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Resumen En los últimos años, el cuerpo médico local ha realizado esfuerzos significativos en el campo del estudio control de los hábitos reproductivos de la población colombiana. Este artículo intenta ilustrar como se pueden utilizar desde el punto de vista demográfico, en forma significativa, los datos obtenidos en esie programa. Aunque los datos disponibles al memento de eseribir este artículo, no se adjustan a los principios del procedimiento cietífico de muestreo, se piensa que tales estu dios podrían contribuir a aclarar ciertos temas, tales como los patrones de emparejamiento, el efecto de la contracepción sobre el espaciamiento de los nacimientos entre parejas casadas, y la relación de la fertilidad con la frecuencia del coito. El artículo trata de algunos aspectos metodo1ógicos que convergen alrededor de estos problemas.

En comparacion con las tendencias anteriores a la Segunda Guerra Mundial, las mujeres de los Estados Unidos tienenahora su primerhijo dentro de un intervalo mas breve luego desu matrimonio, su segundo hijo en una fecha mas cercana a la del primero y el tercer hijo en fecha mas cercana a la del segundo. Tanto los datos defecundidad quepresentan las tabulaciones de la Oficina del Censo de los Estados Unidos como la investigacion de 1960 sobre Crecimiento de la Familia de los Estados Unidos muestran esios resultados. Esto constituye un virajecompleto conrespecio a la tendencia que predominaba conanterioridad a la Segunda Guerra Mundial y especialmente conrespecto al periodo de la depresion economica de la decada de 1930. Los datos de la encuesta sobre Crecimiento de la Familia de los Estados Unidoe suministran conocimientos adicionales respecto a esie fenomeno: (a) Ocurre entre parejas de todos los niveles socioeconomicos; (b) en general, las personas de posicion socio-economica mas alta tienen hijos a intervalos mayores que aquellas de posicion socio-economica mas baja, y los Protestantes tienen hijosa intervalos mas largos quelos Catolicos. El reciente cambio ha tenido el efecto de disminuir eetas diferencias; (c) esta tendencia haciauna reduccion de los intervalos ha ocurrido enforma voluntaria, ya queotros datos obtenidos a traves de la encuesta indican que un alto porcentaje da las perejas tienen conocimiento completo y experiencia en el uso de metodos anticonceptivos.

The knowledge attitudes and practice of family planning were studied among Bedouins in Wadi Turaba Saudi Arabia; 40% were nomadic and 60% were semi - or fully settled. 314 households were interviewed and children under 4 were examined clinically. The average number of pregnancies per mother in the 3 communities was 5.2; 23% said they desired more children 23% did not want more children and 54% were indifferent. The more previous pregnancies a woman had had the less likely she was to want more children. 32% of the mothers from the settled community knew that pregnancy could be prevented vs. 3% in the semisettled community and 0% in the nomadic group. Spacing of children appeared to be due to 2-year lactation periods. Knowledge about contraceptives was virtually nonexistent; in rare situations coitus interruptus is practiced.

A total of 410 women delivering in the U.I.S.E. Maternity Hospital in Kanpur, India, were included in a study to determine the relation of birth interval with birth weight and infant morbidity and mortality. 66.7% of the sample group had a birth spacing of less than 2 1/2 years, 25.1% between 2 1/2 and 3 1/2 years, and 8.2% above 3 1/2 years. As birth interval increased, so did mean birth weight; mean birth weight was lowest (2150 gm) when spacing was less than 1 year and exhibited an upward trend up to 3 1/2 years. 60.8% of the infants delivered at a birth interval of less than 1 year weighed less than 2000 gm compared with 11.3% of the infants born at birth interval of 3-3 1/2 years. The highest percentages of infant morbidity (52.1%) and mortality (13.1%) were found when birth spacing was less than 1 year; both rates were considerably reduced (20.5% and 2.2%, respectively) when birth spacing was 2 1/2-3 1/2 years. Birth spacing is closely related to effective family planning, and its practice may yield substantial child health benefits.

SummaryData were collected from 368 Rwanda women, 50 non-lactating and 318 lactating, to determine the effect of lactation on conception rate and the return of menstruation. During lactation the majority of conceptions were found to be delayed by some 15 months, but the family spacing effect was maximal during the first 9 months. By 27 months after delivery the contraceptive effect of lactation can be assumed to have largely disappeared.

In addition to the regular services of the under-fives clinic a new design of the "Road to Health" weight chart provides for the integration of services for the child with family planning. For this purpose a study of the local range of birth interval is undertaken and the period when the 1st 5% of mothers will give birth to the next child is identified. By subtracting 9 months from this period the month in which 5% of the mothers are expected to conceive can be determined. It is suggested that this be termed the "vulnerable" month. The newly designed "Road to Health" chart includes a space for the nurse to record her interview on birth spacing with the mother when the child is brought in for clinic care. The goal is to encourage the mother to begin a contraceptive method before she reaches the "vulnerable" month. The under-fives clinic may prove to be a significant motivator in the use of contraception. Postponing the next conception may become as important to the health worker as immunizing the children.

Studies conducted with 179 women at Soongnern Clinic in northeast Thailand and 5669 at Siriraj Hospital in Bangkok showed that the women who chose the pill were more likely to do so to space pregnancies than those who selected the IUD. From a survey of 48 women in Soongnern 52% chose the pill for spacing and 48% chose the IUD. Studies with 118 women indicated that 29% selected the pill to prevent pregnancy while 70% opted for the IUD. No information is available on continuation rates for Soongnern. At the Siriraj Hospital a survey involving 2761 women (90% providing reasons for spacing or stopping) showed that 59% adopted the pill to space 40% chose the IUD. Among 2367 women 50% selected the pill and 49% the IUD to prevent pregnancy. These results indicate that the differing reasons for selecting a particular technique partially explains the difference in continuation rates.