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Determinants of Marriage to First Birth Interval in Birjand, Iran: A Retrospective-Prospective Cohort and Survival Analysis

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Population is a component of power and a major contributor to cultural and economic development. In case a country’s population crawls into old age, without a consideration for replacement of… Click to show full abstract

Population is a component of power and a major contributor to cultural and economic development. In case a country’s population crawls into old age, without a consideration for replacement of a younger generation, the country will soon encounter several problems such as employment of foreign nationals instead of the domestic workforce for production purposes (1). Two hundred years ago, women gave birth to several children. In the mid-19th century, for example, women gave birth to 9 or more children in the United States or Australia up until their fertility period ended. A woman had an average delivery of 6 children. The average is currently less than 2 per woman in the same countries (2). Decreased fertility began in Europe in the first half of the 19th century starting in France and followed in the second half of the century in the United States and other European countries, Canada, Australia, and New Zealand (3). Lack of planning is unjustifiable in the twentyfirst century. It is a century in which countries with comprehensive planning and management hold the last word (4). Undoubtedly, an issue that has engaged the policymakers is population and its growth. As opposed to the past when a country’s population represents the majesty of the country, the strength of a powerful country lies with management power (5). Therefore, population growth is a major factor that provides the authorities of a country with the possibility for precise planning (6). Demographic realities in Iran indicate that family planning objectives in terms of fertility reduction and annual control of the population growth have been fulfilled prior to the determined deadline (7). The crude birth rate in 2011 reached 19 per 1000, and the natural growth rate of population was 1.3% (8). Hashemi and Salehi-Isfahani showed that family planning failed to delay first childbirth in rural areas in Iran, while it has had a significant effect in reducing higher ranks, particularly the third rank or those above (9). Therefore, family planning has moved beyond the established purposes. Under these circumstances, measures should be taken to prevent from further fertility reduction. Fertility has undergone a significant reduction in the past three decades. Today, fertility is at a lower rate than it can be compensated across Iran (10). Total fertility rate of 7 children per woman in 1979 is reduced to 1.9 in 2006 (11). When couples have the opportunity to decide on fertility and its timing, the interval will be farther from marriage to first childbirth (12). Fertility plays a key role in population growth. Thus, firstly, factors affecting the time-interval between marriage and first childbirth must be studied so that desirable conditions would be yielded by controlling those factors. Abstract Objectives: The time-interval between marriage and first childbirth (IMF) can affect fertility and pave the way for decreased fertility in future. This study aimed to determine the effective factors on the time of first childbirth in married women of Birjand, Iran. Materials and Methods: This was a retrospective and prospective cohort study incorporating a total of 180 couples from Birjand who were married in 2011. The data were collected by a checklist and subsequently assessed using survival analysis in STATA13 software. Results: From among the participants, 55.2% had a child and the rest were censored. The man’s age at the time of marriage, the interval between marriage contract to marriage ceremony, type of marriage, wife’s place of birth, application of modern methods of contraception, family income per month, and tendency to have a son were the determining factors affecting IMF. Conclusions: More than half of the freshmen admitted to universities across the country are women who will seek employment after they are graduated. Considerations must be made so that they can have their desired number of children, suitable education, and employment.

Keywords: first childbirth; marriage; marriage first; population; country; fertility

Journal Title: International Journal of Women's Health
Year Published: 2017

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