Promoting Optimal Inter-Pregnancy Interval in India through Integrated Public Delivery Systems

Mary Sebastian, Population Council
M. E. Khan, Population Council

Early marriage and closely spaced births are important causes of high maternal mortality and neonatal mortality in Uttar Pradesh, India. This paper attempts to understand compulsions of young couples for early first pregnancy and reasons, despite desiring a second child three years later, do not practice postpartum contraception. 20 FGDs and 30 in-depth interviews of married couples aged 15-25, providers, and elderly women/community leaders were conducted to address these questions. Findings show that young couples experience pressure from elders to demonstrate their fertility early and to see their grandchildren. Strong belief prevails that contraceptive use before first child causes infertility. Despite the desire to enjoy married life they do not succeed as they succumb to family pressure, lack knowledge of contraceptives and their accessibility and opposition from husbands to contraception. Failure of postpartum contraception is also due to misconceptions about timing of next conception—when a woman becomes biologically capable for pregnancy.