Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

Socioeconomic Factors Affecting the Pattern of Using Contraceptives among Multiparous Women in Bangladesh

Document Type : Original Research Article

Authors
Mohammad Safi Uddin 1
Kanak Chapa 2
Nayamat Ullah 3
1 Graduate, School of Governance Studies, Meiji University and Family Planning Officer, Directorate General of Family Planning, Bangladesh
2 Graduated, Department of Child Development and Social Welfare, Government College Applied Human Science
3 Graduated, Department of Development Studies, Islamic University Bangladesh
10.22038/jmrh.2026.79919.2396
Abstract
Background & aim: Despite population policy of Bangladesh, promoting a two-child norm, many families have more than two children. The government provides free domiciliary contraceptive services and counseling to address myths about birth control. Therefore, this study aimed to identify socio-demographic factors influencing the pattern of using contraceptive among multiparous women in Bangladesh.
Methods: This cross-sectional study used data (n=10004) extracted from the Bangladesh Demographic and Health Survey (BDHS) between 24 October 2017 and 15 March 20182017-2018. Ever-married women with two or more children were selected using stratified, multistage cluster sampling design. Data was collected through interviews using the structured BDHS Women’s Questionnaire. Chi-square tests were used for bivariate analysis, followed by binary logistic regression to identify factors influencing contraceptive decisions. Data analysis was conducted using SPSS version 25.
Results: This study determined socio-demographic factors including son preference, limited decision-making power, and insufficient knowledge about the ovulatory cycle influencing contraceptive use among Bangladeshi women with two or more children. Findings also showed that higher education of husbands reduced contraceptive use (P<0.0001), while women's education had no significant impact (P=0.246). Contraceptive use by women were found to be increased with their age and the women from Chittagong, Dhaka and Sylhet divisions showed a greater likelihood to use contraceptives than the others.
Conclusion: The contraceptive prevalence rate (CPR) was higher among women with two or more children, with multiple sociodemographic factors influencing their contraceptive decisions. Addressing multiparous women, this study proposes a special intervention to increase contraceptive use in Bangladesh.
Keywords
Family Planning
Contraceptive
Unwanted Pregnancy
Logistic Regression
Socio Economic Status
Subjects
1.        Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. The Lancet. 2006; 368(9549): 1810–1827.
2.        Campbell AA. The Role of Family Planning in the Reduction of Poverty. Journal of Marriage and the Family. 1968; 30(2): 236.
3.        Kohler HP, Behrman JR. Benefits and Costs of the Population and Demography Targets for the Post-2015 Development Agenda. Prioritizing Development: A Cost Benefit Analysis of the United Nations’ Sustainable Development Goals. 2018; 375–398.
4.        Frost JJ, Sonfield A, Zolna MR, Finer LB. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program. The Milbank Quarterly. 2014; 92(4): 696–749.
5.        Dennis A. Ahlburg. The Impact of Population Growth on Well-being in Developing Countries PDF [Internet]. 1996 [cited 2024 May 13]. Available from: https:// zlibrary.to/dl/the-impact-of-population -growth-on-well-being-in-developing-countries
6.        Unicef. Update on the context and situation of children. 2022.
7.        Chae S, Desai S, Crowell M, Sedgh G, Singh S. Characteristics of women obtaining induced abortions in selected low- and middle-income countries. PLOS ONE. 2017; 12(3): e0172976.
8.        Karar Z Ahsan AAS, Nitai Chakraborty SEA. (PDF) Bangladesh Demographic and Health Survey (BDHS) 2017-2018: Key Indicators Report. ResearchGate. 2019.
9.        Sarnak DO, Wood SN, Zimmerman LA, Karp C, Makumbi F, Kibira SPS, et al. The role of partner influence in contraceptive adoption, discontinuation, and switching in a nationally representative cohort of Ugandan women. Plos One. 2021; 16(1): e0238662.
10.    Uddin ME, MSS TZ, MSS MS. Socio-cultural factors affecting family size between Muslim and Santal Communities in rural Bangladesh. Cultural Anthropology. 2012; 395: 410.
11.    Hahn Y, Islam A, Nuzhat K, Smyth R, Yang HS. Education, marriage, and fertility: Long-term evidence from a female stipend program in Bangladesh. Economic Development and Cultural Change. 2018; 66(2): 383-415.
12.    Dias JG, Tiago De Oliveira I. Multilevel Effects of Wealth on Women’s Contraceptive Use in Mozambique. Plos One. 2015; 10(3): 121758.
13.    Masyarakat JK, Idris H, Info A, Raya J, Km PU, Ogan I, et al. Factors Affecting the Use of Contraceptive in Indonesia: Analysis from the National Socioeconomic Survey (Susenas). Jurnal Kesehatan Masyarakat. 2019; 15(1): 117–123.
14.    Bora JK, Saikia N, Kebede EB, Lutz W. Revisiting the causes of fertility decline in Bangladesh: the relative importance of female education and family planning programs. Asian Population Studies. 2023 ; 19(1): 81–104.
15.    Hossain M, Khan M, Ababneh F, Shaw J. Identifying factors influencing contraceptive use in Bangladesh: Evidence from BDHS 2014 data. BMC Public Health. 2018; 18(1): 1–14.
16.    Robey B, Rutstein SO, Morris L. The reproductive revolution: New survey findings. Population Reports. 1992; 20(4): 1-44.
17.    Visaria A. Religion and son preference in India and Bangladesh: Three essays on comparing Hindus and Muslims on son preference and sex differentials in child health. University of Pennsylvania; 2015.
18.    Lai SL. Fertility differentials in Bangladesh and Pakistan: evidence from demographic and health surveys. Asian Population Studies. 2022; 18(3): 275-293.
19.    Huda FA, Robertson Y, Chowdhuri S, Sarker BK, Reichenbach L, Somrongthong R. Contraceptive practices among married women of reproductive age in Bangladesh: a review of the evidence. Reproductive Health. 2017; 14(1): 1–9.
20.    Ahmed Zohirul Islam Mp, Md. Nazrul Islam Mondal P, Mt. Laily Khatum Ms, Md. Mosiur Rahman P, Md. Rafiq Islam P, Md. Golam Mostafa P, et al. Prevalence and Determinants of Contraceptive use among Employed and Unemployed Women in Bangladesh. International Journal of Maternal and Child Health and AIDS. 2016; 5(2): 92–102.
21.    Haq I, Sakib S, Talukder A. Sociodemographic Factors on Contraceptive Use among Ever-Married Women of Reproductive Age: Evidence from Three Demographic and Health Surveys in Bangladesh. Medical Sciences. 2017; 5(4): 31.
22.    Kundu S. Factors influencing menstrual regulation and its socioeconomic inequalities among ever-married women in Bangladesh: Findings from a nationwide cross-sectional survey. Journal of Biosocial Science. 2022; 1–12.
23.    Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: A systematic review of qualitative research. Reproductive Health. 2009; 6(1): 1–12.
24.    Kundu S. RESEAR CH A RTIC LE Factors influencing menstrual regulation and its socioeconomic inequalities among ever-married women in Bangladesh: Findings from a nationwide cross-sectional survey.
25.    Gafar A, Suza DE, Efendi F, Has EM, Pramono AP, Susanti IA. Determinants of contraceptive use among married women in Indonesia. F1000Research. 2020; 9: 193.
26.    Hakim A, Salway S, Mumtaz Z. Women’s autonomy and uptake of contraception in Pakistan. Asia-Pacific Population Journal. 2003; 18(1): 63–82.
27.    Kim J. Female education and its impact on fertility. IZA World of Labor. 2023.
28.    Lakew Y, Reda AA, Tamene H, Benedict S, Deribe K. Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey. Reproductive Health. 2013; 10(1): 52.
29.    Yao J, Murray AT, Agadjanian V. A geographical perspective on access to sexual and reproductive health care for women in rural Africa. Social Science & Medicine. 2013; 96: 60–68.
30.    Kabagenyi A, Reid A, Ntozi J, Atuyambe L. Socio-cultural inhibitors to use of modern contraceptive techniques in rural Uganda: a qualitative study. The Pan African Medical Journal. 2016 Oct 17;25:78.
31.    Haq I, Alam M, Methun IH. Contributions of Proximate Determinants to Fertility Transition in Bangladesh: An Analysis of Bongaarts’ Fertility Model. International Journal of Travel Medicine and Global Health. 2019; 7(1): 23–32.
32.    Callum C, Sathar Z, ul Haque M. IS MOBILITY THE MISSING LINK IN IMPROVING GIRLS'SCHOOLING IN PAKISTAN?. Asian Population Studies. 2012; 8(1): 5-22.
33.    Nyarko SH. Spatial variations and socioeconomic determinants of modern contraceptive use in Ghana: A Bayesian multilevel analysis. Plos one. 2020; 15(3): e0230139.
34.    Islam S, Nesa MK. Fertility transition in Bangladesh: The role of education. Proceedings of the Pakistan Academy of Sciences. 2009; 46(4): 195-201.
Journal of Midwifery and Reproductive Health
Volume 14, Issue 4
Autumn 2026
Pages 5717-5729