Skip to main content
Erschienen in: Demography 5/2013

01.10.2013

Influences on Pregnancy-Termination Decisions in Matlab, Bangladesh

verfasst von: Julie DaVanzo, Mizanur Rahman, Shahabuddin Ahmed, Abdur Razzaque

Erschienen in: Demography | Ausgabe 5/2013

Einloggen

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

We investigate factors affecting women’s decisions to terminate pregnancies in Matlab, Bangladesh, using logistic regression on high-quality data from the Demographic Surveillance System on more than 215,000 pregnancies that occurred between 1978 and 2008. Variables associated with the desire not to have another birth soon (very young and older maternal age, a greater number of living children, the recent birth of twins or of a son, a short interval since a recent live birth) are associated with a greater likelihood of pregnancy termination, and the effects of many of these explanatory variables are stronger in more recent years. Women are less likely to terminate a pregnancy if they don’t have any living sons or recently experienced a miscarriage, a stillbirth, or the death of a child. The higher the woman’s level of education, the more likely she is to terminate a pregnancy. Between 1982 and the mid-2000s, pregnancy termination was significantly less likely in the area of Matlab with better family planning services.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
We use the term “VPT” here rather than “induced abortion” because some terminations in Bangladesh—namely, those done by menstrual regulation (explained in the next section of this article)—are not considered to be abortions in Bangladesh.
 
2
The median and average durations of pregnancies that end in VPT are shorter than those for miscarriages and, of course, LBs and stillbirths. See Appendix A.
 
3
Abortion is a sensitive topic in Bangladesh; many of the restrictions on MR, particularly its availability only before pregnancy is clinically confirmed—and, in fact, its name—are to reinforce the perception of MR as something other than abortion. Nonetheless, in this article, we sometimes use the term “abortion” to refer to VPT to be consistent with use in the literature. What we call “abortions” includes MRs.
 
4
The Comparison Area contraceptive-use rate might be underestimated because data collection procedures were less rigorous there than in the MCH-FP Area (icddr,b 2011).
 
5
We also estimated a multinomial logistic regression explaining whether pregnancies end in VPT, miscarriage, or stillbirth, all relative to their ending in an LB. The conclusions about influences on VPT are identical to those presented here.
 
6
We initially explored in bivariate analyses how the effects of age and of number of living children on VPT differed across a number of subperiods of time. For both of these explanatory variables, the largest differences were between subperiods before and after 2001. In the multivariate analysis, we interact all explanatory variables with a dichotomous indicator for 2001–2008; the statistical significance of the coefficients of the interaction indicates whether the effects of the variable differ significantly between the two time periods. We also show the statistical significance of the total effects in 2001–2008 of all explanatory variables.
 
7
The duration of the IPI is computed as the amount of time between the date of previous pregnancy outcome and the estimated date of conception, which we compute as the date of last menstrual period (DLMP) before the index outcome plus two weeks. DLMP was not recorded in the Comparison Area before 2001. Also, there is no information on DLMP for women who entered the DSS area after their LMP. For the 42 % of cases with unknown DLMP, we estimated DLMP by subtracting the average outcome-specific duration of gestation for cases with known DLMP (8, 11, 33, and 36 weeks for VPT, miscarriage, stillbirth, and LB, respectively) from the date of the index outcome.
 
8
In exploratory analyses, we considered each two-year subperiod in the 2000s, but effects did not differ significantly across the first three of these.
 
9
The multivariate analysis controls for some variables correlated with older maternal age (e.g., number of living children). When we do not control for the other covariates, the effects are larger for older maternal ages than for the youngest ones.
 
10
The regression also includes an explanatory variable for first pregnancies (as part of the IPI set of variables). All first pregnancies are cases in which there are no living children, so the effects of these two variables need to be considered together. The no-living-children effect by itself is for cases in which the pregnancy is not the woman’s first but her previous pregnancies did not result in the LB of a child who is still alive.
 
11
These were first used for the MINIMAT project, which operates among a subset of women in the MCH-FP Area. They were so popular that other women in the area requested them (personal communication with K. Streatfield, October 27, 2011).
 
Literatur
Zurück zum Zitat Ahmed, K., Rahman, M., & van Ginneken, J. (1998). Induced abortion in Matlab, Bangladesh: Trends and determinants. International Family Planning Perspectives, 24, 128–132.CrossRef Ahmed, K., Rahman, M., & van Ginneken, J. (1998). Induced abortion in Matlab, Bangladesh: Trends and determinants. International Family Planning Perspectives, 24, 128–132.CrossRef
Zurück zum Zitat Ahmed, K., Sarkar, A. H., & Rahman, M. (1996). Determinants of induced abortion in rural Bangladesh. Demography India, 25, 105–118. Ahmed, K., Sarkar, A. H., & Rahman, M. (1996). Determinants of induced abortion in rural Bangladesh. Demography India, 25, 105–118.
Zurück zum Zitat Ahmed, K., van Ginneken, J., & Razzaque, A. (2005). Factors associated with adolescent abortion in a rural area of Bangladesh. Tropical Medicine & International Health, 10, 198–205.CrossRef Ahmed, K., van Ginneken, J., & Razzaque, A. (2005). Factors associated with adolescent abortion in a rural area of Bangladesh. Tropical Medicine & International Health, 10, 198–205.CrossRef
Zurück zum Zitat Alam, N., Mostafa, G., Mondol, L. A., & Bairagi, R. (1999). Recording vital events in Matlab, Bangladesh: Comparison of short and lengthy recall periods, 1996–97. Unpublished manuscript. Dhaka: International Centre for Diarrhoeal Disease Research. Alam, N., Mostafa, G., Mondol, L. A., & Bairagi, R. (1999). Recording vital events in Matlab, Bangladesh: Comparison of short and lengthy recall periods, 1996–97. Unpublished manuscript. Dhaka: International Centre for Diarrhoeal Disease Research.
Zurück zum Zitat Alauddin, M. (1986). Maternal mortality in Bangladesh: The Tangail district. Studies in Family Planning, 17, 13–21.CrossRef Alauddin, M. (1986). Maternal mortality in Bangladesh: The Tangail district. Studies in Family Planning, 17, 13–21.CrossRef
Zurück zum Zitat Bairagi, R. (2001). The effects of sex preference on contraceptive use, abortion, and fertility in Matlab, Bangladesh. International Family Planning Perspectives, 27, 137–143.CrossRef Bairagi, R. (2001). The effects of sex preference on contraceptive use, abortion, and fertility in Matlab, Bangladesh. International Family Planning Perspectives, 27, 137–143.CrossRef
Zurück zum Zitat Bairagi, R., & Rahman, M. (1996). Contraceptive failure in Matlab, Bangladesh. International Family Planning Perspectives, 22, 21–25.CrossRef Bairagi, R., & Rahman, M. (1996). Contraceptive failure in Matlab, Bangladesh. International Family Planning Perspectives, 22, 21–25.CrossRef
Zurück zum Zitat Bendavid, E., Avila, P., & Miller, G. (2011). United States aid policy and induced abortion in sub-Saharan Africa. Bulletin of the World Health Organization, 89, 873–880.CrossRef Bendavid, E., Avila, P., & Miller, G. (2011). United States aid policy and induced abortion in sub-Saharan Africa. Bulletin of the World Health Organization, 89, 873–880.CrossRef
Zurück zum Zitat Bhatia, S., & Ruzicka, L. T. (1980). Menstrual regulation clients in a village-based family planning programme. Journal of Biosocial Science, 12, 31–39. Bhatia, S., & Ruzicka, L. T. (1980). Menstrual regulation clients in a village-based family planning programme. Journal of Biosocial Science, 12, 31–39.
Zurück zum Zitat Bhuiya, A., Aziz, A., & Chowdhury, M. (2001). Ordeal of women for induced abortion in a rural area of Bangladesh. Journal of Health, Population and Nutrition, 19, 281–290. Bhuiya, A., Aziz, A., & Chowdhury, M. (2001). Ordeal of women for induced abortion in a rural area of Bangladesh. Journal of Health, Population and Nutrition, 19, 281–290.
Zurück zum Zitat Bongaarts, J. (1978). A framework for analyzing the proximate determinants of fertility. Population and Development Review, 4, 105–132.CrossRef Bongaarts, J. (1978). A framework for analyzing the proximate determinants of fertility. Population and Development Review, 4, 105–132.CrossRef
Zurück zum Zitat DaVanzo, J., Hale, L., Razzaque, A., & Rahman, M. (2007). Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG (British Journal of Obstetrics and Gynecology), 114, 1079–1087.CrossRef DaVanzo, J., Hale, L., Razzaque, A., & Rahman, M. (2007). Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG (British Journal of Obstetrics and Gynecology), 114, 1079–1087.CrossRef
Zurück zum Zitat Dixon-Mueller, R. (1988). Innovations in reproductive health care: Menstrual regulation policies and programs in Bangladesh. Studies in Family Planning, 19, 129–140.CrossRef Dixon-Mueller, R. (1988). Innovations in reproductive health care: Menstrual regulation policies and programs in Bangladesh. Studies in Family Planning, 19, 129–140.CrossRef
Zurück zum Zitat Grimes, D. A., Benson, J., Singh, S., Romero, M., Ganatra, B., Okonofua, F. E., & Shah, I. H. (2006). Unsafe abortion: The preventable pandemic. The Lancet, 368, 1908–1919.CrossRef Grimes, D. A., Benson, J., Singh, S., Romero, M., Ganatra, B., Okonofua, F. E., & Shah, I. H. (2006). Unsafe abortion: The preventable pandemic. The Lancet, 368, 1908–1919.CrossRef
Zurück zum Zitat Huda, F. A., Ford, E., Deshpande, A., Al Haque, N., Quaiyum, M. A., Healy, J., . . . Johnson, H. B. (2010). Strengthening health system capacity to monitor and evaluate programmes targeting at reducing abortion-related maternal mortality (Reproductive Health Programme Working Paper No. 1). Dhaka, Bangladesh: International Centre for Diarrhoeal Disease Research, Bangladesh. Huda, F. A., Ford, E., Deshpande, A., Al Haque, N., Quaiyum, M. A., Healy, J., . . . Johnson, H. B. (2010). Strengthening health system capacity to monitor and evaluate programmes targeting at reducing abortion-related maternal mortality (Reproductive Health Programme Working Paper No. 1). Dhaka, Bangladesh: International Centre for Diarrhoeal Disease Research, Bangladesh.
Zurück zum Zitat International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). (2011). Health and demographic surveillance system, Matlab: Volume forty two, registration of health and demographic events 2008 (Scientific Report No. 109). Dhaka, Bangladesh: icddr,b. Retrieved from www.icddrb.org International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). (2011). Health and demographic surveillance system, Matlab: Volume forty two, registration of health and demographic events 2008 (Scientific Report No. 109). Dhaka, Bangladesh: icddr,b. Retrieved from www.​icddrb.​org
Zurück zum Zitat Khan, A. R., Jahan, F. A., & Begum, S. F. (1986a). Maternal mortality in rural Bangladesh: The Jamalpur district. Studies in Family Planning, 17, 7–12.CrossRef Khan, A. R., Jahan, F. A., & Begum, S. F. (1986a). Maternal mortality in rural Bangladesh: The Jamalpur district. Studies in Family Planning, 17, 7–12.CrossRef
Zurück zum Zitat Khan, M. A., & Rahman, M. (1997). Determinants of contraceptive method-choice in rural Bangladesh. Asia Pacific Population Journal, 12, 65–82. Khan, M. A., & Rahman, M. (1997). Determinants of contraceptive method-choice in rural Bangladesh. Asia Pacific Population Journal, 12, 65–82.
Zurück zum Zitat Khan, A. R., Rochat, R. W., Jahan, F. A., & Begum, S. F. (1986b). Induced abortion in a rural area of Bangladesh. Studies in Family Planning, 17, 95–99.CrossRef Khan, A. R., Rochat, R. W., Jahan, F. A., & Begum, S. F. (1986b). Induced abortion in a rural area of Bangladesh. Studies in Family Planning, 17, 95–99.CrossRef
Zurück zum Zitat Koenig, M. A., Hossain, M. B., & Whittaker, M. (1997). The influence of quality of care upon contraceptive use in rural Bangladesh. Studies in Family Planning, 28, 278–289.CrossRef Koenig, M. A., Hossain, M. B., & Whittaker, M. (1997). The influence of quality of care upon contraceptive use in rural Bangladesh. Studies in Family Planning, 28, 278–289.CrossRef
Zurück zum Zitat Koenig, M. A., Rob, U., Khan, M. A., Chakraborty, J., & Fauveau, V. (1992). Contraceptive use in Matlab, Bangladesh in 1990: Levels, trends, and explanations. Studies in Family Planning, 23, 352–364.CrossRef Koenig, M. A., Rob, U., Khan, M. A., Chakraborty, J., & Fauveau, V. (1992). Contraceptive use in Matlab, Bangladesh in 1990: Levels, trends, and explanations. Studies in Family Planning, 23, 352–364.CrossRef
Zurück zum Zitat Mitra, S., Ali, M., Islam, S., Cross, A., & Saha, T. (1994). Bangladesh Demographic and Health Survey, 1993–1994. Dhaka, Bangladesh, and Calverton, MD: Mitra and Associates, and Macro International, Inc. Mitra, S., Ali, M., Islam, S., Cross, A., & Saha, T. (1994). Bangladesh Demographic and Health Survey, 1993–1994. Dhaka, Bangladesh, and Calverton, MD: Mitra and Associates, and Macro International, Inc.
Zurück zum Zitat National Institute of Population Research and Training (NIPORT), Mitra and Associates, and MEASURE DHS ICF International. (2013). Bangladesh Demographic and Health Survey, 2011. Dhaka, Bangladesh, and Calverton, MD: NIPORT, Mitra Associates, and ICF International. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and MEASURE DHS ICF International. (2013). Bangladesh Demographic and Health Survey, 2011. Dhaka, Bangladesh, and Calverton, MD: NIPORT, Mitra Associates, and ICF International.
Zurück zum Zitat National Institute of Population Research and Training (NIPORT), Mitra and Associates, & ORC Macro. (2009). Bangladesh Demographic and Health Survey, 2007. Dhaka, Bangladesh, and Calverton, MD: NIPORT, Mitra Associates, and ORC Macro International. National Institute of Population Research and Training (NIPORT), Mitra and Associates, & ORC Macro. (2009). Bangladesh Demographic and Health Survey, 2007. Dhaka, Bangladesh, and Calverton, MD: NIPORT, Mitra Associates, and ORC Macro International.
Zurück zum Zitat National Institute of Population Research and Training (NIPORT), ORC Macro, Johns Hopkins University, & International Centre for Diarrhoeal Disease Research, Bangladesh. (2003). Bangladesh Maternal Health Services and Maternal Morbidity Survey 2001. Dhaka, Bangladesh, Calverton, MD, and Baltimore, MD: NIPORT, ORC Macro International, and the Johns Hopkins University. National Institute of Population Research and Training (NIPORT), ORC Macro, Johns Hopkins University, & International Centre for Diarrhoeal Disease Research, Bangladesh. (2003). Bangladesh Maternal Health Services and Maternal Morbidity Survey 2001. Dhaka, Bangladesh, Calverton, MD, and Baltimore, MD: NIPORT, ORC Macro International, and the Johns Hopkins University.
Zurück zum Zitat Preston, S. H. (1978). The effects of infant and child mortality on fertility. New York: Academic Press. Preston, S. H. (1978). The effects of infant and child mortality on fertility. New York: Academic Press.
Zurück zum Zitat Rahman, M., Akbar, J., Phillips, J. F., & Becker, S. (1992). Contraceptive use in Matlab, Bangladesh: The role of gender preference. Studies in Family Planning, 23, 229–242.CrossRef Rahman, M., Akbar, J., Phillips, J. F., & Becker, S. (1992). Contraceptive use in Matlab, Bangladesh: The role of gender preference. Studies in Family Planning, 23, 229–242.CrossRef
Zurück zum Zitat Rahman, M., DaVanzo, J., & Razzaque, A. (2001). Do better family planning services reduce abortion in Bangladesh? The Lancet, 358, 1051–1056.CrossRef Rahman, M., DaVanzo, J., & Razzaque, A. (2001). Do better family planning services reduce abortion in Bangladesh? The Lancet, 358, 1051–1056.CrossRef
Zurück zum Zitat Rahman, M., & Sutradhar, S. C. (1996). Women’s status and fertility behavior in rural Bangladesh. In A. Kantner, A. Al-Sabir, & N. Chakraborty (Eds.), The Bangladesh Demographic Health Survey 1993–94: Extended analysis (pp. 195–212). Dhaka, Bangladesh, and Honolulu, HI: National Institute of Population and Training (NIPORT), East–west Center. Rahman, M., & Sutradhar, S. C. (1996). Women’s status and fertility behavior in rural Bangladesh. In A. Kantner, A. Al-Sabir, & N. Chakraborty (Eds.), The Bangladesh Demographic Health Survey 1993–94: Extended analysis (pp. 195–212). Dhaka, Bangladesh, and Honolulu, HI: National Institute of Population and Training (NIPORT), East–west Center.
Zurück zum Zitat Razzaque, A., DaVanzo, J., Rahman, M., Ahmed, S. (2011). Pregnancy Termination in Matlab, Bangladesh: Knowledge, Attitudes, and Decision-making Processes. Unpublished document. Dhaka: International Centre for Diarrhoeal Disease Research, Bangladesh. Razzaque, A., DaVanzo, J., Rahman, M., Ahmed, S. (2011). Pregnancy Termination in Matlab, Bangladesh: Knowledge, Attitudes, and Decision-making Processes. Unpublished document. Dhaka: International Centre for Diarrhoeal Disease Research, Bangladesh.
Zurück zum Zitat Ronsmans, C., Vanneste, A. M., Chakraborty, J., & van Ginneken, J. (1997). Decline in maternal mortality in Matlab, Bangladesh: A cautionary tale. The Lancet, 350, 1810–1814.CrossRef Ronsmans, C., Vanneste, A. M., Chakraborty, J., & van Ginneken, J. (1997). Decline in maternal mortality in Matlab, Bangladesh: A cautionary tale. The Lancet, 350, 1810–1814.CrossRef
Zurück zum Zitat Shah, I., & Åhman, E. (2009). Unsafe abortion: Global and regional incidence, trends, consequences, and challenges. Journal of Obstetrics and Gynaecology Canada, 31, 1149–1158. Shah, I., & Åhman, E. (2009). Unsafe abortion: Global and regional incidence, trends, consequences, and challenges. Journal of Obstetrics and Gynaecology Canada, 31, 1149–1158.
Metadaten
Titel
Influences on Pregnancy-Termination Decisions in Matlab, Bangladesh
verfasst von
Julie DaVanzo
Mizanur Rahman
Shahabuddin Ahmed
Abdur Razzaque
Publikationsdatum
01.10.2013
Verlag
Springer US
Erschienen in
Demography / Ausgabe 5/2013
Print ISSN: 0070-3370
Elektronische ISSN: 1533-7790
DOI
https://doi.org/10.1007/s13524-013-0202-8

Weitere Artikel der Ausgabe 5/2013

Demography 5/2013 Zur Ausgabe