Family planning programs in agrarian societies: lactation contraception and its policy implications
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Policy discussions of relationships of economic change and population growth are here examined. Breast feeding has a major contraceptive effect in developing countries, especially in rural areas, where it tends to be universal and prolonged. Hence, lactation has primary importance in fertility control in most rural regions of the world. Where lactational amenorrhea is the major contraceptive mode, declining child mortality will increase birth spacing. The increasing number of efforts to combine family planning programs with maternal and child health care should reduce birth rates even when adoption of unfamiliar contraceptive methods is low. Birth spacing will increase as long as weaning patterns do not change while child mortality rates drop. In most regions population growth will increase with rising numbers of surviving children. Economic modernization often reduces child mortality, tending to result in increased numbers of surviving children, thus raising population growth rates. Also, modernization tends to bring declining breastfeeding and diminishing lactational amenorrhea. Thus, birth rates may tend to increase even more rapidly. Child health programs need linkages to programs supporting breastfeeding and offering other forms of family planning to keep birth rates from rising. Throughout less developed countries, for reasons of child health as well as fertility control, family planning programs should support breastfeeding for more stable rates of population growth. In the case of international family planning, the transfer of contraceptive technology has proved to be difficult. Therefore, ethnographic research is required to learn about the social context. A broad, integrated view of biological conditions must be adopted wherever changes are sought in reproduction, health, or nutritional status.
