This study surveys 100 married and 100 unmarried primiparous mothers, attending the National Maternity Hospital, Dublin, with regard to their contraceptive practice, their planning of their pregnancy and the timing of their first antenatal visit. Nineteen per cent of the married women, but 64% of the unmarried women, had never used any contraceptive method. The contraceptive pill was the most popular method for both groups, but while three in five of the married women had at some time used the pill, only a little more than one in five of the unmarried women had ever used it. One quarter of the women who had used contraception reported that their pregnancy was the result of a failure in their contraceptive method. Eighty-nine per cent of the single group and 20% of the married had not planned their pregnancy. None of the married women, but almost a quarter of the single, delayed their first antenatal visit until after they were 20 weeks pregnant.

This paper explores the inter-relationships between impairment and disability in a sample of 119 teenagers in relation to their psychological adjustment and quality of social life. Poor psychological adjustment and extreme social isolation are associated not so much with individual functional limitations as with particular configurations of impairments and disabilities. It seems that social handicap is not a direct consequence of any impairment or disability but arises generally from severe functional loss and is shaped by dependency on others, restricted choices, physical barriers and adverse reactions of others.

This Study, the first of a series on consanguinity in the Archbishopric of Toledo from 1900 to 1979, analyses in detail the types of consanguineous mating in a population of considerable size, some 650,000 persons, in central spain. during the period covered, very important transformations occurred in Spanish society. The data relate to 21,464 consanguineous marriages. They were divided into two groups, according to the premarital migration of the couple. Significant differences in the frequencies of the types of consanguineous matings, and their secular evolution, are found for the two groups. The expected trend in inbreeding in the total area shows two different tendencies: constancy till the end of the 1950s, followed by a fast decline during the last two decades.

The 1983 Somali Family Health Survey showed that polygamy and monogamy selected women with different social characteristics. Wives in polygamous unions were prone to be younger at first marital cohabitation and to have previous marital disruptions. Since a young age at first cohabitation and number of previous marriages have opposite effects on the cumulative fertility rate of women, the difference in this rate between wives in polygamous and monogamous unions vanished when both factors were controlled in a multivariate analysis.

The cost effectiveness of various modes of family planning service delivery based on the cost per couple-year of protection (CYP) is assessed using 1984 data for 63 projects in ten countries (three each in Africa and Asia, and four in Latin America). More than 4·8 million CYPs were provided through these projects during the year studied. Programmes with the highest volume of services delivered corresponded to lowest average costs: social marketing (2·8 million CYPs) and sterilization projects (960,000 CYPs) cost about $2 per CYP, on average; highest costs were for full service clinics and community-based distribution projects ($13–14 per CYP). Costs of clinics combined with community-based distribution services fell approximately midway between these two extremes.

This paper analyses the effects of age at first marriage, level of education, place of residence, marriage disruption, religion, contraceptive use, and work status on cumulative fertility in Kenya, using data from the 1977–78 Kenya Fertility Survey. Age at first marriage is the main determinant of cumulative fertility, but there are significant effects of level of education and marriage disruption. Place of residence is only significant for the Coast province. The implication of the findings is that to promote any real decline in fertility, emphasis should be placed on providing higher education and work opportunities for young women as an alternative to early marriage.

For nearly three decades men and women have increasingly gained the opportunity to control their childbearing with modern contraceptive technologies. In the early 1960s when oral hormonal contraceptives and intrauterine devices first became publicly available in the United States and Europe, the total fertility rate (TFR) in industrialized countries was about 2·7 implying that two-thirds of childbearing couples, some 87 million, were practising contraception. By comparison, in the developing areas, the TFR was 6·1 and only 18% (60 million couples) were contraceptive users. Thirty years later, estimating for 1990, the number of eligible couples practising contraception in the more developed countries (MDCs) is expected to have increased by half, while in the less developed countries (LDCs) the increase is likely to be six times, suggesting as many as 344 million users. Another way to demonstrate the significance of this trend is with a different statistic—that the level of contraceptive use in LDCs in 1990 will exceed half of all couples of childbearing age and be only ten percentage points below the MDC level of 25–30 years ago.

Who are the men and women who are childless in their mid-30s? Life history data for a British cohort born in 1946 show that age at marriage and marital breakdown were clearly associated with childlessness. Women who were only children were more likely to be childless than those with siblings. Further, early menarcheal age, being highly qualified and having a high status occupation were indirectly related to childlessness. For men, particularly amongst those who had experienced a broken marriage, it was the most ambitious, the highly educated and those in professional occupations who were relatively more likely to be childless.

This study investigates the socio-demographic differentials in mortality during the 1974–75 famine in a rural area of Bangladesh. It is based on household socioeconomic information collected in the 1974 census and registration data on births, deaths and migrations for the period 1974–79 from the Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh. Ownership of selected household items was considered in the analysis as an indicator of household socioeconomic status. Mortality was 62% higher during the famine period and 31% higher during the post-famine period compared to the non-famine period. The mortality of both the poor and the rich increased during the famine period, by 117% and 28% respectively compared to the non-famine period. The poor suffered significantly in all age groups except 5–14 years, while the rich suffered only for ages 65 and over. Poor males suffered more than poor females except for ages 65 and over, while rich females suffered more than rich males except for ages under 1 year.

Because of the importance of contraceptive behaviour in most societies today a better understanding is needed of the social and behavioural factors affecting contraceptive decisions and choices of individuals and couples. This paper examines the need for longitudinal, theoretically-based studies of contraceptive use dynamics, including the timing, duration and interaction of reproductive events which may be more important than contraceptive technology in the social, cultural and economic context of fertility control. New research methods and appropriate analysis of data are relevant. Consideration of the social context is essential for the formulation and implementation of effective policies relating to the provision of contraceptive services.

Nuñoa is a high altitude rural Peruvian community characterized by socioeconomic stratification and differential access to the market economy. Nursing practices and the effects of nursing are also stratified; this translates into a risk of menses at 12 months post-partum nearly seven times greater in wealthier than in poorer women.

Most nursing occurs in the morning, among those who practise on-demand breast-feeding. Nursing episodes are clustered into sessions; the amount of breast-feeding is regulated by varying the number of episodes per session rather than by changing the duration of suckling episodes or the frequency of sessions per hour. Thus, resumption of ovulation is not dependent on the variable spacing of nursing episodes or sessions. The components of nursing activity most likely to be responsible for variation in the duration of post-partum amenorrhoea in these nursing women are mean session duration and mean number of episodes per session.

The mean duration of morning nursing sessions is negatively associated with infant's age, reflecting the greater reliance of younger children on breast-milk. The mean duration of afternoon nursing sessions is positively associated with mother's age, independent of infant's age, possibly reflecting maternal age-related variation in milk production capabilities. Baby minding by older daughters may also help to explain variation in afternoon nursing.

A survey of men's behaviour and opinions with respect to family planning, undertaken in Dakar in 1986, shows that contrary to popular belief, acceptance of contraception at least for the purpose of spacing births is substantial, even among men from the most conservative backgrounds. Actual use of contraceptives varied considerably across occupations. Among functionaries and students, it ranges between 25 and 49%. Among the working class, prevalence is low, especially within marriage. Uncertainty about the position of Islam regarding fertility control is apparent even among the highly educated and is given as a reason for rejecting use of contraceptives.

In 1984 and 1985, a survey was conducted of 7696 women aged 15–44 living in Italy, France, Great Britain, Spain and the Federal Republic of Germany. The aim of the study was to examine the use of contraceptive methods, the differences in contraceptive use, knowledge of fertility, communication about contraception, motives for choice and the perceptions held by women regarding contraceptive methods, particularly oral contraception. The results show important differences between the countries studied.

Recent economic crises have severely affected national and international efforts to reduce the high morbidity and mortality in developing countries. The repercussions of these crises are manifest in declining living standards, increasing poverty, malnutrition, ill health and death. Depressed commodity prices, the oil crisis of the late 1970s, and the ensuing balance of payment problems have weakened most governments' efforts to halt and eventually reverse the economic decline. In sub-Saharan Africa the effects of these crises have combined with an ever-increasing population to render ineffective the limited investments in health care.

The demand for additional children is influenced by the presence of sons within a family. This study is based on cross-sectional data of 9416 currently married women under age 50 from a Pakistan national survey in 1979–80. The analysis suggests that having at least one son in the family influences the demand for additional children. Urban and rural comparisons indicated a higher preference for sons in urban areas. Unless the socioeconomic milieu changes, son preference is likely to remain strong in Pakistan.

An experimental maternal and child health and family planning programme has been in existence in Matlab for almost 10 years. During this time the project has achieved remarkable success in the area of family planning. Based upon a 1984 survey, this study examines the pattern of contraceptive use in the Matlab treatment area, and contrasts it with the regular government programme in the neighbouring comparison area. Important differences between the two areas are observed, with the treatment area characterized by substantially higher levels of current contraceptive use, greater reliance upon temporary methods for birth spacing and, among acceptors of sterilization, more prior experimentation with other methods. In the comparison area lower rates of contraceptive use are observed, with heavy reliance upon tubectomy for limiting family size. The findings suggest that an intensive and innovative family planning programme in rural Bangladesh can achieve success not only in terms of contraceptive prevalence, but can also attract users interested in child spacing and others wanting to limit their family size, by offering the widest range of contraceptive methods.

There is nothing new about the belief that the spread of education with its influence on knowledge and outlook is a central force behind the demographic transition. In 1934 Penrose wrote: ‘when a community has gained the knowledge and acquired the habits necessary to reduce the death rate it will sooner or later gain the knowledge and acquire the habits necessary to reduce the birth rate. There may be time lag between the two processes, but both of them in a large share are the outcome of education’ (Penrose, 1934). It is thus surprising that investigation of the specific influence of parental education on the mortality of children in developing countries was neglected until Caldwell's (1979) analysis of survey data from Ibadan, Nigeria, which demonstrated that mother's education was a more decisive determinant of child survival than other family characteristics such as husband's occupation and education. Other studies followed this influential investigation. The greater contribution to mortality decline of educational advance compared to health care provision, it has been argued, is a contribution to the development versus medical technology debate (Mosley, 1985). Inevitably the beginnings of a counter-reaction may be discerned. Caldwell (1986) stressed that the influence of education should not be considered in isolation from the wider context, while Cooksey et al. (1986, unpublished) consider that the effect of maternal education may have been exaggerated.