Young, single women in urban China are aware of contraceptive methods but some may be too shy to ask for them, research published in the online open access journal BMC Health Services Research reveals. Young women want more information, but need private and anonymous family planning because of judgemental attitudes surrounding premarital sex and particularly premarital pregnancy.

Encouraging contraceptive use among young migrant workers in China to prevent pregnancy and sexually transmitted diseases is no easy task, according to the study by Xu Qian and other researchers from Fudan University, Shanghai, China and Liverpool School of Tropical Medicine, UK. Prompted by their research published in 2004, which showed a high percentage of urban women had experienced abortion prior to marriage, Xu Qian’s team targeted young female workers (aged 16-30) at a Shanghai mobile phone factory. They offered lectures, information leaflets and a free workplace contraceptive service led by the factory’s doctors, who received extra training.

The family planning information leaflets proved popular, but very few women (5%) used the factory’s free family planning service. While 100% of participants attended the first of two lectures on reproductive physiology and barrier methods, just over half made it to the second on oral and emergency contraceptives and preventing sexually transmitted infections. The women voiced concerns about using a workplace service where privacy was compromised, and using a service without paying for it. Overriding concerns were discomfort or embarrassment and being judged by others.

The data collected in this study questions the assumption from previous research in China that young people lack knowledge and awareness of effective contraception methods. The baseline data on attitudes indicated a perceived need for contraceptive use in unmarried youth; around 90% of women in both groups said contraceptive use was necessary in premarital sex. Privacy, anonymity and appropriate services for the young migrant workers may be more important in determining use of contraceptives in this population.

In the urban migrant populations in Shanghai about half of unmarried women have been pregnant, with 40% choosing not to attend legal clinics for safe abortion. China’s National Family Planning Program currently targets only married couples and in privately owned factories, family planning services are limited. The researchers suggest most young women glean information on reproductive health from magazines and the radio.

"Promoting contraceptive use among unmarried female migrants in one factory in Shanghai: a pilot workplace intervention"
Xu Qian, Helen J Smith, Wenyuan Huang, Jie Zhang, Ying Huang and Paul Garner