Final Report (PDF, 2132K) - Measure DHS

Following the birth of a child, there is a period of time during which a woman is infecund--physiologically incapable of conception. This period can be approximately measured by the time frompregnancy termination to the retum of the woman's menstrual cycle. The duration of postpartumamenorrboea depends on a number of factors, such as the general health and nutritional status of thewoman and her breastfeeding practices. Among healthy, well-nourished women who do not breastfeed atall, postpartum amenorrhoea usually lasts two to three months. However, intensive breast:feeding whichis continued well aRer the birth of a child can extend this period to a year or more. The median durationof the postpartum amenorrhoea for women in Ondo State is 12 months. This is consistent with theestimate of 13 months from the 1981-82 NFS for women of Ondo State (National Population Bureau andFederal Ministr) of Health, 1986).In Ondo State the practice of sexual abstinence is almost universal following the birth of a child(Table 2.5). The median duration of abstinence is 18 months. The 1981-82 NFS reported a meanduration of abstinence of 21 months for women of Ondo State (National Population Bureau and FederalMinistry of Health, 1986).The ODHS finding that the median duration of sexual abstinence is slightly longer than themedian duration of breastfeeding, but substantially longer than the median duration of postpartumamenorrhoea implies that sexual abstinence plays a crucial role in determining pregnancy intervals. Therelatively long period of insusceptibility characteristic of women in the Ondo State (median duration 19months) is primarily due to the practice of sexual abstinence.Table 2.6 presents the mean durations for breastfeeding, postpartum amenorrhoea, sexualabstinence, and insusceptibility for subgroups of the population. The mean durations were calculated bythe "current status" method in which the number of women who had a birth in the last 36 months andwere still breastfeeding (amenorrhoeic, abstaining or insusceptible) is divided by the average number ofbirths per month in the last 36 months.While there are important differences in the mean durations of breastfeeding and postpartumabstinence, the discussion here focuses on abstinence because it is the primary determinant of the lengthof insusceptibility for women in Ondo State. The mean duration of sexual abstinence is shorter forwomen under age 30 (20 months) than for women age 30 and above (25 months) and the insusceptibleperiod is similarly shorter for younger women (21 months) than older (26 months) women. In terms ofarea of residence, abstinence is shorter for urban women (20 months) than for rural women (26 months)and shortest for riverine women (19 months). As a result, insusceptibility is about the same for urban andriverine women (22 and 21 months, respectively) but longer for rural women (27 months). In the case ofreligious affiliation, Catholic and Protestant women have shorter periods of abstinence (22 months) thanMuslim women (27 months) and similar differences in insusceptibility (23 versus 28 months).Education is by far the most important background characteristic affecting the period ofpostpartum insusceptibility for women of Ondo State. The durations of bmastfeeding, postpartumamenorrhoea, and abstinence are longest for women with no education (20, 16 and 27 months,respectively), decrease by about 3 months for women with a primary education (18, 14 and 21 months,respectively) and by another 3 months for women with a secondary education (14, 11 and 18 months,respectively). The net result is a steady and substantial decrease in the length of insusceptibility betweenwomen with no education (29 months), women with a primary education (22 months) and women with asecondary education (19 months). All other factors being equal, this would mean that better educatedwomen would have greater need for family planning methods to space their births.16