The effect of child mortality on fertility regulation in rural Bangladesh

This study analyzes longitudinal data from Matlab, Bangladesh, to examine the impact of child mortality on subsequent contraceptive acceptance and continuation. The strong negative impact is found to attenuate with family size, indicating a "replacement effect." An "insurance effect" is observed as contraceptive acceptance and continuation were negatively associated with the number of previous deaths of children. Couples seem to find contraceptive use acceptable if the child who dies is one of a large family. Potentially, contraceptive use could be acceptable for spacing after a child in a small family dies. Family planning programs can help to reduce fertility and maternal and child health risks substantially by supplying appropriate methods to those couples who have experienced a young child's death; to be most effective, methods should be supplied immediately after the child's death.