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The Open Birth Interval Tells a Story


The Open Birth Interval: A Resource for Reproductive Health Program and Women’s Empowerment by Ross and Bietsch was published in the Global Health: Science and Practice journal. This post summarizes the article on the ways information on women’s timing and spacing of births can be used.

What is the Open Birth Interval?

“How long has it been since your last birth?”

Asking a woman this simple question determines the open interval—the period of time since her last birth.

The open birth interval reveals a pattern that varies by a woman’s age, the number of living children she has, her residence, and her socioeconomic level. More importantly, the open interval could reveal a lot about her reproductive behavior, status, and contraceptive needs.

Until now, very little empirical information on open birth intervals has been available. In a Global Health: Science and Practice article, Ross and Bietsch assembled and analyzed data from 232 Demographic and Health Surveys conducted in 74 countries, allowing them to glean a wealth of information on women’s open birth intervals.

A woman in Senegal who participated in a community empowerment program with her children near her home. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment
A woman in Senegal who participated in a community empowerment program with her children near her home. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment

What Can We Learn from Data on Open Birth Intervals?

1. Demand for services among women at different intervals. Across the 74 countries analyzed, more than one-quarter of women are pregnant or have given birth in the last year. That means higher resource demands on antenatal care, pregnancy and delivery, and postpartum care services. This also affects supply demands, clinic loads, personnel needs, and budgets.

Regional variations in distribution of women by birth intervals shows the greatest contrast between countries in sub-Saharan Africa, where more than 75% of women have a child under age 5, countries in other regions that have more than 52% of women with a child under age 5.

2. Demand for contraception and method choice. Contraceptive use and the type of method used shifts as women move through the different birth intervals. Women who use traditional and short-acting methods have the highest demand in the early intervals. As time goes on, women tend to choose longer-acting methods, such as IUDs, and in the final interval, the most common method is sterilization.

Women in Uganda from the Young Mothers Group meeting get family planning information from a community health worker. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment
Women in Uganda from the Young Mothers Group meeting get family planning information from a community health worker. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment

3. Intention to use a contraceptive method. Birth intervals are getting longer in many countries. Data from 56 countries with multiple surveys showed that women in the first interval (pregnant or in the first year after birth) dropped from 33% to 27%; women in the final interval (more than 5 years) rose from 26% to 31%. Length of birth intervals changes a woman’s need to space or limit births and her intentions to use a contraceptive method.

4. Demand for other services. The age of a woman’s youngest child will affect her need for early child care services and essential primary health services for the child, such as immunization and nutrition.

Head nurse Margie Harriet Egessa conducts a checkup on a woman who recently gave birth at Mukujju clinic, Uganda. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment
Head nurse Margie Harriet Egessa conducts a checkup on a woman who recently gave birth at Mukujju clinic, Uganda. 2014, Jonathan Torgovnik/Getty Images/Images of Empowerment

How Can Programs Use Open Birth Interval Information?

Each part of the open interval distribution tells a story that programs can benefit from.

Further Reading

  1. The Open Birth Interval: A Resource for Reproductive Health Program and Women’s Empowerment (Published by the Global Health: Science and Practice Journal)
  2. Healthy Timing and Spacing of Pregnancy (published by Knowledge SUCCESS)
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Sonia Abraham

Scientific Editor, Global Health: Science and Practice Journal

Sonia Abraham is the scientific editor for the Global Health: Science and Practice Journal and has been writing and editing for over 25 years. She holds a Bachelor’s in Biological Sciences from the University of Maryland and a Master’s in Writing from Johns Hopkins.