Effects of lactation and contraceptive use on birth-spacing in Bolivia.

ABSTRACT

Based on the 1989 Demographic and Health Survey of Bolivia, analysis of the joint effects of breastfeeding and contraceptive use on birth-spacing showed the IUD to be the most effective contraceptive method used to delay conception. Breastfeeding significantly lengthened the birth interval, but only following second and higher parity births. In addition, conditions of poverty appeared to further inhibit the return of fecundity and delay conception.

ABSTRACT

PIP This study examines the joint effects of breast feeding and contraceptive use on birth spacing in Bolivia during 1984-88. Data are obtained from the 1989 Bolivian Demographic and Health Survey conducted on a sample of 7923 women aged 15-49 years. The fertility model gives an estimate of the effects of contraceptive method chosen and lactation patterns on the likelihood of another conception following the birth of the index child in separate models by parity. Controls are included for demographic, family background, and community environmental factors. Stopping of breast feeding significantly increased the likelihood of another conception for second and higher order births. Breast-fed first-born infants did not affect the likelihood of a second conception. All use of contraception reduced the likelihood of a conception for all parities. Use of the IUD had the greatest contraceptive effect on the likelihood of a next birth for all parities. The likelihood of a conception was 6-7 times lower among women using an IUD following a third and lower-parity birth compared to women who used no contraception. For IUD-using women with four or more children the likelihood of a next birth was 40 times less likely compared to noncontraceptors. Sex of the index child was found to be unrelated to the likelihood of a subsequent birth. Older mothers, particularly women with high parity births, were less likely to have a subsequent conception. Higher education (9 or more years) lowered the odds of a next birth, but the effects of education decreased with the inclusion of contraceptive patterns in the model. Mothers working for pay were 1.3 times less likely to have a next birth at all parities compared to other women. Women married to men with no schooling were 1.4-2.0 times less likely to have a next birth compared to women with partners with some schooling. Living in Altiplano and Valles regions lowered the odds of conception by 1.3 times. Ethnicity and urbanization affected the likelihood of a next birth. The negative effect of poverty on conception was found to be exacerbated by multiple pregnancies.