甘肃省农村已婚育龄妇女人工流产状况分析

本文通过对甘肃省农村已婚育龄妇女的人工流产状况的分析,建议加强对农村育龄妇女的生殖健康教育,降低非意愿妊娠率及人工流产率,提高育龄妇女的生殖健康水平。     

Can NFP be taught in two short,easy lessons? Simplified NFP for isolated and/or busy couples

Researchers used life table rates from study and comparison groups from rural and urban areas of Cagayan de Oro City, the Philippines to test a simplified method of teaching natural family planning (NFP) defined by calendar, mucus, and cervix indicators. This method included a 6 page booklet, 2 30-minute training sessions, and a question and answer period. Fear of side effects from other contraceptive methods was the leading reason for using NFP (79.4% urban, 85.8% rural). Religious motivation and fear of side effects followed for urban couples, but the percentage was low (14.6%). In rural areas, religious motivation place 3rd (4.1%) preceded by other reasons (6.9%). User error resulted in low accidental pregnancy rates (.8%). Method failure was responsible for higher failure rates than user error, but they were still relatively low (3.4% total). In rural areas, the reason for failure was unclear in 2.6% of couples, but it was only .9% among urban couples. Rural couples who used NFP to space births (spacers) had 2 times the failure rate of those rural couples who used NFP to limit births (limiters) [69% vs. 31%]. Urban spacers had a higher failure rate than urban limiters, but the difference was smaller than it was for rural couples (54.8% vs. 45.2%). Lactation did not have a clear effect on failure rates. For example, in urban areas, partially lactating women had a lower failure rate than nonlactating women (41.9% vs. 58.1%), but in rural areas, lactation had the opposite effect (63.6% for lactating women and 36.4% for nonlactating women). Risk taking resulted in more 6 month pregnancy rates among urban couples than rural couples (12.3% vs. 8.2%). At the end of 6 months, 67.5% of all couples still used the new simplified NFP method (70.3% rural vs. 64.7% urban). Therefore the new simplified NFP method was an effective method for spacing or limiting births.     

An analysis of the change of marriage pattern of Beijing women]

Changes in marriage patterns occur primarily in changes in the age at marriage. During a study of fertility among Beijing, China, women in 1981, another study was undertaken of the marriage situation of 8299 women who were born in 1914, 1920, 1930, 1940, and 1946. Data show that the rate of unmarried women was close to zero, which is one reason for the high birth rate in the past. A majority of the urban and rural women born in 1914, 1920, and 1930 married before the age of 15 years, indicating that the economic, social, and marriage customs for those decades changed very little. The 1940 cohort, however, showed no urban marriages prior to the age of 15 years and less than 1% in the villages, the reason being that these women were of marriageable age in the mid-to-late 1950s when China underwent major social and economic changes that raised the status of women and permitted them to join the work force or go to school. Very few urban women in the 1946 cohort married before 20 years of age, and the number of rural women who married before they were 18 years old declined noticeably. Findings also show that for both urban and rural women, the average age at marriage was 1-3 years later than the modal age at marriage. Beginning with the 1940 cohort the age at marriage was older by 2 1/2 years, signaling major changes. Except for the 1914 cohort, the median age at marriage for all others gradually became higher. 70% of the 1946 cohort voluntarily married after turning 23 years old, reflecting the effectiveness of the late marriage, late birth policy. Although close to 59% of rural women born in 1946 married before 23 years of age, nearly double the rate for urban women, it is nevertheless a major change from the 1930 cohort where 95% of the women married before turning 23 years old.     

Fertility intentions and maternal health behaviour during and after pregnancy

This study examines associations between fertility intentions and maternal health behaviours during and after pregnancy among a nationally representative sample of 3,442 women from India. Two waves of data (2005, 2012) from the India Human Development Survey were analyzed to investigate the influence of unwanted births on women’s use of antenatal care, timely postnatal care, and the delivery setting using binary and ordered logistic regression, partial proportional odds models, and propensity score weighting. Fifty-eight per cent of sample births were unwanted. Regression results show that, net of maternal and household characteristics, women with unwanted births were less likely to obtain any antenatal care and had fewer antenatal tests performed. Unwantedness was also associated with a lower likelihood of delivering in an institutional setting and of obtaining timely postnatal care. The relationships between unwantedness and antenatal care, postnatal care, and delivery setting were robust to models accounting for propensity weighting.     

The determinants and patterns of married women's labor force participation in Korea

The present study investigates the determinants and patterns of married women's labor force participation in Korea. Married women's employment in Korea is largely determined by age, urban residence, household characteristics of the husband's socioeconomic status, family income, fertility, and the lagged effect of work. Older age, rural residence, inferior household economic condition, and recent work experience are the major positive causes of married women's participation in the market work. On the other hand, younger women with preschool children, who currently reside in urban areas, enjoying better household economic conditions (due to higher socioeconomic status of husbands and/or higher family income) are the groups of women with the smallest probability of working in the market. Married women's employment pattern in Korea shows a pattern typical of less-developed and low-income countries in two aspects: married women working and characterized by a low level of education; the difference between urban and rural areas in terms of work participation pattern is remarkable. Although Korea belongs to the advanced group of currently industrializing countries, she lags behind with other developing countries in terms of married women's employment. Moreover, it is difficult to predict in advance that Korea would have similar experiences as those of contemporary advanced countries.     

Barriers to contraceptive use among Pakistani couples

Despite the existence of a family planning program in Pakistan since 1965 and widespread knowledge among Pakistanis about contraception, there is a high level of unmet need for family planning. One recent survey found that while 53% of married women express the desire to avoid pregnancy, less than 20% use contraception. A recent Population Council study conducted in urban and rural areas of Punjab province investigated personal beliefs, family circumstances, social norms, and gender relations among 1310 married women and 554 of their husbands. The unmet need for contraception was highest among women over age 30 years, those with more living children, less educated women, and women living in rural areas. The study found that while most Pakistanis approve of family planning, obstacles to contraceptive use exist in most marriages. 97% of respondents who wanted another child wished for a boy. That preference for sons influences contraceptive use behavior. The fear of social disapproval of contraceptive use, perceived opposition from in-laws and husbands, and fear of health side effects and divine punishment were major reasons identified against contraceptive use. Female contraceptive users were more autonomous and likely to make domestic decisions without consulting their husbands, while husbands defer to social and cultural norms.     

Midpregnancy Marriage and Divorce: Why the Death of Shotgun Marriage Has Been Greatly Exaggerated

Conventional wisdom holds that births following the colloquially termed “shotgun marriage”—that is, births to parents who married between conception and the birth—are nearing obsolescence. To investigate trends in shotgun marriage, we matched North Carolina administrative data on nearly 800,000 first births among white and black mothers to marriage and divorce records. We found that among married births, midpregnancy-married births (our preferred term for shotgun-married births) have been relatively stable at about 10 % over the past quarter-century while increasing substantially for vulnerable population subgroups. In 2012, among black and white less-educated and younger women, midpregnancy-married births accounted for approximately 20 % to 25 % of married first births. The increasing representation of midpregnancy-married births among married births raises concerns about well-being among at-risk families because midpregnancy marriages may be quite fragile. Our analysis revealed, however, that midpregnancy marriages were more likely to dissolve only among more advantaged groups. Of those groups considered to be most at risk of divorce—namely, black women with lower levels of education and who were younger—midpregnancy marriages had the same or lower likelihood of divorce as preconception marriages. Our results suggest an overlooked resiliency in a type of marriage that has only increased in salience.     

How female education affects reproductive behavior in urban Pakistan

Although Pakistan remains in a pretransitional stage (contraceptive prevalence of only 11.9% among married women in 1992), urban women with post-primary levels of education are spearheading the gradual move toward fertility transition. Data collected in the city of Karachi in 1987 were used to determine whether the inverse association between fertility and female education is attributable to child supply variables, demand factors, or fertility regulation costs. Karachi, with its high concentration of women with secondary educations employed in professional occupations, has a contraceptive prevalence rate of 31%. Among women married for less than 20 years, a 10-year increment in education predicts that a woman will average two-fifths of a child less than other women in the previous 5 years. Regression analysis identified 4 significant intervening variables in the education-fertility relationship: marriage duration, net family income, formal sector employment, and age at first marriage. Education appears to affect fertility because it promotes a later age at marriage and thus reduces life-time exposure to the risk of childbearing, induces women to marry men with higher incomes (a phenomenon that either reduces the cost of fertility regulation or the demand for children), leads women to become employed in the formal sector (leading to a reduction in the demand for children), and has other unspecified effects on women's values or opportunities that are captured by their birth cohort. When these intervening variables are held constant, women's attitude toward family planning loses its impact on fertility, as do women's domestic autonomy and their expectations of self-support in old age. These findings lend support to increased investments in female education in urban Pakistan as a means of limiting the childbearing of married women. Although it is not clear if investment in female education would have the same effect in rural Pakistan, such action is important from a human and economic development perspective.     

Mothers’ Marital Status and Type of Delivery Medical Care in Guatemala

The use of modern medical care for child delivery in rural Guatemala is low relative to other Latin American countries. In the previous literature, factors such as a woman’s age, education, ethnicity, religious affiliation and income are found to be important determinants of the type of delivery medical care she receives. This study hypothesizes that a woman’s marital status influences her decision as well. Using a binomial logit framework, the study finds that unmarried women are more likely to see a modern medical provider in delivery than married women, even after controlling for demographic, socioeconomic, and husbands’ characteristics. Therefore, unmarried women seem to make more informed decisions in terms of their attitudes in childbearing and maternal health relative to their married counterparts. As a result, both economic as well as social developments seem necessary to induce changes in the high incidence of maternal mortality and morbidity in Guatemala.     

Marriage Patterns And Cumulative Fertility In West Malaysia: 1966–1967

Differentials in age at first marriage and being married more than once are discussed for a probability sample of West Malaysian currently married women 15-44 years of age. Both marriage ages and the incidence of multiple marriages vary greatly by race, place of current residence, wife's education, and husband's occupation; and the marriage variables are shown to have significant effects on the cumulative fertility of West Malaysian women. Early marriage leads to higher cumulative fertility and multiple marriages lead to lower cumulative fertility. Since the social groups with the highest proportions of early marriages are also those with the highest incidence of multiple marriages, the marriage variables explain some but not all of the variance in cumulative fertility for West Malaysian social groups. After adjustment for the effects of the marriage variables, rural Indian or Pakistani women still have the highest cumulative fertility and urban Chinese women with more than five years of schooling still have the lowest cumulative fertility.     

宫内节育器使用效果的调查分析

对2659例已婚育龄妇女放置宫内节育器(IUD)后1年进行了调查,了解IUD的使用效果。结果显示,农村妇女IUD放置后1年使用率为84.2%,低于城市妇女(P<0.001);带器妊娠和IUD脱落是IUD停止使用的主要原因。应加强技术服务,提高IUD的续用率。     

Age at marriage,family planning practices,and other variables as correlates of fertility in Korea

The relationships between fertility and thirteen variables are examined in three groups of married Korean women, about 400 each from urban, rural, and semi-rural areas. Data were obtained by interview. Age at marriage and family planning practice are the strongest predictors of fertility and account for about 10 percent and 7 percent of the total variance, respectively. Other factors which accounted for lesser fractions of variability are ideal number of children, rural versus urban residence, education, aspiration for daughters, exposure to mass media, and economic status. Most of the relationships appear to be stable over time; others, which are associated with modernization, appear to be changing. The thirteen variables combined can account for a maximum of 40 percent of the variance in fertility.     

Income and fertility: The elusive relationship

This paper uses longitudinal data for 1962–1977 to examine the relationship of husband’s income to 1962 expected fertility, to final parity, and to the discrepancy between initial expectations and final parity, separately for four groups of women who in 1962 either had just given birth to a first, second, or fourth child or had just been married. Although economic reasons frequently were cited in 1977 for downward revisions in family size goals, husband’s income was not positively related to fertility in three of the four parity groups. For the merged sample, excluding women with unwanted births, husband’s income showed a small positive relationship to completed fertility.     

Premarital pregnancies and out-of-wedlock births in denmark, 1950–65

Although comprehensive investigation of child spacing patterns requires consideration of those births that were conceived before marriage, detailed data on such births often are not available, especially in the United States. Danish statistics on first births by duration of marriage and on out-of-wedlock births permit evaluation of trends in premarital pregnancies. For the period 1950-65, they point to (1) a rise in the percentage of all brides who are pregnant at marriage; (2) an increase in the proportion of first births occurring within both six and nine months of marriage; and (3) a rise in out-of-wedlock births.The trend for the country as a whole also characterizes Copenhagen, but at a higher level, and this reflects the capital's more urban character, greater permissiveness, and attraction to young migrants. Age differentials indicate that as high as 90 percent of all first births among married women aged under 20 years and over 50 percent of those to women aged 20-24 years are premaritally conceived. The rise in the number of first births among young women largely accounts for the overall rise in the level of premarital conceptions. Compared to its suburbs, Copenhagen in 1965 had higher levels of premarital conceptions. The overall residential differential stems both from higher proportions of such births in all age groups in Copenhagen (but especially those aged 20 years and over) and from the fact that Copenhagen has proportionally more first births occurrinq to women aged under 20 years, the age group in which the rates of premarital conceptions are especially high.     

Changes in fertility patterns can improve child survival in Southeast Asia

This analysis of 1988 Philippine Demographic Survey data provides information on the direct and indirect effects of several major determinants of childhood mortality in the Philippines. Data are compared to rates in Indonesia and Thailand. The odds of infant mortality in the Philippines are reduced by 39% by spacing children more than two years apart. This finding is significant because infant mortality rates have not declined over the past 20 years. Child survival is related to the number of children in the family, the spacing of the children, the mother's age and education, and the risks of malnutrition and infection. Directs effects on child survival are related to infant survival status of the preceding child and the length of the preceding birth interval, while key indirect or background variables are maternal age and education, birth order, and place of residence. The two-stage causation model is tested with data on 13,716 ever married women aged 15-49 years and 20,015 index children born between January 1977 and February 1987. Results in the Philippine confirm that maternal age, birth order, mortality of the previous child, and maternal education are directly related to birth interval, while mortality of the previous child, birth order, and maternal educational status are directly related to infant mortality. Thailand, Indonesia, and the Philippines all show similar explanatory factors that directly influence infant mortality. The survival status of the preceding child is the most important predictor in all three countries and is particularly strong in Thailand. This factor acts through the limited time interval for rejuvenation of mother's body, nutritional deficiencies, and transmission of infectious disease among siblings. The conclusion is that poor environmental conditions increase vulnerability to illness and death. There are 133% greater odds of having a short birth interval among young urban women than among older rural women. There is a 29% increase in odds for second parity births compared to third or higher order parities. Maternal education is a strong predictor of infant survival only in the Philippines and Indonesia. Adolescent pregnancy is a risk only in Indonesia. Socioeconomic factors are not as important as birth interval, birth order, and maternal education in determining survival status.     

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.     

Population statistics] as of April 1, 1995

A one-page compendium of population data as of April 1, 1995, was provided for Thailand. Total population reached 59,160,000: 29,562,000 males and 29,598,000 females, and 18,683,000 in urban and 40,477,000 in rural areas. Regional distribution of population was 11,884,000 in the North region, 19,262,000 in the Northeast, 7,406,000 in the South, 12,834,000 in the Central (excluding Bangkok Metropolis), and 7,774,000 in Bangkok Metropolis. The age distribution of the population was as follows: 17,038,000 under 15 years old; 37,803,000 aged 15-59 years; 4,319,000 over 60 years old; 19,782,000 aged 6-21 years; 38,226,000 aged 18 years and older; 35,975,000 aged 20 years and older; and 15,273,000 women 15-44 years old. The crude birth rate was 17.4 per 1000 population. The crude death rate was 6.1 per 1000 population. The natural growth rate was 1.1%. The infant mortality rate was 30.9 per 1000 live births. Life expectancy at birth was 66.6 years for males and 71.7 years for females. Life expectancy at 60 years was 18.8 additional years for males and 22.0 additional years for females. The total fertility rate was 1.95 per woman. Contraceptive prevalence was 74.0%. Projected population in 2012 was 70,995,000 persons. Among youth 15-24 years old, 9% of rural single males and females, 25% of other urban single males, and 45% of single Bangkok males lived away from parents. 34% of single other urban females and 31% of single Bangkok females lived away from parents. In rural areas, 36% of married males and 42% of married females lived away from parents. In other urban areas, 64% of married males and 75% of married females lived away from parents. In Bangkok, 99% of married males and 81% of married females lived away from parents.     

Trends and differentials in breast feeding: An update

Analysis of the 1973 National Survey of Family Growth shows a continued downward trend in breast feeding by successive cohorts of American mothers. The downward trend is evident in both measures of incidence (ever-breast feeding) and duration of breast feeding for first and higher-order births. For all cohorts higher-order births are less likely to be breast fed than first births. However, breast feeding of higher-order births is typically of a longer duration. Differentials in breast feeding reveal strong associations with indicators of social class; women who are college graduates, who work as professionals, and who are married to professional husbands are most likely to breast-feed their infants. Differentials in average duration of breast feeding are often reversed from differentials in ever-breast feeding.     

Proximate determinants of Philippine fertility: 1983 levels and patterns

Data from the 1983 National Demographic Survey are used to analyze the proximate determinants of Philippine fertility in each of the 3 stages of family formation and to identify all of the direct and indirect factors affecting fertility levels and trends. 10,843 ever-married women and 12,771 children were included. The analysis pertains first to the starting patterns of family formation, the age at first birth, and the proximate determinants (age at menarche, age at first marriage/union, conception before first birth, fetal wastage first birth, interval between first marriage and first birth). Further analysis examines birth spacing patterns including the postpartum nonsusceptible period, the exposure interval and stopping patterns. Almost all births occur within marriage, and childbearing begins late at 22.5 years. However, 15.4% of first births are conceived premaritally. The mean age at first birth increases from younger to older cohorts. Urban women were slightly older (23.0 years) at the birth of their first child. Those with education below the 4th grade had first births 3.5 years earlier. Contraceptive use was low at 1.8% before first birth. Younger cohorts were more likely to use birth control and urban wives were more likely to use it than rural wives. 6.4% reported a first pregnancy ending in nonlive births, which were primarily spontaneous abortions (5.2%), stillbirths (1.0%), and induced abortions (.2%). 5.8% report never having been pregnant and 1.1% never having given birth to a live-born child. 20.4% were childless between the ages of 15-24 years, and 4.6% between 25-34 years. Childlessness was slightly higher among urban women (7.1%) than rural women (6.7%). A decreasing age at menarche has appeared; i.e., 13.6 years for the cohort 15-24 years, and 14.0 for the oldest cohort. By age 15, 82.9% had begun menstruating. The mean age at marriage is early at 20.7 years, and older cohorts tended to marry later at 21.4 years. Urban women marry a year later (21.4 years) than rural women. Lower educated women marry 4 years earlier. The mean length between first marriage and first birth was 18.4 months. In the younger cohorts, spacing patterns are shorter. Postpartum susceptibility is short. Return to sexual relations after a birth occurred at 2.8 months. The exposure time required to conceive is fairly long at 16.6 months and is attributed to contraceptive use, since coital frequency is high and temporary separation is infrequent. The average age at last birth is late at 37.6 years.     

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.