Declining fertility among North American Hutterites: the use of birth control within a Dariusleut colony

Historically, population researchers considered the Hutterites the champions of high fertility, since they most closely approximated the human fertility potential. Yet contemporary researchers have found evidence of a decline in fertility and a shift from natural to controlled fertility behavior among the Hutterite population. Various reasons for these recent changes have been suggested, including the use of birth control. Using interview data from a Dariusleut colony, this is the first paper to document the presence and prevalence of birth control among the North American Hutterites. All interviewed women recognized the use of birth control and reported that female sterilization was the most commonly used method. I address how the various forms of birth control and the reasons for its use relate to the Hutterite ideology.     

Changes in completed family size and reproductive span in Anabaptist populations

The Anabaptist Amish, Hutterite and Mennonite peoples trace their origins to the Reformation. Although they share certain beliefs, such as adult baptism and the separation of church and state, each group is culturally unique. The Hutterite and Amish are highly fertile and their populations exhibit stable rates of growth. These demographic characteristics reflect communal living among the Hutterites and labor intensive farming practices among the Amish. The Mennonites are the most receptive Anabaptist group to outside socioeconomic influences and provide a demographic contrast to the more conservative Amish and Hutterites. Demographic data collected during a study of aging in Mennonite population samples from Goessel and Meridian, Kansas, 1980, and Henderson, Nebraska, 1981, formed the basis of a cohort analysis in order to assess fertility change over time. Completed family size has decreased significantly in all three communities since 1870. Since the early 1900's the mean age of the mother at first birth has fluctuated but the mean age of mother at the birth of the last child is decreasing significantly for the communities of Goessel and Henderson, thus effectively shortening the reproductive span. The pattern is somewhat different for Meridian, the most conservative of the three communities.     

Decreased fecundability in Hutterite couples sharing HLA-DR.

To study the effects of parental HLA sharing on pregnancy outcome, we initiated population-based studies in the Hutterites. We previously reported longer intervals from marriage to each birth among couples sharing HLA, particularly HLA-DR. In the present report, we present the results of a prospective, 5-year study of fecundability and fetal loss rates in this population. Between April 1986 and April 1991, 154 pregnancies were observed in 104 couples. The median number of months of unprotected intercourse to a positive pregnancy test was significantly longer among couples sharing HLA-DR who stopped nursing prior to the first menses as compared with couples not sharing HLA-DR who stopped nursing prior to the first menses (5.1 vs. 2.0 mo, respectively; P = .016). Fetal loss rates were increased among couples sharing HLA-B as compared with couples not sharing HLA-B (.23 vs. .12, respectively; P = .041, adjusted for age, gravidity, and kinship). These data suggest that our earlier observations of increased birth interval lengths among Hutterite couples sharing HLA were predominantly due to longer intervals until a clinical pregnancy among couples sharing HLA-DR and, to a lesser degree, were due to increased fetal loss rates among couples sharing HLA-B.     

Demographic and endocrinological aspects of low natural fertility in Highland New Guinea

The Gainj of highland Papua New Guinea do not use contraception but have a total fertility rate of only 4.3 live births/woman, 1 of the lowest ever recorded in a natural fertility setting. Reproductive and marital histories were obtained from 305 females and 206 males aged 10+. Each subject was asked about: number of live born offspring ever produced; number of stillbirths ever produced; number and names of offspring currently being nursed; number of current and past spouses; and the cause of dissolution of all past marriages. Blood samples were drawn from 172 volunteer female subjects aged 10-60 years and ovarian function was classified by concentration of progesterone. From an analysis of these cross-sectional demographic and endocrinological data, the causes of low reproductive output have been identified in women of this population as: late menarche and marriage, a long interval between marriage and 1st birth, a high probability of widowhood at later reproductive ages, low effective fecundability and prolonged lactational amenorrhea. These are combined with near-universal marriage, and a low prevalence of primary sterility similar to that found in other populations. Of all the factors limiting fertility, by far the most important are those involved in birth spacing, especially lactational amenorrhea. The effects of widowhood on Gainj fertility are negligible. Factors acting to lower fertility fall into 2 categories: those that determine the age of onset of reproduction and those that act to space births. Given the observed pattern of birth spacing, however, the delay in commencement of reproduction represents on average no more than 1 or 2 live births averted/woman. In contrast, were age at 1st reproduction held constant while reducing birth intervals to a mean of 2.0-2.5 years, total fertility would increase to about 7 or 8. Future research on natural fertility should focus on specific behavioral and physiological mechanisms governing the reproductive process.     

Postpartum lactational amenorrhoea as a means of family planning in the Sudan: a study of 500 cases

The lactational histories of 500 Sudanese women were studied retrospectively to examine postpartum lactational amenorrhea as a method of family planning. Particular attention was given to the factors affecting postpartum lactational amenorrhea, including supplementary feeding and the use of modern contraceptive methods. Breast-feeding was overwhelmingly practised (90%) among this sample, which was roughly representative of the Sudanese population as a whole. The prevalence of amenorrhea among this group of lactating women was quite high (73%). Duration of lactational amenorrhea ranged from 2 to 36 months with a median of 12 months. Introduction of supplementary feeding had little effect on lactational amenorrhea up to the 9th month of breastfeeding. Beyond the 12th month of breastfeeding, lactational amenorrhea was significantly prolonged by postponing the introduction of supplementary feeding until the 4th month or later. Ovulation, and hence conception, during lactational amenorrhea was unpredictable. It occurred as early as the 3rd or as late as the 36th month postpartum. Conceptions interrupting lactational amenorrhea soon after delivery (3-9 months) were more frequent among primiparous women. The failure rate of lactational amenorrhea as a contraceptive was 8.4%. Though extremely high compared to that of the pill, lactational amenorrhea was more useful as a fertility control mechanism because, in this study, a high proportion of women initiated pill use, but soon discontinued it because of side effects. Modern contraceptive practice was not prevalent. Amenorrheic mothers accepted the pill after the 6th month postpartum (41%, compared to lactating mothers whose menses had returned who started much earlier. 49% of the women studied relied completely on the protection of lactational amenorrhea. 57% of all lactating women who used the combined pill reported a reduction in milk production. Knowledge of modern contraception was poor and incorrect in many cases, leading to several policy implications, including usage of sterilization.     

Weaning, body weight, and postpartum amenorrhea duration in pigtailed macaques (Macaca nemestrina)

Early permanent infant separation or weaning decreases the time interval between pregnancies and interbirth intervals for many female primates. At least part of the interpregnancy interval consists of postpartum amenorrhea, a period of non-menstruation lasting from the time of birth until the female begins to ovulate. This study investigated the effects of weaning age and dam's body weight on the duration of the interval between pregnancies, the duration of postpartum amenorrhea, and the number of cycles to conception in a year-round breeder. Female pigtailed macaques (Macaca nemestrina) have an observable perineal swelling that fluctuates throughout the menstrual cycle and provides a means of detecting ovulation. The perineal swelling records of socially housed pigtailed macaques were studied from July 1996 to September 1998. Postpartum amenorrhea data were obtained on 44 females who gave birth to normal, viable infants. As weaning age increased and dam's weight decreased, postpartum amenorrhea, and consequently the interval between pregnancies, increased in duration. The interpregnancy interval consisted almost entirely of the postpartum amenorrhea phase. Our finding that a higher dam's body weight decreased the length of postpartum amenorrhea duration lends support to the hypothesis that a minimum body weight is necessary for menstrual cycles to occur. Most females became pregnant on their first ovulation regardless of weaning age and whether or not they were carrying an infant. As the weaning age of the infant and the dam's weight increased, ovulation went from occurring after separation to occurring before separation.     

Genetic variability of HLA in the Dariusleut Hutterites. A comparative genetic analysis of the Hutterities, the Amish, and other selected Caucasian populations.

There are three endogamous subdivisions of the Hutterite population, a North American religious isolate. These individuals live on communal farms, and residence is strictly patrilocal. We report on the distributions of HLA-A and B alleles and haplotypes in 203 married women from one subdivision--the Dariusleut--in Alberta, Canada. We demonstrate that there is significant linkage disequilbrium among a large fraction of the distinct haplotypes in the Dariusleut Hutterite data; there is a restriction in the number of distinct haplotypes present in the Dariusleut; the Hutterites and the Old Order Amish (Lancaster County, Pennsylvania) are the most genetically distant pair of populations in an ensemble of 11 Caucasian populations; and, finally, the Old Order Amish and the Hutterites are approximately as distant from the Indiana Amish as they are from the eight other Caucasian populations, which are tightly clustered in the space of gene frequencies. These results are consistent with the fact that the Amish and the Hutterites are genetic isolates with small numbers of founders. Certain haplotypes show significant linkage disequilibrium in these as well as in other Caucasian samples. Thus, some of the linkage disequilibrium antedates the formation of these Anabaptist sects.     

High fertility of Old Colony Mennonites in Mexico

Old Colony Mennonites in Mexico appear to demonstrate natural fertility, using no form of artificial birth control and apparently not attempting to limit family size. The resulting fertility is nearly as high as that of the Hutterites, although the Mennonites lack the communal economic system of the latter. Most Mennonites in Mexico migrated from Canada in the 1920s, and the largest single settlement, called the Manitoba Colony, is one of four in the state of Chihuahua. A 1967 partial census obtained data from 38% of the Mennonite households. Family size in the sample was close to that in a local survey taken in the same year. Available church records matched with census forms permitted verification of and corrections to 560 female reproductive histories. The median number of live births to women over age 45 years was 9.5, compared with 10.4 in the Hutterites. Age-specific marital fertility rates and birth intervals closely resembled those of the Hutterites.     

Determinants of natural fertility in Sudan

The population of Sudan (North) is at a very early stage of fertility transition and experiences high, stable fertility at a close to natural level. The high observed fertility is found to be a function of the high proportion of married women and ineffective contraceptive procedures. The data used in this study were drawn from the 1979 Sudan Fertility Survey (SUDFS), in which 3115 ever-married women 50 years old from 12,028 households were interviewed. 90% of Sudanese women breast fed for at least 6 months and 80% for at least 12. The main inhibitor of fertility is perceived to be lactational amenorrhea averaging about 11.8 months, which is reported to be high, although among younger women the duration of amenorrhea is shorter due to earlier introduction of supplementary foods. An average of 5.2 months of postpartum sexual abstinence is evidenced, but this is shorter than the period of amennorhea, and therefore has no effect on the birth interval. Neither does marital instability or mean length of separation, which are both close to nonexistent. Sudanese women are comparatively very infecund. 22% gave birth within the 1st year of marriage, 62% within the 2nd, and 83% the 3rd. The proportion of ever-users of contraception is high (e.g. 15.4% among the 25-34 among category), but current use was low (8.1% for the same). The use of contraception is responsible for a reduction of 4.2% of the fertility per married woman. The duration of temporary separation between spouses, due to temporary or seasonal migration of husbands, and the pathological causes of high primary sterility, which contribute to the low fecundability, need further investigation.     

Reproduction in high altitude Aymara: physiological stress and fertility planning?

Reproductive characteristics at high altitude are described based on the reproductive histories of 720 Aymara women, collected in 1998 and 1999 in a group of twelve peasant communities at a mean altitude of 4000 m in the Bolivian Altiplano. The reproductive pattern is shaped by a late onset of childbearing, associated with a rather short reproductive span and large birth intervals. Environmental conditions could explain the particularly late age at menarche of rural girls compared with their urban counterparts, whereas the age at first birth is likely to be under cultural control. The short reproductive span appears to result from a large mean interval between last birth and menopause, which is essentially determined by cultural decisions. The birth intervals, which are longer than in many traditional societies, could be the result of a slower restoration of postpartum fecundability induced by the hard way of life inherent in the Altiplano (including poor sanitary and nutritional conditions and high workload), perhaps aggravated by hypoxia. However, a secular trend in fertility is perceptible, towards earlier menarche, earlier age at first birth, increasing reproductive span and a slight increase in live births and surviving offspring, which is probably the result of a slow improvement in living conditions. The existence of birth control on the one hand, and a total fertility rate averaging six live births among the couples who do not practise contraception on the other, are other arguments against the hypothesis of a low natural fecundity in these Aymara groups.     

Low twinning rate and seasonal effects on twinning in a fertile population,the Hutterites

This paper analyzes from the mid 18th century to 1987 the birth records of the Dariusleut, one of the three subgroups of the Hutterite population. The aim of this study is to describe several aspects of the twinning rate in a fertile population. The overall rate of twinning was 0.90%:103 twins among all 11492 maternities. The rate peaked at the 7th birth order and at the maternal age of 40 years and over. Until the mid 19th century when the Hutterites lived in Russia, the twinning rate was higher (1.5%), and it decreased during the migration period in the second half of the 19th century (0.7%). After the group had settled in the USA and Canada, the population maintained a twinning rate of 1.0% until 1965. After 1965 the rate decreased to 0.7%, partly due to a decline in fertility among women aged 30 years and over. There was a significant seasonal variation: the twinning rate decreased to 0.5% in May–July compared to 1.2% for the other three seasons during the years up to 1965 (P<0.01), while more recent mothers did not show such a seasonal variation. The incidence of twin births in this population seems to have been influenced by environmental factors, which would change their effect seasonally and secularly.     

Age and fertility: can women wait until their early thirties to try for a first birth?

Postponing the start of childbearing raises the question of fertility postponed versus fertility foregone. One of the limitations of previous studies of 'How late can you wait?' is that any observed decline in the probability of conception with age could be due to a decline in fecundability with age or due to a decline in coital frequency with age or due to both factors. Using data from a multinational longitudinal study conducted to determine the daily probability of conception among healthy subjects, a discrete-time event history model with long-term survivors (sterile population) is used to study the relationship between age and fecundability for childless women, while controlling for the pattern of intercourse within a menstrual cycle. The findings suggest that women can wait until their early thirties to try for a first birth, providing that they are not already sterile, as the magnitude of the decline in fecundability is very modest and of little practical importance.     

Resumption of menstruation among urban post-partum women in Bangladesh.

To investigate the return of menstruation among postpartum women in Dacca, a random sample of 360 women (1-12 months postpartum) was selected from 4 Dacca hospitals for a cross-sectional study; another random sample of 200 women ( 1 month postpartum at time of interview) was selected from the same hospitals for prospective follow up. Many of the women were from rural areas who left the city after delivering their babies; most were under 25 years old at the time of interview. Results of the cross sectional study showed that 63% started menstruating by the 6th postpartum month; 10% were still amenorrhoeic by the 12th postpartum month; 46% were breastfeeding their infants by the 4th month; 90% resumed sexual relations, and 48% were using contraceptives, by the 6th month. Results of the prospective study showed that slightly more than half of the women started menstruating by the end of the 5th postpartum month; almost half stopped breastfeeding by the 5th month, 88.8% were having sexual relations with their husbands, and about 50.5% were on some form of birth control. The findings suggest a much shorter duration of lactational amenorrhea than has been claimed for a rural area of Bangladesh; they also suggest that urban women start menstruating earlier because of their primary reliance on supplementary feeding. The contraceptive effectiveness, as well as health benefits to infants, of prolonged and intensive lactation should be promoted to urban mothers.     

Ancestral and recombinant 16-locus HLA haplotypes in the Hutterites

 Prior studies in the Schmiedeleut Hutterites of South Dakota have demonstrated associations between human leukocyte antigen (HLA) haplotype matching and fetal loss (Ober et al. 1992) and mate preferences (Ober et al. 1997), as well as deficiencies of homozygotes for HLA haplotypes (Kostyu et al. 1993). These studies were based on the serologically-defined five-locus HLA-A, -C, -B, -DR, -DQ haplotype. To further elucidate the effects of specific major histocompatibility (MHC) loci or regions on fetal loss and mate choice, we genotyped a sample of Hutterites for 14 MHC loci by DNA or biochemical methods. Typing for additional loci in the HLA-A to HLA-DPB1 region increased the number of recognized Hutterite MHC haplotypes to 67, and further localized the site of cross-over in 9 of 15 recombinant haplotypes. Hutterite MHC haplotype sequences are similar to those observed in outbred Caucasians, suggesting that the influence of HLA haplotypes on fetal loss and mating structure may be general. Received: 1 May 1998 / Revised: 2 December 1998     

Inbreeding effects on fertility in humans: evidence for reproductive compensation.

The effects of inbreeding on prereproductive mortality have been demonstrated in many natural populations, including humans. However, little is known about the effects in inbred individuals who survive to adulthood. We have investigated the effects of inbreeding on fertility among inbred adult Hutterites and demonstrate significantly reduced fecundity among the most inbred Hutterite women, as evidenced by longer interbirth intervals (P=.024) and longer intervals to a recognized pregnancy (P=.010) but not by increased rates of fetal loss (P>.50). These data suggest the presence of recessive alleles that adversely affect fecundity among the population. In contrast, completed family sizes do not differ among the more and the less-inbred Hutterite women who were born after 1920, suggesting that reproductive compensation is occurring among the more-inbred and less-fecund women. This recent reproductive strategy would facilitate the maintenance of recessive alleles and contribute to an overall decline in fertility in the population.     

Maternal responsiveness of sows towards piglet's screams during the first 24 h postpartum

In this study we focused on sow responsiveness towards piglet screams which are proposed to have an important link to posture changes and early piglet crushing. A sow's responsiveness to screams of her piglets was investigated along the first 24 h after birth, the period of highest mortality, in 15 lactating sows housed in farrowing crates. We compared the sow's response to playbacks of screams of trapped piglets to her response to a control sound during birth, 8–12 h postpartum and 20–24 h postpartum. We did the same with playbacks of screams of fighting piglets during nursings 8–12 h postpartum and 20–24 h postpartum. The sow’ responsiveness to screams of own trapped piglets was analyzed within the whole 24 h and to screams of fighting piglets 30 min between 8 and 12 h postpartum and 30 min between 20 and 24 h postpartum. A sow was scored as responsive if she changed her posture in response to the stimuli. Sows had a four times higher response towards playbacks with screams than towards the control stimulus. The proportion of the sows’ responsiveness to screams (44%) of trapped piglets did not change significantly between birth, 8–12 h postpartum and 20–24 h postpartum. Sows responded to 28% of playbacks of fighting piglets by terminating a nursing independently from the time after birth. Playbacks and real screams of own piglets were similarly effective in evoking a response for both types of screams. There was no significant association between the sows’ responsiveness to screams of trapped piglets and piglet mortality nor between screams of fighting piglets and weight gain. In conclusion our results indicate that sows maintained their responsiveness towards piglet screams during trapping and during fighting for teats within the first 24 h. Playbacks and real screams were similarly effective in evoking a response. We discuss the importance of the sound characteristics of piglet screams related to the sows’ response.     

The causes of the decline in fecundability with age

Abstract

Demographers have frequently suggested that women's fecundability reaches a maximum some time in their twenties and thereafter remains at a plateau for some years. Recent work by Bendel and Hua (1978) reinforces the author's previously expressed suspicion that this theory is incorrect. The present note is an effort to synthesize current knowledge about the variation with age of the reproductive parameters underlying fecundability. It is suggested (1) that the major cause of the decline in fecundability across ages 20–40 is a decline in coital rates, and (2) that a smaller part of the decline in fecundability is caused by a rise in risk of unrecognized spontaneous abortion. It is concluded that the “biological capacity to conceive” does not vary much during ages 20–40.     

Studies of cystic fibrosis in Hutterite families by using linked DNA probes.

Several multigenerational S-leut Hutterite families with cystic fibrosis (CF) were ascertained. Linkage studies with DNA marker loci MET and pJ3.11 (D7S8) were performed to determine whether (1) the CF gene in this inbred population is linked to DNA markers on chromosome 7, as it is in outbred populations of European origins, and (2) ancestral origin(s) of the CF gene could be determined. Our results indicate that the CF gene in Hutterite families segregates with chromosome 7 markers, identified by probes metH and pJ3.11. Thus, the CF mutation in Hutterites is likely to be either at the same locus as or at one closely linked to that reported in outbred populations. Heterozygous carriers could be distinguished from normal homozygous sibs of affected individuals. In the families studied, three different chromosome 7 haplotypes carried the CF mutation, raising the possibility that the CF gene may have been introduced into this population by as many as three different ancestors.     

Sequential aspects of spontaneous abortion: maternal age, parity, and pregnancy compensation artifact

At least 3 hypotheses predict that spontaneous abortion risk differs during reporductive history: genuine maternal age effects change individual risks; genuine birth order effects change individual risks; and variant individual risks, which are really independent of both age and parity, produce an artifactual association of risk with age in populations of women. The availability of large numbers of reproductive histories recorded on magnetic tape by the Collaborative Study on Cerebral Palsy provides an opportunity to weigh these hypotheses. Information was gathered between mid-1959 and mid-1966 by 13 hospitals, mostly east of the Mississippi. Random samples of essentially all women registering in the obstetric clinics of the collaborating institutions entered the study. Generally, these women came from poorer urban areas. Data are taken from the interviews at 1st registrations only. At this time, women had prior reproductive histories of varying lengths. The data are analyzed to yield broad comparative evaluations of the maternal age, parity, and artifact hypotheses. When the logit transforms of abortion risks were regressed on maternal age, the linear component was positive and significant at the 1% level in every ethnic group. In all categories except blacks, the fit to such a simple model was quite adequate. Fit in the case of the blacks was disturbed by the high rate among 13-year olds and the low rate among 37-year olds. The 37-year old black sample was the only one to depart markedly from the trend of increased risk at high age. Primary analysis of birth order defects used Slater's (1962) rank order statistic on a group of histories. In every ethnic category the observed mean value of Slater's statistic exceeds its expected value of 0.5; every standardized deviation has a negligibly small probability when tested against the normal distribution. The conclusin is that spontaneous abortions tend to come late in a reproductive history. The white data showed a definite trend contrary to expectation under the pregnancy compensation hypothesis. Although not significant in the "o" (liveborn) versus "x" (abortion) contrast, the lowering trent in maternal age with prior abortion experience was signifixant for the longer histories. Equally surprising was the apparent positive finding in the black data. In sum, the data clearly showed that among women with histories mixing spontaneous abortions and live births, risk of abortion was greater at higher parity. Although the women sampled tended to be young, and increase of risk with age was demonstrated in the white sample. These effects were not because of sample biases. Black age effects were possibly confounded with pregnancy compensation artifact which can mimic aging influence in unselected samples.     

Fertility at low and high altitude in Central Nepal

Since the 1930s, a number of different studies have tended to show that fertility is lower at high altitude. The present investigation attempts to provide some answers to this question by examining completed fertility rate (CFR) in Highland and Lowland villages in Central Nepal and relating rate differences to age at menarche, age at 1st childbirth, age at 1st marriage, incidence of venereal disease, birth control (vasectomy or hysterectomy), length of postpartum amenorrhea, and breastfeeding. Data was obtained by direct questioning, and under-reporting of births thus cannot be excluded. Fertility histories were taken from post-menopausal women over the age of 45 years. Results indicate no significant difference in reported menarcheal ages between highlanders and lowlanders. Age at 1st marriage and 1st childbirth were both significantly later in highlanders. CFR was significantly lower in highlanders. It would appear that the reduced fertility rate at high altitude can be partly attributable to later age at marriage and later 1st childbirth. Other factors, e.g., husband absenteeism and remarriage have also been suggested as possible contributors to the observed difference. This paper presents the results of a multiple regression analysis using 9 dependent variables: ages of marriage, 1st childbirth and menarch, the average gap between pregnancies, the average amount of time the husband was away, the number of marriages, presence or absence of venereal disease at some time, whether birth control was practiced and altitude status. Average pregnancy gap, age at 1st childbirth and presence or absence of venereal disease were the only variables that independently made a significcant contribution to CFR variance. The increase in pregnancy gap may be related to longer periods of breastfeeding in high altitude women and there would be a concomitant delay in recommencement of menstruation. In testing the hypothesis, no difference is found in reported duration of breastfeeding or in postpartum amenorrhea. The age at marriage and age at 1st childbirth accounted for over 16% of the explained variance in CFR. Some of the observed difference in CFR can be explained by the difference in marital age but not by the interval between marriage and 1st childbirth, as it was very similar in both groups. The lower CFR among the high altitude population could be due to lowering of biological fecundity at high altitude, or simply a matter of choice. The difference might reflect human reproductive hormone differences between high and low altitude populations. Further research will be needed to determine whether or not differences in CFR can be explained by variation in these factors.