Birth Spacing Reseach
Centro Medico's Female Patients: Investigating Women's Health at the Clinic
Northwestern Medical student and Centro Medico Volunteer Julia Chu decided to do her MPH final requirement at Centro Medico. Since Julia had a special interest in women's health, specifically in maternal and perinatal morbidity and mortality, she researched birth spacing in Centro Medico's surrounding communities.
While planning her project, she learned that short intervals - less than two years - between pregnancies had been associated with increased maternal and perinatal morbidity and mortality. Additionally, she also learned that women in rural areas in Bolivia only want 2 to 3 children in their lifetime but in reality have 5 to 6 children over a relatively short period of time.
She then developed a survey that explored rural women's attitudes toward birth spacing and contraceptive use. Her studied aimed to investigate whether limited access to contraception, lack of sex education and cultural factors can explain why rural women commonly have more children than they desire.
Julia's research did show that women in the clinic area have more children than they desire or have children spaced too closely together. The women see this as a normal part of life. As the women in Julia's study put it, they would have waited longer in between pregnancies but got pregnant, so what could they have done?
Often the women in her study did not use birth control. Their reasons for not using birth control included lack of education on birth control methods and their side effects, inconsistent access to contraceptives and being part of a culture that is accepting of having many children over a short period of time.
The Bolivian government provides birth control, but it is not as easy as it sounds. Frequently government programs at local health posts only give a one-month supply at each visit. Inclement weather and bad road conditions often make it difficult to return to the post every month. In addition, the selection is usually limited to birth control pills or Depo-Provera injections. Sometimes the supplies even run out, causing poor patients to pay out-of-pocket at the local pharmacy or simply go without birth control.
In addition to completing a fascinating research for her MPH degree, Julia found it enlightening to talk to the women at the clinic. In general, the women seemed very comfortable and happy to speak with her and did not shy away from answering questions that probed feelings about their pregnancies or their attitudes toward contraceptives.