Journal of Pregnancy and Child Health
Open Access

Cox proportional; Anemia; Childbearing; Pregnancy

Introduction

Furthermore, compared to children of women who had less births and more births, those whose mothers had more births had a higher likelihood of being underweight and a higher risk of stunting, anemia, and mortality. In developing nations like India, maternal, child, and nutritional outcomes have been major public health concerns. Under Sustainable Development Goal-3 (SDG-3), the United Nations has set a target for improving maternal, child, and nutritional outcomes, with a focus on underdeveloped areas. At the program and policy levels, it is thought that there is a natural synergy between maternal, infant, child, and family planning services that benefits both women and their offspring. Integration of family planning services with nutritional outcomes services for maternal, neonatal and child health has shown encouraging improvement in a wide range of health care, processes, and outcomes [1]. The research available suggests that family planning can significantly affect attaining important maternal, infant, and child health and nutritional goals in the global setting.

Numerous direct and indirect factors, including family planning, have an impact on maternal and child health and nutritional outcomes. The timing, spacing, and limitation of births is a continual process; integration of family planning with maternal and child health and nutrition services does not happen in a single episode. Family planning aids couples in making decisions about when to have children, how often to have them, and how many to have at a time. Prior research has examined the impact of timing (age at first birth), spacing (birth interval), and limitation (number of children) on maternal, neonatal, child, and adolescent health, as well as nutrition outcomes, separately. Based on the timing of the marriage and the first birth subsequently, the first birth's timing is evaluated and the time interval between the marriage date and the first birth. The first birth's timing affects the health and nutritional consequences for the mother, the newborn, and the child [2]. The women's health is negatively impacted by the timing of the first pregnancy when they are still adolescents since they are going through a crucial stage of physical development that is impeded by pregnancy and childbearing. However, delaying birth until women are physically and psychologically ready will lead to better pregnancy and delivery outcomes, even if marriage occurs at a young age. Family planning is useful in postponing pregnancy till ideal ages. Contrarily, poor mother, infant, and child health and nutritional outcomes result from shorter birth spacing, a greater number of births as a result of repeated childbearing as a result of low acceptance of family planning, higher unmet need for family planning, and more unintentional births.

Methods

The body of the woman frequently loses macronutrients and micronutrients throughout pregnancy, delivery, and lactation due to inadequate birth spacing and repeated childbirth. The risk of Intrauterine Growth Restriction (IUGR), Low Birth Weight (LBW), early birth, and tiny birth size is increased by such unplanned childbirth [3]. The baby's poor pregnancy and delivery outcomes increase their risk of childhood mortality and leave them prone to slower physical development. On the other hand, studies that used both direct and indirect proxies of family planning, such as unintended pregnancies, especially when based on cross-sectional data from Demographic and Health Surveys (DHSs), lack a thorough outline of empirical evidence on the pathways of the influence of family planning on maternal, newborn, child, and nutritional outcomes. In addition, unwanted pregnancies are caused by a variety of societal or cultural factors in addition to the lack of access to or failure of family planning. According to recent data, India's fertility rate has been lowering and the number of unplanned pregnancies has decreased.

Results

As a result, an unexpected delivery is not a reliable indicator of future family planning. Moreover, restrictions relating to family planning and maternal, child, and nutritional outcomes cannot be directly linked by planning questions in DHS data. The best results will be possible with the right combinations of all three components comprising a comprehensive framework of planning of births, which are not identified in the previous studies. Progress in age at first birth, birth order, and birth interval helps to achieve favorable for maternal, child health, and nutritional outcomes, but the best outcomes will be possible with the right combinations of all three components. For instance, many Indian states go above and beyond to achieve replacement-level fertility through female sterilizations, which has undoubtedly resulted in a rapid decline in fertility [4]. At the same time, however, there has been only modest progress in the age at first birth and hardly any improvement in the birth interval. In an ironic greater understanding of birth planning in India is necessary given the country's dropping fertility rate and the stagnating, unmet need for family planning.

Women's health outcomes

Therefore, in a situation where the use of contraceptives is declining, as is evident from the recent National Family and Health Survey, this article advances an argument for a comprehensive strategy of planning of births (through appropriate timing, spacing, and limiting of births) rather than individual components (NFHS). A few recent studies have predicted different maternal and child nutritional outcomes among women who adopted better family planning compared to those of their counterparts using the intersectional dimensions of the continuous process of planning of births (as a proxy of family planning results). Family planning and the detailed theoretical framework demonstrating connections between Nutritional results for mothers and their health have been examined elsewhere. Using a recent nationally representative large-scale database available in India and a framework created in the context of South Asia, this study aims to provide comprehensive empirical evidence demonstrating the effects of the intersectional axes of the planning of births on the selected key maternal, child health, and nutritional outcomes. As outcome markers for the study, we took into account maternal, child nutritional status, and childhood mortality. Indicators of maternal health and nutritional outcomes include BMI and anemia, whereas measures of child health outcomes include stunting, underweight, anaemia, and mortality. According to WHO recommendations, there are three categories for maternal BMI: undernourished, normal, and obese. Stunted and underweight children are those whose weight-for-age and height-for-age ratios are fewer than standard deviations, respectively [5, 6].

Predictors

For the women and their children, both severe and less severe anemia has been taken into consideration. The survival rates of the life tables for the most recent 10 years of birth history have been used to indirectly estimate the under-five death rates. The continuous process of timing, spacing, and limiting births namely, the Interval Between Marriage and First Birth (IBMFB), the Interval Between Birth and Subsequent Birth (IBBSB), and birth order was used to produce the predictor variable, the intersectional axis of the planning of births. There are three categories for birth order: 1, 2, and > 3. For the first birth order, the IBMFB has been divided into 2 years, 2e3 years, and > 3 years; conversely, for the birth order > 1, the IBBSB has been divided into 3 years and 3 years. Nine intersectional axes for birth planning have been developed altogether. For the multivariate analysis, the socioeconomic, demographic, and other associated confounders (region) have been taken into account. The area is split up area is separated among the Empowered Action Groups (EAG) states, Bihar, Uttar Pradesh, and others the remaining states of India.

Discussion

To determine the relationship between the planning of births and mother, newborn, and child health and nutritional outcomes, we performed both bivariate and multivariate statistical analyses. Separate binary logistic regression models were used to evaluate the impact of birth planning on child stunting, underweight, and women's and children's anemia. The multinomial logistic regression and multiple classification analysis conversion models were used to estimate the adjusted association between the planning of births and maternal BMI. The predicted probabilities have been estimated as a post estimation of the regression models and converted to percentages for simplicity of interpretation. Additionally, using Cox-proportional hazard regression, the effects of birth planning on under-five mortality were evaluated. For the women and children individually, the univariate sample distribution by outcome and predictor variables.

Conclusion

According to estimates of women's nutritional condition and anemia levels, percent of them are anemic and 18 percent are underweight. Approximate percentages of the children that are stunted, underweight, and anemic are 38 percent, 35 percent, and 58 percent, respectively. In various axes of birth planning, the sample distribution for women ranges from a minimum of 5 percent to a maximum of 19 percent. The percentage of children in the entire sample for the various intersectional axes of birth planning spans from a low of 7% to a high of 18%. In general, more women in the sample have birth spacing that is less than three years apart.

Conflict of Interest

None

Acknowledgement

None

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