Bangladesh 1993-1994 Demographic and Health ... - Measure DHS

Table 5.6 indicates that a large majority (81 percent) of currently married women interviewed in theBDHS were sexually active in the four weeks prior to the interview. A small proportion (4 percent) had nothad sexual relations since delivering a baby (postpartum abstaining) and 15 percent were abstaining formasons other than having recently given birth. Most of these women had been sexually inactive for less than2 years; only 2 percent of currently married women had not had sexual intercourse for two years or longer.The likelihood that a woman has been sexually active in the last four weeks declines with the age ofthe woman, as well as with marital duration. Married women in Chittagong Division appear to have slightlylower coital frequency than women in other divisions. Not surprisingly, women who are not usingcontraception are less likely to have had sexual intercourse in the four weeks preceding the interview thanwomen who are using some method. Presumably, one reason why women choose not to use contraceptionis that they are not sexually active and therefore do not require protection. However, an alternativeexplanation is that couples that are using a contraceptive method feel less worried about the fear of pregnancyand thus increase their coital frequency.5.6 Postpartum Amenorrhea andInsusceptibilityThe risk of pregnancy following abirth is largely influenced by two factors:breastfeeding and sexual abstinence. Postpartumprotection from conception can be prolongedby breastfeeding through its effect onthe length of amenorrhea (the period prior tothe return of menses). Protection can also beprolonged by delaying the resumption of sexualrelations. Women are defined as insusceptibleif they are not exposed to the risk ofpregnancy, either because they are amenorrheicor abstaining following a birth.The percentage of children whosemothers are postpartum amenorrheic, abstainingand postpartum insusceptible is shown inTable 5.7 by the number of months sincebirth. These distributions are based on currentstatus data, i.e., on the proportion of birthsoccurring x months before the survey forwhich mothers are still amenorrbeic, abstainingor insusceptible. The estimates of themedian and mean durations shown in Tables5.7 and 5.8 are calculated from the currentstatus proportions at each time period. Thedata are grouped in two-month intervals tominimize fluctuations in the estimates.Table 5.7 Postpartum amenorrhea~ abstinence and insusceptibilityPercentage of births in the three years preceding the survey forwhich mothers are postpartum anaenorrheic, abstaining andinsusceptible, by number of months since birth, and median andmean durations, Bangladesh 1993-94NumberMonths Amenor- Insus- ofsince birth rheic Abstaining ceptible births< 2 97.6 85,1 98.9 1752-3 81.3 28,9 84.2 2734 -5 62.4 9,1 64.1 2246-7 62.2 7,3 64.5 1978-9 57.1 5.2 60.0 22910-11 48.8 2,5 50.8 19612-13 43.3 5,7 45.0 26714-15 31.0 3,3 32.6 28616-17 26.6 3.0 28.5 20318-19 15.8 3.4 17.5 15820-21 15.4 2.9 17.5 14922-23 9.5 3.1 12.0 19524-25 4.8 1.5 6.3 24326-27 5.0 0.9 5.9 28028-29 2.9 2.4 5.3 23130-31 3.5 2.2 5.0 19732-33 5.8 0.9 6.5 19334-35 1.5 2.3 3.8 204Total 32.3 8.9 34.2 3899Median 10.3 2.0 10.8Mean 11.8 3.7 12.4Prevalence/ 1Incidence mean 11.5 3.2 12.1IThe prevalence-incidence mean is borrowed from epidemiologyand is defined as the number of children whose mothers areamenorrheic (prevalence) divided by the average number of birthsper month (incidence).The period of postpartum amenorrhea is considerably longer than the period of postpartum abstinenceand is by far the major determinant of the length of postpartum insusceptibility to pregnancy. By 6-7 monthsfollowing birth, 62 percent of women are still amenorrheic, while only 7 percent are still abstaining.Similarly, at 12-13 months postpartum, 43 percent of women are amenorrheic, compared to 6 percent still77