Factors Associated with Birth Spacing in Rural Haiti

Guidelines recommend birth spaces of 36-60 months. Our study examined birth spacing in rural Haiti. Multigravidous women, ages 20-47 years (mean 32.7) attending the Haitian Health Foundation’s MCH clinics were interviewed in Haitian Creole (June-August 2013) regarding reproductive histories, community participation, and family planning (FP) knowledge. 104 women from 68 villages reported 440 pregnancies and 383 deliveries. Birth spacing ranged from 10-141 months (mean 42.9 months). 40% of women averaged birth spacing <36 months, with 14% >60 months. 97% of respondents reported lifetime use of one or more family planning methods. 93.2% of women used Lactational Amenorrhea (LAM) at least once and 65.4% used it after every delivery. LAM was recognized as a FP method by14.4% of women, with a few incorrectly reporting LAM after child was 6+ months old. Excluding LAM, FP use in our sample (43%) was higher than statistics for all rural women in Haiti (34%, DHS 2012). There was a negative relationship between number of fathers and lifetime use of FP (r = -.241, p<0.05).  More respondents said they did not want more children (98%) compared to information on Haitian women in general (80%).   Mean birth spacing of all women was within the recommended range, but the majority had average birth spaces outside this range. LAM was frequently used but not usually viewed as FP and not always used correctly when identified. Women’s intentions not to have more children often change when they have a new partner.  These findings have significant implications for health promotion messages.