{
    "abstract": "Better hygiene, nutrition, housing, health care and education are needed to prevent some of the estimated 15 million deaths in children under 5 and 500,000 maternal deaths that occur each year in the developing countries. The World Fertility Surveys and other studies beginning in the 1970s in Africa, Asia, the Middle East, and Latin America demonstrated the direct relationship between family planning and maternal and child mortality and morbidity. A child born in a high mortality country of Asia or Africa has a 20 times greater risk of dying before age 5 than a child in the US, Japan, or Sweden. Methods for reducing this mortality are known, including spacing of pregnancies, limiting family size, and avoiding pregnancy at unfavorable ages. During 1986, approximately 2 million children under 5 died from causes associated with rapid procreation and short birth intervals. It is estimated that 1 in 5 of these deaths would have been avoided if the interval between births had been longer. The high mortality rate is partly due to maternal exhaustion; mothers have insufficient time to recuperate between births, especially if they practice prolonged breast feeding, are undernourished, or engage in arduous physical labor. Inability to give high quality care to several children at a time may be another factor. From the 3rd birth on, women run 4 times greater risks of abortion or fetal death than in the 1st or 2nd pregnancy. The proportion of low birth weight babies increases significantly after the 4th child, explaining their vulnerability to health problems or death. Large family size may also prejudice the nutritional status of children. Infant mortality in the entire world in mothers under 20 is estimated at 126/1000 live births. The 1st child of an adolescent mother has an 80% greater probability of death than the 2nd or 3rd child of a mother aged 25-34 years. Lack of access to contraception and lack of motivation to use it are factors preventing tremendous infant mortality gains in the developing world. Only about 6000 of the estimated half million maternal deaths each year occur in developed countries. The indirect causes of maternal mortality are related to the unfavorable status of women reflected in poverty, illiteracy, lack of access to health care, and procreation patterns. The World Fertility Surveys indicate that 200,000 maternal deaths would be avoided each year if women not wanting more children had access to contraception. Contraceptive use would also prevent most of the estimated 100,000-200,000 maternal deaths from complications of abortion each year. The 4 basic elements of a maternal health program are primary care, prenatal care, attendance at delivery by trained personnel, and rapid access to emergency medical care.",
    "authors": [
        {
            "affiliation": null,
            "firstname": "D E",
            "initials": "DE",
            "lastname": "Aizenman"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": null,
    "journal": "Profamilia : planificacion, poblacion y desarollo",
    "keywords": [
        "Abortion, Induced--complications",
        "Adolescent Pregnancy",
        "Age Factors",
        "Birth Limiting--beneficial effects",
        "Birth Spacing--beneficial effects",
        "Causes Of Death",
        "Child Mortality--prevention and control",
        "Delivery Of Health Care",
        "Demographic Factors",
        "Developing Countries",
        "Differential Mortality",
        "Family Planning",
        "Fertility",
        "Fertility Control, Postconception",
        "Health",
        "Health Services",
        "Infant Mortality--prevention and control",
        "Maternal Age",
        "Maternal Health Services",
        "Maternal Mortality--prevention and control",
        "Maternal-child Health Services",
        "Mortality",
        "Parental Age",
        "Population",
        "Population At Risk",
        "Population Characteristics",
        "Population Dynamics",
        "Prenatal Care--beneficial effects",
        "Primary Health Care",
        "Reproductive Behavior",
        "Research Methodology"
    ],
    "methods": null,
    "publication_date": "1988-12-01",
    "pubmed_id": "12157689",
    "results": null,
    "title": "[Impact of family planning on maternal-child health. The future of humanity depends on our children].",
    "xml": "<Element 'PubmedArticle' at 0x788506f4a930>"
}