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Church AC, Ibitoye M, Chettri S, Casterline JB. Traditional supports and contemporary disrupters of high fertility desires in sub-Saharan Africa: a scoping review. Reprod Health 2023; 20:86. [PMID: 37280648 DOI: 10.1186/s12978-023-01627-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 05/22/2023] [Indexed: 06/08/2023] Open
Abstract
RATIONALE The desired number of children is markedly higher in Sub-Saharan Africa (SSA) than in other major regions. Efforts to understand how and why these desires are generated and maintained have yielded a broad research literature. Yet there is no full picture of the range of contextual, cultural, and economic factors that support and disrupt high fertility desires. OBJECTIVE This scoping review synthesizes thirty years of research on the determinants of fertility desires in SSA to better understand what factors underlie men and women's stated fertility desires and how they weigh the costs and benefits of having (more) children. METHOD We identified and screened 9863 studies published from 1990 to 2021 from 18 social science, demographic, and health databases. We appraised determinants of fertility desires from 258 studies that met inclusion criteria according to their roles as traditional supports or contemporary disrupters of high fertility desires. RESULTS We identified 31 determinants of high fertility desires, which we organized into six overarching themes: economy and costs; marriage; the influence of others; education and status; health and mortality; and demographic predictors. For each theme, we summarize ways in which the determinants both support and disrupt high fertility desires. We find that high fertility remains desirable in many regions of sub-Saharan Africa but contemporary disrupters, such as the economic situations and increases to family planning and education, cause individuals to decrease their desired fertility with such decreases often viewed as a temporary adjustment to temporary conditions. Most included studies were quantitative, cross-sectional, and based on survey data. CONCLUSION This review demonstrates how traditionally supportive and contemporary disruptive forces simultaneously influence fertility desires in sub-Saharan Africa. Future studies analyzing fertility desires in sub-Saharan Africa should be informed by the lived experiences of men and women in this region, with qualitative and longitudinal studies prioritized.
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Affiliation(s)
- Anna C Church
- Department of Sociology, The Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA.
| | - Mobolaji Ibitoye
- Institute for Population Research, The Ohio State University, 060 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
| | - Shibani Chettri
- College of Public Health, The Ohio State University, 250 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43210, USA
| | - John B Casterline
- Institute for Population Research, The Ohio State University, 060 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH, 43210, USA
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Marteleto LJ, Dondero M, Kumar S, Mallinson DC. Measuring Fertility Intentions During Times of Crisis: An Example Using Survey Data Amid the Covid-19 Pandemic. Stud Fam Plann 2023; 54:161-180. [PMID: 36739473 PMCID: PMC10035575 DOI: 10.1111/sifp.12219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Fertility intentions-intentions regarding whether and when to have children-predict reproductive health outcomes. Measuring fertility intentions is difficult, particularly during macrostructural shocks, for at least two reasons: (1) fertility intentions may be especially volatile during periods of uncertainty and (2) macrostructural shocks may constrain data collection. We propose a set of indicators that capture how a macrostructural shock directly alters fertility intentions, with a particular focus on the Coronavirus disease 2019 (Covid-19) pandemic. We advance the conceptualization and construct of fertility intentions measures in three ways. First, we demonstrate the value of direct questions about whether women attributed changes in fertility intentions to the pandemic. Second, we highlight the importance of a typology that delineates fertility postponement, advancement, foregoing, and indecision. Third, we demonstrate the importance of incorporating a granular time window within a two-year period to capture short-term changes to fertility intentions. We exemplify the value of our proposed measures using survey data from a probabilistic sample of women aged 18-34 in Pernambuco, Brazil. We discuss the self-reported change in intentions due to Covid in wave 1 as well as panel change across waves. We further ground our contributions by uncovering important variations by social origin and parity.
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Affiliation(s)
- Letícia J Marteleto
- Department of Sociology, University of Texas-Austin, Austin, TX, USA
- Population Research Center, University of Texas-Austin, Austin, TX, USA
| | - Molly Dondero
- Department of Sociology, American University, Washington, DC, USA
| | - Sneha Kumar
- Population Research Center, University of Texas-Austin, Austin, TX, USA
| | - David C Mallinson
- Department of Family Medicine and Community Health, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Marteleto LJ, Dondero M, Koepp A. Scars from a Previous Epidemic: Social Proximity to Zika and Fertility Intentions during the COVID-19 Pandemic. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2023; 9:23780231231184767. [PMID: 37520157 PMCID: PMC10372507 DOI: 10.1177/23780231231184767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
We examine whether women's social proximity to Zika during the Zika epidemic predicts intentions to avoid a pregnancy because of the COVID-19 pandemic either directly or indirectly via subjective assessments of the pandemic. We apply path models on unique microdata from Brazil, the country most affected by Zika and an epicenter of COVID-19, to understand whether a novel infectious disease outbreak left lasting imprints shaping fertility intentions during a subsequent novel infectious disease outbreak. Findings show that Zika social proximity is associated with fertility intentions through an indirect path related to subjective assessment of the COVID-19 pandemic. These findings emerged regardless of whether a woman herself had or suspected she had Zika and speak to the transformative consequences of novel infectious disease outbreaks that go beyond mortality and health.
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Bornstein M, Norris A, Shaba G, Huber-Krum S, Gipson JD. "I know my body and I just can't get pregnant that easily" - Women's use and non-use of the injection to manage fertility. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100071. [PMID: 37021076 PMCID: PMC10069985 DOI: 10.1016/j.ssmqr.2022.100071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Approximately one-third of contraceptive users in Malawi use the Depo-Provera injection, a method that must be re-injected every three-months to prevent pregnancy and may reduce fecundity for a time after discontinuation. Little is known about how women use the injection to achieve their desired family size. In 2018, we conducted 20 in-depth interviews with women who were part of a cohort study in rural Malawi. Interviews focused on contraceptive decision-making. Data were indexed (summarized) and coded using narrative, process, and thematic codes. Women described the importance of knowing about their "natural" fertility by having children prior to ever using contraception because women considered contraception to have a potential negative effect on fertility. Women then applied what they learned about their fertility (i.e., how easy/difficult it was to become pregnant) to manage their fertility over their reproductive life-course. As part of fertility management, women frequently described using the injection less frequently than clinically recommended, using signs from their body (e.g., menstruation) to determine when to reinject. Managing fertility through subclinical injection use was viewed as a way to optimize women's' chances of preventing unintended pregnancy while maintaining their ability to become pregnant when they wanted to. Women wanted to play an active role in managing their fertility and were not passive consumers of contraception. It is therefore critical that family planning programs provide contraceptive counseling to women that engages their desire to manage their fertility, acknowledges their concerns about fertility, and helps them choose a method that best fits their needs.
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Affiliation(s)
- Marta Bornstein
- The Ohio State University College of Public Health, Division of Epidemiology, 250 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43201, USA
- University of California Los Angeles Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive S, Los Angeles, CA, 90015, USA
| | - Alison Norris
- The Ohio State University College of Public Health, Division of Epidemiology, 250 Cunz Hall, 1841 Neil Ave, Columbus, OH, 43201, USA
| | | | - Sarah Huber-Krum
- Harvard T.H. Chan School of Public Health, Cambridge, MA, 02115, USA
| | - Jessica D. Gipson
- University of California Los Angeles Fielding School of Public Health, Department of Community Health Sciences, 650 Charles E. Young Drive S, Los Angeles, CA, 90015, USA
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Mkwashapi D, Todd J, Mahande M, Changalucha J, Urassa M, Marston M, Renju J. No association between fertility desire and HIV infections among men and women: Findings from community-based studies before and after implementation of an early antiretroviral therapy (ART) initiation program in the rural district of North-western Tanzania. OPEN RESEARCH AFRICA 2022; 5:30. [PMID: 37600565 PMCID: PMC10432893 DOI: 10.12688/openresafrica.13432.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 08/22/2023]
Abstract
Background: Fertility is associated with the desire to have children. The impacts of HIV and antiretroviral therapy (ART) on fertility are well known, but their impacts on the desire for children are less well known in Tanzania. We used data from two studies carried out at different periods of ART coverage in rural Tanzania to explore the relationship between HIV infection and fertility desires in men and women. Methods: We conducted secondary data analysis of the two community-based studies conducted in 2012 and 2017 in the Magu Health and Demographic system site, in Tanzania. Information on fertility desires, HIV status, and social-economic and demographic variables were analyzed. Fertility desire was defined as whether or not the participant wanted to bear a child in the next two years. The main analysis used log-binomial regression to assess the association between fertility desire and HIV infection. Results: In the 2012 study, 43% (95% CI 40.7-45.3) of men and 33.3% (95% CI 31.8 - 35.0) women wanted another child in the next two years. In 2017 the percentage rose to 55.7% (95% CI 53.6 - 57.8) in men and 41.5% (95% CI 39.8 - 43.1) in women. Although fertility desire in men and women were higher in HIV uninfected compared to HIV infected, age-adjusted analysis did not show a statistical significance difference in both studies (2012: PR=1.02, 95%CI 0.835 - 1.174, p<0.915 and 2017: PR = 0.90 95%CI 0.743 - 1.084 p= 0.262). Discussion: One-third of women and forty percent of men desired for fertility in 2012, while forty percent of women and nearly half of men desired for fertility in 2017. The data showed fertility desire, in 2012 and 2017 were not related to HIV infection in both periods of ART coverage.
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Affiliation(s)
- Denna Mkwashapi
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Jim Todd
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom, UK
| | - Michael Mahande
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania, Tanzania
| | - John Changalucha
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Mark Urassa
- Department of Sexual and Reproductive Health Research, Tanzania National Institute for Medical Research, Mwanza, Tanzania, Tanzania
| | - Milly Marston
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom, UK
| | - Jenny Renju
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania, Tanzania
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Alhassan N, Madise NJ. Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services. Front Glob Womens Health 2021; 2:652902. [PMID: 34816208 PMCID: PMC8594021 DOI: 10.3389/fgwh.2021.652902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Family planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives. Methods: The study analysed data from the 2015–16 Malawi Demographic and Health survey. The sample was comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives. Results: The results show that the number of living children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe, or Tumbuka ethnic origin and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television, had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao, and other ethnic minority women in union who were aged 15–19 and 40 years and above and those who were Catholic, SDA/Baptist, or Muslim had the lowest mDFPS (36%). Conclusion: This study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is a need for policymakers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.
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Saya GK, Premarajan KC, Roy G, Sarkar S, Kar SS, Ulaganeethi R, Olickal JJ. Current fertility desire and its associated factors among currently married eligible couples in urban and rural area of Puducherry, south India. Afr Health Sci 2021; 21:1385-1395. [PMID: 35222604 PMCID: PMC8843305 DOI: 10.4314/ahs.v21i3.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background There are paucity of studies on current fertility desire at community level. Objective To assess current fertility desire and its associated factors among eligible couples of reproductive age group in Puducherry, India. Methods A community-based cross-sectional study from 2016 to 2017 among 2228 currently married eligible couples assessed socio-demographic and fertility-related factors associated with fertility desire. Data were collected based on the National Family Health Survey questionnaire. Association of fertility desire was assessed by univariate and generalised linear regression analysis. Results Out of 1979 respondents, current fertility desire within two years was 13.7% (95% CI, 12.3%–15.3%). Mean number of children (SD) currently living and preferred was 1.77(0.851) and 2.11 (0.528) respectively. After adjusting for confounders, the significant factors positively associated with fertility desire include woman's age of 18–24 (APR = 2.91), 25–29 years (APR=2.48), 30–34 (APR=2.47), 35–39(APR=2.06), high socioeconomic status (APR=2.02), those without child (APR=52.35) and those with one child (APR=35.60). Conclusion The fertility desire is comparatively lesser than other areas. Those without or with a single child and high socioeconomic status group had comparatively more fertility desire.
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Affiliation(s)
- Ganesh Kumar Saya
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Kariyarath Cheriyath Premarajan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Gautam Roy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Revathi Ulaganeethi
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jeby Jose Olickal
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Yeboah I, Kwankye SO, Frempong-Ainguah F. Predictors of underachieved and overachieved fertility among women with completed fertility in Ghana. PLoS One 2021; 16:e0250881. [PMID: 34115779 PMCID: PMC8195416 DOI: 10.1371/journal.pone.0250881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 04/15/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND A woman's ability to achieve her preferred family size is critical in addressing issues of high fertility in sub-Saharan Africa. The socio-cultural context in sub-Saharan Africa presents some difficulty for the attainment of preferred fertility for many women. Few studies in sub-Saharan Africa have examined the extent to which women are unable to achieve their preferred family sizes. This study, therefore, examines the factors that are associated with the non-attainment of women's preferred fertility by the end of their reproductive years. DATA AND METHODS The study analyzed pooled cross-sectional data with a sub-sample of 1,888 currently married women aged 45-49 years from five rounds of the Ghana Demographic and Health Survey, 1993 to 2014. Test of associations and multinomial logistic regression analysis were used to examine the predictors of underachieved and overachieved fertility relative to achieved fertility. RESULTS The results indicate that 44 per cent of the women recorded overachieved fertility while about 36 per cent underachieved their fertility. Partner wants more, experiencing child loss and married more than once were significantly associated with overachieved fertility. Nonetheless, increased years of a woman's education and delaying her at first birth were negatively associated with overachieved fertility. On the other hand, underachieved fertility was significantly associated with having a partner with fewer fertility preference, being of the Islamic faith and ever use of modern contraception. CONCLUSION Partner's fertility preference, child loss experience, marrying more than once and ever use of modern contraception were important predictors of a woman's inability to achieve her fertility preference. Policies to regulate men's fertility behaviour, delaying age at first birth, use of modern contraception, encouraging longer years of education, and reducing infant and child mortality are important strategies to achieve fertility preference in Ghana.
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Affiliation(s)
- Isaac Yeboah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
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Weitzman A, Barber JS, Heinze J, Zimmerman M. How Nearby Homicides Affect Young Women's Pregnancy Desires: Evidence From a Quasi-Experiment. Demography 2021; 58:927-950. [PMID: 33861339 PMCID: PMC8406045 DOI: 10.1215/00703370-9160045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Leveraging spatiotemporal variation in homicides that occurred during a 2.5-year weekly panel survey of 387 women ages 18-22 in Flint, Michigan, we investigate how young women's desires to become pregnant and to avoid pregnancy evolve in response to local homicides during the transition to adulthood. To address the endogeneity of exposure, we explore how the same woman's pregnancy desires (1) differed, on average, across weeks before and after the first homicide occurred within a quarter mile of her home; (2) evolved in the aftermath of this initial homicide exposure; and (3) changed in response to additional nearby homicides. One-fifth (22%) of women were exposed to a nearby homicide at least once during the study, and one-third of these women were exposed multiple times. Overall, the effects of nearby homicides were gradual: although average desires to become pregnant and to avoid pregnancy differed after initial exposure, these differences emerged approximately three to five months post-exposure. Repeated exposure to nearby homicides had nonlinear effects on how much women wanted to become pregnant and how much they wanted to avoid pregnancy. Together, our analyses provide a new explanation for why some young women-especially those who are socially disadvantaged-desire pregnancy at an early age.
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Affiliation(s)
- Abigail Weitzman
- Department of Sociology and Population Research Center, University of Texas Austin, Austin, TX, USA
| | - Jennifer S Barber
- Department of Sociology and Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Justin Heinze
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Marc Zimmerman
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Michel P. Model of neo-Malthusian population anticipating future changes in resources. Theor Popul Biol 2021; 140:16-31. [PMID: 33794280 DOI: 10.1016/j.tpb.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
In this paper we develop a class of models to study a population and resource dynamical system in which the decision to give birth is based on a rational far-sighted cost-benefit analysis on what the future of the resource level will be. This leads to consider a system in which a time forward population/resource dynamical system is coupled with a time backward Bellman's equation (which models the choice of having a child). We construct, from a population model with food consumption, an example, to study the change in time of the fertility rate when a catastrophic change in resource is announced at a given moment, when a birth control policy is announced and we compare these two announcements in case nothing happens. Moreover, we provide, mathematical tools to theoretically and numerically study this complex coupling of time forward and time backward equations.
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Affiliation(s)
- Philippe Michel
- Ecole Centrale de Lyon, University Claude Bernard Lyon 1, CNRS UMR 5208, Ecully, 69130, France.
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Abstract
Persistently high levels of unintended fertility, combined with evidence that over- and underachieved fertility are typical and not exceptional, have prompted researchers to question the utility of fertility desires writ large. In this study, we elaborate this paradox: widespread unintendedness and meaningful, highly predictive fertility desires can and do coexist. Using data from Malawi, we demonstrate the predictive validity of numeric fertility timing desires over both four-month and one-year periods. We find that fertility timing desires are highly predictive of pregnancy and that they follow a gradient wherein the likelihood of pregnancy decreases in correspondence with desired time to next birth. This finding holds despite the simultaneous observation of high levels of unintended pregnancy in our sample. Discordance between desires and behaviors reflects constraints to achieving one's fertility and the fluidity of desires but not their irrelevance. Fertility desires remain an essential-if sometimes blunt-tool in the demographers' toolkit.
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Affiliation(s)
- Sara Yeatman
- Department of Health and Behavioral Sciences, University of Colorado Denver, Campus Box 188, PO Box 173364, Denver, CO, 80217, USA.
- University of Colorado Population Center, Boulder, CO, USA.
| | | | - Sarah Garver
- Sociology Department, University of Chicago, Chicago, IL, USA
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12
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Timæus IM, Moultrie TA. Pathways to Low Fertility: 50 Years of Limitation, Curtailment, and Postponement of Childbearing. Demography 2020; 57:267-296. [PMID: 31970647 PMCID: PMC7051933 DOI: 10.1007/s13524-019-00848-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study applies survival analysis to the birth histories from 317 national surveys to model pathways to low fertility in 83 less-developed countries between 1965 and 2014. It presents period measures of parity progression, the length of birth intervals and total fertility that have been standardized fully for age, parity, and interval duration. It also examines parity-specific trends in the proportion of women who want no more children. Outside sub-Saharan Africa, fertility transition was dominated by parity-specific family size limitation. As the transition progressed, women also began to postpone their next birth for lengthy periods in many countries. During the first half of the fertility transition in much of sub-Saharan Africa and in some other countries, however, women stopped childbearing without targeting particular family sizes. Moreover, birth intervals in sub-Saharan Africa have been lengthening since the onset of the transition. Birth control is not restricted to a dichotomy between limitation and spacing. Other reasons for curtailing childbearing and postponing having another birth also shape countries’ pathways through fertility transition.
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Affiliation(s)
- Ian M Timæus
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK. .,Centre for Actuarial Research, University of Cape Town, Cape Town, South Africa.
| | - Tom A Moultrie
- Centre for Actuarial Research, University of Cape Town, Cape Town, South Africa
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13
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The emergence of birth limitation as a new stage in the fertility transition in sub-Saharan Africa. DEMOGRAPHIC RESEARCH 2020. [DOI: 10.4054/demres.2020.42.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Cleland J, Machiyama K, Casterline JB. Fertility preferences and subsequent childbearing in Africa and Asia: A synthesis of evidence from longitudinal studies in 28 populations. Population Studies 2019; 74:1-21. [DOI: 10.1080/00324728.2019.1672880] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Childbearing intentions among women in high-fertility contexts are usually classified into those wanting to have a baby, those wanting to 'space' a birth and those wanting to 'limit' their family size. However, evidence from Africa increasingly suggests that women's intentions are more complex than this classification suggests, and that there is fluidity in these intentions. This research explores women's accounts of their childbearing intentions and decisions in order to examine how this fluidity plays out in a low-fertility context in urban Africa. Six focus group discussions were conducted in April and May 2012 with women of reproductive age in Nairobi, Kenya. Participants were recruited using random and purposive sampling techniques. The focus group discussions had an average of seven participants each. Data were coded thematically and analysed using Nvivo software. The analysis explored the factors that women consider to be influential for childbearing and found that the health of the mother and child, costs of raising a child and relationships were commonly reported to be important. Evidence of intentions to space births and limit family size was found. However, the data also showed that there is fluidity in women's family planning intentions, driven by changes in relationships or household finances, which often result in a desire to avoid pregnancy in the present moment. The fluidity observed in women's childbearing intentions cannot be accounted for by the concepts of either 'spacing' or 'limitation' but is best explained by the concept of 'postponement'. The research reveals the need for family planning clinics to provide a full method mix, as well as high-quality counselling, to enable women to choose a method that best suits their needs.
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