The "amazing" fertility decline: Islam, economics, and reproductive decision making among working-class Moroccan women

Often it is understood that Islam prohibits family planning because the Qur'an does not explicitly address contraception. Public health and development officials have recently congratulated the Muslim world for decreases in fertility given the supposed constraints placed on reproductive healthcare by Islam, while popular culture writers have warned the West of threats by young Muslims if the population goes uncontrolled. This article draws on data collected through interviews with working-class women seeking reproductive healthcare at clinics in Rabat, Morocco, and with medical providers to challenge the link between Islamic ideology and reproductive practices and the correlation among Islam, poverty, and fertility. Morocco, a predominantly Muslim country, has experienced a dramatic decrease in fertility between the 1970s and today. I argue that patients and providers give new meanings to modern reproductive practices and produce new discourses of reproduction and motherhood that converge popular understandings of Islam with economic conditions of the Moroccan working class.     

"Fewer children, better life" or "as many as God wants"? Family planning among low-income Iranian and Afghan refugee families in Isfahan, Iran

In the West it is often assumed that religion (esp. Islam) and contraception are mutually exclusive. Yet, the Islamic Republic of Iran has one of the most successful family-planning programs in the developing world, and is often looked to as a potential model for other Muslim countries. Although Iran's family-planning program has been extremely successful among Iranians, it has been far less successful among Afghan refugees and other ethnic groups. Afghans and Iranians both seek services in Iran's public health sector for family health care, treatment of infectious disease, and childhood vaccinations. On these occasions, all adult married patients are strongly encouraged to use family planning to reduce the number of offspring. In this article, we explore how Iran's family-planning program is differentially perceived and utilized among low-income Iranian and Afghan refugee families in rural and urban locations. Particular attention is given to how different interpretations of Islam may or may not influence reproductive health-related behaviors and how cultural factors influence reproductive strategies.     

"He won't be my son": Middle Eastern Muslim men's discourses of adoption and gamete donation

In the Sunni Muslim world, religious mandates prohibit both adoption and gamete donation as solutions to infertility, including in the aftermath of in vitro fertilization (IVF) failures. However, both of these options are now available in two Middle Eastern countries with significant Shi'ite Muslim populations (Iran and Lebanon). On the basis of fieldwork in multisectarian Lebanon, I examine in this article attitudes toward both adoption and gamete donation among childless Muslim men who are undertaking IVF with their wives. No matter the religious sect, most Muslim men in Lebanon continue to resist both adoption and gamete donation, arguing that such a child "won't be my son". However, against all odds, some Muslim men are considering and undertaking these alternatives to family formation as ways to preserve their loving marriages, satisfy their fatherhood desires, and challenge religious dictates, which they view as out of step with new developments in science and technology. Thus, in this article I examine the complicated intersections of religion, technology, marriage, and parenthood in a part of the world that is both poorly understood and negatively stereotyped, particularly in the aftermath of September 11, 2001.     

Global uptake of fertility preservation by women undergoing cancer treatment: An unmet need in low to high-income countries

Although the incidence of cancers is on the rise globally, mortality has continued to decrease due to advances in early detection and treatment. Cancer treatments such as chemotherapy and radiotherapy can impact the reproductive capacity of survivors by inducing premature ovarian failure and subsequent infertility causing significant psychological distress with decreased quality of life. Despite the increasing need for fertility preservation services for the rising number of cancer survivors and the recent advances in assisted reproductive technology, many women with cancers in low, middle, and to a lesser extent, high-income countries have no access to these services. This article, therefore, presents an overview of the effect of cancer treatment on fertility, options of fertility preservation, and factors influencing fertility preservation utilization by women who had a cancer diagnosis. In addition, we discuss the availability, practices, and outcomes of fertility preservation services in low, middle, and high-income countries and highlight pragmatic steps to improving access to oncofertility care for women with cancers globally.     

Life-history theory, fertility and reproductive success in humans

According to life-history theory, any organism that maximizes fitness will face a trade-off between female fertility and offspring survivorship. This trade-off has been demonstrated in a variety of species, but explicit tests in humans have found a positive linear relationship between fitness and fertility. The failure to demonstrate a maximum beyond which additional births cease to enhance fitness is potentially at odds with the view that human fertility behaviour is currently adaptive. Here we report, to our knowledge, the first clear evidence for the predicted nonlinear relationship between female fertility and reproductive success in a human population, the Dogon of Mali, West Africa. The predicted maximum reproductive success of 4.1+/-0.3 surviving offspring was attained at a fertility of 10.5 births. Eighty-three per cent of the women achieved a lifetime fertility level (7-13 births) for which the predicted mean reproductive success was within the confidence limits (3.4 to 4.8) for reproductive success at the optimal fertility level. Child mortality, rather than fertility, was the primary determinant of fitness. Since the Dogon people are farmers, our results do not support the assumptions that: (i) contemporary foragers behave more adaptively than agriculturalists, and (ii) that adaptive fertility behaviour ceased with the Neolithic revolution some 9000 years ago. We also present a new method that avoids common biases in measures of reproductive success.     

Variation and change in fertility in West Central Nepal

This article employs temporal and intracultural frames of reference to examine patterns of variation in fertility among the caste-Hindus of West Central Nepal. Before the onset of major socioeconomic development in the region, three groups, the large-farm high castes, the small-farm high castes, and the low castes, exhibited distinct patterns of reproductive behavior which have been traced over the course of 25 years. Analysis of age-specific fertility rates suggests that one group, the small farm high-caste, maintained relatively low fertility before major development of the region occurred, and, over time, began using modern contraception in order to keep fertility low. Evidence from the low castes suggests that they are beginning deliberately to reduce fertility, but the large-farm high castes continue to have high fertility.     

Correcting contraceptive failure rates for sample composition and sample selection bias

Abstract

There is reason to believe that in the short run marriages are becoming more stable in some Western African countries such as Cameroon. One of the crucial questions facing these countries is whether fertility rates can be expected to increase or decrease due in part to the increased stability of marriages. Analyzing 1978 Cameroon World Fertility Survey data and using a multivariate regression model which compares the fertility rate of women who have had at least one marital disruption with that of continuously married women, we studied the relationship between marital instability and fertility. The results show that fertility rates for women married more than once are significantly lower than those for continuously married women even before the end of their first marriage. Furthermore, marital disruption significantly reduces fertility rates after the dissolution of the first marriage. Finally, even after the length of reproductive time lost is controlled, there is an inverse relationship between the number of marriages and fertility. The results are discussed in the context of economic development, modernization, and urbanization.     

Examining the Relationship between Life Expectancy,Reproduction, and Educational Attainment

Life history theory aims to explain the relationship between life events, recognizing that the fertility and growth schedules of organisms are dependent on environmental conditions and an organism’s ability to extract resources from its environment. Using models from life history theory, we predict life expectancy to be positively correlated with educational investments and negatively correlated with adolescent reproduction and total fertility rates. Analyses of UN data from 193 countries support these predictions and demonstrate that, although variation is evident across world regions, strong interactions exist among life expectancy, reproductive investments, and educational attainment, and these relationships occur independently of economic pressures and disease burdens. The interactions are strongest, however, in countries with a life expectancy of ≥60 years as these countries tend to have stable economies and a limited HIV/AIDS burden. These findings suggest that policies aimed at influencing education and reproductive decisions should consider environmental characteristics that drive people’s expectations about their longevity.     

Milk banks through the lens of Muslim scholars: one text in two contexts

When Muslims thought of establishing milk banks, religious reservations were raised. These reservations were based on the concept that women's milk creates 'milk kinship' believed to impede marriage in Islamic Law. This type of kinship is, however, a distinctive phenomenon of Arab tradition and relatively unknown in Western cultures. This article is a pioneer study which fathoms out the contemporary discussions of Muslim scholars on this issue. The main focus here is a religious guideline (fatwa) issued in 1983, referred to in this article as 'one text', by the Egyptian scholar Yūsuf al-Qaradāwī who saw no religious problem in establishing or using these banks. After a number of introductory remarks on the 'Western' phenomenon of milk banks and the 'Islamic' phenomenon of 'milk kinship', this article analyses the fatwa of al-Qaradāwī 'one text' and investigates the 'two contexts' in which this fatwa was discussed, namely, the context of the Muslim world and that of Muslim minorities living in the West. The first context led to rejecting the fatwa and refusing to introduce the milk banking system in the Muslim world. The second context led to accepting this system and thus allowing Muslims living in the West to donate and receive milk from these banks. Besides its relevance to specialists in the fields of Islamic studies, anthropology and medical ethics, this article will also be helpful to physicians and nurses who deal with patients of Islamic background.     

How contemporary human reproductive behaviors influence the role of fertility-related genes: the example of the p53 gene

Studies on human fertility genes have identified numerous risk/protective alleles involved in the occurrence of reproductive system diseases causing infertility or subfertility. Investigations we carried out in populations at natural fertility seem to suggest that the clinical relevance that some fertility genes are now acquiring depends on their interaction with contemporary reproductive behaviors (birth control, delayed childbearing, and spacing birth order, among others). In recent years, a new physiological role in human fertility regulation has emerged for the tumor- suppressor p53 gene (P53), and the P53 Arg72Pro polymorphism has been associated with recurrent implantation failure in humans. To lend support to our previous observations, we examined the impact of Arg72Pro polymorphism on fertility in two samples of Italian women not selected for impaired fertility but collected from populations with different (premodern and modern) reproductive behaviors. Among the women at near-natural fertility (n = 98), the P53 genotypes were not associated with different reproductive efficiency, whereas among those with modern reproductive behaviors (n = 68), the P53 genotypes were associated with different mean numbers of children [Pro/Pro = 0.75相似文献   

How does variance in fertility change over the demographic transition?

Most work on the human fertility transition has focused on declines in mean fertility. However, understanding changes in the variance of reproductive outcomes can be equally important for evolutionary questions about the heritability of fertility, individual determinants of fertility and changing patterns of reproductive skew. Here, we document how variance in completed fertility among women (45–49 years) differs across 200 surveys in 72 low- to middle-income countries where fertility transitions are currently in progress at various stages. Nearly all (91%) of samples exhibit variance consistent with a Poisson process of fertility, which places systematic, and often severe, theoretical upper bounds on the proportion of variance that can be attributed to individual differences. In contrast to the pattern of total variance, these upper bounds increase from high- to mid-fertility samples, then decline again as samples move from mid to low fertility. Notably, the lowest fertility samples often deviate from a Poisson process. This suggests that as populations move to low fertility their reproduction shifts from a rate-based process to a focus on an ideal number of children. We discuss the implications of these findings for predicting completed fertility from individual-level variables.     

Global Violence and Indonesian Muslim Politics

The attacks of September 11, 2001, in the United States and the U.S.-led campaign in Afghanistan provoked fierce threats of violence in Indonesia, the world's largest majority-Muslim country. Western journalists portrayed these reactions as among the most destabilizing in the Muslim world. Less widely reported, however, was the intensification of a struggle between Muslim proponents of democracy and neof undamentalist conservatives, sparked by the same incidents. This article explores the varied reactions of Muslims to the violence of September 11 and its aftermath in light of this contest between rival Muslim groupings. It examines their competing visions of Islam and nation, as well as their supporting alliances in state and society. The example highlights the pluralism of Muslim politics and the special challenges of democratic transitions. Emphasizing the plurality and permeability of civilizations, the example also suggests that there is no "clash of civilizations" between Islam and the West but, rather, a more open process of globalization, localization, and exchange. [Keywords: Islam, Indonesia, violence, democratization, civilization]     

Muslim community organizations – sites of active citizenship or self-segregation?

Ethno-religious community organizations in Western countries have often been described as being disconnected from mainstream society, and Muslim community groups have been a special focus of such critique. This article offers a counter-narrative to these widespread allegations. It draws on a synthesis of emerging research on the citizenship-enhancing effects of mosque involvement and on an explorative study involving thirty in-depth interviews with civically active Muslims in Australia and Germany. The article examines the potential of Muslim community organizations to mobilize their member into performing their citizenship through civic and political participation. It offers empirical evidence that many Muslim community organizations, rather than promoting social segregation, act as accessible entry point for Muslims’ civic participation, facilitate cross-community engagement and provide gateways to political involvement. These civic potentials of Muslim community organization have remained underestimated in the public and political discourse on cohesive societies and healthy democracies.     

The possibilities of retaining fertility in malignant gynecological tumors

The protection of reproductive organs and retaining fertility have always been of paramount importance in gynecology. Development of gynecological oncology and reproductive medicine over the last few decades have achieved and, indeed, made it compulsory to insist on retaining fertility when treatment of malignant disease leaves an opportunity for future pregnancies. The basic rule of gynecological cancer surgery is clarified further that radicality should not be more extensive than necessary and, at the same time, as intensive as the least necessary. One of the new challenges of current demographic trends, mostly in developed countries, is that the first child by the average family is planned nearly 10 years later than some decades ago. As a result, more and more women experience the development of malignant disease before they complete their family planning intentions. Beside the improved cancer treatment methods, deep frozen conservation of eggs and ovarian tissue together with chemotherapy and GnRH agonist treatment will provide further opportunity to enhance reproductive potential of women who are successfully treated of their gynecological cancer.     

Perceptions of men on role of religious leaders in reproductive health issues in rural Pakistan

Religion holds unique importance in people's lives, and has been cited as an important factor in reproductive health. Pakistan has a Muslim majority and the character of the country is strongly marked by Islam. In rural areas, where the majority of the population reside, religious leaders are considered as opinion makers. The perception of adult males regarding the influence of the 'religious factor' in their use of modern contraceptive methods, and their views on the role of religious leaders in community education, were explored through a cross-sectional survey conducted in twelve rural districts of Pakistan in 2000. A sample of 180 married adult males participated in the study through consecutive sampling. The study was qualitative, utilizing tools such as in-depth and key-informant interviews. The majority of men interviewed considered that religious leaders were against fertility control, and 29% cited religion as a reason for their non-use of modern contraceptives. Respondents also suggested that the involvement of religious leaders in reproductive health programmes is essential for the programmes' effectiveness in rural areas. They thought that religious leaders could contribute positively to community education, and suggested ways in which they could educate the community in reproductive health issues. They also suggested various channels through which religious leaders could be approached to convince them to cooperate in reproductive health programmes. The study concludes that involving religious leaders in rural settings could enable reproductive health programmes and services to reach more conservative groups in society, and thus contribute effectively to bringing about positive change in the attitudes of Pakistani society towards reproductive health.     

Women's autonomy and reproductive preferences in Eritrea

Current research and policies on reproductive behaviours in many East African countries focus primarily on proxy indicators of women's autonomy, and very little emphasis is placed on direct indicators of women's autonomy. In this paper, data from the 2002 Eritrea Demographic and Health Survey (EDHS) are used to address some of the most frequently raised questions about the link between women's autonomy and reproductive behaviour. The results from the multivariate logistic models show that although the relationship between women's autonomy and reproductive preferences in Eritrea is complex, some clear, broad patterns exist that have implications for theory and policy. First, although the different dimensions of women's autonomy influence the outcome variables differently in terms of magnitude and statistical significance, most of them have a strong connection; in particular, women's final say in decisions regarding day-to-day household purchases and spousal communication are significant explanatory variables in fertility preferences and ever-use of modern contraception. Second, many background (proxy) variables, particularly household economic condition and employment, exert a strong and independent influence over fertility preferences and ever-use of contraception regardless of a woman's autonomy. In their relationship to reproductive behaviours, therefore, employment and economic status cannot be considered as proxies for women's autonomy in Eritrea. A complete explanation of the relationship between women's autonomy and reproductive preferences must recognize the effects of both the background and direct autonomy indicators. Interventions are needed to improve women's decision-making autonomy and strengthen their negotiating capacity on family planning if an increased desire to limit fertility is to be attained.     

Islamic preaching and women’s spectatorship in West Java

In the urban villages of Bandung, the capital city of the Indonesian province of West Java, many Muslim women routinely attend between four and six oratorical and/or pedagogical events per week. This article analyses this participation by observing the forms and patterns of these women’s spectatorship, specifically observing their mobility, the interaction between their life‐cycles and their participation habits, the gendered embodiment of Islamic knowledge they display, the effect of hegemonic masculinities, and preaching performances which treat them not only as Muslims intent on increasing their Islamic knowledge, but also as pleasure‐taking subjects. The article concludes that the conduct and management of preaching events intended for mixed audiences are highly sensitive to women’s spectatorship and warns against the assumption that Islamic practice is a punishing sphere of patriarchy. In fact, when the influence of women’s spectatorship on the conduct and management of such preaching events is appreciated, West Java’s preaching events appear as a feminised domain.     

Early sexual maturity among Pumé foragers of Venezuela: fitness implications of teen motherhood

Because humans have slow life histories, discussions of the optimal age at first birth have stressed the benefits of delayed reproduction. However, given the diversity of ecological, fertility, and mortality environments in which humans live, reproductive maturity is expected to be highly variable. This article uses reproductive histories to examine a pattern of early menarche and first birth among the Pume, a group of South American foragers. Age at menarche and first birth are constructed using both retrospective and cross‐sectional data for females over the age of 10 (n = 83). The objectives are first to define these patterns and then discuss their reproductive consequences. On average, Pume girls reach menarche at age 12.9, and give birth to their first child at age 15.3–15.5 (retrospective and cross‐sectional data, respectively). This populational average falls several years prior to what often is considered the human norm. Two questions are then considered. What are the infant mortality costs across a mother's reproductive career? How does surviving fertility vary with age at first birth? Results indicate that the youngest of first‐time mothers (<14) are four times more likely to loose their firstborns than older first‐time mothers (≥17). Given parity‐specific mortality rates, the optimal strategy to minimize infant mortality and maximize reproductive span is to initiate childbearing in the midteens. Women gain no additional advantage in surviving fertility by delaying childbearing until their late teens. Am J Phys Anthropol, 2008. © 2008 Wiley‐Liss, Inc.     

Stall in fertility decline in Eastern African countries: regional analysis of patterns,determinants and implications

We use data from the Demographic and Health Surveys to examine the patterns of stall in fertility decline in four Eastern African countries. Contrary to patterns of fertility transition in Africa that cut across various socio-economic and geographical groups within countries, we find strong selectivity of fertility stall across different groups and regions in all four countries. In both Kenya and Tanzania where fertility decline has stalled at the national level, it continued to decline among the most educated women and in some regions. While fertility has remained at pre-transition level in Uganda over the past 20 years, there are signs of decline with specific groups of women (especially the most educated, urban and those in the Eastern region) taking the lead. For Zimbabwe, although fertility has continued to decline at the national level, stall is observed among women with less than secondary education and those in some of the regions. We link these intra-country variations to differential changes in socio-economic variables, family planning programme environment and reproductive behaviour models. The results suggest that declines in contraceptive use, increases in unmet need for family planning, increasing preferences for larger families, and increases in adolescent fertility were consistently associated with stalls in subgroup fertility across all four countries. These results are consistent with models that emphasize the role of declines in national and international commitments to family planning programmes in the premature stall in sub-Saharan fertility transition.     

Low fertility in contemporary humans and the mate value of their children: sex-specific effects on social status indicators

Evolutionary explanations of low fertility in modern affluent societies commonly state that low fertility is the outcome of high parental investments in the quality of their children. Although the empirical evidence that modern parents do face a quantity–quality trade-off is strong, two issues that are relevant from an evolutionary perspective have not received much attention. First, sex differences in the proximate aspects of quality have been largely ignored. Second, the relationship between the quantity of children and their reproductive success in contemporary low-fertility societies remains unclear. In this article, we study the quantity–quality trade-off as a trade-off between the number of children and the mate value and reproductive success of those children. We examine the trade-off in two steps. First, a lower number of children is expected to increase the mate value of these children. Second, greater mate value is expected to lead to greater reproductive success. Using sex-specific indicators of mate value, we test these hypotheses in a representative sample of the Dutch population aged 55–85 in 1992 (n=3229). This sample contains information on three successive generations in which the middle generation has completed fertility. We find support for the first hypothesis, but only partial support for the second hypothesis. A higher number of children is traded off against the mate value of the children, but not against their reproductive success. We conclude that the conditions under which the quantity of children is traded off against their reproductive success depend on the social environment.