Prospective study of birth interval dynamics in rural Bangladesh

Abstract A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registration programme since 1966. The selected women were interviewed bi-weekly and were asked questions about menstruation, pregnancy, lactation, husband's occupational absences, and monthly urine tests for pregnancy were taken. The results for 193 non-contracepting women revealed that the seasonal pattern of births previously observed in this population could be associated with a corresponding seasonal pattern of conceptions and that this was due to a seasonal trend in fecundability. The highest conception rates were in the coolest months of the year. Post-partum lactational amenorrhoea was very prolonged, averaging 17 months for women with a surviving child. The appearance of the first post-partum menstrual flow (onset of ovulation) also had a seasonal trend which could not be adequately explained. The median waiting time to conception, once menstruation had resumed was eight months. This interval was influenced by seasonal fluctuations, as well as by the age of women and by husbands' absences. The foetal wastage rate was 15·0 per 100 conceptions, with 62 per cent of the foetal losses occurring during the second month of gestation. Overall, the average birth interval was 33 months, with the prolonged lactational amenorrhoea accounting for almost 45 per cent of this interval. From the Department of Population Dynamics, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205.     

Nutrition and Fertility in Bangladesh: Breastfeeding and Post Partum Amenorrhoea

From 1975 to 1980 a prospective study a nearly 2,500 married, fertile women was conducted in Matlab, Bangladesh at the International Centre for Diarrhoeal Disease Research. Women were interviewed at monthly intervals to collect information on nutritional and reproductive status, in order to study the factors associated with natural fertility. The median duration of amenorrhoea for women with no child deaths was 15.5 months, with older women and those of higher parities recording longer durations than younger women or those of lower parities. Median duration of amenorrhoea for women with six or more years of education was 8.4 months compared to 16.4 months among women with no education. When classified by weight at pregnancy termination, average duration of amenorrhoea of women weighing less than 38 kg was 17.6 months compared to 13.6 months among women weighing more than 44 kg. Proportional hazards analyses show that mother's education, parity, month of birth, supplementation practices and nutritional status were significantly associated with the probability of resuming menstruation.     

Lactation and fertility in Rural Bangladesh

Summary Analysis of data from various phases of a study of post-partum amenorrhoea in Bangladesh illustrated good aggregate consistency of response on menstrual status, but less individual consistency on duration of post-partum amenorrhoea. Using life table techniques, the median duration of amenorrhoea was calculated as 19.9 months for women with births between February and September 1974. There were substantial seasonal variations in duration, with the median decreasing from 21.5 months for women with February births to 16.9 months for those with September births. By contrast, the median duration of post-partum amenorrhoea varies by only two months for women in the lowest and highest quartiles of weight and weight for height. The seasonal pattern was similar for all weight groups.     

Population planning in Asia in the 1970s

Analysis of data from various phases of a study of post-partum amenorrhoea in Bangladesh illustrated good aggregate consistency of response on menstrual status, but less individual consistency on duration of post-partum amenorrhoea. Using life table techniques, the median duration of amenorrhoea was calculated as 19.9 months for women with births between February and September 1974. There were substantial seasonal variations in duration, with the median decreasing from 21.5 months for women with February births to 16.9 months for those with September births. By contrast, the median duration of post-partum amenorrhoea varies by only two months for women in the lowest and highest quartiles of weight and weight for height. The seasonal pattern was similar for all weight groups.     

An exploration of China's mortality decline under Mao: A provincial analysis, 1950–80

Between 1950 and 1980, China experienced the most rapid sustained increase in life expectancy of any population in documented global history. We know of no study that has quantitatively assessed the relative importance of the various explanations proposed for this gain in survival. We have created and analysed a new, province-level panel data set spanning the decades between 1950 and 1980 by combining historical information from China's public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that gains in school enrolment and public health campaigns together are associated with 55–70 per cent of China's dramatic reductions in infant and under-5 mortality during our study period. These results underscore the importance of non-medical determinants of population health, and suggest that, in some circumstances, general education of the population may amplify the effectiveness of public health interventions.

Supplementary material for this article (Babiarz et al. 2014, Suppl.) is available at: http://dx.doi.org/10.1080/00324728.2014.972432     

The boundaries of genocide: Quantifying the uncertainty of the death toll during the Pol Pot regime in Cambodia (1975–79)

The range of estimates of excess deaths under Pol Pot's rule of Cambodia (1975–79) is too wide to be useful: they range from under 1 to over 3 million, with the more plausible estimates still varying from 1 to 2 million. By stochastically reconstructing population dynamics in Cambodia from extant historical and demographic data, we produced interpretable distributions of the death toll and other demographic indicators. The resulting 95?per cent simulation interval (1.2–2.8 million excess deaths) demonstrates substantial uncertainty over the exact scale of mortality, yet it still excludes nearly half of the previous death-toll estimates. The 1.5–2.25 million interval contains 69 per cent of the simulations for the actual number of excess deaths, more than the wider (1–2 million) range of previous plausible estimates. The median value of 1.9 million excess deaths represents 21?per cent of the population at risk.

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2015.1045546     

Pregnancy outcome and the time required for next conception

Abstract Variations in the time required for next conception by outcome ofthe preceding pregnancy, and the age of woman, are studied for Taiwanese women. Pregnancy interval, defined as the period between the end of one pregnancy and the beginning of the next, is taken as a measure of the time required for the next conception. The averages and variances of pregnancy intervals are estimated from reports of pregnancies occurring in a probability sample of 2,443 married women, aged 20-39, living in Taichung (Taiwan) in 1962. The effects of 'truncation bias' and 'memory bias' on the two moments of pregnancy intervals are estimated indirectly by cross-classifying women according to their ages at interview and their ages at the beginning (or end) of each pregnancy interval. The moments of post-partum amenorrhoea are, then, estimated indirectly from the moments of pregnancy intervals. The effects of truncation bias and memory bias are compensatory in this sample. In the absence of contraception, women, on an average, took longer to conceive following a live birth than following a foetal death. The time taken for next conception increases as women become older irrespective of the outcome of the preceding pregnancy.     

The impact of infant and child death on subsequent fertility in Ethiopia

This paper uses hazard regression models to assess the impact of experienced infant and child mortality on the risk of subsequent conceptions in Ethiopia. The purpose of this paper is to test for the presence of a fertility response to an infant or child death, net of the effects of truncated breastfeeding on fecundity. Using retrospective birth history data from a national survey in Ethiopia, we find a significantly higher risk of a conception in the months following the death of an index child, even after controlling for postpartum amenorrhoea and breastfeeding status. The fertility response is strongest after the death of the fourth or fifth child, which is when most women in Ethiopia are at or near their desired family size. However, we find no evidence of a fertility response to the death of a nonindex child. We attribute the higher risk of a conception following an index child’s death to the intentional efforts of couples to reduce the waiting time to a next birth and thereby replace the deceased child. However, absent evidence of replacement fertility in response to the death of older nonindex children, we interpret the response to the death of an index child as an emotional response to child loss rather than a conscious strategy to meet a fertility target.

Genetic influence on age at first birth of female twins born in the UK, 1919–68

Using a sample of monozygotic (945, 42?per cent) and dizygotic (1,329, 58?per cent) twin pairs born 1919–68 in the UK, we applied innovative tobit models to investigate genetic and environmental influences on age at first birth (AFB). We found that a substantial part (40?per cent) of the variation in AFB is caused by latent family characteristics. Genetic dispositions (26?per cent) play a more important role than the shared environment of siblings (14?per cent), with the non-shared environment/measurement error having the strongest influence (60?per cent). Like previous studies, this study reveals marked changes in estimates over time, and supports the idea that environmental constraints (war or economic crisis) suppress and normative freedom (sexual revolution) promotes the activation of genetic predispositions that affect fertility. We show that the exclusion of censored information (i.e., on the childless) by previous studies biased their results.

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2015.1056823     

An investigation of the unexpectedly high fertility of secular,native-born Jews in Israel

Secular, native-born Jews in Israel enjoy the socio-economic status of many affluent populations living in other democratic countries, but have above-replacement period and cohort fertility. This study revealed a constellation of interrelated factors which together characterize the socio-economic, cultural, and political environment of this fertility behaviour and set it apart from that of other advanced societies. The factors are: a combination of state and family support for childbearing; a dual emphasis on the social importance of women's employment and fertility; policies that support working mothers within a conservative welfare regime; a family system in which parents provide significant financial and caregiving aid to their adult children; relatively egalitarian gender-role attitudes and household behaviour; the continuing importance of familist ideology and of marriage as a social institution; the role of Jewish nationalism and collective behaviour in a religious society characterized by ethno-national conflict; and a discourse which defines women as the biological reproducers of the nation.

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2016.1195913     

High foetal mortality and birth intervals

Abstract Studies of birth intervals have generally separated the process into: (1) the period of infertility following a pregnancy termination; (2) the length ofthe interval from the end of the infertile period to the next conception (which reflects the probability of conception), and (3) the average duration of pregnancy for both live births and foetal deaths.(1) Empirically derived intervals between successive live births average from 19 to 30 lunar months(2) (Table 1), depending upon the population studied and the birth order.(3) Estimates of conception rates using birth intervals data require some estimate of the extent to which foetal wastage increases the birth interval.     

Sodomy’s Penumbra

This article advocates a sodomitical approach to sodomy. Its approach is framed alongside and against three historical glosses on sodomy law: first, that sodomy law instantiates homophobia; second, that sodomy law targets sexual violence against boys; third, that sodomy law reaches assaultive sex against women that did not register as assaultive enough to qualify as “rape” by sexist juries. The first story of sodomy law is mostly wrong. The other two glosses pivot on protection: protection of boys or protection of girls and women. These accounts, tethered to identitarianism, underplay sodomy law’s multiplicity, as a source and symptom of our conflicted understandings of when sex is sex and when sexual violence is rape.

The first part of the article explains my choice of sodomitical sites. The second part complicates the story of sodomy as phobic. The third part complements the historiography of sodomy as protective against boys. The fourth part argues that the gloss on sodomy law as a corrective to disbelieved women is appealing but untrue. The final part makes the case that fellatio matters. The prevalence of forcible oral sex in sodomy cases intimates a cultural pluripotence of oral sex, as well as shifting definitions—in law and life—of sex and rape. This last story of sodomy law remains undetected under an identitarian radar.     

Breast feeding,mortality in childhood and fertility in a rural zone of Senegal

The data analysed in the present study were collected in the course of a demographic survey conducted at repeated intervals in the Sine-Saloum region of Senegal.1 This study was financed by a grant from the ‘Fond d'aide et de coopération’ of France, from 1963-65, and by the WHO Section for Research on Human Reproduction from 1966-67. The study was conducted by ORSTOM in collaboration with the Statistical Service of Senegal. The data used in this paper were analysed at INED. Only the data concerning the Sine (Niakhar) area are analysed here.     

Truncated cross-sectional average length of life: A measure for comparing the mortality history of cohorts

Period life expectancies are commonly used to compare populations, but these correspond to simple juxtapositions of current mortality levels. In order to construct life expectancies for cohorts, a complete historical series of mortality rates is needed, and these are available for only a subset of developed countries. The truncated cross-sectional average length of life (TCAL) is a new measure that captures historical information about all cohorts present at a given moment and is not limited to countries with complete cohort mortality data. The value of TCAL depends on the rates used to complete the cohort series, but differences between TCALs of two populations remain similar irrespective of the data used to complete the cohort series. This result is illustrated by a comparison of TCALs for the US with those for Denmark, Japan, and other high-longevity countries. Specific cohorts that account for most of the disparity in mortality between the populations are identified.

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2015.1019955     

On the decomposition of life expectancy and limits to life

Life expectancy is a measure of how long people are expected to live and is widely used as a measure of human development. Variations in the measure reflect not only the process of ageing but also the impacts of such events as epidemics, wars, and economic recessions. Since 1950, the influence of these events in the most developed countries has waned and life expectancy continues to lengthen unabated. As a result, it has become more difficult to forecast long-run trends accurately, or identify possible upper limits. We present new methods for comparing past improvements in life expectancy and also future prospects, using data from five developed, low-mortality countries. We consider life expectancy in 10-year age intervals rather than over the remaining lifetime, and show how natural limits to life expectancy can be used to extrapolate trends. We discuss the implications and compare our approach with other commonly used methods.

Supplementary material for this article is available at: http://dx.doi.org/10.1080/00324728.2014.972433     

A proposed explanation of the fertility gap differentials by socio-economic status and modernity: The case of Egypt

The present paper is part of a larger analysis of data collected in the summer of 1970 in the city of Cairo.1 A joint study between the Institute of Statistical Studies and Research and Centre for Sociological Studies, Cairo. The present analysis is based on a sub-sample of 569 households.     

CharacteriStics and utilization of midwives in a selected rural area of East Pakistan

The purpose of this study was to obtain information about the utilization of midwives (dais) by village women and to learn more about the characteristics and practices of those dais. Two interview schedules were prepared. The first was used to interview 632 village women to determine who performed or assisted with their last two deliveries. The second was used to obtain information from 21 dais.The results of the first phase may be summarized as follows: (a) 38 per cent of the women were delivered by relatives; (b) 33 per cent of the women delivered their own children; (c) 14 per cent were delivered by neighbors; (d) 6 per cent were delivered by dais; (e) 2 percent were delivered in hospitals; and (f) the remaining 7 per cent were accounted for by several minor categories.The results of the interviews with dais are summarized as follows: (a) they are mainly widows and older women; (b) they have no formal training; (c) they work for friends, neighbors, and relatives and receive a sari as compensation; (d) they cannot handle complicated deliveries; (e) they deliver 3-4 children a year; (f) their sterilizing procedures depend upon soap, water, and folk beliefs; (g) most think midwifery is a worthwhile service; (h) about one-half have a general understanding of the reproduction process; (i) most do not know how to prevent conception; and (j) about half think that it is a good idea to participate actively in a family planning program.     

Factors Affecting Birth Rates among White Women 20–24 Years of Age: A Trend Analysis (January 1972–march 1992)

Using Current Population Survey data, Vital and Health Statistics data, photoperiod data and temperature data, this article attempts to provide an interdisciplinary explanation of monthly (N = 243) variation in the dependent variable representing the birth rate (the rate of conceptions that become live births) for white women 20–24 years of age. Among the selected explanatory variables, four were found to play significant roles in accounting for the variation of the birth rate. They were rates of female absence from the labor market (nonparticipation plus unemployment), male employment rates, length-of-night variations and the days in the month of conception. Rainwater's concept of validating activities (1974) and recent quality of life research regarding domains serve as a basis for development of the concepts compensatory validation and contextual compatibility. Research and policy implications are discussed.