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Mr. Malthus confesses that his proposal to exclude them would not remove the evil, and both he and Mr. Godwin have declared that the true remedy can alone be found in preventives. I The right of couples "to determine freely and responsibly the number and spacing of their children", long taken for granted in most of the world, was formally declared at the 1968 International Conference on Human Rights. [Extracted from the article]

Background: Each year, over half a million women die of complications of pregnancy, child bearing or unsafe abortion, the vast majority in developing countries ,Significant proportion of these deaths could be avoided through the effective use of family planning, Family planning is recognized as among the 4 core components of safe motherhood. Objective: identify the knowledge, attitude and practice among males and females in reproductive age to ward family planning methods in AL-Mukalla district . Material :a total of 600 male and female ,in reproductive age living in AL- Mukalla district were interviewed about their knowledge, attitude and practice of family planning, Descriptive cross- sectional study was conducted in AL- Mukalla district, 2012, using self-administered questionnaires. Results: About 3.5% of respondents were illiterate ,there knowledge(89,5%) for traditional methods (99.3%)was more than modern methods and approval (67%) about family planning methods. the females mostly preferred IUCD (16,7%) and males preferred women use pills 17.5%, The most common source of family planning information was Midwives and nurses , closely followed by doctors ,the believes toward the benefits of family planning , males were more than females (32.2%-14% respectively) includes child spacing between pregnancies prevention of pregnancy, delay of pregnancy and.(37.5%males and 47%females ) were believes FPMs cause psychological upset , sterility (33.6% males and 25.4% females),followed by change in the body function and other problems (cancer, irregularity of the cycle ). the Previous usage of family planning methods was 33%,at the time of this study the usage of family planning methods was ( 29.83%) the most common is modern (66.8% ) the common was IUCD(40.2%) the most common reason for non-practice of family planning was the side effect followed by religious un approval. Conclusion: the intensive targeted information ,education and communication (IEC) program, and efforts should move at increasing the awareness of family planning on women toward modern methods . [ABSTRACT FROM AUTHOR]

This study applies survival analysis to the birth histories from 317 national surveys to model pathways to low fertility in 83 less-developed countries between 1965 and 2014. It presents period measures of parity progression, the length of birth intervals and total fertility that have been standardized fully for age, parity, and interval duration. It also examines parity-specific trends in the proportion of women who want no more children. Outside sub-Saharan Africa, fertility transition was dominated by parity-specific family size limitation. As the transition progressed, women also began to postpone their next birth for lengthy periods in many countries. During the first half of the fertility transition in much of sub-Saharan Africa and in some other countries, however, women stopped childbearing without targeting particular family sizes. Moreover, birth intervals in sub-Saharan Africa have been lengthening since the onset of the transition. Birth control is not restricted to a dichotomy between limitation and spacing. Other reasons for curtailing childbearing and postponing having another birth also shape countries' pathways through fertility transition. [ABSTRACT FROM AUTHOR]

Many PNG women and health agencies see lack of male involvement and support for family planning and vasectomy services as placing the burden of contraception on women. Vasectomy is a family planning method used by males as a contraceptive option to control birth and reduce unwanted pregnancies. This study was undertaken in Itutang community along Lower Ramu River in Middle Ramu District, Madang Province. Data was collected using a mixed method study approach. Qualitative data was collected through unstructured interviews and observation with post-vasectomy males, family planning providers and males in the community. Quantitative data was collected from the questionnaire administered by the researcher. The researcher completed 12 interviews (in-depth and focus groups) and 47 surveys were collated for this study. The aim of using both qualitative and quantitative methods in data collection was to understand males' involvement in vasectomy and investigate factors that motivated males to accept vasectomy and other family planning services. The study found that males show a great interest in vasectomy services. This was largely due to the influences exerted by spouses of the males who received vasectomy procedure. Post-vasectomy males and a white missionary couple of New Tribes Mission Church were advocates of vasectomy and family planning in the community. The missionary couple from United State pioneered the family planning program in the church to reach out to families and married couples to consider options of birth control and spacing of children. Geographical conditions and remoteness of the rural communities were perceived challenges for health service providers to extend family planning services to the communities. Burdens of family chores and unavailability of female contraceptive options prompted males to accept vasectomy as a permanent contraception choice. [ABSTRACT FROM AUTHOR]

Overturning a generation of research, Cinnirella et al. Demography, 54, 413-436 (2017) found strong parity-dependent fertility control in pre-Industrial England 1540-1850. We show that their result is an unfortunate artifact of their statistical method, relying on mother fixed effects, which contradicts basic biological possibilities for fecundity. These impossible parity effects also appear with simulated fertility data that by design have no parity control. We conclude that estimating parity control using mother fixed effects is in no way feasible. We also show, using the Cambridge Group data that Cinnirella et al. used, that there is no sign of parity-dependent fertility control in English marriages before 1850. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the frequency of type of contraceptive usage after counselling in women seeking post abortion care. METHODOLOGY: A quasi experimental trial was conducted at Department of Gynaecology & Obstetrics Unit-I, JPMC, Karachi from August 2014 to May 2015. A sample of 753 married women age between 18-40, who had presented for induced abortion were included in the study RESULTS: The mean ± SD age was 31.47±5.54 years which ranged from 18-40 years. After counselling, 59.1% females were started using any method of contraception. Most common method was oral contraceptive pills 27.6%, 14.6% used condoms, 11.4% had intrauterine device while 2.9% used injectable contraceptives, 1.5% used sub dermal implant & 1.1% used tubal ligation. CONCLUSION: The current study found that if females have adequate knowledge about different methods of contraception and their capability to control birth spacing. So females can adopt any methods instead of conceiving unwanted pregnancy and then to go for induced abortion. [ABSTRACT FROM AUTHOR]

We describe a regression-based approach to the modelling of age-, order-, and duration-specific period fertility, using retrospective survey data. The approach produces results that are free of selection biases and can be used to study differential fertility. It is applied to Demographic and Health Survey data for Ethiopia, Kenya, Tanzania, and Zimbabwe to investigate differential trends in fertility by education. Parity progression fell and the intervals following each birth lengthened between the 1970s and 2000s in all four countries. Fertility fell most among women with secondary education. In contrast to other world regions, postponement of successive births for extended periods accounted for much of the initial drop in fertility in these African countries. However, family size limitation by women with secondary education in Ethiopia and Kenya and longer birth spacing in Zimbabwe also played significant roles. Thus, birth control is being adopted in Eastern Africa in response to diverse changes in fertility preferences. [ABSTRACT FROM AUTHOR]

Reliance on traditional methods of birth control causes psychological tension in couples because the fear of unwanted pregnancy bars them from experiencing a healthy sexual life. However, in Assam, half of all contraceptive users depend on traditional methods of birth control. The current study used National Family Health Survey 2005–2006 data. Out of 3840 sample women in the age group 15–49 years, 1286 women are filtered for the present study. Most of the demographic and socioeconomic characteristics of traditional method users fall between those of modern spacing method users and terminal method users. Thus, the burden of unwanted fertility is highest among the traditional method users. [ABSTRACT FROM AUTHOR]

We use duration models on a well-known historical data set of more than 15,000 families and 60,000 births in England for the period 1540-1850 to show that the sampled families adjusted the timing of their births in accordance with the economic conditions as well as their stock of dependent children. The effects were larger among the lower socioeconomic ranks. Our findings on the existence of parity-dependent as well as parity-independent birth spacing in England are consistent with the growing evidence that marital birth control was present in pre-transitional populations. [ABSTRACT FROM AUTHOR]

Background: Contraception, a little researched topic in the Saudi Arabian context, receives attention in the demographic transition for its implications on population policy. The population of Saudi Arabia appears homogeneous but shows differences across social and economic groups. An important component of demography - contraception is been hypothesized in Saudi Arabia, as a determinant of fertility, along with other factors such as age at first marriage, women's educational attainment, husband's education, child deaths, women's work force participation, place of residence, type of family, preference for sons, level of living, and administrative area of residence. This hypothesis has significance due to the fertility differentials depending upon marital relations, female literacy, modernization and migration. This study intends to capture the attention of academicians and social reformers in line with building ''happy families". The specific objectives of the study were to assess the associates and determinants of contraceptive use and to ascertain the importance of factors promoting contraceptive use. Methods: Here the contraceptive use of a unique group of ever-married women employees of King Saud University Riyadh was examined in 2015, with an aim to assessing its associates and determinants. The sample of 354 women was drawn by a simple random sampling method tested with a self-administered questionnaire. Analyses were primarily means of age at first marriage, age of husband at marriage, age gap between spouses, years lived with husband, and number of children; association of demographic, geographic, social, and economic variables; and determinants. Results: Demographic variables of age, number of marriages, age of husband at first marriage, and continuing with first marriage; geographic variable of place grown up; social variables of type of family and type of job; and economic variable of income are significant associates of contraceptive use. Meanwhile, age, continuing with first marriage, age at first marriage, number of children, and home ownership are significant predictors. Conclusions and recommendations: Manipulation of these indicators or characteristics of women facilitate the demographic scenario desired by the Kingdom or conceptualized in the population policy. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To assess the level of awareness of contraception among patients of reproductive age groups. Study Design: Cross-sectional analytical study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi Pakistan, between Jul 2018 to Jul 2019. Methodology: Women aged more than 18 years and not disoriented at the time of data collection were included in the study. Women younger than 18 years or those getting treatment for psychiatric illnesses or amenorrhea were excluded from the study. A predefined proforma was used to collect data from the study participants. Results: The mean age of the female patients was 26.5±8.6 years. The awareness regarding contraception was seen in 207(64.2%) female patients. Notably, 190(59.1%) women were aware of contraceptive methods. 210(65.3%) of the female patients considered contraception a safe practice. 225(69.7%) female patients thought contraception was necessary for child spacing. 82(25.4%) female patients had used some contraceptive at least once in their lifetime. Most women use oral contraceptive pills because of their easy-to-use and inexpensive features. Age and marital status significantly associated with the degree of awareness among participants (p<0.05). Conclusion: The study concluded that most of our study population were well aware of contraception and its uses, but they avoided using the contraceptive methods because of certain religious boundaries and misconceptions regarding the harmful effects of contraception on their health. [ABSTRACT FROM AUTHOR]

Background: Poor access and low contraceptive prevalence are common to many Low- and Middle-Income Countries (LMICs). Unmet need for family planning (FP), defined as the proportion of women wishing to limit or postpone child birth, but not using contraception, has been central to reproductive health efforts for decades and still remains relevant for most policy makers and FP programs in LMICs. There is still a lag in contraceptive uptake across regions resulting in high unmet need due to various socioeconomic and cultural factors. In this mixed method scoping review we analyzed quantitative, qualitative and mixed method studies to summarize those factors influencing unmet need among women in LMICs.Methods: We conducted our scoping review by employing mixed method approach. We included studies applying quantitative and qualitative methods retrieved from online data bases (PubMed, JSTOR, and Google Scholar). We also reviewed the indexes of journals specific to the field of reproductive health by using a set of keywords related to unmet contraception need, and non-contraception use in LMICs.Results: We retrieved 283 articles and retained 34 articles meeting our inclusion criteria. Of these, 26 were quantitative studies and 8 qualitative studies. We found unmet need for FP to range between 20 % and 58% in most studies. Woman's age was negatively associated with total unmet need for FP, meaning as women get older the unmet need for FP decreases. The number of children was found to be a positively associated determinant for a woman's total unmet need. Also, woman's level of education was negatively associated--as a woman's education improves, her total unmet need decreases. Frequently reported reasons for non-contraception use were opposition from husband or husbands fear of infidelity, as well as woman's fear of side effects or other health concerns related to contraceptive methods.Conclusion: Factors associated with unmet need for FP and non-contraception use were common across different LMIC settings. This suggests that women in LMICs face similar barriers to FP and that it is still necessary for reproductive health programs to identify FP interventions that more specifically tackle unmet need. [ABSTRACT FROM AUTHOR]

Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post-abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post-abortion contraceptive use. [ABSTRACT FROM AUTHOR]

Birth spacing is of considerable importance to study the tempo and quantum of fertility. Using data from the National Family Health Survey III, this study explored the birth interval dynamics in Odisha, an eastern state of India. The life table analysis of spacing between births clearly suggests that birth spacing in the recent past has increased and the proportion of women moving to the second, third, and fourth parity has declined, leading to the decline in fertility in Odisha. From the proportional hazards model, educational level of women, age of women at previous birth, sex and survival status of the previous child, and the period effect are found to be important determinants of birth spacing at higher parities. Socioeconomic differences do not show a large effect at lower order births. This highlights the fact that most women in Odisha, regardless of their background characteristics, tend to have second births. [ABSTRACT FROM AUTHOR]

Background: This study used data from recent Demographic and Health Surveys (DHS) to examine the impact of short or long preceding birth intervals on neonatal and under-five mortality. In order to minimize the effect of selection issues, we examined child mortality outcomes of the same mother, comparing short or long interval births against births with what had previously been considered optimal intervals. Methods: We analyzed 47 DHS datasets from low- and middle-income countries. For each dataset, we compared neonatal and under-five mortality of short preceding interval births (<18 months, <24 months) to reference interval births (24-<60 months) of a mother, using conditional logistic regression matching on the mother. We also conducted the same matched analysis for long (⩾60 months, ⩾72 months) preceding interval births. These associations were then meta-analyzed. We also stratified the analyses by mothers' completed fertility (fertility at end of reproductive period) to assess whether maternal characteristics highly correlated with completed fertility modify the association between birth interval and child mortality. Results: Children with shorter preceding intervals had increased odds of both neonatal (<24 months, OR: 1.61, 95% CI: 1.52-1.70) and under-five mortality (<24 months, OR: 1.48, 95% CI: 1.40-1.56). When the associations were stratified by the mothers' completed fertility, the impact of short intervals was greatly reduced or eliminated for low fertility mothers. In contrast, mortality associations became stronger for children of high fertility mothers. However, when the births of high fertility mothers were limited to birth orders 2-4, the associations were comparable to those of low fertility mothers. Longer preceding birth intervals had lower odds of mortality than reference intervals (i.e. under-5 mortality for ⩾60 months, OR 0.59, 95% CI: 0.52-0.67). This effect was also mediated by mothers' completed fertility; there was a strong protective effect of longer birth intervals for the high fertility mothers but not for low fertility mothers. Conclusions: These analyses reproduced findings reported in previous literature that shorter birth intervals are associated with higher child mortality. However the negative impact of short birth intervals may only occur in high parity births. Reproductive health interventions that seek to lengthen birth intervals may have larger impact by targeting women with high parity. This finding is consistent with the concept of maternal depletion as the underlying cause of increased adverse child outcomes associated with shorter birth intervals. [ABSTRACT FROM AUTHOR]

Background: Though birth interval has beneficial effects on health status of the mother and their children, it is affected by range of factors some of which are rooted in social and cultural norms and the reproductive behaviors of individual women. However, there was limited data showed the determinants of birth intervals in rural pastoral communities of South Ethiopia. Therefore, the study was aimed to assess the determinants of inter birth interval among women's of child bearing age in Yaballo Woreda, Borena zone, Oromia Regional State, Ethiopia. Methods: A community based unmatched case-control study with multi stage sampling technique was conducted from January to March 2012. Cases were women with two subsequent birth intervals of less than three years and controls were women with two subsequent birth intervals between three and above years. Simple random sampling technique was employed to select six hundred fifty two (326 cases and 326 controls) study subjects. All explanatory variables that were associated with the outcome variable (birth interval) during bivariate analysis were included in the final logistic model. Multivariable backward logistic regression when P values less than or equal to 0.05 and 95% CI were used to determine independent determinants for the outcome of interest. Results: The median duration of birth interval was 31 & 40 months among cases and controls respectively. Variables such as number of children (AOR 3.73 95% CI: (1.50, 9.25), use of modern contraceptives (AOR 5.91 95% CI: (4.02, 8.69), mothers' educational status (AOR 1.89 95% CI: (1.15, 3.37), and sex of the child (AOR 1.72 95% CI: (1.17, 2.52) were significantly associated with birth intervals. Conclusions: Concerted efforts to encourage modern contraceptive use, women education, and breastfeeding should be made. [ABSTRACT FROM AUTHOR]

This paper investigates the impact on birth intervals of three distinct birth control strategies: stopping childbearing, spacing births and the postponement of further childbearing for reasons unrelated to women's family-building histories. A macro-simulation model of the family-building process is described that incorporates heterogeneity in fecundability. This model is used to demonstrate that the postponement of further childbearing has a distinctive impact on schedules of duration-specific fertility rates that differs from that of both family-size limitation and birth spacing. In particular, the simulation results, supplemented by an analytical exposition, show that reductions in fertility due to spacing are a function of interval duration and its log, while reductions due to postponement are a function of interval duration and its square. This provides a way to test statistically for the presence of, and distinguish between, differential postponement and spacing in regression analyses of birth history data. [ABSTRACT FROM AUTHOR]

We investigated birth-interval dynamics in 24 African countries using data from 76 Demographic and Health Surveys conducted since 1986. Controlling for selection bias in the birth-history data using the Brass–Juárez method and regression models produced almost identical results. Birth intervals have lengthened in every country examined. This analysis uncovered a distinctive and previously undocumented pattern of childbearing that is prevalent across sub-Saharan Africa. After allowing for time trends in birth-interval length, the lengthening of birth intervals in almost every country varies little by women's age or parity. Moreover, in several countries, birth intervals are now too long to be explicable by birth spacing contingent on the age of women's youngest child. Rather, women are postponing births for other reasons. These findings offer empirical support for the idea that the fertility transition in sub-Saharan Africa is following a different pattern from that observed elsewhere. [ABSTRACT FROM PUBLISHER]

The probability distribution of parity-specific closed birth intervals in a heterogeneous population of women is obtained from Biswas' (1980) concept of gradually decreasing fecundabilities. The distribution of parity-specific last closed birth intervals and its moments of various orders are derived for a heterogeneous female population. Simulations are used to compare with models for a homogeneous female population with constant fecundability. The consideration of heterogeneity allows a better fit for empirical closed birth intervals. [ABSTRACT FROM AUTHOR]

Abstract: Background: China launched a nationwide family planning program offering birth control methods and family planning services in the 1970s. Promotion of the widespread use of long-term contraceptive methods has been one of the program''s core strategies. This paper reviews the history of China''s Family Planning Program at the national level from 1970 to 2010. Special attention is paid to the history of contraception policy. Study Design: This study provides an overview of the last four decades of the Chinese Family Planning Program. Programmatic goals are highlighted during different time periods, with special attention being paid to the role of contraceptive use and the history of contraceptive policy. Results: The Chinese Family Planning Program has experienced several transitions. It has evolved from the 1970s period of moderate policy, represented by wan, xi, shao (late marriage and childbearing, birth spacing and limited fertility), through the strict one-child policy of 1979 to the early 1990s. From the mid-1990s to the present, a relatively lenient policy has been in force, characterized by client-centered informed choice. Conclusions: The success of the Chinese Family Planning Program has long been heavily dependent on policies advocated by the central government, including programs promoting contraception to reduce fertility rates. The Program also depended on a logistical support system, including organizational safeguards and free provision of contraception and family planning services. [Copyright &y& Elsevier]

Background: Longer intervals between consecutive births decrease the number of children a woman can have. This results in beneficial effects on population size and on the health status of mothers and children. Therefore, understanding the practice of birth interval and its determinants is helpful to design evidence based strategies for interventions. The objective of this study was to determine duration and determinants of birth interval among women of child bearing age in Lemo district, southern Ethiopia in March 2010. Methods: A community based cross sectional study design with stratified multistage sampling technique was employed. A sample of 844 women of child bearing age were selected by using simple random sampling technique after complete census was conducted in selected kebeles prior to data collection. Structured interviewer administered questionnaire was used for data collection. Actual birth interval was measured with the respondents' memory since majority of the women or their children in the area had no birth certificate. Results: Majority (57%) of women were practicing short birth interval length with the median birth interval length of 33 months. Actual birth interval length is significantly shorter than preferred birth interval length. Birth interval showed significant variation by contraceptive use, residence, wealth index, breast feeding and occupation of husbands. Conclusion: low proportion of optimal birth spacing practices with short actual birth interval length and longer preferred birth interval lengths were evident among the study subjects. Hence interventions to enhance contraceptive utilization behaviors among women in Lemo district would be helpful to narrow the gap between optimal and actual birth spacing. [ABSTRACT FROM AUTHOR]

Fertility control had been used for thousands of years in different forms. Adequate child-spacing is considered a positive factor on the health of mothers and their children. The current work is a cross-sectional study done in Tikrit Teaching Hospital, Obstetrics unit included 270 married women in the period between 1st of February 2010 to the 30th of April 2010. The aim of this work was to study the family planning methods and factors influencing using it by women attending Tikrit Teaching Hospital. The study found that the prevalence of using contraception was (74.1%), the IUCD type was the most common type used by the participants. The most common reason of choosing a specific method of contraception was the advice of doctor (35%). With increasing age there is increasing use of contraception. There was a high percentage of using contraception in high parity mother . The educated women use contraception more than non-educated women, in regard to residency, urban women use contraception more than rural women. In conclusion, there are sociodemographic factors affect using contraception. It is recommended to improve health education concerning contraception among married women. [ABSTRACT FROM AUTHOR]

It has often been argued that there are good theoretical and historical reasons to expect that deliberate birth spacing has played an important role in fertility patterns before the demographic transition. Yet, it has proved difficult to find hard empirical evidence. In this article, we propose a new model of the speed of parity progression that includes both fixed and random effects and that efficiently captures unobserved heterogeneity between couples in fecundability and postpartum amenorrhea. With this model, we demonstrate that pre-transition couples in the Netherlands indeed spaced their births during about the first ten years of marriage. In addition, we have found strong differentials in birth intervals by socio-economic position and religion. Finally, we also show how and why the model can be used with left-censored census data. ☆ An earlier version was presented at the XXV International Population Conference (IUSSP), Tours, France, July 2005. [ABSTRACT FROM AUTHOR]

Short birth intervals can have adverse consequences for maternal and infant outcomes. Optimal birth spacing is often presumed to be achieved through the practice of family planning and use of contraceptives, yet most of the available research does not address explicitly the contribution of contraceptive-method use to birth spacing or maternal and infant survival. We conducted a systematic literature review to assess the body of evidence linking contraceptive use to birth-interval length. Fourteen studies published in English between 1980 and 2008 met our eligibility criteria for inclusion. The findings from these studies are mixed but suggest that the use of contraceptives is protective against short birth intervals. Although results are favorable, many of the studies and methodologies employed are dated. More current research is needed to determine the impact of contraceptive-method use on birth-interval length in order to inform the promotion of family planning for reducing maternal and infant morbidity and mortality through birth spacing. [ABSTRACT FROM AUTHOR]

The successful Counter Sexual Revolution will consist of a combination of doctrinal reaffirmation, renewal of prudent pastoral practices, and practical help. The practical help of natural family planning (NFP) has developed from the calendar rhythm of the early 1930s to the systems taught today. Prudent pastoral practices include proper instruction before marriage including the right kind of course on natural family planning (NFP). The right kind of NFP course includes ecological breastfeeding, understandable transmission of Catholic moral teaching, and some form of systematic natural family planning. [ABSTRACT FROM AUTHOR]

By concentrating on abortion, the culture wars have avoided facing a crisis about the end of life. This paper explores four themes: (1) the technological transformation of birth and death into matters of decision, not matters of fact; (2) abortion as the nexus of Eros (sex) with Thanatos (death); (3) the real crisis, conveniently masked by our obsession with sex, looming at the end of life, not at its beginning; (4) the surplus-repression that protects us from assuming responsibility for choosing between life and death. [ABSTRACT FROM AUTHOR]

Much of the literature on fertility transition presumes that birth control is practiced either to limit family size or to space births. This article argues that women also use birth control to postpone pregnancy. Postponement is not synonymous with spacing. It arises when women delay their next birth for indefinite periods for reasons unrelated to the age of their youngest child, but without deciding not to have any more children. Postponement has a distinctive impact on the shape of birth-interval distributions that differs from the impacts of family size limitation, birth spacing, or a mixture of the two behaviors. Some populations, such as that in South Africa, have developed fertility regimes characterized by birth intervals far longer than can be accounted for by birth spacing. Postponement of further childbearing that eventually becomes permanent may be an important driver of the transition to lower fertility in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Using high-quality longitudinal data on 125,720 singleton live births in Matlab, Bangladesh, we assessed the effects of duration of intervals between pregnancy outcomes on infant and child mortality and how these effects vary over subperiods of infancy and childhood and by the type of outcome that began the interval. Controlling for other correlates of infant and child mortality, we find that shorter intervals are associated with higher mortality. Interval effects are greater if the interval began with a live birth than with another pregnancy outcome. In the first week of the child's life, the effects of short intervals are greater if the sibling born at the beginning of the interval died; after the first month, the effects are greater if that sibling was still alive. Many relationships found are consistent with the maternal depletion hypothesis, and some with sibling competition. Some appear to be due to correlated risks among births to the same mother. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the contraceptive efficacy of the etonogestrel-releasing implant Implanon® as assessed in international studies and during nine years of marketing experience. Methods The analysis included 11 international studies and data collected during nine years of marketing experience (1998-2007). Seven of these studies were noncomparative; the four other studies included the 6-rod levonorgestrel implant system or an intrauterine device as a comparator. All studies except one were of at least two years in duration, and all had contraceptive efficacy as the objective. Market data were provided unsolicited to Organon, part of Schering Plough. Results The integrated efficacy analysis included 923 non-breastfeeding women who were exposed to the implant for 24,100 cycles. No in-treatment or pretreatment pregnancies were reported. Fifty posttreatment pregnancies were reported, six of which occurred within 14 days of implant removal, indicating that fertility had quickly returned. Over a nine-year marketing period an overall pregnancy rate of 0.049 per 100 implants sold (estimated Pearl Index = 0.031 based on all pregnancies reported) was calculated. When only counting contraceptive method failures the pregnancy rate amounts to 0.010 per 100 implants sold (estimated Pearl Index = 0.006). Conclusion Implanon® is a highly effective and quickly reversible subdermal method of long-acting hormonal contraception for women. Typical use of this implant achieves a contraceptive protection exceeding 99%. [ABSTRACT FROM AUTHOR]

In this paper intergenerational dimensions of reproductive behavior are studied within the context of the experience of a mid-sized Spanish town just before and during the demographic transition. Different indicators of reproduction are used in bivariate and multivariate approaches. Fertility shows a small, often statistically significant intergenerational dimension, with stronger effects working through women and their mothers than those stemming from the families of their husbands. These effects are materialized mainly through duration-related fertility variables, are singularly absent for variables such as age at first birth or birth intervals, and are much stronger in the case of firstborn daughters than with later siblings. There is a substantial increase in the strength of intergenerational effects during the course of the demographic transition, most visible in age at last birth and duration of reproduction (between women and their mothers), as well as in the effects working through the families of their husbands. These results underscore the on-going importance of biological dimensions of reproduction as well as the way attitudes toward reproduction are taught within the family. The changes identified in this study suggest that the transmission of values and attitudes became more important for reproductive outcomes during this period of demographic modernization. [ABSTRACT FROM AUTHOR]

China's family planning programs have emphasized delayed marriage and longer spacing between births. Since 1970, the fertility has declined from 6 to 1.8 births and the mean age at first marriage has gone up but the recommended spacing intervals have not been fully realized. Despite the fertility decline it is being debated among scholars whether China has completed a sustainable demographic transition or not, especially in rural areas. The aim of this study was to analyze trends in the timing and patterns of marriage and childbearing in relation to successive family planning policies. A cluster random sample of 1,336 women aged 15-64 at the time of the survey (2000) was selected in one rural county in Yunnan province. Life-table techniques were used to analyze the cumulative proportion of women marrying and having a certain number of births. Cox's hazard regression model was used to estimate the effects of various covariates on the "hazard" for a woman to have a second birth. Our findings demonstrate how childbearing patterns have changed in the direction of delayed marriage, a decreased interval between first marriage and first child, and significantly longer spacing between the first and second child. This transformation of childbearing patterns corresponds well with the requirements of the policies. Considering the characteristics of Yunnan, it seems likely that the changing fertility behavior has been more influenced by a strictly enforced family planning policy than by societal changes leading to the adoption of a new, smaller family norm. [ABSTRACT FROM AUTHOR]

We look at whether women's status and autonomy affect birth-to-conception intervals using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines. We followed 1123 married, fecund women, aged 25-49, for up to 5 years. In a 1994-1995 survey, women were asked about the timing of their last birth. In 1998-2000, women were asked about any pregnancies since the 1994-1995 survey. Using these two surveys, we calculated birth to conception intervals. Women were censored if they reached their 50th birthday during follow-up. We measure autonomy based on whether the wife has the final say in 10 household decisions as measured in the 1994-1995 survey. Using Cox proportional hazards models we find that women with more decision-making autonomy have significantly longer birth-to-conception intervals in unadjusted models. After adjustment for age, wealth, education, other socio-economic variables, and women's status, decision-making autonomy remained a significant predictor in all models. This effect remains even after adjusting for contraceptive use, implying that autonomy influences birth-to-conception intervals through other mechanisms above and beyond increased contraceptive use. Additionally, few of the women's status variables were significantly associated with time to next conception. Women who had their first birth later in life were more likely to conceive during the observation period suggesting that they may be having shorter birth intervals in order to "catch up" with their peers. Maternal and child health-care efforts can help women achieve their desired spacing goals by supporting women's autonomy-in addition to ensuring they have accurate information and a range of contraceptive options. [ABSTRACT FROM AUTHOR]

Objective: To identify the extent of demand for birth spacing, according to age and parity among married women of reproductive age (MWRA) in developing countries.Methods: Secondary analysis of data from the Demographic and Health Surveys (DHS) using cross-tabulations. Data collected from nationally representative samples of MWRA in selected developing countries between 1990 and 2004.Results: Demand for birth spacing is the most prevalent reason for an interest in family planning among married women aged 15-29 years in the majority of developing countries examined. In the 15-19-year age cohort, the demand for spacing is proportionally the most prevalent reason for a demand for family planning. A demand for spacing even exists among young, zero-parity married women in each country examined. Findings on the demand for spacing among zero-parity married women quantifies the expressed desire of some married women in developing countries to postpone a first birth or the timing of a first pregnancy.Conclusion: The substantial demand for birth spacing among young, low- and zero-parity women suggests that family planning programs in developing countries may need to reevaluate how accessible services are for this cohort of potential contraception users. Currently, many service-delivery protocols, counseling practices and service provider training may not fully address the needs of younger, low- or zero-parity clients. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the length of the interval between an abortion and the next pregnancy is associated with increased risks of adverse maternal and perinatal outcomes in Latin America.Method: Retrospective cross-sectional study using information from 258,108 women delivering singleton infants and whose previous pregnancy resulted in abortion recorded in the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay, between 1985 and 2002. Adjusted odds ratios were obtained through logistic regression analysis.Result: Compared with the post-abortion interpregnancy intervals of 18 to 23 months, intervals shorter than 6 months were significantly associated with increased risks of maternal anemia, premature rupture of membranes, low birth weight, very low birth weight, preterm delivery, and very preterm delivery.Conclusion: In Latin America, post-abortion interpregnancy intervals shorter than 6 months are independently associated with increased risks of adverse maternal and perinatal outcomes in the next pregnancy.Definition: Post-abortion interpregnancy interval (PAII): the time elapsed between the day of the abortion and the first day of the last menstrual period for the index pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: The relationship between interpregnancy interval and adverse birth outcomes (i.e., low birth weight, preterm birth, and small size for gestational age) was examined in three recent studies conducted in Utah and Michigan of the United States. These studies were conducted among different populations, used different study designs (i.e., cross-sectional and retrospective cohort designs), and addressed several other methodological limitations in the previously published literature. In addition, the data were stratified by, and controlled for, several maternal reproductive risk factors. A J-shaped relationship between interpregnancy interval and adverse birth outcomes was observed in all three studies. The risk for adverse birth outcomes is lowest when the interpregnancy interval was 18–23 months and increased when the interval departed from 18–23 months. This J-shaped relationship existed at levels of maternal reproductive risk factors and after these risk factors were controlled for using logistic regression. Based on the consistency of the findings from all three studies, it appears that the J-shaped relationship between interpregnancy interval and adverse birth outcomes is causal. This information can be used by health care providers and public health programs to counsel and educate women who recently gave births on reducing the risk for adverse birth outcomes by means of appropriate pregnancy spacing. [Copyright &y& Elsevier]

Objective: This paper examines the association between birth intervals and infant and child mortality and nutritional status.Methods: Repeated analysis of retrospective survey data from the Demographic and Health Surveys (DHS) program from 17 developing countries collected between 1990 and 1997 were used to examine these relationships. The key independent variable is the length of the preceding birth interval measured as the number of months between the birth of the child under study (index child) and the immediately preceding birth to the mother, if any. Both bivariate and multivariate designs were employed. Several child and mother-specific variables were used in the multivariate analyses in order to control for potential bias from confounding factors. Adjusted odds ratios were calculated to estimate relative risk.Results: For neonatal mortality and infant mortality, the risk of dying decreases with increasing birth interval lengths up to 36 months, at which point the risk plateaus. For child mortality, the analysis indicates that the longer the birth interval, the lower the risk, even for intervals of 48 months or more. The relationship between chronic malnutrition and birth spacing is statistically significant in 6 of the 14 surveys with anthropometric data and between general malnutrition and birth spacing in 5 surveys. However, there is a clear pattern of increasing chronic and general undernutrition as the birth interval is shorter, as indicated by the averages of the adjusted odds ratios for all 14 countries.Conclusion: Considering both the increased risk of mortality and undernutrition for a birth earlier than 36 months and the great number of births that occur with such short intervals, the author recommends that mothers space births at least 36 months. However, the tendency for increased risk of neonatal mortality for births with intervals of 60 or more months leads the author to conclude that the optimal birth interval is between 36 and 59 months. This information can be used by health care providers to counsel women on the benefits of birth spacing. [ABSTRACT FROM AUTHOR]

Objective. Healthy People 2010 calls for reductions in rapid repeat births (RRBs), defined as births occurring within 24 months after a previous birth for women of all ages, and prevention of repeat births during adolescence, regardless of the birth interval. Home visiting has been promoted as a mechanism to prevent child abuse and neglect and to improve pregnancy outcomes. This study aims to assess the impact of home visiting in preventing RRB and its malleable determinants and assesses the influence of RRB on the mother and the index child. We hypothesized that maternal desire to have a RRB, access to a family planning site, and use of birth control would be significant malleable determinants and that the effects of the program in preventing RRB would be mediated through its influence on these variables. We also hypothesized that the occurrence of RRB would result in increased stress and family dysfunction, resulting in adverse maternal and child outcomes such as severe maternal stress, maternal neglect of the index child, decreased maternal warmth toward the index child, and increased behavior problems of the index child. Methods. The Healthy Start Program (HSP) is a home visiting program to prevent child abuse and neglect and to promote child health and development among newborns of families identified as being at risk for child maltreatment. This study was a randomized, controlled trial of Hawaii's HSP, in which eligible families were randomly assigned to home-visited and control groups. A total of 643 families at risk for child abuse were enrolled between November 1994 and December 1995. Data to measure RRB and malleable determinants were collected through structured maternal interviews and observation of the home environment. We measured RRB through maternal self-report by asking about a subsequent birth in follow-up interviews at 1, 2, and 3 years. To measure the malleable determinants, we measured the mother's desire for a RRB at baseline and at the... [ABSTRACT FROM AUTHOR]

Focuses on political management in the Indonesian family planning program. Political institutions and family planning programs; Concerns in program design and implementation.

Many scholars have argued that deliberate birth spacing may have played a role before and during the modern fertility transition. There are good historical and theoretical reasons for this view, but it has proved to be hard to demonstrate convincingly that birth intervals were in fact partly determined by attempts at deliberate fertility control. This paper suggests a method of securing evidence on the issue for married couples. The method is applied to three cohorts living in a Belgian town in the nineteenth century. The findings indicate that, even before the fertility transition, couples in the working class were controlling their fertility by deliberate spacing. [ABSTRACT FROM AUTHOR]

Effects of childbearing on women's mortality and the implications of family planning programs in reducing these effects are examined in a 20-year prospective study of more than 2,000 women in Matlab, Bangladesh. Maternal mortality is defined as a death occurring in the six weeks after childbirth. But childbearing may affect women's survival beyond this brief period. Additional hypotheses considered relate to 1) cumulative exposure to childbearing, whether measured by parity or pace of childbearing, 2) age at first birth, and 3) effects beyond the reproductive ages. The results offer no support to cumulative exposure hypotheses, showing no link between parity or pace of childbearing and mortality risk. Instead, we identify an extended period of heightened mortality risk associated with each birth--the year of the birth and the two subsequent years. Family planning programs, by reducing the number of children and therefore a woman's exposure to extended maternal mortality risk, potentially increase survival. Research is needed to identify and address the specific causes of extended maternal mortality risk so that appropriate ameliorative programs may be developed. [ABSTRACT FROM AUTHOR]

A key explanation for the fall in fertility is that first births have increasingly been postponed thereby shortening women's total childbearing years and increasing their chances of childlessness. While some women attempt to extend their reproductive life through assisted reproductive technology, such procedures account for only 2 percent of all births. It appears that, although they tend to revise their family size preferences downward in their 1920s, women now end up having fewer children than they would like to have or intend having. Such trends are in marked contrast to those of some 40 years ago when couples often had more children than they expected because of relatively inefficient means of contraception. Clearly, the effects of the development of the contraceptive pill and its widespread acceptance have been revolutionary. In Australia in 1961, the contraceptive pill became available for distribution via medical prescriptions from those practitioners who approved of its use. In 1972, sales tax on all contraceptives was removed and the pill was placed on the Pharmaceutical Benefits List, thereby lowering the price substantially, increasing its use, and leading to widespread acceptance.

Much of the inconsistency that has appeared in studies of the effect of women's work on fertility in less developed countries has been attributed to the varying accessibility of employment in the modern sector. The analysis presented in this paper shows that continuity of work matters more than sector of work. It also confirms that, even in a setting of low contraceptive prevalence, increased fecundity associated with the less intense breastfeeding practices of working women do not result in shorter birth intervals. The influence of women's work on fertility control is likely to be underestimated if the effects of sporadic versus continuous work are conflated, or if fecundity differentials by work status are unmeasured. [ABSTRACT FROM AUTHOR]

Discusses the factors influencing birth spacing practices of women. Survival and health of the previous children; Social status and employment of mothers; Cultural norms and customs that influence women's birth spacing practices.

Talks about birth intervals. Median birth interval in developing countries; Reason for the need of women to space births longer; Trends in birth intervals from 1986 to 2001.

This article investigates birth spacing among agriculturalists in a northern Jordanian village. The correlation coefficient between birth spacing and family size indicates that for the family size to be increased, the family should have short interbirth intervals. This means that maximizing the reproductive success was an optimal strategy to accomplish the various agricultural works. The factors that affect the interbirth intervals are early infant weaning, leaving infants at home without breastfeeding for long periods of time each day, mothers' knowledge deficit regarding birth control and a conscious action by parents to increase the number of children born either in response to the actual death of one of their children or as a means of hoarding. Increasing the family size in the village is considered to be an optimal strategy for better crop production and is achieved by maximizing reproductive success. The investment in children may result in increasing their inclusive fitness in the future. Large areas of cultivated lands demand more work and time, which forced the farmers to have more members in the family because labor cost is too expensive and not affordable. The shortage in yields surplus and seasonal variability restrained the farmers from buying modern tools and technologies for their fieldwork.

The standardized rate of third births declined by over 50 percent in Austria between the late 1970s and the mid-1990s. The third birth was also postponed gradually over the years until 1991-92, after which the tempo of childbearing suddenly increased in response to a change in the parental-leave policy. This new policy inadvertently favoured women who had their second or subsequent child shortly after their previous one. We cannot find any indication that the general decline in third births can be seen as a consequence of women's increasing independence from their husbands at the stage in life we study. Furthermore, it still seems to be more difficult to combine motherhood and labour-force participation in Austria than in Sweden, which is a leader in reducing this incompatibility. These developments reflect the tension between advancing gender equality and the dominance of traditional norms in Austria. [ABSTRACT FROM AUTHOR]

A prospective study conducted between 1995 and 1998 assessed trends in contraceptive use in rural Rakai District, Uganda. Over a period of 30 months, women's use of modern contraceptives increased significantly from 11 percent to 20 percent. Male condom use increased from 10 percent to 17 percent. The prevalence of pregnancy among sexually active women 15-49 declined significantly from 15 percent to 13 percent. Women practicing family planning for pregnancy prevention were predominantly in the 20-39-year age group, married, better educated, and had higher parity than others, whereas women or men adopting condoms were predominantly young, unmarried, and better educated. Condom use was particularly high among individuals reporting multiple sexual partners or extramarital relationships. Contraceptive use was higher among women who desired fewer children, among those who wished to space or terminate childbearing, and among women with previous experience of unwanted births or abortions. Self-perception of HIV risk increased condom use, but HIV testing and counseling had only modest effects. Contraception for pregnancy prevention and for HIV/STD prophylaxis are complementary. [ABSTRACT FROM AUTHOR]

Analyzes data on married women's use of birth spacing methods in Kerala, India. Prevalence of adoption of sterilization as a method for delaying births; Linking of educational attainment and socio-economic status to increased use of temporary birth control methods.

Censuses and surveys frequently collect information on period fertility through questions on the timing of last births. The standard approach to estimating fertility with open-interval data uses the proportion of women giving birth in the year before the interview. I propose a more efficient, maximum likelihood method for estimating fertility from open-interval data. I illustrate a mathematical derivation of the new method, perform sensitivity analyses, and conduct empirical tests with Brazilian census data. The new estimators have small biases and lower variance than standard estimators for open-interval data. Consequently, the new method is more likely to generate accurate results from small or moderately sized samples. [ABSTRACT FROM AUTHOR]

Focuses on the promotion of birth spacing among the Maya-Quiche of Guatemala. 1990s challenge of increasing the acceptance of family planning in hard-to-reach populations; Assessment of an intervention program implemented in 1993-96; Need for more funding to sustain the program.