Divorce in the early years of marriage in England and Wales: results from a prospective study using linked records

A representative sample of over 1000 couples who married during 1979 in England and Wales was followed from the date of marriage until mid-1984 to investigate the characteristics of couples who divorce soon after marriage. Results of this 5 year study show that couples who apparently lived together before marriage had a below average chance of early divorce, whereas couples where the addresses of the partners before marriage were very close had a significantly high rate of early breakdown. The chance of early divorce was significantly above average for spouses marrying in their teens and for both husbands and wives who, at their marriage, belonged to social class 5 (work in unskilled manual occupations). Couples who married with a civil ceremony had an above average (and those marrying with a religious ceremony a below average) risk of early divorce, but such differences were found to be negligible on analyzing the results from a matched case-control study in which each "case" marriage (one which did end in early divorce) was matched with a "control" marriage (one which did not end in early divorce). There is substantial evidence that age at marriage and previous marital status of the marriage partners have a decided influence upon the propensity to divorce. 2 conclusions concerning fertility are more likely than the average married couple to have had a pre-maritally conceived child, and 2) that couples who divorce relatively quickly tend on average to have larger family sizes, even if children who were pre-martitally conceived are exluded.     

A test of the child replacement hypothesis: nineteenth century Massachusetts

Child mortality experiences may affect subsequent fertility of couples by exerting a physiological effect, influencing length of birth, interval, or a replacement effect, in which couples continue to procreate in an attempt to reach a desired number of surviving offspring. Where biological constraints are potentially important, however, it may be difficult to distinguish between purely physiological and purely behavioral components of the process regulating production. Natural spacing of births and onset of sterility may be affected by health and diet and prior childbearing and breastfeeding practices. Biological pressures can, in turn, be infuenced behaviorally both by social custom and individual choice. Studies of 126 families in 19th century Massachusetts show that reduction in infant mortality is not a prerequisite for onset of family limitation. Results for the study population did not exhibit a relationship between parity progression ratios and the experience of child mortality, consisten with the child replacement hypothesis. 1 factor involved may be the parent's expectations of more than the desired number of children because of imperfect contraceptive technology at the time. Preference for the sex of children also may weaken overall replacement effect, since the death of a child of "undesired" sex will not be replaced. The cohort age-specific fertility patterns indicate that a reduction in overall fertility level in the communities studied was parity-dependent and directed at stopping childbearing at some given range of family size. At any rate, parents are not passive participants in a natural regime of births and deaths. While child replacement may be present in some societies, it is relatively inefficient and perhaps infrequent.     

Can women remember how many children they have borne? Data from the east Caribbean.

The number of births reported by 786 women of native ancestry on the 1954 census of St. Barthélémy, French West Indies, was compared to the number of births registered to these same women in the records of vital events. The magnitude of the difference between the two numbers was related to a woman's parity and marital status, but not to her age or literacy. In general, the agreement between the two numbers was very high, with the mean of reported parities within 5 per cent of the mean of registered births for all age groups except one, where the difference was 5.6 per cent. The women of St. Barthélémy were well able to remember the number of children they had borne. It appears likely that the discrepancies between reported parities and registered statistics in previous studies are the result of cultural misunderstandings in questionnaires, or perhaps sample decay, rather than of women's memory loss.     

Child mortality, social status, and fertility in India

The incidence of child mortality in relation to the social status and fertility of Indian women was investigated on the assumptions that: 1) the higher the social status, the lower the child mortality rate; and 2) the lower the child mortality rate, the lower the family size. 311 married women in Chandigarh were grouped into 4 status categories: (1) higher educated working women (95); (2) higher educated nonworking women (75); (3) less educated nonworking women (75); and (4) less educated working women (66). The 311 women gave birth to a total of 1075 children (960 living and 115 who had died, mostly between the ages 0-5 years). Percentage of children living (89%) was different for each status category: 93% for category 1; 92% for category 2; 91% for category 3; and 81% for category 4. When analyzed by proportion of women who had lost children in each status category, the relationship between child mortality and social status confirmed the assumption that the higher the social status, the lower the mortality. In category 1, 87% had not experienced any child mortality in their family; in category 2, the figure was 77%; category 3, 72%; and category 4, 48%. The findings also confirmed the other assumption that the lower the mortality rate, the lower the fertility (Table 2).     

Teenage motherhood and infant mortality in Bangladesh: maternal age-dependent effect of parity one

Nuptiality norms in rural Bangladesh favour birth during the teenage years. An appreciable proportion of teenage births are, in fact, second births. This study examines the relationship between teenage fertility and high infant mortality. It is hypothesized that if physiological immaturity is responsible, then the younger the mother, the higher would be the mortality risk, and the effect of mother's 'teenage' on mortality in infancy, particularly in the neonatal period, would be higher for the second than the first births. Vital events recorded by the longitudinal demographic surveillance system in Matlab, Bangladesh, in 1990-92 were used. Logistic regression was used to estimate the effects on early and late neonatal (0-3 days and 4-28 days respectively) and post-neonatal mortality of the following variables: mother's age at birth, parity, education and religion, sex of the child, household economic status and exposure to a health intervention programme. The younger the mother, the higher were the odds of her child dying as a neonate, and the odds were higher for second children than first children of teenage mothers. First-born children were at higher odds of dying in infancy than second births if mothers were in their twenties. Unfavourable mother's socioeconomic conditions were weakly, but significantly, associated with higher odds of dying during late neonatal and post-neonatal periods. The results suggest that physical immaturity may be of major importance in determining the relationship between teenage fertility and high neonatal mortality.     

Reproductive life of some Gujar women of Punjab

Data was collected on current age, age at menarche, marriage age, maternal age at 1st birth, age at the birth of last child, age at menopause, total number of conceptions, live births, stillbirths, abortions, dead children and living children for a sample of 150 Gunjar women of Punjab, India, during September and October 1977 to study their reproductive life. The women ranged in age from 45-55 years. The mean age at menarche was 14.90 years for the sample. The median age at menopause was 46.20 years. The mean age at marriage of the present sample was 12.56+-2.50 years; the mean age of the mother at the birth of her 1st child was 16.85 years; and the mean age at the birth of the last child was 38.68 years. The average number of conceptions was 7.2; the average number of live births of these 150 women was 6.90. The fertility of this population was natural as they were not using any family planning method.     

Child fostering as a reproductive strategy among Southern African pastoralists

Information on child fosterage was obtained on 1902 individuals in the course of collecting 611 reproductive histories from Herero and Mbanderu pastoralists in northwestern Botswana in southern Africa. The hypothesis that women foster out their children as a strategy for increasing the number of children they produce is tested. Analysis of these data indicate that sex and birth year of children and parents' marital status significantly influence a child's risk of being fostered, but the relationship of fostering to fertility is unclear. More recently born individuals, females, and children born to parents who were not married to each other are more likely to be fostered than older individuals, males, and children born to parents who were married to each other. A child's risk of being fostered does not appear to be influenced by mother's age if the parents were married to each other, while children born to parents who were not married to each other are more likely to be fostered if the mother is very young, but this pattern is not clear. No association between fostering and mortality was found.     

Effects of consanguineous marriages on fertility among three endogamous groups of Andhra Pradesh

To assess interrelationships between consanguineous marriage and fertility, 3 caste groups in Andhra Pradesh--the Desuri Kapu, an affluent agricultural caste; the Devanga, an artisan caste in the middle range of the hierarchy; and the Mala, a scheduled caste at the bottom--were selected for field study. Consanguineous marriages are an essential part of the social structure in this area of southern India. A total of 2524 marriages were analyzed, of which 46% were consanguineous. 19% of consanguineous marriages were between uncle and niece, 22% were between 1st cousins, and 5% were between more distant cousins. The Devanga had the highest rate of related marriages (48%), followed by the Desuri Kapu (47%) and the Mala (41%). Higher caste individuals, and wealthier persons within each caste, are more likely to marry relatives so they can avoid splitting their properties through dowry of bride price. The consanguineous unions as a whole were significantly more fertile than nonconsanguineous unions. The mean number of pregnancies, live births, and surviving offspring was 4.85, 4.44, and 2.99, respectively, among consanguineous couples compared with 3.41, 3.32, and 2.87, respectively, among nonconsanguineous couples. Although the number of pregnancies and live births was significantly higher among consanguineous couples in all 3 castes compared with nonconsanguineous couples, the difference in the number of surviving children between consanguineous and nonconsanguineous unions was not significant among the wealthier castes. This suggests that child mortality is higher among the offspring of consanguineous unions, despite their greater wealth.     

A case-control study of maternal knowledge of malnutrition and health-care-seeking attitudes in rural South India.

INTRODUCTION: In India, approximately 20 percent of children under the age of four suffer from severe malnutrition, while half of all the children suffer from undernutrition. The contributions of knowledge and attitudes of nutrition-conscious behaviors of the mothers to childhood malnutrition has been unclear. The purpose of this study was to explore maternal knowledge of the causes of malnutrition, health-care-seeking attitudes and socioeconomic risk factors in relation to children''s nutritional status in rural south India. METHODS: A case-controlled study was conducted in a rural area in Tamil Nadu, India. Thirty-four cases and 34 controls were selected from the population of approximately 97,000 by using the local hospital''s list of young children. A case was defined as a mother of a severely malnourished child under four years of age. Severe malnutrition was defined as having less than 60 percent of expected median weight-for-age. A control had a well-nourished child and was matched by the location and the age of the child. Interviews obtained: (1) socioeconomic information on the family, (2) knowledge of the cause of malnutrition and (3) health-care-seeking attitudes for common childhood illnesses, including malnutrition. RESULTS: Poor nutritional status was associated with socioeconomic variables such as sex of the child and father''s occupation. Female gender (OR = 3.44, p = .02) and father''s occupation as a laborer (OR = 2.98, p = .05) were significant risk factors for severe malnutrition. The two groups showed a significant difference in nutrition-related knowledge of mild mixed malnutrition (OR = 2.62, p = .05). No significant difference was apparent in health-care-seeking attitudes. Based on their traditional beliefs, the mothers did not believe that medical care was an appropriate intervention for childhood illnesses such as malnutrition or measles. DISCUSSION: The results suggested that the gender of the child and socioeconomic factors were stronger risk factors for malnutrition than health-care availability and health-care-seeking attitudes. The father''s occupation was a more accurate indicator for malnutrition than household income. These results suggest a need for intensive nutritional programs targeted toward poor female children and their mothers.     

A hazard logit model analysis of covariates of childhood mortality in Matlab, Bangladesh.

In a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety of covariates and childhood mortality was examined. Economic status of household, education of mother, sex of the children, health intervention programmes, age of mother, and live birth order of the children were identified as having a statistically significant impact on child survival when the effect of age was controlled. The effects of sex of the children, health programmes, age of mother, and birth order were found to be dependent on the age of the children, but the effect of mother's education was dependent on sex of the children.     

Effect of child survival on contraceptive use in Bangladesh.

A study in Bangladesh showed that couples who lost a child often stopped practising contraception in order to have another child. Logistic regression analysis revealed that contraceptive continuation was related to maternal age, parity, husband's education and the sex of the last child.     

Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents’ understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers’ knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018–1.802). When asked why vaccination rates may be low in their community, the two most common responses were “fearful of side effects” and “ignorance/disinterest/laziness” (44% each). The factors influencing caregivers’ demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates.     

The delineation of fertility strategies in a tribal population of India: the Koyas of Koraput District,Orissa

Demographic data collected for a tribal population of India, the Koyas of Koraput District, Orissa, were examined in light of 2 models of reproductive behavior associated with the economic value of children: the replacement effect and son survivorship motivation. Both models are united in the concept that infant/child mortality affects subsequent fertility. The database consists of retrospective fertility histories of Koya women who had completed their reproductive period. The total number was 260, with the total offspring numbering 1407. 2 distinct cohorts of women were formed for the purpose of analysis, separated only by the criterion of offspring survival: women who had experienced infant child mortality (129 women with 739 children); and women who completed their reproductive period without suffering offspring loss of this nature (132 women with 668 children). The cohort without child loss had a mean parity of 5.10, lower than the average parity of 5.73 recorded for the cohort whose reproductive histories included at least 1 infant/child death. Age specific marital fertility and birth interval analyses indicated that this differential was because of biological, not behavioral, factors. The age pattern of fertility of females suffering offspring mortality failed to demonstrate a high rate of childbearing in the later age intervals of the reproductive period, a characteristic pattern of couples attempting to "replace" lost offspring. Birth interval analysis pointed to biological "interval effect," whereby infant/child mortality caused a cessation of lactation and hence a shortening of postpartum amenorrhea. Computer simulation further indicated that the higher fertility differential of the cohort experiencing offspring loss still did not result in high son survivorship values. The findings agree with earlier studies indicating that for predemographic transitional populations, economically motivated fertility strategies are ineffectual.     

Impact of child mortality and sociodemographic attributes on family size desires: some data from urban India

Using follow-up data on a sample of mothers who gave birth at a Lucknow city hospital in India, the family size ideals of the women were examined in relation to experienced and perceived levels of child mortality and socioeconomic and demographic characteristics. The fear of child mortality and their own experience tended to increase the size of family which the mothers considered to be ideal. Under the conditions of assured survival of all children born to a couple, the study mothers considered on the average 2.83 children as ideal, as compared to 3.68 under conditions of uncertain survival. The couples with a rural background thought higher numbers of children were ideal, as compared to those with an urban background. More of the females who belonged to joint families preferred fewer children compared to those in nuclear families. Within the overall mean ideal family size of 2.83, the Hindu females thought fewer children made up an ideal family than their Muslim counterparts. Further, among the Hindus, the mean number of children considered ideal varied inversely with caste status. About 44% of the illiterate females considered 4 or more children as ideal, compared to about 5% of those with education to graduate or higher levels. The educational level of the males also influenced the family size preferences of their wives which varied inversely with them. The family size ideals of the females varied significantly with their husbands' occupational status. The females who lived in relatively poor housing conditions considered higher numbers of children as ideal. The preference is for smaller families with younger mothers. The female's age at marriage is important. The females currently using birth control methods considered an average 2.72 children as ideal, in contrast to 2.98 for those who were not using any method; the difference in means is significant.     

Maternal age at last birth in Egypt

To assess the effects of women's education, residence, and marital experience on their age at the birth of their last child, a proportional hazards regression model was applied to 1980 Egyptian Fertility Survey (EFS) data. The detailed data include the date of birth of each child for every women interviewed, and the woman's date of birth and age at interview. Age at last birth was examined by regression analysis on birth history and socioeconomic information. 4 hypotheses were tested: women who are well educated have a greater probability of ending childbearing earlier than women with less education; women in rural areas have a higher probability of having their last child at older ages than urban women; marital disruption without remarriage lowers the probability of older maternal age at last birth; and marital disruption with remarriage increases the probability that a woman stops reproducing at an older age. The overall chi-square indicates a significant regression. All coefficients were significant, except the coefficient for women with intact 1st marriages. Women with more education had a greater probability of ending childbearing earlier than women with less education. Rural women tended to have their last children at ages significantly older than overall age at last birth. Current residence in urban areas had the opposite effect. The coefficient for those with intact 1st marriages was insignificant, meaning that the mean age at last birth for this group of women was not much different from the overall mean. Remarried women tended to end childbearing at ages significantly older than the overall average age at last birth, suggesting that these women tended to have children by their new husbands. Those with dissolved 1st marriages who had not remarried had a higher probability of ending childbearing earlier than did older women. Marriage age and final parity had highly significant negative coefficients; as marriage age and number of children born increased, so did the "survival" time or the age at last birth. Results from the hazards model indicate that the effects were as anticipated. The median age at last birth for the total sample of women aged 45-49 was 45-49 years. The median age at last birth was about 2 years older for rural compared to urban women. Illiterate women had the oldest median age at last birth of the education groups. There was little differences between median ages at last birth for women with intact 1st marriages and those whose 1st unions were dissolved and who had remarried. The median age at last birth increased with final parity.     

Multivariate analysis of infant and child mortality in Java and Bali

The data used in this analysis come from the 1976 Indonesian Fertility Survey, part of the World Fertility Survey. The data are examined 3 times, fitting them to models which include different combinations of independent variables. The dependent variables are: 1) the proportion of children born between 5 and 15 years before the survey who died before their 1st birthday, for infant mortality; and 2) among those alive on their 1st birthday, the proportions who died before reaching their 5th birthday, for child mortality. The figures indicate that the chance of dying for children who were 1st born, born shortly after a previous child, whose previous sibling had died, who lived in rural areas, or had parents who were young and with little education, was greater than for children without these characteristics. In all 3 models used, the greatest net effects are attributed to the survival of a preceding sibling or the length of the preceding interval. Birth order does not have a significant gross effect on infant mortality, but the net effects are significant because of the control on maternal age. Education of both parents has significant effects, but these are overshadowed in magnitude by the demographic variables. Maternal education has a greater influence in determining differences in child mortality than was found for infant mortality. Father's education also has a significant independent effect, but mainly for 1st births. It is uncertain whether these variables are measuring the effect of schooling as such, or other characteristics such as economic status or various social roles adopted by people with different levels of education. The variables distinguishing urban from rural status shows significant gross effects which are greatly reduced when controls for other variables are introduced in the model which includes all births. That is to say, the difference in the survival chances of a child in the city is more a function of the education of its parents, and the associated demographic variables than city residence as such. Access to medical services is quite probably the main element in these differences. The findings are weakened to some extent by the lack of satisfactory data on household economic status which might have provided a better base for indirectly discerning the effects of nutrition and sanitation on mortality at young ages.     

Kin influences on fertility in Thailand: Effects and mechanisms

It has been suggested that human mothers are cooperative breeders, as they need help from others to successfully raise offspring. Studies working under this framework have found correlations between the presence of kin and both child survival and female fertility rates. This study seeks to understand the proximate mechanisms by which kin influence fertility using data from the 1987 Thailand Demographic and Health Survey (DHS), a nationally representative sample of 6775 women. Kin influence is measured by the length of time couples live with the husband's or wife's parents after marriage. Event history analysis, multilevel modeling and structural equation modeling are used to investigate both fertility outcomes and potential pathways through which postnuptial residence may influence fertility outcomes, including employment status, maternal and child outcomes, contraceptive use, breastfeeding duration, and age at marriage. We show that living virilocally (with husband's kin after marriage) increases total fertility by shortening time from marriage to first birth, and increasing the likelihood of progression to each subsequent birth. These effects are mediated through correlations between virilocal residence and earlier age at marriage as well as delayed initiation of contraceptive use. We find no influence of husband's kin on maternal or child outcomes. Living uxorilocally (with wife's kin after marriage) also reduces age at marriage, shortens time from marriage to first birth and (marginally) improves child survivorship, but has no effect on other child and maternal outcomes or progression to subsequent births and results in a similar number of living children as women living neolocally.     

Abortion in Canada: religious and ideological dimension's of women's attitudes

This paper examines a number of demographic and sociocultural factors (e.g., age, marital status, family size, religion, religious assiduity, sex-role ideology) as predictors of women's attitudes toward abortion, using data from the Canadian Fertility Survey of 1984. The findings suggest that women's abortion attitudes are to a greater extent based on ideological positions. It appears that anti-abortion stance affects those women who are religious, presumably by increasing the relationship between their general sex-role ideological stances and abortion attitudes. Abortion attitudes also vary according to a woman's education, her size, and province/region of residence.     

Human sex ratio at birth and mother's birth season: multivariate analysis.

We used a population-based historical French Canadian database to examine the effects of mother's birth season on sex ratio at birth. Non-first births in the database (n = 127,658) were analyzed for their sex, parish size (2 large parishes of Montreal and Quebec or the other smaller parishes), time period (births up to 1719 or those from 1720), maternal age (< or = 24, 25-29, 30-34, 35+ years), sex of the preceding sibling (male or female), and birth seasons of the child and his or her parents (February-April, May-July, August-October, November-January). Season of child's birth significantly affected the sex ratio (chi 2 = 11.507, d.f. = 3, p = 0.009), with the births in February-April or May-July showing a lower sex ratio. Season of mother's birth also contributed highly significantly to the variation of sex ratio (chi 2 = 15.196, d.f. = 3, p = 0.002); mothers born in February-April had a low sex ratio among their children (sex ratio = 1.013). In contrast, season of father's birth did not affect the sex ratio (chi 2 = 0.618, d.f. = 3, p = 0.892). When a multiple logistic model was applied to the data, mother's birth season was the single most significant factor. The lower sex ratio from mothers born in February-April was observed consistently for every maternal age and delivery season. Seasonal influences on female fetuses seem to have changed their future reproductive characteristics.     

Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda

Introduction

The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future.

Methods

We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission) attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods.

Results

318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men''s risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14) and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07) were significantly (p≤0.05) more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004) and those who were HIV seropositive (APR 1.09, p = 0.03) were also more likely to be interested in child circumcision for HIV prevention.

Conclusions

A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.