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Do Higher Status and More Autonomous Women Have Longer Birth Intervals? Results from Cebu, Philippines

Citation

Upadhyay, Ushma D. & Hindin, Michelle J. (2005). Do Higher Status and More Autonomous Women Have Longer Birth Intervals? Results from Cebu, Philippines. Social Science & Medicine, 60(11), 2641-2655.

Abstract

We look at whether women's status and autonomy affect birth-to-conception intervals using data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in the Philippines. We followed 1123 married, fecund women, aged 25–49, for up to 5 years. In a 1994–1995 survey, women were asked about the timing of their last birth. In 1998–2000, women were asked about any pregnancies since the 1994–1995 survey. Using these two surveys, we calculated birth to conception intervals. Women were censored if they reached their 50th birthday during follow-up. We measure autonomy based on whether the wife has the final say in 10 household decisions as measured in the 1994–1995 survey. Using Cox proportional hazards models we find that women with more decision-making autonomy have significantly longer birth-to-conception intervals in unadjusted models. After adjustment for age, wealth, education, other socio-economic variables, and women's status, decision-making autonomy remained a significant predictor in all models. This effect remains even after adjusting for contraceptive use, implying that autonomy influences birth-to-conception intervals through other mechanisms above and beyond increased contraceptive use. Additionally, few of the women's status variables were significantly associated with time to next conception. Women who had their first birth later in life were more likely to conceive during the observation period suggesting that they may be having shorter birth intervals in order to “catch up” with their peers. Maternal and child health-care efforts can help women achieve their desired spacing goals by supporting women's autonomy—in addition to ensuring they have accurate information and a range of contraceptive options.

URL

http://dx.doi.org/10.1016/j.socscimed.2004.11.032

Reference Type

Journal Article

Year Published

2005

Journal Title

Social Science & Medicine

Author(s)

Upadhyay, Ushma D.
Hindin, Michelle J.