Abstract
Demographers’ interest in reproductive health stems largely from their interest in fertility. Various female health conditions, e.g., reproductive tract infections, tend to reduce fertility or cause infertility. Family planning, an intrinsic component of reproductive health, has had an important impact on child and maternal mortality, as well as on the level of fertility and child spacing. The emergence of HIV/AIDS has heightened the interest of demographers in reproductive health. It is a leading cause of mortality, but it has also reduced fertility, diminished population growth, and modified age structures. It has restrained sexual and marital behavior, been responsible for transmission of disease from mothers to newborn children, played a possible role in international migration flows, and increased orphanhood and family destabilization.
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Notes
- 1.
These two techniques were employed in a University of Pennsylvania/University of Malawi joint study, initiated in 1998, covering the responses of people in small rural villages of Malawi to the AIDS epidemic (Watkins 2004). As part of this study, HIV tests were also performed and, where there were no logistical problems, this device for securing sensitive data was deemed successful.
- 2.
The singulate mean age at marriage is a mean based on census or survey data rather than marriage registration. It is the mean age at first marriage of those in the age range 15–49 years of age who have ever been married.
- 3.
Age at first marriage has fluctuated greatly in the MDC, especially in the United States. For example, the marriage age in the MDC was much lower during the Baby Boom era, as was that in the United States. The United States has always tended to have a lower age at first marriage than the MDC as a group.
- 4.
In the United States, consensual unions are commonly a childless state that serves as a trial period prior to marriage and has only a modest degree of legal recognition. Cohabiting couples, cohabiting relationships, or unmarried-partner households in the United States generally have no legal recognition but are accepted by much of the public with little stigma as a temporary household arrangement. A few states sanction such unions as common-law marriages.
- 5.
In a later chapter I discuss the research that links caloric restriction to an increase in the life span of various subhuman species, including mice and rats. Caloric restriction reduces fertility in these rodents and it appears that the animals’ response to this shortage of energy is to channel more of it into their own maintenance and less into reproduction (Holliday 2004).
- 6.
In spite of the theoretical advantage of the fetal loss rate, the fetal loss ratio may still be considered preferable for international comparisons. The registration of fetal losses is irregular and the effect of this irregularity is compounded when fetal losses are included with the births in the base of the fetal loss rate. Because of the likelihood that poor registration of fetal losses will occur in association with poor registration of births and, hence, that the errors in each component will offset one another to some extent, fetal loss ratios may sometimes be of satisfactory quality even where the basic data are questionable.
- 7.
Other more detailed findings are that, compared with children born less than 2 years after a previous birth, children born three to 4 years after a previous birth are 1.5 times more likely to survive the first week of life, 2.2 times more likely to survive the first 28 days of life, 2.3 times more likely to survive the first year of life, and 2.4 times more likely to survive to age 5.
- 8.
The condom was originally designed to prevent infection but in the middle of the nineteenth century it began to assume a major role as a contraceptive. The condom continued in this use for many decades and by the mid-1930s it became the most common contraceptive method. (During World Wars I and II, when condoms were distributed to military personnel, its use as a protection against STDs was given new impetus but this practice also stigmatized its use as encouraging illicit sex.) By the 1960s it was replaced by the female methods of contraception, namely the pill and the IUD, in the industrialized countries (except in Japan). Use of the condom as a standard method of contraception is rare in the nonindustrialized countries as compared with the industrialized countries. According to the United Nations, 21% of married couples in the More Developed Countries and 5% of couples in the Less Developed Countries rely on the condom.
The emergence of HIV/AIDS in the 1980s, the rapid spread of the disease, and the current HIV/AIDS epidemic have brought the condom into use as the principal means of preventing the transmission of the disease. The condom is quite effective in the reduction of sexually transmitted diseases, but religious and cultural beliefs have been barriers to its use. It is greatly underused, especially in the areas where STDs are most prevalent. Sub-Saharan Africa exhibits the least condom use – several percent at most – and the worst HIV/AIDS epidemic. Strong efforts are being made to encourage greater use of the condom there as elsewhere.
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Siegel, J.S. (2012). Reproductive Health. In: The Demography and Epidemiology of Human Health and Aging. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1315-4_9
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