Use and Acceptability of Birth Spacing Contraceptive Among Multiparae in Bangladesh

Background: Contraception is one of the critical components of reproductive health, enabling women to control their fertility according to their desires and circumstances. This study aimed to determine the prevalence and acceptability of contraceptives among sexually active multiparous women for birth spacing. Methods: This is a cross-sectional study among married women aged 15-40 years having at least one child from January to June 2013 in the Department of Obstetrics and Gynecology, ICMH (Institute of Child and Mother Health), Matuail, Dhaka. Findings: A total of 433 women participated in this study. A majority of the respondents were in the mid-thirty (73.9%) and housewives (94.7%). Almost half (49.0%) of the respondents had primary education. Surprisingly, close to half of the respondents married before 18 years (42.7%). Almost two-thirds (64.4%) of the respondents received oral contraceptive pills previously, followed by condoms (17.1%) and injectable contraception (14.5%). More than half (51.6%) of the participants were motivated by health workers to use a contraceptive method. In terms of reasons for using the family planning methods, convenience to use (38.1%), being safe (31.9%), and accessibility (23.1%) were the most common reasons. Whereas side effects (49.9%), shifting to other forms (43.9%), and wanting more children (6.2%) were the most common reason for changing family planning methods. The respondents mostly used the oral pill at any education level. However, injectable contraception was higher within higher education levels, and IUD was higher within the illiterate group.

Birth Spacing and Fertility in the Presence of Son Preference and Sex-Selective Abortions: India's Experience Over Four Decades

Since the advent of prenatal sex-determination technologies in the mid-1980s, India has experienced an increasingly male-biased sex ratio at birth, presumably from sex-selective abortions. Abortions lengthen birth intervals, but we know little about how birth spacing has changed or the effects of these changes. I show that, although the overall length of birth intervals increased from 1970 to the mid-2010s, well-educated women with no sons had the most substantial lengthening, as well as the most male-biased sex ratios. Furthermore, most of these changes took place immediately after the introduction of prenatal sex-determination technologies. Consequently, some women without sons now have longer birth intervals than those with sons, reversing India's traditional spacing pattern. Women with low education continue short birth spacing when they have no sons, with only limited evidence of male-biased sex ratios. Because of the rapid lengthening of birth intervals, period fertility rates substantially overestimated how fast cohort fertility fell. Moreover, predicted cohort fertility is still 10%–20% above the period fertility rate. If the lengthening of birth intervals arises from repeated abortions, the associated short pregnancy spacing may counteract any positive effects of longer birth spacing. There is, however, no evidence of this effect on infant mortality. Judging from sex ratios, sex-selective abortion use is not declining.

Wife's Perception of Contraception Equipment

The high birth rate in Indonesia is still a major problem in the population. One of the programs to suppress population growth is through the family planning program. Perceptions of couples of childbearing age regarding family planning have a strong enough influence to determine the use of contraceptives by their wives. This study aims to explore how the wife's perception of contraception. The research method used is qualitative with in-depth interviews. Informants who will conduct in-depth interviews are 4 informants who are wives and currently using contraceptives. The results showed that the informants first found out information on the use of contraceptives, namely by health workers. Informants feel that family and self-support affect the use of contraceptives. Informants use contraceptives to control the population, limit birth rates, and regulating birth spacing, informants will feel different discomforts when using contraceptives. informants have the view that Islam does not prohibit the use of contraceptives. Based on this, we can say that the perception of wives in using contraceptives is influenced by several aspects of the information, family support as well as the perception of a wife against contraceptives cheap and tangka it is a benchmark for the wife in the use of contraception other than required by the state. To regulate the distance between pregnancies, the wife also believes in terms of health and religious beliefs that using contraceptives does not violate the norms and beliefs they currently hold.

FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS GIZI BALITA DI PUSKESMAS KRUI KABUPATEN PESISIR BARAT

Introduction: Toddler nutrition problems are still a global problem. The number of malnourished children in developing countries reaches 181.92 million (32%). Data in Indonesia in 2018 the percentage of malnutrition is 3.9%, while malnutrition is 13.8%. In Lampung Province in 2018, 3.1% of children under five experienced malnutrition, and 12.8% for undernutrition. This figure according to WHO has been considered a health problem because its prevalence is> 15.0%. Data of West Pesisir Regency in 2018, the percentage of malnutrition and malnutrition in children aged 0-59 months is 2.06% for malnutrition, and 9.01 for malnutrition.Purpose: To identify the factors that influence the nutritional status of children under five.Method: This type of research is quantitative with cross sectional approach. The population was all mothers and children under five in the Krui Public Health Center in West Pesisir Regency, with a total sample of 268 people, using proportional random sampling. Data analysis in this study used the chi-square test.Results: The results of univariate analysis showed that most respondents were well-informed (74.6%), had good birth spacing, as many as 171 people (63.8%), had good socio-economic conditions, as many as 155 people (57.8%) . The results of the bivariate analysis that there is a relationship of knowledge (p-value = 0.000, and OR = 7.846), birth spacing (p-value = 0.000, and OR = 7.304), and socioeconomic with the nutritional status of children under five in Krui Public Health Center West Pesisir Regency 2020 (p-value = 0.000, and OR = 2.575).Conclusion: there is a relationship of knowledge, birth spacing, socioeconomic, with the nutritional status of children under five in the Krui Public Health Center, West Pesisir Regency. Suggestions for improving counseling and also risk factors such as birth spacing that is too tight. Keywords: Factors, Malnutrition, Under Five Years Old Pendahuluan: Masalah gizi balita masih menjadi permasalahan global. Jumlah anak kekurangan gizi di negara yang berkembang mencapai 181,92 juta (32%). Data di Indonesia tahun 2018 persentase gizi buruk yaitu 3,9%, sedangkan gizi kurang yatu 13,8%. Di Provinsi Lampung tahun 2018 sebanyak 3,1% balita mengalami gizi buruk, dan 12,8% untuk gizi kurang. Angka ini menurut WHO sudah dianggap masalah kesehatan karena prevalensinya >15,0%. Data Kabupaten Pesisir Barat tahun 2018, persentase gizi buruk dan gizi kurang pada balita usia 0-59 bulan yaitu sebesar 2,06% untuk gizi buruk, dan 9,01 untuk gizi kurang.Tujuan: Diketahui faktor-faktor yang mempengaruhi status gizi balita.Metode: Jenis penelitian adalah kuantitatif dengan pendekatan cross sectional. Populasi adalah seluruh ibu berserta balita di Puskesmas Krui Kabupaten Pesisir Barat, dengan jumlah sampel 268 orang, menggunakan proportional random sampling. Analisis data pada penelitian ini menggunakan uji chi-square.Hasil Penelitian: Hasil analisis univariat bahwa sebagian besar responden berpengetahuan baik (74,6%), memiliki jarak kelahiran baik, yaitu sebanyak 171 orang (63,8%), memiliki sosial ekonomi baik, yaitu sebanyak 155 orang (57,8%). Hasil analisis bivariat bahwa ada hubungan pengetahuan (p-value = 0.000, dan OR= 7.846), jarak kelahiran (p-value = 0.000, dan OR= 7.304), dan sosial ekonomi dengan status gizi balita di Puskesmas Krui Kabupaten Pesisir Barat Tahun 2020 (p-value = 0.000, dan OR= 2.575).Kesimpulan: ada hubungan pengetahuan, jarak kelahiran, sosial ekonomi, dengan dengan status gizi balita di Puskesmas Krui Kabupaten Pesisir Barat. Saran agar ditingkatkannya penyuluhan dan juga faktor risikonya seperti jarak kelahiran yang terlalu rapat. Kata Kunci : Faktor, gizi kurang balita

A study of knowledge, attitude and practice regarding child birth spacing and its methods among the antenatal women of rural Thoothukudi, Tamil Nadu

Background: India is the second highest populated country in the world with 1.32 billion populations and will reach 1.53 billion by next 30 years. The birth spacing is defined as the time interval between two births. While knowledge of birth spacing has reached substantial levels, conversion of this knowledge into a change in attitude and practicing of birth spacing appears lagged and challenged. Our objective was to assess the knowledge, attitude and practice of various birth spacing methods among the antenatal women of rural Thoothukudi.Methods: A descriptive cross sectional study was conducted among antenatal women who came for their routine antenatal checkup at the PHCs. Data was collected with a pre-tested, semi-structured questionnaire and analysed. Results were expressed in percentages and proportions.Results: Out of 120 antenatal women participated in the study, majority (82.5%) had knowledge about ideal spacing period of 2 to 3 years. But majority of the women (79.20%) did not practice any of the birth spacing methods and only 20.80% women were actually practicing some of the birth spacing methods and the common method was Copper-T. The common reason for not adopting and discontinuance of contraceptive method is fear of its adverse effects (31%).Conclusions: The study results revealed that most of the women were aware that birth spacing between pregnancies is important and knew only about Cu-T. Also they knew that the ideal spacing interval should be 3 years. Thus Health Education Programmes are a must to enhance the knowledge of antenatal women about birth spacing methods.

Short interpregnancy interval: circumstance or choice?

IntroductionDespite the knowledge of pregnancy risks attributable to inadequate birth spacing, over one-third of pregnancies occur within 18 months of a preceding birth. In this qualitative study we sought to interview women with a short interpregnancy interval (sIPI) to explore their knowledge of contraception and birth spacing and their experience of counselling on these themes.MethodsWe conducted in-depth interviews with women with a sIPI (live-birth less than 18 months prior to conception of current pregnancy) at Royal Prince Alfred Hospital and Canterbury Hospital in Sydney, Australia. Women were recruited at the second antenatal visit or day 3 postpartum. Interviews were recorded and transcribed. The six-phase thematic analysis framework described by Braun and Clarke was used to perform qualitative data analysis.ResultsTwenty women were interviewed (IPI range: 3–18 months). The three central themes that arose were that perceptions of IPIs are shaped by individual circumstances, a lack of information from healthcare providers (HCPs) on IPI and contraception limited women’s ability to make informed decisions, and that reproductive life planning is an important element of pregnancy care.ConclusionsIn this study, women with a sIPI did not feel informed about birth spacing, had poor knowledge of reliable contraceptives, and remained at risk of further closely spaced pregnancies. There was a desire among women with a sIPI to receive clear and consistent education on these topics. HCPs need to do more to educate women in the antenatal and postnatal period to help them space their pregnancies appropriately.

Acceptance of birth spacing methods and it’s determinants among postnatal women in a tertiary care setting from Kerala

Background: According to VISION FP2020 healthy birth spacing is defined as delaying the first birth by two years and maintaining the birth interval of at least three years between the two children with the help of various contraceptives.Methods: This was a hospital based cross sectional study conducted among primiparous postnatal women in the department of obstetrics and gynecology SAT hospital, Trivandrum for one year duration. 134 women who had their first delivery were included in this study. A semi structured questionnaire was used to study the sociodemographic variables, reproductive history, contraceptive knowledge, attitude towards contraception and intention to use birth spacing methods by interview technique.Results: The acceptance of birth spacing methods among the study population was 56.8%. 59.1% opted to use family planning methods 6 weeks after delivery while 40.9% planned to use after 6 months. Determinants which were significantly associated with acceptance of family planning methods were education of wife (p<0.01), husbands’ education, socioeconomic status, religion and contraceptive awareness (p<0.01). 47.1% of women preferred DMPA injections, 39.1% opted for intrauterine devices. 13.8% of women opted for condom. Convenience, long term protection, and ease of use were the important reasons cited. The reasons for non-acceptance included fear of side effects, spouse not staying together, opposition from husbands, lack of awareness and religious restrictions.Conclusions: Female literacy, accessibility, cafeteria approach, and counselling contributed to acceptance. If the availability and awareness of injectable contraceptives is made at all the points of health delivery system, the acceptance of birth spacing can further be increased and unplanned pregnancies avoided.

Knowledge and Attitude Regarding Birth Spacing Methods among Primigravida Mothers Attending Antenatal OPD at a Selected Hospital, Kamrup (M), Assam: A Descriptive Study

Introduction: One of the many decisions made in the households, which has consequences on family wellbeing, is the timing and spacing of children. According to WHO birth spacing should be maintained at least two to three years to improve maternal health, reduce infant and child mortality. Aims & Objectives: To assess the knowledge and attitude regarding birth spacing methods among primigravida mothers attending antenatal OPD at a selected hospital, Kamrup (M), Assam. Materials and Methods: A descriptive survey research design was adopted and purposive sampling technique was carried out to collect the samples. The sample size was 100 primigravida mothers who were attending antenatal OPD at Maternity and Child Welfare Hospital, Dhirenpara, Guwahati, Assam and who fulfills the inclusion criteria. Results: Study findings showed that majority i.e. 48% respondents have inadequate knowledge, 46% respondents have moderate knowledge and 6% have adequate level of knowledge. Also Majority i.e. 78% respondents have moderately desirable attitude, 22% have desirable attitude and 0% had undesirable attitude regarding birth spacing methods. There was moderate positive correlation between knowledge and attitude (r=0.309). There was significant association of knowledge with education, occupation and pregnancy in months, and also attitude with pregnancy in months, previous information regarding birth spacing and source of information. Conclusion: Study found that knowledge were inadequate with moderately desirable attitude, therefore there should be more awareness programmes related to birth spacing methods among primigravida mothers. So as to improve their level of knowledge and to have a positive attitude towards birth spacing. Key words: primigravida, mothers, birth spacing, knowledge, attitude, contraceptive.

735Dynamics and Determinants of Birth Spacing in India

Background Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc. Methods The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India. Results Cox’ regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P &lt; 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P &lt; 0.01), infant mortality (P &lt; 0.01) and family income (P &lt; 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P &lt; 0.01), sex of previous child (P &lt; 0.05), lactation (P &lt; 0.01), education of mother (P &lt; 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception. Conclusions Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox’s stepwise regression models. Key messages To control the growth of population, birth spacing must be maintained.

Effect of Birth Interval on Foetal and Postnatal Child Growth

Background. Although available evidence suggests short birth intervals are associated with adverse perinatal outcomes, little is known about the extent to which birth spacing affects postnatal child growth. The present study assessed the independent association of birth interval with birth weight and subsequent postnatal growth indices. Methods. This retrospective cohort study carried out in the rural areas of Kassena-Nankana district of Ghana compared postnatal growth across different categories of birth intervals. Birth intervals were calculated as month difference between consecutive births of a woman. The study population comprised 530 postpartum women who had delivered a live baby in the past 24 months prior to the study. Results. Using the analysis of covariance (ANCOVA) that adjusted for age of the child, gender of the child, weight-for-length z-score (WLZ), birth weight, adequacy of antenatal care (ANC) attendance, and dietary diversity of the child, the mean length-for-age z-score (LAZ) among children of short preceding birth interval (<24 months) was significantly higher than among children of long birth interval (that is, at least 24 months) ((0.51 versus −0.04) (95% CI: 0.24–0.87), p = 0.001). The adjusted mean birth weight of children born to mothers of longer birth interval was 74.0 g more than children born to mothers of shorter birth interval (CI: 5.89–142.0, p < 0.03). Conclusions. The results suggest that a short birth interval is associated positively with an increased risk of low birth weight (an indicator of foetal growth), but birth spacing is associated negatively with the LAZ (an indicator of postnatal growth).