Contraception and Reproduction Health Consequences for Women and Children in the Developing World (1989) / Chapter Skim
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2 Hypotheses about Reproductive Patterns and Women's and Children's Health
2 Hypotheses about Reproductive Patterns and Women's and Children's Health
Pages 12-24
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From page 12... ...
Next, we discuss hypothesized indirect effects of changes in reproduction on women and children's health. Indirect effects refer to changes in household structure and parental roles and new or foregone opportunities that are a consequence of changes in the number and timing of births that may themselves influence health.
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From page 13... ...
DIRECT EFFECTS OF REPRODUCTIVE PATTERNS ON HEALTH Reproductive Patterns and Women's Health Practicing physicians and midwives have observed that women who have many children and women with certain reproductive patterns are at higher risk of poor health and mortality. These observed relationships may be directly causal or may be due to confounding factors.
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From page 14... ...
. injury Inadequate development of reproductive system and incomplete growth Adequate prenatal and interpartum care less likely Body in poorer condition for pregnancy and childbirth Inadequate time to rebuild nutritional stores and regain energy level Abomons performed by unsafe means increase exposure to injury, infection, hemorrhage, and death Reduced availability of family resources for women's health and nutrition Aggravated health condition Direct health risks and benefits associated with ca~tracephve methods risk of obstructed labor, pregnancy-induced hypertension, and birth complications.
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From page 15... ...
By avoiding pregnancy, women with health problems may substantially improve their own chances for survival and good health. Third, in addition to reducing the total number of pregnancies and avoiding potentially higher-risk pregnancies, women in many developing countries can also substantially reduce their risk of reproductive morbidity and mortality by using contraception to avoid unwanted pregnancies rather than resort to unsafe abortion to terminate such pregnancies.
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From page 16... ...
For this reason, some of the hypothesized effects of reproductive patterns on children's health are closely related to the effects of reproductive patterns on women's health. Specifically, children who are firstborn or are of high birth order, children born into larger families, children born to very young or older mothers, children born after short previous interbirth intervals or before a short subsequent interbirth interval, and children who were unwanted at the time they were conceived may be at higher risk of poor health and mortality than other children.
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From page 17... ...
; competition among similar aged siblings for limited family resources; early termination of breastfeeding; low biIthweight; increased exposure to infection from children of similar ages (Conscious or unconscious) neglect; child born into a stressful situation Early termination of breastfeeding; no maternal care; disease may be passed to child Hommonal contraception may interrupt breastfeeding for younger children in large families and may contribute to the economic wellbeing of the family, thus increasing both total family income and possibly per capita income.
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From page 18... ...
The consequences for children born after short interbirth intervals may be poorer intrauterine growth as well as a higher risk of preterm birth. We noted above that competition among siblings in large families for scarce resources may mean that higher-order children, or possibly all children, may be at greater risk of poor health.
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From page 19... ...
Close birth spacing may also increase children's exposure to infectious diseases by fostering transmission of infections among household members who are of similar ages. Many infectious childhood diseases affect a relatively narrow age range.
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From page 20... ...
The process of making explicit decisions about reproductive matters may lead to disagreement between spouses, conflicts between parents and their adult children about family size, and anxiety about violating traditional, often religious ideals surrounding sexual practices and childbearing. Another hypothesized indirect effect of family planning on health relates to the use of health services.
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From page 21... ...
For example, a baby born after a pregnancy of short gestation is more likely to be in poor health and to be born within a short interval after the preceding birth. Although the short interval is not the cause of the child's poor health, both the short interval and the child's poorer health are due to the short gestation of the pregnancy.
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From page 22... ...
For many couples in developing countries, obtaining effective health care and fertility control methods may require substantial persistence and knowledge of how to obtain information and deal with an ineffective delivery system. Adults who have these skills, abilities, and beliefs are likely to use health services, to carry out health-improving practices at home, and to use contraceptive services.
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From page 23... ...
A key question is whether teenagers outgrowphysiologically, psychologically, or economicall~whatever causes their children to have poorer health outcomes, or whether it is a persistent characteristic of the types of women who become pregnant as teenagers. The evidence regarding the hypothesized effect of maternal age on children's health typically comes from analyses of data on maternal ages at children's births and the children's health (typically survival measures)
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From page 24... ...
This report focuses principally on the evidence from previous research concerning the hypotheses about the direct effects of family planning or reproductive control on the health of women and children. Although it is possible that indirect effects may be equally or more important than the direct effects under consideration, investigation of these hypotheses is outside the scope of this report.
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