Childbearing and women's survival: New evidence from rural Bangladesh

Effects of childbearing on women's mortality and the implications of family planning programs in reducing these effects are examined in a 20-year prospective study of more than 2,000 women in Matlab, Bangladesh. Maternal mortality is defined as a death occurring in the six weeks after childbirth. But childbearing may affect women's survival beyond this brief period. Additional hypotheses considered relate to 1) cumulative exposure to childbearing, whether measured by parity or pace of childbearing, 2) age at first birth, and 3) effects beyond the reproductive ages. The results offer no support to cumulative exposure hypotheses, showing no link between parity or pace of childbearing and mortality risk. Instead, we identify an extended period of heightened mortality risk associated with each birth-the year of the birth and the two subsequent years. Family planning programs, by reducing the number of children and therefore a woman's exposure to extended maternal mortality risk, potentially increase survival. Research is needed to identify and address the specific causes of extended maternal mortality risk so that appropriate ameliorative programs may be developed.