Short birth intervals can have adverse consequences for maternal and infant outcomes. Optimal birth spacing is often presumed to be achieved through the practice of family planning and use of contraceptives, yet most of the available research does not address explicitly the contribution of contraceptive-method use to birth spacing or maternal and infant survival. We conducted a systematic literature review to assess the body of evidence linking contraceptive use to birth-interval length. Fourteen studies published in English between 1980 and 2008 met our eligibility criteria for inclusion. The findings from these studies are mixed but suggest that the use of contraceptives is protective against short birth intervals. Although results are favorable, many of the studies and methodologies employed are dated. More current research is needed to determine the impact of contraceptive-method use on birth-interval length in order to inform the promotion of family planning for reducing maternal and infant morbidity and mortality through birth spacing.
Since the 1994 Cairo International Conference on Population and Development, there has been increasing interest in promoting women's empowerment, particularly for sexual and reproductive health. Women's ability to negotiate the timing of intercourse with an intimate partner has not been extensively studied. This study explored the relationships between married women's autonomy and the time since most recent sexual intercourse in Ghana, Malawi, Mali, Rwanda, Uganda, and Zimbabwe using the Demographic and Health Surveys. Significant variation both within and between countries in the timing of most recent sex was found. A strong relationship between women's decision-making autonomy and time since last sexual intercourse in all six settings, even after controlling for factors such as the husband living elsewhere, age, marital duration, and other sociodemographic variables, was found. Men's decision-making autonomy was not associated with the time since last intercourse. Understanding how women's position in the household influences their sexual activity may be an essential piece in protecting the sexual rights of women and helping them to achieve a sexual life that is both safe and pleasurable.
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