Caesarean deliveries, subsequent reproductive behaviour and children ever born in India

Against the backdrop of the alarming rise in Caesarean section (C-section) births in India, this study aimed to examine the association between C-section births, fertility decline and female sterilization in the country. A cross-sectional design was used to investigate the association between C-section delivery and subsequent reproductive behaviour in women in India. Data were from the National Family Health Survey (NFHS-4). The study sample comprised 255,726 currently married women in the age group of 15–49 years. The results showed a strong positive relationship between C-section births and female sterilization. The predicted probabilities (PP) from the multivariate regression model indicated a higher chance of female sterilization in women with C-section births (PP = 0.39, p<0.01) compared with those with non-C-section births (PP = 0.20, p<0.01). Both state-level correlation plots and Poisson regression estimates showed a strong negative relationship between C-section births and mean children ever born (CEB). Based on the results, it may be concluded that the use of C-sections and sterilization were strongly correlated in India at the time of the NFHS-4, thus together contributing to fertility decline. A strong negative association was found between the occurrence of C-sections and CEB. The increased and undesired use of C-section births and consequent female sterilization is a regressive socio-demographic process that often violates women’s rights. Fertility decline should happen through informed choice of family planning and must protect the reproductive rights of women.

Point of Reference: A Multisited Exploration of African Migration and Fertility in France

A considerable literature explores whether the fertility of migrants from high-fertility contexts converges with that of women in lower fertility destinations. Nonetheless, much of this research compares migrants’ reproductive outcomes to those of native-born women in destination countries. Drawing on research emphasizing the importance of transnational perspectives, we standardize and integrate data collected in France (the destination) and in six high-fertility African countries (the senders). We show that African migrants in our sample had higher children ever born (CEB) than native French women but lower CEB than women in corresponding origin countries. These findings suggest that socialization into pronatalist norms is an incomplete explanation for migrant fertility in the first generation, an insight that is overlooked when analyzing destination settings only. Next, we conduct multivariate analyses that weight migrants’ background characteristics to resemble women in both origin and destination countries. Findings indicate that observed differences between African migrants in France and women in African origin countries help explain differences in CEB between the two groups, which supports selection. We also demonstrate that African migrants in France had delayed transitions into first, second, and third births and lower completed fertility compared to women in origin countries, thus disputing the disruption hypothesis. Finally, we show that observed differences between African migrants in France and native French women explain differences in CEB between the two groups, which supports adaptation. These multifaceted findings on selection, disruption, and adaptation would be obscured by analyzing destination settings only, thus validating a multisited approach to migrant fertility.

Estimation and Projection of Fertility, 2001-2031: Province 2, Nepal

Fertility is an essential tool of population growth which levels and patterns can assist to formulate and evaluate policies related to population change. Fertility decline in Nepal has been tested and tried with different studies gives different figures like demographic health survey and national census data but varies data in provincial level. This study describes number of children ever born and number of birth before 12 months who were given birth by reproductive (15-49) age group of women. The study has utilized census data from CBS that were conducted in 2001 and 2011. These national household censuses were carried out in 12.5 percent of total household. From census data files 1,063,903 and 1,304,079 number of reproductive age group of women were identified through analysis. The study was carried out adhering to the Arriaga method and changing P/F ratio method. Age sex pyramids and frequency table represent demographic scenario of provincial 2. The TFR values of province 2 exact years 2016, 2021, 2026 and 2031 were obtained by linear interpolation and extrapolation by 2031, it will to reach TFR replacement level.

Regional education and wealth-related inequalities in malnutrition among women in Bangladesh

Objectives: This paper examines the associations of socio-economic and demographic correlates with malnutrition among women and investigates education and wealth-related inequalities in malnutrition among women by region. Design: We utilise a two-level mixed-effects logistic regression model to evaluate the associations and employ the concentration, Wagstaff and Erreygers’s correction indices to measure socio-economic inequalities in malnutrition among women. Setting: Bangladesh Demographic and Health Survey data. Participants: Non-pregnant women aged 15–49 years. Results: We find evidence of a significant cluster effect in the data. Women’s age, marital status, total children ever born, education level, husband’s/partner’s education level, residence and wealth index appear to be significantly associated with women underweight and overweight/obesity status. Underweight status is higher among less-educated women and women from poor households, whereas overweight/obesity is more concentrated among higher educated women and women from wealthy households. The southwestern region of the country demonstrates lower education and wealth-related inequalities in malnutrition among women. In contrast, the central and the northeastern areas apparently experience the highest education and wealth-related inequalities in malnutrition among women. The regional differences in predicted probabilities of being underweight shrink at higher education level and the richest quintile, whereas the differences in overweight/obese diminish at the primary education level and lower quintile households. Conclusions: Our findings strengthen the evidence base for effective regional policy interventions to mitigate education and wealth-related inequalities in malnutrition among women. There is a need for developing regional awareness programmes and establishing regional monitoring cells to ensure proper health and nutrition facilities in underprivileged regions.

The association between paternal characteristics and exclusive breastfeeding in Ghana

Background Studies have shown that partners play an influential role in exclusive breastfeeding practice and that they can act as either deterrents or supporters to breastfeeding. However, there are limited studies on the influence of partners’ characteristics on exclusive breastfeeding in Ghana. This study examined the association between partners’ characteristics and exclusive breastfeeding in Ghana. Methods This cross-sectional study used data from the 2014 Ghana Demographic and Health Survey. Infants less than 6 months old (exclusively breastfed or not) with maternal and paternal characteristics were included in the study. A total of 180 participants were used for the study. A binary logistic regression was used to examine the influence of partners’ characteristics on exclusive breastfeeding. Results Partners’ characteristics such as education, desire for children, religion, and children ever born were associated with exclusive breastfeeding. Mothers whose partners had primary education (AOR = 0.12; CI 95%: 0.02–0.93; p = 0.04) were less likely to practice exclusive breastfeeding compared to those whose partners had no formal education. Also, mothers whose partners desired more children (AOR = 0.20; CI 95%: 0.06–0.70; p = 0.01) were less likely to practice exclusive breastfeeding compared to those whose partners desire fewer children. Conclusion Improving EBF requires the involvement of partners in exclusive breastfeeding campaigns/programmes. A more couple-oriented approach is required by health practitioners to educate and counsel both mothers and partners on the importance of exclusive breastfeeding in Ghana.

Trend and Determinants of Fertility in a Declining Fertility Regime: A Study of Rural Uttar Pradesh

This study is an attempt to examine the socio-economic and demographic differentials in children ever born and desire for additional child in rural Uttar Pradesh using the empirical data set. Two stage stratified random sampling procedure was applied to select the respondents from ten villages of rural Raebareli district. Total 460 women having with at least one child below ten years of age were interviewed during September 2016 to February 2017. Children ever born (CEB) and desire for another child were the main outcome variables of the study. One-way ANOVA and chi-square test were used in the bi-variate analysis. Poisson regression and logistic regression were used in multivariate analysis. The mean children ever born in the study area was 2.7 children per women and 64.7 per cent of fecund women who had two children and not currently pregnant had no desire for another child. Women’s education, economic status of the household, autonomy index and higher caste group were significantly negatively associated with the children ever born in the study area. The desire for another child was significantly higher among those who had only daughters (OR = 1.99; p < 0.01). In conclusion, more emphasis needs to be placed on messages conveyed through the mass media, addressing the benefits of small family size and family planning, and programs that focus on reduction in newborn mortality could also be considered, which would also help to reduce fertility.

Women Born to Older Mothers Have Reduced Fertility. Evidence From a Natural Fertility Population

Are daughters of older mothers less fertile? The human mutation rate is high and increases with chronological age. As female oocytes age, they become less functional, reducing female chances at successful reproduction. Increased oocyte mutation loads at advanced age may be passed on to offspring, decreasing fertility among daughters born to older mothers. In this paper we study the effects of maternal ageing on her daughter's fertility, including total number of children, age at last birth, and neonatal mortality among her children. We study fertility histories of two generations of women from mutually exclusive families from a pre-demographic transition historical population in the Dutch province of Zeeland. Using mixed effect Poisson and linear models to take within family (sibling) relations into account, we show that among married daughters fertility is reduced for those who were born to mothers with an advanced maternal age, resulting in fewer children ever born and earlier ages at last birth. We do not find consistent evidence for effects on neonatal mortality. These results may indicate that women born to older mothers are negatively affected by their mothers' increased age.