Completed Family Size Research Articles

Konisation non in sano

Sharp conization is a diagnostic and therapeutic intervention. From 1970 to 1990 at the clinic of the city of Graz, Austria, conization was performed in 3663 female patients aged 15-84 who had a diagnosis of cervical intraepithelial neoplasia (CIN) III. All the women were followed up with colposcopy, cytology, and palpation. In those who were not healthy (non in sano) a biopsy and/or a cervical canal curettage was also performed. Conization was done in 2984 (82%) healthy women. Within 5-7 years in 8 cases a recurrence of CIN III could be established. In 669 patients (18%) conization took place in unhealthy women. In 345 (52%) cases, the alteration extended toward the cervix, in 262 (39%) it was peripheral, and in 62 (9%) it was peripheral and extending toward the cervix in the unhealthy women. In 228 (34%) women with an average age of 45 years who did not want any children or had completed family size, hysterectomy was carried out. As a result, in 69 (30%) women, surface carcinoma could be demonstrated. During follow-up, in 4 women 1-4 years after hysterectomy, a vaginal intraepithelial neoplasia III (VAIN III) could be established. 441 (66%) of the women with an average age of 35 years who desired a child were subjected to very strict control. In 53 (12%) patients, the persistence of atypical epithelium changes could be shown by means of biopsy or cervical canal curettage, and thus hysterectomy was performed. In 1 patient a case of VAIN III occurred after hysterectomy. In the remaining 338 patients, the persistence of cervical intraepithelial neoplasia could be demonstrated. In the hysterectomy group, 5 residual findings were ascertained, while in the group without hysterectomy, only 1 occurred. The low (1%) rate of recidivity means that the issue of possible hysterectomy cannot be approved. The exact histological processing and strict follow-up guarantee that the necessary therapeutic treatment measures are always employed.

Family planning practice in Central Sudan

Community and hospital based studies were conducted to assess the major factors related to the practice of family planning during 1989 and 1990 in Central Sudan. The mothers of 1592 births in the community and 1357 births in the hospital were interviewed by trained study workers. Prevalence of contraceptive use prior to current pregnancy was 13.0% and knowledge of a family planning method was 43.0% among hospital women and 51.0% among community women. The major predictors of use of a family planning method were parity, socioeconomic status, knowledge of source of service and maternal age. The average completed family size was 7.7 children and with the exception of a lengthy breast feeding duration, the factors examined favored a high fertility. Women preferred and apparently practiced behaviors conducive to spacing rather than limiting the number of their children. The results between the hospital, the community, and the Sudan Demographic and Health Survey 1989/1990 were consistent suggesting a minimal effect of selection bias and increasing the validity of these findings. Accessible and available family planning services coupled with wider information on family planning through health personnel and the media are needed. In particular, special efforts should be made to reach women of low socioeconomic status.

From weavers to workers: demographic implications of an economic transformation in Twente (the Netherlands) in the nineteenth century

Partant des aspects démographiques de la proto-industrialisation, on examine le processus de transition qui mène soit à une industrialisation réelle, soit au contraire à un retour aux travaux des champs. Deux villages des Pays-Bas sont etudies à cette fin, situés dans la région de Twente, où domine une industrie textile enracinée dans l'agriculture. L'organisation de Pagriculture subit au début du 19e siècle des changements structurels, accompagnés d'une intervention de l'Etat dans l'économie régionale, avec pour conséquence un boom du tissage à domicile, ce qui, dans certaines communautés, conduit à l'industrie mécanisée et dans d'autres au contraire à un retour à la terre. La reconstitution des families permet à l'auteur de suivre le comportement démographique tant à l'époque de la protoindustrialisation qu'après, suivant l'un ou l'autre processus d'évolution. II s'avère que ni la proto-industrialisation, ni l'industrialisation, ni le retour à la terre n'ont, dans les deux villages étudiés, d'influence profonde sur le comportement démographique. II n'y a en effet pas de différences spectaculaires quant à l'âge au mariage ou à la dimension de la famille complète, entre groupes professionnels ou entre communautés; il n'y a pas non plus de changement majeur en ce domaine au long de la période étudiée.

Breastfeeding: A natural method for child spacing

Lactational amenorrhea plays an important role in child spacing. Recent research has led to a consensus regarding the status of lactational amenorrhea as a method of family planning. This is currently referred to as the lactational amenorrhea method. Research priorities were to field test the lactational amenorrhea method and define the factors that influence lactational amenorrhea and the interface between the lactational amenorrhea method and other family planning methods.

Changes in the Demographic Behaviour of Migrants in Australia and the Transition between Generations

Mortality of migrants in Australia is generally lower than in their countries of origin and in comparison with the Australian-born population (but with a few important exceptions), and there is relatively little change with longer duration of residence in Australia. Except for migrants from the less developed countries, the average completed family size of most birthplace groups in Australia seems to follow the levels in the countries of origin. Completed family size also shows little convergence to the Australian level with increasing duration of residence in Australia, although two major exceptions are women from the Netherlands and Malta. For most birthplace groups, convergence to the Australian level of average completed family size seems to occur only when the Australian-born daughters of migrant women begin their childbearing. Rapid socio-economic change is also observed between parent and child generations, and the composition of most ethnic groups is changing through out-marriage and the emergence...

Modernization and household formation on St. Bart: Continuity and change

The population of Saint Barthelemy, French West Indies, consists of descendants of French peasants who emigrated to the West Indies nearly three centuries ago. As in rural France, new households are formed on the island upon marriage. This study analyzes changes in marriage patterns that have occurred in the 99 years between 1878–1976. These changes include increase in marriage distance, increase in completed family size, increase in celibacy, decrease in the frequency of cousin marriage, and decrease in the percentage of mothers bearing children out of wedlock. The data are derived from the parochial and civil records of birth, death, and marriage of nearly 10,000 individuals. Despite changes in marriage patterns and modernization of the island, there has been little change in household form or the process of household formation.

Women and Health in Choco, Colombia

Part of a larger project designed to study and promote primary health care (PHC) in the Colombian province of Choco this article reports on the health status of women in the area. One of Colombias poorest provinces Choco has 300000 mostly rural inhabitants 90% of them black and 65 Indian. The PHC project ran from 1979-1988 and one of its components involved the training of rural health workers selected by their communities in the delivery of primary health that ranged from curative and preventive medicine to family planning. Relying on a village-based monitoring system the project collected data on morbidity mortality and the coverage of health activities. In 1982 the project carried out a survey on socioeconomic conditions and morbidity. Data shows that single women lead 22% of the households in the region and that 50% percent of the people are living in free unions instead of marriages. Since women have a reduced access to land female headed households face increased economic risks. Although literacy levels were the same for men and women infant mortality was significantly higher among children of illiterate women. Morbidity levels were often higher among women including a 435 prevalence rate of vaginal discharge. The rate of cervical cancer was also very high. Furthermore fertility rates reflect the low prevalence of family planning. The average completed family size was 7.5 children/women and the average number of pregnancies in women over 45 was 9. This study indicate that besides increased primary health services education and socio-economic improvement are needed.

Marital Status and Reproductive Performance in Kipsigis Women: Re-evaluating the Polygyny-Fertility Hypothesis

The effects of marital status on fertility and offspring survivorship are examined with data on six marriage cohorts of Kipsigis women, agro-pastoralists of south western Kenya. Neither marriage order, nor the average number of co-wives married to a man during a woman's reproductive years, is associated with completed family size, nor with any of the components of reproductive performance. The mechanisms whereby polygyny might potentially lower the reproductive performance of polygynously married women in the Kipsigis and other populations are discussed in some detail, with particular reference to resource shortages, sexual and economic favouritism, the observance of post partum taboos, disease, husband's age, co-wife co-operation, education, sterility, and age at menarche and marriage.

Marriage and Childbearing in China Since 1940

Increased age at marriage in China has contributed significantly to the large decline in fertility that has occurred. If every married couple had attained its actual completed family size and age at marriage had not changed there would have been 104 million more births since 1950. Cohorts marrying in the 1950s and 1960s followed surprisingly closely the structure of a mathematical model of first marriage rates by age derived from the pattern of first marriage frequencies in Sweden in the nineteenth century. The fit to the model schedule was destroyed in the 1970s by administratively enforced postponement of marriage. (EXCERPT)

The Income–Fertility Relationship: Effect of the Net Price of a Child

This article examines the relationship between income and completed family size in empirical fertility models. The relationship, which is hypothesized to be positive, often is negative in empirical studies. This perverse result is thought to occur because of the many correlations between income and other factors that affect fertility. In this research, these other factors--such as the net price of a child, the opportunity cost of the wife's time, and supply factors--are statistically controlled, and the income effect is positive and significant. When the net price of a child is not controlled, however, the income effect becomes negative and significant.

Menarche, menopause and reproduction in the Kipsigis of Kenya.

Among the Kipsigis, a population of south-western Kenya who do not use contraception, age at menarche and age at last live birth could be determined for a cohort of post-menopausal women, through reference to clitoridectomy ceremonies that can easily be dated. While a woman's age at last live birth was strongly associated with the length of her reproductive lifespan, completed family size was better predicted by age at menarche. The demographic implications of variation in menarcheal age are discussed.

HLA sharing and fertility in Hutterite couples: evidence for prenatal selection against compatible fetuses.

Antigenic differences between mother and fetus (i.e., blood group incompatibilities) were traditionally considered deleterious for viviparous reproduction. Recently, evidence has accumulated suggesting that maternal response to paternally derived fetal antigens, paradoxically, may facilitate maintenance of pregnancy. Thus, fetuses whose paternally derived antigens do not differ from maternal antigens (i.e., histocompatible pregnancies) may be at a selective disadvantage during pregnancy. Parents sharing histocompatibility antigens (i.e., HLA) may produce compatible fetuses and show overall reduced fertility. Indeed, increased HLA sharing has been reported in some couples experiencing repetitive spontaneous abortion. However, the effects of HLA sharing in couples not selected because of previous pregnancy losses have not been assessed. To elucidate the reproductive effects of maternal-fetal histocompatibility, we initiated prospective population-based studies of parental HLA sharing and reproductive outcome in the Hutterites, a population isolate that lives communally and proscribes contraception. The relationship between HLA-A, -B, and -DR sharing and reproductive outcome was examined in 111 Hutterite couples. Intervals from marriage to each birth were no longer among couples sharing antigens; differences were significant at the second birth and remained significant through the sixth birth (P less than .05). When the effects of sharing at individual loci were examined, HLA-DR was the only individual locus that was a significant predictor of birth interval length (P = .025). Completed family sizes were 6.5 and 9.0 among couples sharing and not sharing HLA-DR, respectively (P = .082, 2-tailed). However, recognized fetal loss rates did not differ among couples sharing and not sharing antigens.(ABSTRACT TRUNCATED AT 250 WORDS)

Fitness and fertility among Kalahari !Kung.

In this paper we develop a model that examines fertility and childhood mortality patterns and their relationship to environmental variables. Interactions among environmental variables can account for different fertility patterns and different mixes of these variables can produce similar patterns of fertility. Our model attempts to quantify the idea that there is a trade-off between producing a few children likely to survive to reproductive age and producing a greater number of children with lower chances for survival. The optimum mix of these strategies depends on environmental characteristics. We use the model to make predictions about fertility and mortality patterns among two Bushmen populations of southern Africa--the Ghanzi and Ngamiland !Kung--using data collected by Harpending in 1967-1968. The results do not support explanations of the low fertilities observed among !Kung Bushmen women, in whom it is thought that fitness is maximized by limiting fertility, and show no relationship between mortality and family size in either !Kung population. Instead, the number of offspring reaching reproductive age in both populations increases as their completed family size increases. We examine the effects of sex, birth order, and paternal investment on mortality. No sex ratio differences and no differences in mortality by sex or birth order are present. Infant mortality among women who married more than once is significantly higher than among women who married once, suggesting that paternal care has a significant effect.

Economic models of fertility behaviour in Australia.

The author analyses individual fertility patterns in Australia from the perspective of recent economic models of the family. The emphasis is on the relationship between fertility and economic variables such as human capital, market wages, and wealth. "Several dimensions of fertility are considered, including 'quality' of children, completed family size, and the decision whether to have children or not." Data are from the 1973 Social Mobility in Australia Survey.

Maternal Mortality in Matlab, Bangladesh: 1976-85

This paper reports findings from a study of maternal mortality in Matlab, Bangladesh during the 1976-85 period. The study employed a multiple-step procedure to identify maternity-related deaths to all reproductive-aged women within the study area during this period. A total of 387 maternal deaths were identified, resulting in an overall maternal mortality ratio of 5.5 per 1,000 live births. The introduction of a family planning program in half of the Matlab study area led to a moderate but significant reduction in maternal mortality rates, relative to the comparison area. This appears to have been primarily due to a reduction in the overall number of pregnancies in the treatment area, since among women who became pregnant, mortality risks remained high. The results of this study underscore the need for a broad-based service strategy that includes but is not limited solely to family planning, in order to achieve significant reductions in maternal mortality levels in settings such as rural Bangladesh.

Contraceptive choice in the completed family

In Belgium, the contraceptive choices and views on completed family size were studied. The study involved a 2-page questionnaire; the 1st part was self-administered while the 2nd half of the questionnaire allowed for the physician to interview the respondents. The survey studied the demographic characteristics of the respondents and the relationship of these characteristics to contraceptive choice, family size and possible future choice in contraception. Demographic information assayed included age and occupation and religion of the respondent and the number of unplanned children. 235 of the 359 respondents (2/3) considered their family complete. 70% of those surveyed used some form of contraception with oral contraceptives and female sterilization being the most popular currently used methods and oral contraceptives and condoms being the most popular ever used method. Motivations for contraceptive choice were also evaluated (family health, age, socioeconomic conditions, etc). Although a large number of unplanned pregnancies were reported, they were not necessarily unwanted. The failure a contraceptive method may account for this. Over 80% of those surveyed had used oral contraceptives at some time. Although the couples agreed on family size, the reasoning behind their decision was obtuse and not well planned. Sterilization created mixed emotions among both partners. Its popularity stems from the standard recommendation of discontinued use of oral contraceptives after age 35. However, doctors need to be considerate of the ambivalent feelings of their patients and recommend choices that leave options open without presenting health risks.

Recent trends in fertility and family formation.

"Australia's fertility has declined significantly since the 1950s, and has remained below the long-term replacement level since 1976. The current trend appears to be towards a further decline. This paper describes the patterns of the fertility decline in terms of age and parity of the mother, and the effect on recent fertility decline of the postponement of marriage and family formation. The implications of the continued decline in fertility on completed family size are studied by reference to fertility patterns of marriage cohorts."

Intergenerational transmission of relative fertility and life course patterns

The direct relationship between fertility and fertility behavior of mothers and daughters was examined. It was hypothesized that the relative propensity to control family sizes in 1 generation is transmitted to the following generation and that transmission of fertility levels across generations is in part a result of the transmission of specific fertility-determining life-course behaviors across generations. The data were derived from the Mormon Historical Demography projects set of computerized family geneologies. To assess the importance of cohort effects the completed fertility of 1st daughters and last daughters was compared by mothers completed family size and mothers birth cohort. Daughters who were the last born tended to have lower fertility than 1st born daughters. For 1st born daughters a positive association between mothers and daughters family size was confirmed. The distribution of mothers and daughters relative to the median births for their respective cohorts was examined. Each woman was allocated to 1 of 3 groups: low -- completed fertility was 2 or more children less than the median for all women in the birth cohort; medium -- completed fertility was equal to + or - 1 child from the median for other women in the same birth cohort; and high -- completed fertility was 2 or more children greater than the median for all women in the birth cohort. It was expected that a greater proportion of daughters than mothers would have relatively low fertility. For the 1830-39 cohort only 15% of the mothers had relatively low fertility but 25% of their daughters did; for other mother cohorts the comparisons were 15:26 18:26 and 15:23. It also was expected that the daughters of low fertility mothers would be more likely to have relatively low fertility. For low fertility mothers in the 1830-39 cohort 33% of daughters had relatively low fertility; 24% fell in the relatively high fertility group. The expected difference was found for the 1840-49 cohort of mothers and for the 1860-69 cohort but not for the 1850-59 cohort. It also was expected that the daughters of relatively high fertility mothers would have relatively high fertility. 33% of daughters with high fertility mothers in the 1st cohort had relatively high fertility; only 23% had low fertility. This pattern was consistent for each of the other cohorts of mothers. Tabular and multivariate analyses supported the strong possibility that both fertility behavior and indirect associations regarding timing of fertility-related life course events were transmitted intergenerationally. Cohort-specific influences were substantial. The analyses confirmed both the hypothesized intergenerational fertility association and the hypothesized cohort-specific effects.

Post-partum amenorrhoea, birth intervals and reproductive potential in captive chimpanzees

Aspects of reproductive history and performance in captive female chimpanzees were examined from the records of Taronga Zoo, Sydney. All the females had raised their own infants. The average duration of post-partum amenorrhoea in Taronga females was 28 months which was shorter than that in free-living females at Gombe National Park. Despite this shorter post-partum amenorrhoea, the average age difference between surviving offspring of the captive females is similar to that observed in the free-living population. As a result, the “completed family sizes” of females at Taronga have been similar to those observed in free-living populations.

The Completion of Childbearing: Change and Variation in Timing

Using data on fertility histories from the 1980 US Current Population Survey which included about 77000 households in a national probability sample the timing of the completion of childbearing (as measured by the age of the mother at her final birth) of successive 20th-Century cohorts of US women (born in 1906-15 1916-25 1926-30 and 1931-35) investigated. Data from the National Survey of Family Growth (NSFG) were also used to examine the likely age at completion of childbearing for ever-married women who had not passed the reproductive period by the time of the survey. By examining the entire distributions of age at final birth as well as summary measures a substantial cohort change in the timing of the last birth among Whites and Blacks was found that was not evident from the summary measures of central tendency and dispersion. Among Whites the cohort changes consisting of a 50% reduction in the proportion finishing reproduction later than 35 years of age were not simply due to differing completed family size and age at 1st birth. In addition with these other factors controlled in a regression analysis women who experienced marital disruption and remarriage by age 45 took longer to finish their reproduction and more educated women took less time. Such effects were not statistically significant for Blacks who have experienced large reductions in the proportions of women finishing reproduction early (age<25) and late. For younger cohorts with incomplete reproduction the likely age at 1st birth was projected using the NSFG data. For both races the projected mean age was 26.6 for the youngest White cohort and 27.8 and 25.4 for the youngest 2 Black cohorts as opposed to a range from 28.1-28.7 for the oldest cohort.