Child mortality and fertility regulation behavior in Bangladesh : implication for family planning programs

A strong and negative impact of child death on subsequent contraceptive acceptance was observed regardless of the number of surviving children. A child death negatively affected subsequent contraceptive continuation among parents with four or fewer surviving children, but not among parents with more than four surviving children, indicating that parents wanted to replace a dead child by postponing contraceptive use. The study concludes that contraceptives may be acceptable for both limiting and spacing purposes even if a child dies in a relatively large family, and contraceptives may be acceptable for spacing after a child dies in a small family. Family planning programs can substantially reduce fertility and maternal and child health risks by counseling, motivating, and supplying contraceptives to parents whose young child has died. Mothers are exposed to a high risk of conception immediately following a child death due to the abrupt truncation of breastfeeding and thus deserve special attention from family planning workers for counseling and supply of contraceptives. (Author abstract)