institute of the State University of Rio de Janeiro (IMS/UERJ). “This is the same mistaken idea as the one which states that the poor segment of the population is about to create a demographic explosion. Among the poor segments of the population, pregnancy is generally viewed as providing social status in view of the lack of professional opportunities; it is viewed as a way of entering the adult world. Among the middle classes, pregnancy becomes acceptable at a much later age, when professional and financial issues have already been dealt with. Hence the reason for more abortions in these segments of the population,” she adds
In the researcher’s opinion, while teenage pregnancy is viewed as something undesirable, as an indicator of “underdevelopment,” at the same time society closes access to contraceptive methods and criminalizes abortion and the day-after contraceptive pill. “Teenage pregnancy is unacceptable, but there is no similar consensus in regard to allowing the use of certain methods to interrupt pregnancy,” says Maria Luiza. “The contraceptive and reproductive choices are being made within a context in which abortion is illegal, there is very little information available, and the availability of emergency contraceptive methods is not widely implemented in public schools. What would the life of these young people be like if the institutions improved their actions and the nation provided more equal opportunities,?” Sandra wonders. After all, being informed about contraceptive methods is no guarantee that they will be properly used. “At this age, sexual encounters are mostly unpredictable, and therefore the notion of contraception is not incorporated into adolescents’ daily lives. Adolescents feel uncomfortable talking about sex with their families or going to the drugstore to buy condoms. The birth control pill, with its side effects on the bodies of adolescents living in a society that demands perfect bodies, adolescents´ ecological tendency to avoid taking chemical products, and forgetting to take the birth control pill – all of these factors lead to unwanted pregnancies,” says Eliane Brandão, of the IMS/Federal University of Rio de Janeiro. All of these factors are coupled with contraceptive-related failures and unqualified healthcare professionals who do not know how to deal with adolescents to explain contraceptive methods.
Imagem: FONTE: PESQUISA NACIONAL DE DEMOGRAFIA E SAÚDE - 2006“The fact is that sex among adolescents is still taboo, something which is not being dealt with properly by government authorities, by the school and by the family. Why is it that campaigns advocating the use of condoms to prevent transmission of HIV – and which has had enormous repercussions – failed to link problems related to sexually transmitted diseases to the issue of pregnancy? It was a total lack of vision,” Elza points out. The researcher is not very optimistic about the enthusiasm of girls who get pregnant during adolescence. “ In general, this positive view is post facto; that is, it is a way of accepting an inevitable fact,” she says.
The demographer also partially disagrees with the thesis that the majority of teenage girls who dropped out of school because they got pregnant would have dropped out anyway or had already dropped out. “It is fitting to ask why this is still happening in a society where the best job opportunities are associated with higher educational levels. Our schools do not have any special programs for young mothers. Even though we do not have any substantial data, we have to consider that being a mother in a context in which poorly educated people have very few opportunities will have serious consequences on the lives of these young girls,” she adds. A young girl with no children has 60 times more chances of staying in school than a young mother of the same age and income level.
“In Brazil, the lack of education and opportunities is driving many adolescents to start a family as a life project. This is not the case in a better educational and economic system, as can be witnessed in developed countries, where general fertility rates have declined, and not only among adolescents,” Elza says. Who would actually plan to be a young mother in a country without day care centers or support for adolescent mothers, obliging them to depend on the solidarity of their family members and neighbors to survive and enter the job market? “This explains the long lines of women waiting for sterilization, which exposes them to STDs. It is not easy to exert sexuality. This is a natural right, but there are risks entailed.” The research revealed an unexpected fact: in the higher-income bracket, 44% of the girls from the ages of 15 and 20 years have never had sexual intercourse. “This percentage figure really surprised us. The girls stated that they have other things to do to keep busy and that they want to keep their virginity until they get married: this is not only an issue of avoiding pregnancy or sexual intercourse. This conservative attitude is increasing and could be associated with the growing number of Evangelicals,” Elza points out.
The Federal Government’s Provisional Measure 577 established a national registry of pregnant and postpartum women. The objective of this registry, which is to reduce maternal mortality, could result in identifying the number of abortions, “ which is a direct invasion of a woman’s privacy and entails the possibility of pressure from conservative groups in the sense of advocating proposals and measures that would impact the progress made in this respect, such as the freezing of embryos and experiments with stem cells,” says Elza.
There is another factor in this new demographic arrangement: the phenomenon of pregnancy after the age of 30. The research study shows that “women from higher social and income levels are the ones who decide not to have children and instead concentrate on personal and professional fulfillment. What draws attention is the fact that 45% of these women have never married or had a stable partner. In the period from 1996 to 2006, the percentage of childless women under the age of 30 went up from 5.3% to 9.2% and the percentage of women who bore children after the age of 30 or more went up from 4.8% to 6.7%,” says Elza. The perception that these women have of their lives is that they made the right choice and that they will be better mothers when they are over the age of 30 or more. However, when the postponing of child bearing goes beyond the biological limits, thus resulting in fertility-related problems, a new element is added to this demographic shift: namely assisted reproduction. “Thirty percent of the women at a fertile age state that they cannot have children, either because they are sterile or because they have undergone a sterilization procedure. This percentage figure goes up to 57% among women from the ages of 35 to 49. Of the fertile women in this age group, 7% stated that they want to have children. If we take into account the women who regret they had undergone sterilization procedures, the result is a high percentage of women who want to resort to assisted reproduction,” explains Sandra Garcia, of Cebrap, author of the research study Reprodução assistida no Brasil, Assisted Reproduction in Brazil. This study was sponsored by FAPESP under the Young Researchers program.
Imagem: Veridiana Scarpelli
Assisted reproduction, a phenomenon seen in various European countries and in the United States, has been in increasing demand in Brazil. However, most of the related treatments are conducted at private clinics and are therefore very expensive. “Nowadays, the lower-income segment of the population – and not only wealthy couples – want to have access to the reproduction process, which is a Constitutional right. The State is responsible for making the related treatments available to the population in general,” says Sandra.
Homosexual men and women, as well as singles, also claim this right. The National Policy of Full Attention to Assisted Human Reproduction was implemented in 2005, as a policy under SUS, the Brazilian National Health Care System, but was soon suspended. “This is disrespectful to citizen rights; in addition, suspension of the policy means that assisted reproduction is not regulated, making women more vulnerable. Whenever a new assisted reproduction technology is announced in the media, it is not uncommon to hear of women rushing off to specialized clinics, in their search for new technological solutions that are still not on the market and need more time to be validated,” says the researcher. In Sandra´s opinion, assisted reproduction will not prevent the decline in the fertility rate, but it can bring fulfillment to many people. “However, women have to be more active in terms of fighting for this right. The existing attitude might be due to the fact that women have been fighting for a long time to have the right of access to abortion and to contraceptive methods, priority demands that have not been fully met yet,” says Sandra. “On the other hand, the deconstruction, by feminists, of motherhood as women´s destiny has led to strong criticism and resistance to reproductive technologies,” she adds.
Researcher Elza Berquó states that “men and women should have the right to decide on their sexuality, sexual preferences, and reproduction. It is the State´s responsibility to provide information and conditions to make sex safe, and therefore pleasurable.” The country´s new demographic map is being designed within the scope of intimacy. Becoming acquainted with and understanding this new demographic arrangement may contribute to ensuring and expanding sexual and reproductive rights.
Assisted reproduction in Brazil: social-demographic aspects and challenges for public policies (nº 2010/14827-6); Modality Young Investigator; Coordinator Sandra Garcia – Cebrap; Investment R$ 142.680,00