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BackgroundFertility rates remain persistently high in Nigeria, with little difference across socioeconomic groups. While the desire for large family size is culturally rooted, there is little understanding of how repeated child mortality experiences influence fertility behaviour and parity transition in Nigeria.MethodsUsing birth history data from the 2013 Nigeria Demographic and Health Survey (NDHS), we applied life table techniques and proportional-hazard regression model to explore the effect of child survival experience on parity transitions. We hypothesize that a woman with one or more child death experience is at elevated risk of progressing towards higher parities.ResultsOur findings show that child mortality is concentrated among mothers living in deprived conditions especially in rural areas of the northern part of Nigeria and among those with little or no education and, among those belonging to Hausa/Fulani ethnicity and Islam religion. Mothers with repeated experience of child deaths were significantly at a higher rate of progressing to higher parities than their counterparts (HR: 1.45; 95% CI: 1.31–1.61), when adjusted for relevant biological and socio-demographic characteristics.ConclusionRecurrent experience of child deaths exacerbates the risks to higher parity transition. Interventions aimed at reducing fertility in Nigeria should target promoting child survival and family planning concurrently.

Background In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. Method This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. Result According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women’s residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth ( Conclusion This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.

Inter-pregnancy interval is an important determinant of both maternal and child health. Suboptimal inter-pregnancy interval has been associated with adverse maternal outcomes -including postpartum hemorrhage and hypertensive disorders, direct causes of maternal mortality. Both overall maternal mortality and the contribution of postpartum hemorrhage on maternal mortality have increased in Tanzania. If we are to achieve sustainable development goal (SDG) number 3.1 to reduce the global maternal mortality ration to less than 70 per 100,000 live births by 2030, it is highly important that such contributors are dealt with. This study aimed to determine the distribution and trends of inter-pregnancy interval and to deduce its association with adverse maternal outcomes among women who delivered at Kilimanjaro Christian Medical Centre (2000-2015).A retrospective cohort study was designed using Kilimanjaro Christian Medical Centre medical birth registry data for women who delivered from 2000 to 2015. Women with at least two births recorded in the registry were included. A total of 7,995 births from 6,612 mothers were analyzed. Anemia during pregnancy, post-partum hemorrhage and pre-eclampsia were adverse maternal outcomes of interest. Data analysis was performed using multivariable logistic regression models allowing for robust standard errors. Crude and adjusted odds ratio with their respective 95% confidence intervals were estimated. More than half (51.7%) of non-first births were born within sub-optimal IPI. The median IPI was 34 months (IQR: 33.5 months). The median IPI increased from 11 months in 2002 to 35 months in 2006 and plateaued until 2014, but it rose to 41.6 months in 2015. Median IPI was shorter in young women

The prevalence of child undernutrition in South Asia is high, as is also the unmet need for family planning. In previous literature, the biodemographic relationship of family planning, particularly birth order and birth spacing, and nutritional status of children have been assessed separately. The aim of this study was to work on the hypothesis that the planning of births comprising timing, spacing, and number of births improves child undernutrition, especially in the areas with high prevalence of stunting and underweight.We used recent Demographic and Health Survey data from four selected South Asian countries. Binary logistic regression models were applied to estimate the adjusted percentage of stunting and underweight by identified independent factors.Findings suggested that after controlling for other socioeconomic factors, children in the first birth order with24 mo of interval between marriage and first birth have a lower risk for stunting (20%; p 0.01) and underweight (14%; p 0.05), respectively, than other scenarios of the planning of births. The probability of child undernutrition is lower among children born with24 mo of birth spacing than its counterpart in all birth orders, but the significance of birth spacing reduces with increasing birth orders.Appropriate planning of births using family planning methods in countries with high birth rates has the potential to reduce childhood undernutrition. Thus, the planning of births emerges as an important biodemographic approach to eradicate childhood undernutrition especially in developing regions like South Asia and thereby to achieve sustainable development goals by 2030.

The association between a single interpregnancy interval (IPI) and birth outcomes has not yet been explored using matched methods. We modeled the odds of preterm birth, being small for gestational age, and having low birth weight in a second, live-born infant in a cohort of 192,041 sibling pairs born in Western Australia between 1980 and 2010. The association between IPI and birth outcomes was estimated from the interaction between birth order and IPI (with 18-23 months as the reference category), using conditional logistic regression. Matched analysis showed the odds of preterm birth were higher for siblings born following an IPI of

Several studies show that maternal and neonatal/infant mortality risks increase with younger and older maternal age (18 and34 years), high parity (birth order3), and short birth intervals (24 months). Family planning programs are widely viewed as having contributed to substantial maternal and neonatal mortality decline through contraceptive use--both by reducing unwanted births and by reducing the burden of these high-risk births. However, beyond averting births, the empirical evidence for the role of family planning in reducing high-risk births at population level is limited. We examined data from 205 Demographic and Health Surveys (DHS), conducted between 1985 and 2013, to describe the trends in high-risk births and their association with the pace of progress in modern contraceptive prevalence rate (yearly increase in rate of MCPR) in 57 developing countries. Using Blinder-Oaxaca decomposition technique, we then examine the contributions of family planning program, economic development (GDP per capita), and educational improvement (secondary school completion rate) on the progress of MCPR in order to link the net contribution of family planning program to the reduction of high-risk births mediated through contraceptive use. Countries that had the fastest progress in improving MCPR experienced the greatest declines in high-risk births due to short birth intervals (24 months), high parity births (birth order3), and older maternal age (35 years). Births among younger women18 years, however, did not decline significantly during this period. The decomposition analysis suggests that 63% of the increase in MCPR was due to family planning program efforts, 21% due to economic development, and 17% due to social advancement through women's education. Improvement in MCPR, predominately due to family planning programs, is a major driver of the decline in the burden of high-risk births due to high parity, shorter birth intervals, and older maternal age in developing countries. The lack of progress in the decline of births in younger women18 years of age underscores the need for more attention to ensure that quality contraceptive methods are available to adolescent women in order to delay first births. This study substantiates the significance of family planning programming as a major health intervention for preventing high-risk births and associated maternal and child mortality, but it highlights the need for concerted efforts to strengthen service provision for adolescents.

Background: Currently, family planning metrics derived from nationally-representative household surveys such as the Demographic and Health Surveys (DHS) categorise women into those desiring to space or limit (permanently stop) births, or according to their age in the case of young women. This conceptualisation potentially ignores a large and growing group of young women who desire to delay a first birth. This study uses household survey data to investigate the characteristics and needs for family planning of women who want to delay their first birth.Methods: The research was conducted in two rural districts in southern Tanzania (Tandahimba and Newala), and nested within the Expanded Quality Management Using Information Power (EQUIP) study. Data were collected as part of a repeated cross sectional household survey conducted between September 2013 and April 2014. The socio-demographic characteristics, including parity, contraceptive practices and fertility intentions of 2128 women aged 13–49 were analysed. The association between women's life stages of reproduction (delayers of first birth, spacers of subsequent pregnancies and limiters of future birth) and selected contraceptive outcomes (current use, unmet need and demand for modern contraceptives) was assessed using the point estimates and 95% confidence intervals for each indicator, adjusted for the survey design.Results: Overall, four percent of women surveyed were categorised as 'delayers of first birth', i.e. sexually active but not started childbearing. Among this group, the majority were younger than 20 years old (82%) and unmarried (88%). Fifty-nine percent were currently using a modern method of contraception and injectables dominated their contraceptive use. Unmet need for contraception was higher among delayers (41%; 95% CI 32–51) and limiters (41%; 95% CI 35–47) compared to spacers (19%; 95% CI 17–22).Conclusions: Delayers of first birth have very high unmet needs for modern contraceptives and they should be routinely and separately categorised and measured within nationally-representative surveys such as Demographic and Health Survey and Multiple Indicator Cluster surveys. Acknowledging their unique needs could help catalyse a programmatic response.

To reduce infant mortality through improved family planning, a better understanding of the factors driving contraceptive use and how this decision affects infant survival is needed. Using dynamic panel-data models of infant deaths, birth intervals, and contraceptive use, this study analyzes the causal effects of birth spacing on subsequent infant mortality and of infant mortality on the use of contraceptives and the length of the next birth interval. Data are drawn from the Health and Demographic Surveillance System in Matlab, Bangladesh, where almost 32,000 births have been observed from 1982 to 2005. Our main finding is that complete contraceptive use could reduce infant mortality of birth order two and higher by 7.9 percent. The net effect of complete contraceptive use on the total infant mortality rate is small (2.9 percent), however, because the favorable effect on higher order births is partly offset by the rise in the proportion of high-risk first births.

Background : Evidence shows that family planning contributes to the decline in child mortality by decreasing the proportions of births that are considered high risk. The main objective of the present analysis was to examine the trends in use of modern contraceptives and their relationship with total fertility rate (TFR) and distribution of births by demographic risk factors as defined by mother’s age, birth interval, and birth order at the sub-national level in Ethiopia. Design : Analyses used data from three Demographic and Health Surveys in Ethiopia (2000, 2005, and 2011), which are nationally representative data collected through questionnaire-based interviews from women 15–49 using a stratified, two-stage cluster sampling. First, we examined the trends of and relationship between TFR (in the 3 years before each survey) and modern contraceptive use among currently married women in all administrative regions over the time period 2000–2011 using linear regression analysis. We also examined the relationship between birth risks and under-five mortality using the no-risk group as a reference. Finally, multiple logistic regression analysis was performed to estimate the relationship between the effect of being a resident in one of the regions and having an avoidable birth risk (which includes births to mothers younger than 18 and older than 34 years, birth interval of less than 24 months and birth order higher than third) after adjusting for select covariates including wealth, educational status, residence, religion and exposure to family planning information. Results : Sub-national-level regression analysis showed an inverse relationship between modern contraceptive use among married women and the TFR, with an average decrease of TFR by one child per woman associated with a 13 percentage point increase in modern contraceptive use between 2000 and 2011. A high percentage of births in Ethiopia (62%) fall in one of the risk categories (excluding first births), with wide regional variation from 55% in Gambela to 72% in the Somali region. The multivariate analysis showed women living in the Somali, Afar and Benishangul-Gumuz regions had significantly higher odds of having avoidable birth risk compared to those in Addis Ababa after controlling for observed covariates. The trend analysis showed there was a significant drop in the proportion of births from women above 34 years between 2000 and 2011. There was no significant decline in births to women less than 18 years between 2000 and 2011. Conclusions : A majority of births in Ethiopia fall in one of the risk categories, with substantial region-to-region variation in the percentage of births with avoidable risk factors, Somali and Afar having the highest burden. The analysis indicated that births in the three regions had significantly higher odds of having one of the avoidable risk factors compared to Addis Ababa, and we suggest family planning programmes need to identify differentials of modern contraceptive use at the sub-national level in order to better address coverage and equity issues. Keywords: Ethiopia; distribution of birth risks; modern contraceptive use; total fertility (Published: 9 November 2015) Responsible Editor: Peter Byass, Umea University, Sweden. To access the supplementary material for this article, please see Supplementary files in the column to the right (under ‘Article Tools’) Citation: Glob Health Action 2015, 8 : 29720 - http://dx.doi.org/10.3402/gha.v8.29720 This paper is part of the Special Issue: Countdown to 2015 for maternal, newborn and child survival . More papers from this issue can be found at http://www.globalhealthaction.net

Background Several birth characteristics are associated with high mortality risk: very young or old mothers, short birth intervals and high birth order. One justification for family planning programs is the health benefits associated with better spacing and timing of births. This study examines the extent to which the prevalence of these risk factors changes as a country transitions from high to low fertility. Methods We use data from 194 national surveys to examine both cross section and within-country variation in these risk factors as they relate to the total fertility rate. Results Declines in the total fertility rate are associated with large declines in the proportion of high order births, those to mothers over the age of 34 and those with multiple risk factors; as well as to increasing proportions of first order births. There is little change in the proportion of births with short birth intervals except in sub-Saharan Africa. The use of family planning is strongly associated with fertility declines. Conclusions The proportion of second and higher order births with demographic risk factors declines substantially as fertility declines. This creates a potential for reducing child mortality rates. Some of the reduction comes from modifying the birth interval distribution or by bringing maternal age at the time of birth into the ‘safe’ range of 18-35 years, and some comes from the actual elimination of births that would have a high mortality risk (high parity births).

Background A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited. Methods and Results Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score

This paper examines the association between infant mortality of the first born and subsequent children using data from rural Bangladesh collected during the period 1971-82. It shows that birth spacing and age of mother at the time of the second birth are important predictors of the survival status of the first child. The findings are discussed in terms of policy implications.This study examines the mortality of the first born and the death of a subsequent child in Bangladesh. Data are obtained from the Demographic Surveillance System of the International Center for Diarrheal Disease Research during 1974-82. The sample includes 1772 mothers who had first births and 1032 who had second births. 245 first-born and 159 second-born infants died. 740 mothers of first-born infants did not have a second child. 176 women had signs of secondary infertility. Bivariate analysis of the correspondence between first mortality status and age at death of the second child indicates an inverse relationship. The probabilities of neonatal or infant death among second children were highest among mothers whose first child also died neonatally. The second-birth mortality risk was consistently higher for all mortality among first births up to 1 year of age and lower if the first birth survived the neonatal stage. Risk was higher among mothers aged under 20 years and if the second child was a male. If the first child was a male, the probability of the second child surviving was higher. The hazard model analysis reveals that birth spacing was an important determinant. Shorter birth interval between first and second births was related to a higher relative risk of dying among first births. The analysis suggests that birth spacing and maternal age at the time of the second birth were important factors relating to the survival status of the second child. The implication of the findings is that biological variables, such as birth weight, may offer a better explanation for the association between socioeconomic and demographic factors and infant mortality. Health interventions, such as child care and nutrition education, may be more effective in reducing the risk of subsequent mortality.

The effects of birth spacing on neonatal and post-neonatal mortality in Brazil were found to be very consistent with models based on data from other South American countries. The model for neonatal mortality simplified to three significant variables, whereas the model for post-neonatal mortality included four significant interactions.Researchers used 1986 data from the Brazil Demographic and Health Survey to determine the effects of birth spacing on neonatal and post neonatal mortality then compared the results with other countries (World Fertility Survey). 1st births had a higher relative risk (RR) of neonatal death (1.49) than births of order 203 Brazil. A similar pattern existed for Peru, Ecuador, Costa Rica, Colombia, and Guyana. In Brazil, 4-6 birth order had the lowest risk (.62). High order births (7+) for all the countries had an RR almost the same as the baseline 2-3 birth order class. Birth order was significant (p.01). Post neonatal mortality for 1st births in Brazil was more favorable than other countries, but the RR for high order births was less favorable. The RR of neonatal mortality declined with mother's education for Brazil (p.05) as well as it did for Peru, Ecuador, Colombia, and Costa Rica. It did not fall in Guyana, however, where it was elevated (1.19) for mothers with 4-6 years of schooling. The positive effect of maternal education was even stronger for post neonatal mortality in Brazil (.62 for 4.6 years and .27 for 7+ years). The effect was basically the same for all the countries, but mothers with 4-6 years of education in Guyana (1.03) had slightly higher post neonatal mortality. The RR of neonatal mortality for the index child if there were 1 surviving sibling born 0-2 years earlier was only slightly increased (1.25) in Brazil, but if there were 1 dead sibling born 0-2 years earlier, RR stood at 2.4 and was significant. This RR rose further if 2 or more children were born in this interval (3.71). For infants in Brazil who had 2+ siblings born 2-4 years earlier, the RR of neonatal mortality was elevated (1.83). Indeed Brazil had higher neonatal mortality for these children than did the other countries. Birth spacing was highly significant (p.001).

Data on birth intervals are said to detect current changes in underlying fertility behavior earlier than birth rates and are used especially in developing countries to evaluate family planning programs. Birth interval information comes mostly from retrospective inquiries into maternity histories. Accounting for adolescent sterility and temporary separation between partners, a stochastic model is developed and presented capable of describing the variation in the length of closed birth intervals by birth order for women of a given marriage duration. This model may be used to analyze data on birth intervals in any population where women are exposed to the risk of conception soon after marriage. It is applied to survey data from northern India, whereby the risk of conception and risk of assuming susceptibility to conception following adolescent sterility are estmated along with the maximum duration of adolescent sterility among women with varying ages at consummation of marriage.

There has been long-standing interest in the effects of maternal age, birth rank, and birth spacing on infant and child mortality. Contradictory inferences about the role of these factors have arisen on occasion because of the absence of adequate controls, the use of cross-sectional or incomplete reproductive histories, and inattention to the effect of family size goals and birth limitation practices. This study analyzes completed reproductive histories for German village populations in the 18th and 19th centuries, a period when deliberate fertility control was largely absent. Our results confirm previous studies of the association of infant mortality with maternal age, although in the present data these differentials are largely limited to neonatal mortality. They also confirm the importance of birth interval as a factor in infant mortality. Sibship size is positively related to infant mortality even when birth rank is controlled. However, once sibship size is controlled, there are no systematic differences in infant and child mortality by birth order. The mechanisms relating sibship size and mortality are explored.

While several studies have been done on the relationship between infant mortality and birth intervals none have been done on a specific population. For this reason 3500 rural women in Nepal were interviewed and pregnancy histories taken. Out of a total of 9800 live births reported all children under 5 years of age were eliminated from the study; 1st order births were tabulated into only some of the results leaving a total sample of 4527 children over 5 years of age with a pre and post birth interval factor. Because women of early or late childbearing age are known to have more complications pre or postnatally the respondents were divided into 4 groups: those under 19 20-24 25-29 and those 30 or over. 38% of infants whose mothers waited less than 18 months to have another child died before they reached the age of 5. Pre birth intervals of more than 30 months have a 10-20% mortality rate with women in the older age categories having a slightly better chance for their babies to survive. Similar statistics were found for the post birth interval base. Short post birth intervals provide even greater danger to the infant than short pre birth intervals. The results show that women who become pregnant 30 months following the birth of their previous child are at much higher risk than those who wait at least 42 months to have another child. The above results present a powerful argument for the spacing of children. Because natural means of birth control such as breastfeeding or taboos on intercourse during lactation are decreasing as a country develops there will be a greater need for widespread contraception use and family planning.

The proportional hazards models of birth intervals based on the data from the 1976 Jordan Fertility Survey indicate that in Jordan the influence of infant death on subsequent fertility is not uniform among all population subgroups. Child survival seems to have only minimal influence on fertility among women at low birth orders and less educated women. The fertility of women with low education is consistently high, consequently, there is little room for fertility to be decreased by the death of an infant. On the other hand, the fertility of women in the highest educational category is relatively low. The World Fertility Survey results show that women in this category tend to breastfeed their children for a shorter period, and tend to use contraception more often. This latter practice is therefore the main determinant of low fertility among these women. The increase in the probability of a birth for this educational class after a child's death, can be regarded as a result of the motivation to replace the lost child. The loss of a child significantly increases the subsequent fertility of women of all birth orders, but the effect increases with birth order. Breastfeeding is common among orders but the use of contraception is more prevalent among women in the highest birth order. The results show that the motivation to use contraception is perhaps higher when the child survives that when it dies. Thus, in the higher birth order category, both the lactational effect and that of contraceptive use are operating, whereas differences in the birth probabilities by the survival of the previous infant in the lower birth order category may result from the lactational effect only. The impact of infant death is similar among rural and urban women. Further analysis shows that the observed differences in the birth intervals of women with and without infant death experience cannot be attributed to the fecundity differentials of these 2 groups of women. The findings here reported have important implications for programs designed to reduce fertility. Women in the highest educational class normally exhibit low fertility, but those who experience child loss tend to have higher subsequent fertility. It is suggested that special family planning programs should be aimed at this group of women.

While previous studies have examined the relationship between child survival and contraceptive use, they have not considered the impact of the sequence of child mortality on the practice of family planning. The present paper addresses this issue by considering how the birth order of nonsurviving outcomes affects the decision to contracept in the subsequent interval, using data collected from over 10,000 women at the time of hospital delivery. Results indicate that, even when gravidity and the total number of surviving children are held constant, the outcome of the penultimate pregnancy is highly associated with interval contraception.

In this paper we develop a model that examines fertility and childhood mortality patterns and their relationship to environmental variables. Interactions among environmental variables can account for different fertility patterns and different mixes of these variables can produce similar patterns of fertility. Our model attempts to quantify the idea that there is a trade-off between producing a few children likely to survive to reproductive age and producing a greater number of children with lower chances for survival. The optimum mix of these strategies depends on environmental characteristics. We use the model to make predictions about fertility and mortality patterns among two Bushmen populations of southern Africa--the Ghanzi and Ngamiland !Kung--using data collected by Harpending in 1967-1968. The results do not support explanations of the low fertilities observed among !Kung Bushmen women, in whom it is thought that fitness is maximized by limiting fertility, and show no relationship between mortality and family size in either !Kung population. Instead, the number of offspring reaching reproductive age in both populations increases as their completed family size increases. We examine the effects of sex, birth order, and paternal investment on mortality. No sex ratio differences and no differences in mortality by sex or birth order are present. Infant mortality among women who married more than once is significantly higher than among women who married once, suggesting that paternal care has a significant effect.

The impact of the number, order, and spacing of siblings on child and adult outcomes has been the topic of research by scholars in 4 separate fields (human biology, psychology, sociology, and economics), and the barriers to communication between academic disciplines are strong. Also most researchers have had to work with data sets gathered for other purposes. This has resulted in a relative inadequacy of research. Social scientists have 3 theories concerning the relationship between the number, order, and spacing of siblings and child and adult outcomes: that an increase in the number of siblings or a decrease in the spacing between them dilutes the time and material resources that parents can give to each child and that these resource dilutions hinder the outcome for each child; that account must be taken not only of parental resources but also of the resources given to each child by his/her siblings; and that there is no causal relationship between number, order and spacing of siblings and child outcomes and that any apparent relationships are spurious. In light of these theories, the question arises as to how should the sibling variables be measured. The most important aspect of sibling number is that it is a variable over time. Yet, the proper measurement of sibling number has an additional complication. According to all existing theories, the ages of the other siblings are relevant for the outcome for the given child. All of the relevant information is now available only when it is possible to construct a matrix in which the rows present the age of the given child and the columns the age grouping of the siblings for whom a count of sibling number will be made. Many such matrices could be developed, some much more elaborate than others. For illustrative purposes, Table 1 presents the matrix of the number of siblings for a child who is the first-born among 5 children, all of whom are spaced exactly 3 years apart and all of whom are financially dependent only up to exact age 21. Table 2 presents the matrix for the last-born child among 5 children with characteristics identical to those in Table 1. It can be inferred from these tables that the oldest child in the family, as compared to the youngest child, probably will suffer from a diminution of parental resources, most likely financial resources, in adolescence. The youngest will suffer from a reduction of parental resources, probably time resources, in infancy and early childhood. Research concerned with the consequences of the number and spacing of children should be based on data sets for which some version of this matrix can be constructed.

The relationships between length of the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, pregnancy order, maternal age, and maternal history of previous child deaths and neonatal and postneonatal mortality were explored in a rural Bangladeshi population using a multiple regression analysis. Specific interactions between the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, and history of previous child deaths were examined. An inverse relationship was observed between postneonatal mortality and the length of the interpregnancy interval when the pregnancy preceding the interval was a surviving infant. No such trend was observed for neonatal mortality. Post‐neonatal mortality rates among children whose mothers had experienced two or more previous child deaths were essentially the same as that for infants whose mothers had experienced 0–1 child deaths when the interpregnancy intervals were more than 24 months. A...

2 10-year marriage cohorts from 2 surveys of married women in Melbourne were compared on their timing of the 1st and 2nd births. The results showed that women who were married in the early 1970s were much more likely to delay their first birth until about the 3rd or 4th year of marriage compared with women who married in the 1960s. This tendency to delay the 1st birth was probably aided by effective contraception, as it coincided with widespread use of the oral contraceptive. There was no difference in the timing of the 2nd birth in relation th the 1st birth between the 2 marriage cohorts. Women who delayed childbearing also preferred smaller families. Indeed, the increase in the % of women delaying childbearing appears to be synonymous with the trend toward the two-child family. Altough the number of married women in the labor force increased significantly from the early to the later cohort, a desire to work was not usually cited as the reason for delaying childbearing. Rather, economic reasons were most frequently mentioned for delaying childbearing.