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PubMed1998

Assessing and interpreting birth spacing goals in Costa Rica.

A procedure for assessing birth spacing goals, an important component of fertility preferences, is proposed and applied to 1993 Costa Rican data. Based on a reverse or backward survival analysis, preferred birth intervals are estimated to range between 3.5 and 4.5 years (1.5 years for the interval union to first birth). These intervals are 2 or 3 years shorter than crude estimates from data on open or last closed intervals, which are upwardly biased by selection and left censoring effects. To achieve these spacing preferences, a cohort must spend about two-thirds of the time using contraception (one-third in the interval union to first birth). An inverse association between desired family size and desired birth interval is evident only in parity-specific analyses.

Birth Intervals↗
PubMed1993

Siblings' neonatal mortality risks and birth spacing in Bangladesh.

This paper studies the familial association of neonatal mortality in Matlab, Bangladesh and its relationship to birth-spacing effects on mortality. Findings show that familial association is strongest for siblings of adjacent birth orders. Moreover, birth-spacing effects on neonatal mortality are stronger when the preceding child has survived the neonatal period than when it has died. Transitional (Markov), random-effects, and marginal models for correlated data are introduced, and are contrasted in interpretation and technique. Familial association of neonatal mortality can be approximately well by a first-order Markov model using generalized estimating equations (GEE) to allow for higher-order correlation.

Adult↗
PubMedDate not supplied

Jordanian men's attitudes and views of birth-spacing and contraceptive use (a qualitative approach).

This qualitative study was carried out to understand the meaning that Jordanian men attach to birth-spacing/family planning and to identify their attitudes and practices regarding contraceptives. Six focus group discussions were conducted over a 3-month period starting April 1996, with each group containing 6-10 men. The sample consisted of Jordanian men residing in Amman. Education, social class, and marital status stratified men's selection. The discussions were moderated by a social psychologist of the same sex. With respondents' consent, data gathered in the discussion groups were tape-recorded, transcribed, and critically analyzed using the content analysis method. The researchers found that there was a consensus among all men about the link between the concept of birth-spacing/family planning and the concept of better health for the mother and the child. Yet, the practice of contraception was influenced by some religious and cultural beliefs including that of "RIZK" (or fortune) which comes when the child is born. Moreover, some knowledge deficits concerning modern methods of contraception, and their side effects in particular, were noted. Some unfavorable attitudes of men for themselves using male contraceptives were also noted. Most men in the study indicated that spousal communication takes place on issues related to family planning, but the final decision is, in most cases, left to the husband alone (the head of the house). The demand for an increasing number of male children and the resistance of males to use condoms were among the most prevalent unexpected phenomena noticed in this study. The study concludes by recommending that special attention be directed to males when delivering family planning services.

Adult↗
PubMedDate not supplied

Birth weight and the effects of birth spacing and breastfeeding on infant mortality.

Analyses previously reported, based on data from the World Fertility Survey (WFS), are replicated here with data from the Malaysian Family Life Survey. Comparison of results, when data limitations inherent in the World Fertility Surveys are reproduced or relaxed, suggests that these limitations cause little distortion, and thus bolsters confidence in the validity of results based on WFS data in which these limitations are inescapable. Generalizations based on the present investigation and on the body of previous work that it tends to validate are presented. Most significantly, these include the greater importance of both breastfeeding and birth spacing under generally unfavorable conditions, the variability of durations to which some benefit of continued breastfeeding persists, and the observation that the great majority of birth-spacing effects operate through some mechanism other than the association of breastfeeding with birth interval lengths.

Adult↗
PubMedDate not supplied

Knowledge and attitude of males regarding birth spacing and contraception.

A cross sectional study with 368 males (husbands of women delivered at Regional Institute of Medical Sciences hospital) revealed that 89% of them were aware of contraception. But only the meaning of birth spacing was known to 13% of them correctly. Education, income and parity were significantly associated with knowledge on birth spacing.

Adult↗
PubMed1992

Birth spacing and child health in urban Brazilian children.

The associations between birth interval and a range of child health outcomes were examined in a population-based cohort of approximately 3500 urban Brazilian children. The effects of several socioeconomic and maternal confounding factors were controlled for in the analyses. Children born after shorter birth intervals (less than 18 and 18 through 23 months) were disadvantaged with respect to most of the health outcomes when compared with children born after intermediate birth intervals (24 through 35, 36 through 47, and 48 through 71 months). Effects were particularly marked for birth weight, postneonatal mortality, and anthropometric status at mean age 19 months. Children born after a long birth interval (greater than 71 months) also showed some disadvantage for birth weight, perinatal mortality, and infant mortality. However, this group experienced lower risks of hospitalizations during the first 19 months of life and better anthropometric status at mean age 19 months. This study provides data that are scarce from such settings and contributes to the quantification of associations between birth spacing and child health. This information is important in the planning of appropriate intervention strategies.

Anthropometry↗
PubMed1983

The effects of birth spacing on child and maternal health.

Child and maternal mortality and morbidity are examined in relation to the interval between pregnancies. Most data available pertain to child mortality. Very little reliable information links child morbidity or maternal health detriments to short birth spacing. The evidence on child mortality suggests that very short intervals (conceptions less than six months after a birth) are detrimental to survival of the second child, but these results must be viewed in light of the methodological difficulties of studies of this subject. Policy implications of the data are perhaps less clear than is sometimes assumed.

Adolescent↗
PubMed1990

[Birth spacing in Puerto Rico].

This paper uses life table methods to analyze the process of family formation in Puerto Rico. Despite a continuing decline in fertility, the pattern of birth spacing is very rapid with a big proportion of short intergenesic intervals. This indicates a clear distinction between spacing and stopping behavior. Some possible health implications are discussed.

Age Factors↗
PubMed1997

Effects of infant feeding practices and birth spacing on infant and child survival: a reassessment from retrospective and prospective data.

Retrospective and prospective data collected in Cameroon were used to reassess hypotheses about how infant and early childhood mortality is affected by birth spacing and breast-feeding. These data show that: (a) a short preceding birth interval is detrimental for child survival in the first 4 months of life; (b) full and partial breast-feeding have direct protective effects on child survival in the first 4-6 months of life, with the effects of the former stronger than those of the latter; (c) early subsequent conception significantly increases mortality risks in the first 16 months of life of the index child. These findings are robust to various controls, e.g. study design, data defects, child's health conditions at/around birth, postnatal maternal and child recurrent illnesses, patterns of utilisation of health care services, and immunisation status of the child.

Birth Intervals↗
PubMed1983

Promotion of birth spacing on Idjwi Island, Zaire.

Idjwi Island in Lake Kivu in eastern Zaire supports approximately 50,000 largely subsistence farmers, the Bani-Iju. Rapid population growth, a declining economy, and a deteriorating environment have already converged to produce significant malnutrition in this isolated community. The highly structured and traditional social order, particularly regarding reproductive mores, is examined here in its relevance to an intervention program for reducing the demographic pressure by increasing birth spacing. The mean birth interval of approximately three years appears to be shrinking, and is far too brief to prevent rapid population growth. The program, which included films about contraception, did not lead to a longer birth interval among the Bani-Iju, but did succeed in informing women about family planning. It is concluded that no intervention program for promotion of family planning is likely to be effective without substantial improvement in the economy.

Adolescent↗
PubMed2004

Deliberate birth spacing before the fertility transition in Europe: evidence from nineteenth-century Belgium.

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.

Belgium↗
PubMedDate not supplied

The effects of breastfeeding and birth spacing on child survival in China.

Using data from the In-depth Fertility Survey, conducted in Shanghai Municipality and Shaanxi Province, People's Republic of China, in April 1985, this study shows that breastfeeding and birth spacing have significant effects on child survival in Shaanxi, but not in Shanghai (controlling for potential confounding factors and reverse causality). The effect of breastfeeding decreases with age. Introducing proper supplemental food is very important for child survival in Shaanxi, where a high proportion of children are breastfed exclusively for much too long, sometimes up to nine months. An increase in the length of the previous birth interval improves child survival in Shaanxi significantly, especially for high-order children, and the first child has the highest survivorship in both Shanghai and Shaanxi. The effects of subsequent birth intervals are statistically significant in Shaanxi, but have a small actual impact on child survival in the first few years of life, since the arrival of a sibling does not affect the index child's risk of dying in the first few months of life, when the mortality rate is extremely high.

Age Factors↗
PubMedDate not supplied

Effects of lactation and contraceptive use on birth-spacing in Bolivia.

Based on the 1989 Demographic and Health Survey of Bolivia, analysis of the joint effects of breastfeeding and contraceptive use on birth-spacing showed the IUD to be the most effective contraceptive method used to delay conception. Breastfeeding significantly lengthened the birth interval, but only following second and higher parity births. In addition, conditions of poverty appeared to further inhibit the return of fecundity and delay conception.

Adolescent↗
PubMed2002

Birth spacing initiative in Oman.

The Sultanate of Oman, faced with the potential for a population explosion that would drain national educational and economic resources, has initiated a birth spacing program which is in its fifth year of implementation at all Ministry of Health facilities. The program was developed based on data from a survey of married Omani women of childbearing age and their spouses. Success has been attributed to the inclusion of Muslim religious leaders at all stages of planning and implementation to deflect people's concern that child spacing is forbidden, and to educational outreach to men.

Adult↗
PubMed2001

Pregnancy outcome and birth spacing among Palestinian women between 1940 and 1989.

In a sample of 1,250 Palestinian women living in cities, villages and refugee camps of the West Bank over a period of 50 years, we studied the number of pregnancies, children and miscarriages per woman, the waiting time to the first pregnancy, birth spacing between children, and the average age of women at first live birth. The average number of pregnancies, the percentage of miscarriages, the waiting time to the first pregnancy and the birth interval between children decreased with time in all locations. The average age of women at first live birth in cities and villages showed very little difference, but slightly lower in refugee camps.

Abortion, Spontaneous↗
PubMed1980

Nursing frequency, gonadal function, and birth spacing among !Kung hunter-gatherers.

Mothers among !Kung hunter-gatherers nurse briefly and frequently, with brief intervals between nursing bouts (mean +/- standard error, 13.19 +/- 1.28 minutes). The low levels of 17 beta-estradiol and progesterone in the serum of the mother are correlated with infant's age and with interbout interval, but not with total nursing time. Maternal gonadal function is apparently suppressed by a timing-dependent, prolactin-mediated effect of breast stimulation. Interbout interval may be a key variable in lactation infertility. If so, it solves the puzzle of !Kung birth spacing.

Amenorrhea↗