Bangladesh has experienced a rapid decline in fertility in the past
several decades, facilitated by proactive population policies,
provision of contraceptives, and broader societal shifts, encouraging
smaller families and use of contraceptive to achieve revised
childbearing norms. This paper presents 18 years of data from the
Sample Registration System, a demographic surveillance system operated
by the Maternal and Child Health-Family Planning Extension Project in
six study areas in Bangladesh. Prospective measurements of
women\u2019s fertility preferences were used for classifying nearly
25,000 birth outcomes from 1983 to 2000 as intended, unintended, or
\u2018up to God/Allah\u2019. Over the 18-year period, the level of
unintended births varied from 22% to 38%, with the lowest levels in the
mid-1990s. Fatalistic responses declined significantly from 25% in the
mid-1980s to 1% by the late 1990s. Results of the comparison of two
geographic areas of Bangladesh indicate differential declines in the
levels of unintended pregnancies over the study period. Prospective
measurements of unintended pregnancies were 2-3 times the magnitude
indicated by retrospective estimates of unwanted births from the
demographic and health surveys conducted during the study period. This
unique dataset provides a rare opportunity to visualize the vast
changes in fertility preferences and unintended births in Bangladesh
from 1983 to 2000. Significant declines in fatalistic responses reflect
broader social changes that occurred in Bangladesh to facilitate the
fertility decline and contraceptive uptake. The drastic differences
between prospective and retrospective measurements of fertility
preferences highlight the importance of considering the strengths and
limitations of each method when attempting to estimate the true level
of unintended pregnancies and births in a population