Fertility Desires and Contraceptive Transition

Fertility desires are fundamental to understanding contraceptive use, yet the relationship between the two remains unclear and is the subject of much debate in demography. To understand the macro-level relationship between fertility desires and contraceptive transition in low- and middle-income countries, we introduce a conceptual model that articulates the micro-level processes through which a desire to avoid childbearing translates into contraceptive use and reasons for their frequent misalignment. The model calls for a more nuanced understanding of fertility desires, differentiates between the acceptability and accessibility of contraception, and highlights the multilevel forces that shape the costs of fertility regulation. These micro-level processes are key to understanding the evolving role of changes in fertility desires and changes in the implementation of desires on contraceptive transition across time and space. We conclude these relationships are additive, multiplicative, and dynamic over time.