South Korea and Cuba are dissimilar in religion, economy, culture and attitudes toward premarital sexual relations. In 1960, Korea instituted a national family planning programme to combat rapid population growth. Cuba explicitly rejected Malthusian policies, but made family planning universally available in 1974 in response to health needs. Both countries have undergone rapid fertility declines and today have less than replacement level fertility. Both countries have also used a similar mixture of methods, including a high prevalence of female sterilisation. Abortion has played a major role in the fertility decline of both countries, rising in the first half of the fertility transition and then falling, although remaining a significant variable in the second half. It is concluded that access to contraception, voluntary sterilisation, and safe abortion has a direct impact on fertility and has been associated with a rapid fall in family size in two very different countries.
PIP: It is argued that access to contraception, voluntary sterilization, and safe abortion had a direct impact on fertility decline in two countries (Cuba and Korea) that differed in religion, economic conditions, culture, and attitudes. Both countries achieved below replacement fertility through high rates of contraceptive prevalence and ready access to legal abortion. Family planning services were provided in both countries through the public sector and in Korea through a subsidized private sector. Fertility decline in both countries occurred at the same time as the initiation of family planning programs. Family planning was introduced in Korea in order to reduce population growth and in Cuba in order to reduce the incidence of induced abortion and not for demographic reasons. Both Korea and Cuba had successful family planning programs over the past ten years that combined awareness, accessibility, and perceived quality. Korea adopted legal abortion as a means of reducing high maternal mortality rates and fertility. Cuba adopted legal abortion, during a period when the government lacked hard currency and consumer items such as birth control pills. Even antibiotics were difficult to obtain, particularly for teenagers. Both countries worked to improve services for teenagers. The experiences with family planning in both countries provide support for the theory that socioeconomic forces are not needed to push fertility lower. It is suggested that access to reversible and permanent contraception and safe abortion increases the speed of the transition and permits lower fertility than would otherwise be achieved without formal family planning programs. Fertility decline occurred in Korea under rising incomes and Cuba experienced declines during a period of economic declines. Both countries need to expand options for reducing exposure to pre-union adolescent pregnancies.