Contraceptive use and maternal weight among the poor in rural Bangladesh

Abstract

Objective: Examine if contraceptive method use is associated with maternal weight among the poor in rural Bangladesh, after controlling for the influence of demographic and socioeconomic confounding factors. Poor women in Bangladesh are believed to suffer from chronic malnutrition primarily because of low level of calorie as well as micronutrient consumptions. High fertility or repeated pregnancies and its associated resource-scarcity may also adversely affect maternal nutrition. Contraceptive use may prevent fertility-related maternal malnutrition. Moreover, the use of hormonal methods, like oral pills, may lead to weight gain which is recognized as a contraceptive side-effect in well-nourished populations. In Bangladesh, about 50% of the women use contraception, and over 20% of women use oral pills. Methodology: The study includes 2,185 randomly selected married women of reproductive age from landless households in four rural thanas of Tangail and Mymensingh districts. Information on height, weight, perceived health, contraceptive use, and demographic and socioeconomic conditions was collected through a family-life survey conducted in 1993-1994. Body mass index (BMI) and perceived health were regressed on the type and use duration of contraceptive methods and control variables. Contraceptive methods were categorized as: pills, permanent methods, and condoms or traditional methods. Sixty-four injectables and 26IUD cases were excluded from the analysis. Results: The oral pill users had significantly higher BMI than the non-users. The BMI significantly increased with the duration of use of oral pills. Neither the use of permanent and other methods nor the durations of use of these methods were associated with BMI. The positive association between the use duration of oral pills and the BMI indicated that hormonal methods helped increase the poor women's weight. Women's perceived health was positively and significantly associated with the duration of pill use, but not with those of other methods meaning that weight gain was not a discomfort. Conclusion: The prolonged use of oral pills seems to provide beneficial effect among the poor women. Further research is needed to better understand whether or not weight gain due to pill use provides nutritional benefit to poor women in Bangladesh