Vietnam Seeks to Modernize Its Methods of Birth Control

HANOI —  Concerned about a national shortage of condoms and its abortion rate--the highest in Asia--Vietnam is trying to revolutionize the way this densely populated nation looks at birth control.

For the last decade, Vietnam has made family planning a top priority and made admirable progress in curbing population growth. But birth control remains primitive, with abortion being the most common way to meet the Communist government’s goal of limiting each family to two children.

Although officially discouraged by the government, abortion has become so common in Vietnam that 40% of all pregnancies are terminated by the procedure, and on average every woman has 2.5 abortions in her lifetime, the Vietnam Institute of Sociology says. Most hospitals perform abortions for $3 and do not require the patient to provide any information about herself.

Condoms are in such short supply that smuggling them from China has become a hot business. So now the government is stepping in. It has opened Vietnam’s first condom factory in Ho Chi Minh City, formerly Saigon, and is subsidizing the cost--condoms sell for 10 cents each--to make the contraceptives affordable to all. It also is using billboards and TV spots to push condoms as a desirable alternative to abortion.

Until its recent change of heart, the government had been reluctant to promote condoms because it associated them with casual sex, prostitution and homosexuality--sensitive subjects in this conservative society. Its new direction, including soliciting funds from the United Nations to subsidize the sale of 100 million condoms over the next four years, underscores the importance to the government of reining in population growth.

“We consider it one of our most important national issues,” said Phan Thanh Tram, head of the women’s studies department at the Women’s Union, a government-sponsored organization. “If we don’t have reasonable population growth, we can never develop economically or sustain our development.”

Other countries in heavily populated Southeast Asia are also trying to limit the size of families. The only exceptions are Malaysia, which, with 20 million people, considers itself underpopulated, and the Philippines, which is predominantly Roman Catholic.

In 1961, Vietnam was one of the world’s first developing countries to formulate a family planning program. But Government Decree 216 was tough to enforce and became sidetracked by the Vietnam War--for which Hanoi needed more young men, not fewer. The casualties Vietnam suffered in the war left the country with a gender imbalance, 51 women for every 49 men.

“We weren’t too successful at first,” said Tran Tien Duc of the government’s National Committee for Population and Family Planning. “We didn’t have experience in selling family planning to the people, and such things are a very personal matter. Then the war came in 1965, and we had more pressing issues to deal with.”

Today, Vietnamese officials know that the nation’s population--57% of which is younger than 25--is a potential time bomb. The population has doubled to 76 million since 1970 and could reach 150 million within a generation, Duc said.

The social and economic strains of such an increase would appear certain to dash the government’s goal to transform Vietnam into an industrialized nation with a modern economy and a per capita income of $2,000--nearly seven times the current level--by 2020.

The family planning program, however, is already paying dividends. The average number of children born to each woman between the ages of 15 and 49 dropped to 2.7 in 1997 from 3.8 in 1989, the government says.

Hanoi has strengthened its family planning policy by decreeing that government employees who have more than two children can lose their jobs or be forced to give up some perks. Those who have a third child must pay a one-time tax of about $12.

Because sons are more valued than daughters--sons help support their parents, but daughters go off and become part of another family--it is not unusual for a couple with daughters to keep trying to conceive a son.