Share / Export Citation / Email / Print / Text size:

Statistics in Transition New Series

Polish Statistical Association

Central Statistical Office of Poland

Subject: Economics , Statistics & Probability


ISSN: 1234-7655
eISSN: 2450-0291





Volume / Issue / page

Related articles

VOLUME 19 , ISSUE 3 (September 2018) > List of articles


Laxmi Kant Dwivedi

Keywords : breastfeeding, birth spacing, contraception, Cox regression, simulation analysis

Citation Information : Statistics in Transition New Series. Volume 19, Issue 3, Pages 407-431, DOI:

License : (BY-NC-ND 4.0)

Published Online: 13-December-2018



Birth spacing is one of the important aspects of reproductive health. Therefore, it is felt by demographers that birth spacing needs to be studied from time to time in view of the epidemiological transition taking place worldwide. Using the third round of National Family Health Survey-3 data, the central hypothesis of this paper is to find out the relative advantages of breastfeeding over other methods of contraception among non-sterilized women by using simulative approach of the Cox regression analysis in India and its regions. The results show that if women were not having amenorrhea period and had a high level of breastfeeding, the chance of not having next live birth was only two percent lower than those women who were using spacing methods in India. This pattern was found to be almost similar in all the regions of India except central and southern regions. There is no significant gain in postponing the next live birth has been observed in using the contraceptives than breastfeeding. An effort has also been made to apprise the policymakers of the interrelation between breastfeeding, postpartum amenorrhea, contraceptive use and birth spacing. Nonetheless, policymakers should promote programs that encourage both breastfeeding and contraceptive use. Breastfeeding has direct benefits for infant health in addition to its role in lengthening birth intervals beyond postpartum amenorrhea.

Content not available PDF Share



ANDERSON, J. E., BECKER, S., GUINENA, A. H., MCCARTHY, B. J., (1986).  Breastfeeding Effects on Birth Interval Components. A Prospective Child Health Study in Gaza. Studies in Family Planning, Vol.17, 3, pp. 153–160.

AROKIASAMY, P (2002): Breastfeeding and Its Contraceptive Role on Postpartum Amenorrhoea and the Waiting Time to Conception in India. GENUS, 58 (1), pp. 121–158.

BHAT, P. N. M., ZAVIER, A. J. F., (2005). Role of Religion in Fertility Decline: The Case of Indian Muslims. Economic and Political Weekly, XL (5), pp. 385–402.

BONGAARTS, J, POTTER, R. G., (1983): Fertility, Biology and Behaviour: An Analysis of the Proximate Determinants, New York: Academic Press.

BUTZ, W. P., DA VANZO, J., (1981). Determinants of Breastfeeding and Weaning Patterns in Malaysia, Paper Presented at the Annual Meeting of the Population Association of America. Washington, DC, pp. 26–28 March.  

COX, D. R., (1972).  Regression Models and Life Tables, Journal of the Royal Statistical Society. Series B, 34, pp. 187–220.

DA VANZO, J., RAZZAQUE, A., RAHMAN, M., HALE, L., AHMED, K., KHAN, M., A., MUSTAFA, G., GAUZIA, K., (2004). The Effects of Birth Spacing on Infant and Child Mortality, Pregnancy Outcomes, And Maternal Morbidity and Mortality in Matlab, Bangladesh. Rand Corporation: Rand Labor and Population Working Paper Series, WR-198 (October).

DA VANZO, J., STARBIRD, E. H., (1991). Correlates of Short Inter-birth Intervals in Peninsular Malaysia: Their Pathways of Influence through Breastfeeding and Contraceptive Use. Studies in Family Planning, Vol. 22, 4, pp. 241–54.

DAVANZO, J., HABICHT, J. P., (1986). Infant Mortality Decline in Malaysia, 19461975: The Roles of Changes in Variables and Changes in the Structure of Relationship, Demography, Vol. 23, 2, pp. 143–160.

DWIVEDI, L. K., RAM, F., RESHMI, R. S., (2007). An Approach to Understanding Change in Contraceptive Behaviour in India. GENUS, LXIII  (3-4), pp. 19–54.  

DWIVEDI, S. N., SINGH, R., (2003). On Assessing the Child Spacing Effect of Breastfeeding Using Cox Proportional Hazard Model with NFHS Data, Demography India, Vol. 32, 2, pp. 215–224. 

FAMILY HEALTH INTERNATIONAL, (1988). Consensus Statement: Breastfeeding as a Family Planning Method. The Lancet, 8621, pp. 1204– 1205.

HENRY, L (1961). Some Data on Natural Fertility. Eugenics Quarterly, 8 (2), pp. 81–91.

HOLMAN, D. J, GRIMES, M. A., ACHTERBERG, J. T., BRINDLE, E., O’CONNOR, K. A. (2006). Distribution of Postpartum Amenorrhea in Rural Bangladeshi Women. American Journal of Physical Anthropology, 129 (4), pp. 609–619.

HOWIE, P. W., MCNEILLY, A. S., (1982). Effect of Breastfeeding Patterns on Human Birth Intervals. Journal of Reproduction and Fertility, 65, pp. 545–557.

KLEINBAUM, D. G., (1996a). Survival Analysis. Statistics in Health Sciences. Springer-Verlag, New York, Inc.  

KLIENBAUM, D. G., (1996b). Statistics in the Health Sciences. Springer, New York, Inc. USA.  LAST, J. M., (1988). A Dictionary of Epidemiology (2nd edition). New York Oxford, Toronto, Oxford University Press.

MARBANIANG, S. L., (2003). Health and Family Welfare Programme and Fertility Change in Meghalya. Unpublished PhD Thesis, International Institute for Population Sciences, Mumbai, India.  

MERCHANT, K., MARTORELL, R., (1998). Frequent Reproductive Cycling: Does It Lead to Nutritional Depletion of Mothers? Progress in Food and Nutrition Science, Vol. 12, 4, pp. 339–369.

MTURI, A. J., (1997). The Determinants of Birth Intervals among NonContraception Tanzanian Women. African Population Studies, Vol. 12, 2 Accessed at on September 26, 2012.

NAMBOODIRI, N. K., (1974). Which Couples at Given Parties Expect to have Additional Births? An Exercise in Discriminant Analysis. Demography, Vol. 11, 1, pp. 45–56.

NAMBOODIRI, N. K., (1983). Sequential Fertility Decision Making and the Life Course. In: Bulatao, RA and Lee, RD (Eds.), Determinants of Fertility in Developing Countries, Fertility Regulation and Institutional Influences, New York, Academic Press, 2, Studies in Population, pp. 444–472.  

NATH, D. C., LAND, K. C., SINGH, K. K., (1994). The Role of Breastfeeding beyond Postpartum Amenorrhoea on the Return of Fertility in India: A Life Table and Hazards Model Analysis. Journal of Biosocial Sciences, Vol. 26, 2, pp. 191–206.

NJOGU, W., MARTIN, T., C., (1991). Fertility Decline In Kenya: The Role of Training and Spacing of Births in IRD/Macro International, Proceedings of the Demographic and Health Surveys World Conference, Vol. III, Washington, D.C., Columbia, Maryland.

OJHA, A., (1998). The Effect of Sex Preference on Fertility in Selected States of India. The Journal of Family Welfare, Vol. 44, 1, pp. 42–48.

PATHAK, K. B., (1966). A Probability Distribution for the Number of Conceptions. Sankhya. Series B, Vol. 28 (3/4), pp. 213–218.

POTTER, J., E., (1987b). The Influence of Maternal Health Care on the Prevalence and Duration of Breastfeeding in Rural Mexico, Studies in Family Planning, Vol.18, 6, pp. 309–319.

POTTER, J. E., MOJARRO, O., NUNEZ, L., (1987a). The Influence of Health Care on Contraceptive Acceptance in Rural Mexico. Studies in Family Planning, Vol.18, 3, pp. 144–156.

POTTER, R. G., (1963). Birth Intervals: Structure and Change, Population Studies, Vol. 17, 2, pp. 155–166. RAM, U., DWIVEDI, L. K., GOSWAMI, B., (2007). Understanding Contraception Use among Muslims of Indian, Pakistan and Bangladesh, Journal of Population and Social Studies, Vol.15, 2, pp. 101–130.

RODRIGUEZ, G, HOBCRAFT, J., MCDONALD, J., MENKEN, J., TRUSSELL, J., (1983). A Comparative Analysis of the Determinants of Birth Intervals. Comparative Studies, Number 30, London: World Fertility Survey.

SAHU, D., (1998). Breastfeeding Practices, Postpartum Amenorrhoea and Fertility Transition in Orissa. 1982-93: A Study Based on Two Large Scale Sample Surveys, International Institute for Population Sciences, Mumbai, India.

SAXENA, P. C., (1977). Breast-feeding: It’s Effects on Post-partum Amenorrhea, Social Biology, 24 (1), pp. 45–51.

SAXENA, P. C., PATHAK, K. B., (1977). On a Distribution of Post-partum Amenorrhea Period Following a Live Birth, Demography India, 6 (1&2), pp. 174–181.

SEHGAL, J. M., (1971). Indices of Fertility Derived from Data on the Length of Birth Intervals. Using Different Ascertainment Plans. Unpublished PhD Thesis, School of Public Health, University of North Carolina, Chapel Hill, USA.  

SHEKHAR, C., DWIVEDI, L., K., RAM, F., (2006). Fertility Goals and Regulation Dynamics in Northeastern States of India: An Application of Supply-Demand Framework. Journal of Empirical Research in Social Science, Vol. 1, 2, pp. 12–33.

SHEKHAR, C., (2004). Understanding Reproductive Changes and Proximate Determinants in India. Unpublished PhD Thesis, International Institute for Population Sciences, Mumbai, India.

SHEPS, M. C., (1964). On the Time Required for Conception. Population Studies, Vol. 18, pp. 85–97.

SHEPS, M. C., MENKEN, J. A., (1972). Distribution of Birth Intervals According to the Sampling Frame. Theoretical Population Biology, Vol. 3, 1, pp. 1–26. 

SINGH, S. N., (1964). On the Time of First Birth. Sankhya. Series B, Vol. 26 (1/2), pp. 95–102.

SINGH, K. K., SUCHINDRAN, C. M., SINGH, K., (1999). Breast-feeding and Postpartum Amenorrhoea: An Indian Experience. Demography India, 28 (1), pp. 1–12 SRINIVASAN, K., (1980). Birth Interval Analysis in Fertility Surveys. WFS Scientific Reports, 7.

SRINIVASAN, K, PATHAK, K. B., PANDEY, A., (1989). Determinants of Breastfeeding and Postpartum Amenorrhoea in Orissa. Journal of Biosocial Science, 21 (3), pp. 365–371.

SWENSON, I., THANG, N. M., (1993). Determinants of Birth Intervals in Vietnam: A Hazard Model Analysis. Journal of Tropical Pediatrics, Vol. 39, 3, pp. 163– 167.  

TRUSSELL, J., MARTIN, L. G., FELDMAN, R., PALMORE, J. A., CONCEPCION, M., DATIN NOOR LAILY B. T., DATO’ ABU BAKAR, (1985).  Determinants of Birth-Interval Length in the Philippines. Malaysia and Indonesia: A Hazard Model Analysis. Demography, Vol. 22, 2, pp. 145–168.