DHS COMPARATIVE

REPORTS 36

USE OF FAMILY PLANNING IN THE 

POSTPARTUM PERIOD

SEPTEMBER 2014

This publication was produced for review by the United States Agency for International Development (USAID). The report was prepared by

William Winfrey and Kshitiz Rakesh of ICF International.

DHS Comparative Report No. 36 

Use of Family Planning in the Postpartum Period 

William Winfrey 

Kshitiz Rakesh 

ICF International 

Rockville, Maryland, USA 

September 2014 

Corresponding author: William Winfrey, Futures Institute, 41-A New London Turnpike, Glastonbury, 

Connecticut, USA; phone: 301-775-9286; email: bwinfrey@futuresinstitute.org 
Acknowledgment: The authors thank Sarah Staveteig and Kerry MacQuarrie for assistance in using the 

reproductive calendar. The authors also thank Anne Pfitzer, John Ross, and John Stover for helpful 

reviews that spotted errors in the analysis and helped shaped the presentation of the results. 

Editor: Bryant Robey 

Document Production: Yuan Cheng 

This study was carried out with support provided by the United States Agency for International 

Development (USAID) through The DHS Program (#AID-OAA-C-13-00095). The views expressed are 

those of the authors and do not necessarily reflect the views of USAID or the United States Government. 

The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. For additional information about the DHS Program contact: 

DHS Program, ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: 301-

407-6500, fax: 301-407-6501, email: reports@dhsprogram.com, Internet: www.dhsprogram.com. 

Recommended citation: 

Winfrey, William, and Kshitiz Rakesh. 2014. Use of Family Planning in the Postpartum Period. DHS 

Comparative Report No. 36. Rockville, Maryland, USA: ICF International. 
iii 

Contents 

Tables ........................................................................................................................................................... v 

Figures ......................................................................................................................................................... vi 

Preface ........................................................................................................................................................ vii 

Abstract ....................................................................................................................................................... ix 

Executive Summary ................................................................................................................................... xi 

1. Introduction ............................................................................................................................................. 1 

1.1. Literature Review ........................................................................................................................... 1 

2. Data and Methods ................................................................................................................................... 3 

2.1. DHS Data Used in the Study .......................................................................................................... 3 

2.2. Methods .......................................................................................................................................... 4 

3. Results ...................................................................................................................................................... 9 

3.1. Evolution of Family Planning Use across the Postpartum Period ................................................ 9 

3.2. Family Planning Methods in the Postpartum Period .................................................................. 12 

3.3. Differences in Postpartum Family Planning Use by Demographic Factors, Socioeconomic 

Factors, Fertility Preferences, and Use of Maternal Health Services ......................................... 18 

4. Discussion .............................................................................................................................................. 31 

References .................................................................................................................................................. 33 

Appendix .................................................................................................................................................... 35

v 

Tables 

Table 1. List of surveys, by year ................................................................................................................... 3 

Table 2. Postpartum family planning use at 1-2 months, 3-5 months, 6-8 months, 9-11 months 

tabulated using the reproductive calendar and tabulated based on current use of family 

planning at time of interview, 43 DHS surveys, 2005–2013 .......................................................... 6

Table 3. Postpartum family planning use (any method) at one-month intervals in the postpartum 

period for births 12-23 months preceding the survey, tabulated using the reproductive 

calendar, 43 DHS surveys, 2005–2013 ........................................................................................... 9

Table 4. Surveys categorized by levels of family planning use at one month and 12 months 

postpartum .................................................................................................................................... 12

Table 5. Postpartum family planning method mix and method mix among currently married women, 

43 DHS surveys, 2005–2013 ........................................................................................................ 13

Table 6. Postpartum family planning use (any method) by age of mother at birth, birth order, and 

number of children under age 5, 43 DHS surveys, 2005–2013 .................................................... 19

Table 7. Postpartum family planning use (any method) by urban-rural location, wealth status, and 

educational attainment, 43 DHS surveys, 2005–2013 .................................................................. 22

Table 8. Postpartum family planning use (any method) by wantedness of the birth, birth order relative 

to ideal family size, and desire to have another child, 43 DHS surveys, 2005–2013 ................... 26

Table 9. Postpartum family planning use (any method) by use of antenatal care and place of delivery, 

43 DHS surveys, 2005–2013 ........................................................................................................ 28

Appendix Table A1. Numbers of births for Table 6, postpartum family planning use disaggregated by 

demographic factors ..................................................................................................................... 35

Appendix Table A2. Numbers of births for Table 7, postpartum family planning use disaggregated by 

socioeconomic factors .................................................................................................................. 37

Appendix Table A3. Numbers of births for Table 8, postpartum family planning use disaggregated by 

fertility preferences ....................................................................................................................... 39

Appendix Table A4. Numbers of births for Table 9, postpartum family planning use disaggregated by 

use of antenatal care and place of birth delivery .......................................................................... 41
vi 

Figures 

Figure 1. Evolution of family use (any method) in the postpartum period for Armenia, Azerbaijan, 

Bangladesh, Benin, Ghana, Moldova, and Niger ...................................................................... 11

Figure 2. Use of pills, injectables, female sterilization, LAM, and periodic abstinence as a 

percentage of all family planning use for postpartum women and currently married 

women, Niger 2012, India 2005-2006, and Peru 2012 ............................................................. 18

Figure 3. Postpartum family planning use (any method) and family planning use by currently 

married women (any method) disaggregated by wealth index, Bangladesh 2011 and 

Indonesia 2012 .......................................................................................................................... 24
vii 

Preface 

The Demographic and Health Surveys (DHS) Program is one of the principal sources of international data 

on fertility, family planning, maternal and child health, nutrition, mortality, environmental health, 

HIV/AIDS, malaria, and provision of health services. 

One of the objectives of The DHS Program is to provide policymakers and program managers in low- and 

middle-income countries with easily accessible data on levels and trends for a wide range of health and 

demographic indicators. DHS Comparative Reports provide such information, usually for a large number 

of countries in each report. These reports are largely descriptive, without multivariate methods, but when 

possible they include confidence intervals and/or statistical tests. 

The topics in the DHS Comparative Reports series are selected by The DHS Program in consultation with 

the U.S. Agency for International Development. 

It is hoped that the DHS Comparative Reports will be useful to researchers, policymakers, and survey 

specialists, particularly those engaged in work in low- and middle-income countries. 

Sunita Kishor 

Director, The DHS Program 

ix 

Abstract 

This report used reproductive calendar data from 43 Demographic and Health Surveys (DHS) 

representing 61 percent of the developing world’s population (excluding China) to examine the use of 

family planning in the postpartum period. Postpartum women are more likely to use injectables and the 

lactational amenorrhea method and less likely to use female sterilization compared with all currently 

married women. In most countries use of postpartum family planning is not strongly related to the age of 

the mother, parity, or the wantedness of the last birth. In most countries use of postpartum family 

planning is positively related to urban location, wealth, education level, achievement of desired family 

size, and current fertility desires. It is negatively related to the number of children under age 5 born to the 

woman. There is the strong correlation between use of maternal health care and use of postpartum family 

planning. 

Keywords: postpartum family planning, family planning, maternal health services 

xi 

Executive Summary 

This report uses the reproductive calendar of the Demographic and Health Surveys (DHS) to examine the 

use of family planning in the postpartum period. The reproductive calendar has been used infrequently in 

such analyses. Previous global analyses of postpartum family planning have measured family planning 

use at the time of the survey. Using the reproductive calendar allows for more robust analysis of 

postpartum family planning by increasing the sample sizes available at any point in time during the 

postpartum period. 

The study analyzes data from 43 country surveys representing 61 percent of the developing world’s 

population (excluding China). To the author’s knowledge, this is the first analysis of postpartum family 

planning using the DHS reproductive calendar with such broad global coverage. The countries analyzed 

are: Albania, Armenia, Azerbaijan, Bangladesh, Benin, Bolivia, Burkina Faso, Burundi, Cambodia, 

Colombia, Comoros, Egypt, Ethiopia, Ghana, Guyana, Honduras, India, Indonesia, Jordan, Kenya, 

Kyrgyz Republic, Lesotho, Madagascar, Malawi, Maldives, Moldova, Mozambique, Namibia, Nepal, 

Niger, Nigeria, Pakistan, Peru, Rwanda, Senegal, Sierra Leone, Tajikistan, Tanzania, Timor-Leste, 

Uganda, Ukraine, Zambia, and Zimbabwe.

Three types of analysis were performed: 1) a comparison of postpartum family planning tabulated using 

the reproductive calendar with postpartum family planning tabulated based on current use of family 

planning; 2) a comparison of postpartum family planning methods with the methods used by all currently 

married women; and 3) disaggregation of postpartum family planning use based on demographic 

characteristics, socioeconomic characteristics, fertility preferences, and use of maternal health services. 

The two methods of tabulating use of postpartum family planning yielded similar results in most cases. 

As the postpartum period extended, the match between the two tabulation methods became closer. At 1-2 

months postpartum the measures for 33 of the 43 countries were within 10 percent of one another. At 9-

11 months postpartum the measures for 41 of the countries were within 10 percent of one another. In 

general, the family planning method mix for postpartum women was different than the mix for all 

currently married women. Levels of use of injectables and the lactational amenorrhea method were 

greater among postpartum women than all currently married women, while the level of use of female 

sterilization was greater among currently married women than postpartum women. 

In disaggregation, use of postpartum family planning showed some broad trends by background 

characteristics. In most countries use of postpartum family planning is not strongly related to the age of 

the mother, parity, or the wantedness of the last birth. In most countries use of postpartum family 

planning is positively related to urban location, household wealth, education, achievement of desired 

family size, and current fertility desires. It is negatively related to the number of children under age 5 born 

to the woman. There is a strong correlation between the use of maternal health care (including antenatal 

care and facility based-births) and postpartum family planning. 

Given its broad reach, this report cannot reach definitive conclusions, but it does suggest several areas for 

further investigation and analysis. These include: 1) In-depth analysis and interpretation of results on a 

country-by-country basis; 2) further comparison of overall use and postpartum use of family planning; 3) 

examination of the relationship between postpartum family planning and birth intervals; 4) improved 

access to the reproductive calendar by researchers without advanced data analysis skills; 5) inclusion of 

postpartum family planning tabulations in DHS final reports; and 6) multivariate analysis to generate 

results that are more robust in establishing causality or plausible correlations. 

1 

1. Introduction 

This report examines the use of family planning in the postpartum period based on data from the 

infrequently used reproductive health calendar. Previous extensive examinations of postpartum family 

planning using the Demographic and Health Surveys (DHS) have looked exclusively at current use of 

family planning relative to the most recent birth (e.g., Ross and Winfrey 2001; Borda et al. 2010). 

However, with this particular mode of analysis relatively few births are available for tabulation. For 

example, to examine postpartum family planning at one month postpartum, only women who had a birth 

a month before the survey are eligible for analysis. In contrast, by using the reproductive calendar this 

comparative report looks at many more births than just the most recent birth. To the extent that women’s 

recall is good, the results will be more robust and it will be possible to examine differences in postpartum 

family planning use across a wide range of characteristics. 

This report will be the first quantitative report to the authors’ knowledge that has looked at postpartum 

family planning across a wide set of countries using the reproductive calendar. As such, its main intent is 

to create a baseline understanding of levels of postpartum family planning and differentials for women 

with different demographic and socioeconomic characteristics, fertility preferences, and use of maternal 

health services. Broad conclusions for the 43 countries analyzed here will be few, partially due to the 

geographic disparity of the countries. Also, in-depth analysis of any given country is not the intent of the 

study. The discussion section of the report will present a few broad conclusions and some ideas for how 

the reproductive calendar can be used for individual countries to analyze postpartum family planning in 

more depth. 

1.1. Literature Review 

1.1.1. Methods used to assess postpartum family planning 

Typically, postpartum family planning is evaluated by disaggregating current use of family planning 

relative to the time of most recent birth for an interviewed woman. Using the Demographic and Health 

Surveys for this kind of analysis leads to a small number of observations. An analysis of 17 African 

countries by Borda and colleagues (2010) used sample sizes for tabulation that were often smaller than 

100 observations. In spite of the small sample sizes, the authors found that frequently there was a 

significant association between postpartum family planning use and return to menses. Previous to this, 

Ross and Winfrey (2001) used similar methods to examine family planning use, unmet need, and 

intention to use family planning in the postpartum period. They found high levels of unmet need for 

family planning and low levels of contraceptive use in the postpartum period in most countries. 

Although the reproductive calendar is freely available for download for many countries, it has been used 

infrequently to evaluate postpartum family planning use. Recently, three studies have used the 

reproductive calendar. Akinlo and colleagues made an analysis of the impact of maternal health services 

on postpartum family planning use in Nigeria (Akinlo et al. 2013). Hotchiss and Do published 

multivariate results for the impact of antenatal and postnatal care on use of postpartum family planning in 

Kenya and Zambia (Hotchkiss and Do 2013). Previously, Gebreselassie and colleagues looked at 

postpartum family planning in the Dominican Republic, Indonesia, Kenya, and Peru using the 

reproductive calendar (Gebreselassie et al. 2010). However, to the authors’ knowledge there has never 

been a comprehensive documentation of global postpartum family planning use using the reproductive 

calendar. 

 
2 

1.1.2. Factors associated with postpartum family planning use 

Several studies have looked at the relationship between postpartum family planning and potential 

explanatory factors. These factors can be roughly divided into demographic characteristics, 

socioeconomic characteristics, fertility preferences, and use of maternal health services. The following 

briefly summarizes the results from four studies (Akinlo et al. 2013; Hotchkiss and Do 2013; 

Gebreselassie et al. 2010; Zerai and Tsui 2001). In all, these studies examined Bolivia, Dominican 

Republic, Egypt, Indonesia, Kenya, Nigeria, Peru, Thailand, and Zambia. 

Demographic characteristics. In general, older women use postpartum family planning less frequently 

than younger women. However, there is not a clear trend that the youngest women use family planning 

more than middle-aged women. Only one study, based on Nigeria, used birth order or parity and it did not 

show a clear relationship with postpartum family planning use (Akinlo et al. 2013). 

Socioeconomic characteristics. When wealth, as measured by the DHS wealth index, was included in the 

analyses, it was always found to have a strong relationship with postpartum family planning use. 

Education was also found in all cases to be related to greater postpartum family planning use. In bivariate 

relationships, being in an urban area was positively related to the use of postpartum family planning. 

However, this relationship frequently disappeared in multivariate analyses where other control variables 

were included (Hotchkiss and Do 2013). 

Fertility preferences. Fertility preferences were measured two ways in these studies. First, in four 

countries studies analyzed wantedness of the child that was just born (Gebreselassie et al. 2010). Only in 

Peru was wantedness found to be related to postpartum family planning use. Second, forward-looking 

fertility preferences were examined for Bolivia, Egypt, Thailand, Kenya, and Zambia (Zerai and Tsui 

2001; Hotchkiss and Do 2013). They were significantly correlated with postpartum family planning use in 

all countries except Zambia. 

Use of maternal health services. Use of antenatal care and/or delivery care has been examined in all of the 

surveys included in the studies (Akinlo et al. 2013; Hotchkiss and Do 2013; Gebreselassie et al. 2010; 

Zerai and Tsui 2001). In all cases except one, these factors have been found to be related to postpartum 

family planning use. The exception is Zambia, where antenatal care was not found to be significantly 

correlated with postpartum family planning use in a multivariate analysis (Hotchkiss and Do 2013). 
3 

2. Data and Methods

2.1. DHS Data Used in the Study 

The data used in this study come from the most recent national DHS surveys with fieldwork that took 

place between 2005 and 2012 and that contain a reproductive calendar. 

The 43 surveys selected for this analysis represent the following countries: Albania, Armenia, Azerbaijan, 

Bangladesh, Benin, Bolivia, Burkina Faso, Burundi, Cambodia, Colombia, Comoros, Egypt, Ethiopia, 

Ghana, Guyana, Honduras, India, Indonesia, Jordan, Kenya, Kyrgyz Republic, Lesotho, Madagascar, 

Malawi, Maldives, Moldova, Mozambique, Namibia, Nepal, Niger, Nigeria, Pakistan, Peru, Rwanda, 

Senegal, Sierra Leone, Tajikistan, Tanzania, Timor-Leste, Uganda, Ukraine, Zambia, and Zimbabwe 

(Table 1). 

The population of these 43 countries represents 46 percent of the total population of less developed 

countries, and 61 percent if China is excluded (United Nations Population Division 2012). 

Table 1. List of surveys, by year 

Year Countries 

2005 Moldova 

2005-2006 India 

2006 Azerbaijan 

2006-2007 Namibia 

2007 Ukraine, Zambia 

2008 Bolivia, Egypt, Ghana, Nigeria, Sierra Leone 

2008-2009 Albania, Kenya, Madagascar 

2009 Guyana, Lesotho, Maldives 

2009-2010 Timor-Leste 

2010 Armenia, Burkina Faso, Burundi, Colombia, Cambodia, Malawi, Rwanda, Tanzania 

2010-2011 Senegal, Zimbabwe 

2011 Bangladesh, Ethiopia, Mozambique, Nepal, Uganda 

2011-2012 Benin, Honduras 

2012 Comoros, Indonesia, Jordan, Kyrgyz Republic, Niger, Peru, Tajikistan 

2012-2013 Pakistan 
4 

2.2. Methods 

The analysis in this report uses the information in the DHS reproductive calendar. All women for whom 

the calendar was completed and who gave birth1

 in the last five years are included in the analysis, 

regardless of marital status. The reproductive calendar typically records, for each of the 60 months 

preceding the interview, all pregnancies, births, and terminations, as well as use of family planning. This 

report merges the reproductive calendar with the birth record for each of the births in a survey for the last 

60 months. Therefore, the earliest surveys in 2006 can capture births back to 2001. Three basic analyses 

are performed in this report: 1) postpartum family planning is tabulated monthly for a twelve-month 

period; 2) the method mix for postpartum family planning users is tabulated at three months postpartum; 

and 3) postpartum family planning at three months is tabulated disaggregating by demographic factors, 

socioeconomic factors, fertility preferences, and use of maternal health services. 

2.2.1. Definition of the postpartum period 

This report uses two definitions of the postpartum period. First, a postpartum period of 12 months is used 

in a comparison of postpartum family planning based on tabulation of the reproductive calendar versus a 

tabulation of postpartum family planning based on use of family planning at the time of the survey. This 

extended postpartum period is used because it will help the reader better understand how well the two 

measures compare with one another. The second definition of the postpartum period is based on a period 

three months postpartum. This definition is used for the disaggregation of postpartum family planning 

based on demographic factors, socioeconomic factors, fertility preferences, and use of maternal health 

services. The emphasis of this report is the early adoption of postpartum family planning. The further one 

moves away from the postpartum period the more likely it is that the postpartum family planning users 

will resemble all users of family planning. In several countries use of family planning at one month or 

two months was virtually nil (even in countries with high contraceptive prevalence, such as Bangladesh). 

At three months, all countries with at least moderate levels of overall family planning use see some 

uptake of postpartum family planning. Therefore, three months was chosen as the postpartum period for 

analysis. 

2.2.2. Use of the reproductive calendar to establish postpartum family planning 

The reproductive calendar is based upon the memory of women over the last 60 months. The month of a 

birth is likely remembered with little error. Use of family planning over a 60-month period is probably 

remembered well for periods near the interview date, and less well for the more distant times. Also, 

initiation of family planning might be remembered relatively accurately if family planning was initiated 

immediately postpartum. Rather than needing to remember a particular month, a woman could remember 

that she started using family planning immediately following birth, an event easily remembered or likely 

to be documented. 

Table 2 makes a comparison of postpartum family planning based on two methods of tabulation. The first 

is based upon the retrospective recall of women from the reproductive calendar. The tabulations are for 

births that were from 12 to 23 months before the survey. This relatively narrow band of time was chosen 

to make the time period as close as possible to the time of the interview. This is useful since several of the 

countries represented in this report experienced rapid increases in use of family planning over the five 

years preceding the survey. The second tabulation is based on current family planning use as reported in 

the interview. 

 

1

 This report does not consider postabortion family planning. 
5 

The tabulations drawn from the reproductive calendar are based on many more observations, and the 

same number of observations (in this case, births) are used for each column of tabulation. This is because 

we have information for each month concerning family planning. In contrast, each column of the 

tabulation on family planning use based on data about current use has a different number of observations 

(in this case, women), because a given birth is used only once in the calculations. 

In general there is variation between the two methods of tabulation. In 16 of 43 cases the difference 

between the two methods of tabulation is greater than 5 percent at 1-2 months postpartum, and in 10 cases 

the difference exceeds 10 percent. At 9-11 months the differences become less stark, with 13 of 43 cases 

having differences of greater than 5 percent, and 2 cases having differences of greater than 10 percent. It 

probably is impossible to know which of the methods is more correct, for at least three reasons: 1) The 

two methods are not measuring the same point in time—that is, current family planning use was queried 

at least one year after the family planning use was queried with the calendar. 2) The tabulation of 

postpartum family planning based on current use of family planning suffers from large standard errors in 

the measurement due to small sample sizes. 3) The measurement of family planning based on the 

reproductive calendar likely suffers from large measurement errors. 
Table 2. Postpartum family planning use at 1-2 months, 3-5 months, 6-8 months, 9-11 months tabulated using the reproductive calendar 

and tabulated based on current use of family planning at time of interview, 43 DHS surveys, 2005–2013 

Tabulations based on use of family planning 

obtained from the reproductive calendar 

(average of use in time span postpartum), 

births 12 to 23 months preceding the interview 

Number 

of 

births 

Tabulations based on use of family planning 

at time of interview 

Numbers of women for tabulations based on 

currently married women at time of interview 

1-2 

months 

postpartum 

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum

1-2 

months 

postpartum

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum 

1-2 

months 

postpartum

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum

West and Central Africa Benin 2011-2012 3.1 5.8 9.0 10.0 2,548 2.3 5.9 7.9 7.3 971 1,277 1,178 1,136 

Burkina Faso 2010 1.5 5.7 9.1 11.2 2,995 2.7 6.8 9.5 13.5 1,276 1,513 1,414 1,223 

Ghana 2008 2.7 6.9 15.0 19.5 602 1.8 9.2 16.4 21.0 283 301 268 276 Niger 2012 17.1 22.7 23.5 23.1 2,374 11.7 19.4 25.7 24.4 1,316 1,426 1,301 1,107 

Nigeria 2008 3.7 8.2 11.6 13.2 6,310 4.5 12.9 14.9 16.5 2,741 3,328 3,223 3,028 

Senegal 2010-2011 6.1 11.6 14.8 16.3 1,367 8.7 15.4 18.8 16.8 619 704 679 598 

Sierra Leone 2008 3.9 4.3 4.4 5.1 1,138 3.0 4.4 5.3 3.0 561 647 573 495 

East and Southern Africa Burundi 2010 6.0 10.0 12.8 15.5 1,664 15.1 22.1 19.1 22.3 633 729 741 712 Comoros 2012 5.1 12.8 17.3 19.5 648 7.4 15.9 22.7 24.6 278 393 330 283 Ethiopia 2011 5.8 13.0 16.9 19.3 2,051 4.2 15.0 19.4 20.7 1,138 1,280 1,165 849 

Kenya 2008-2009 12.7 27.5 34.2 37.6 1,184 16.0 25.6 33.1 38.2 537 600 638 539 

Lesotho 2009 18.0 27.6 34.6 40.1 847 21.8 36.3 37.7 49.5 303 417 294 310 

Madagascar 2008-2009 9.8 17.3 24.0 28.9 2,263 13.0 18.1 23.0 29.3 994 1,265 1,166 1,066 

Malawi 2010 10.7 25.7 39.7 46.8 4,117 13.1 34.4 46.9 51.9 1,509 1,634 1,995 1,753 

Mozambique 2011 2.2 5.5 7.5 9.2 2,328 1.8 5.1 9.2 14.2 927 1,064 1,050 1,074 

Namibia 2006-2007 22.4 33.2 40.5 44.2 1,075 20.3 44.5 58.6 63.7 371 491 419 426 Rwanda 2010 12.9 25.8 33.0 38.6 1,720 13.4 35.7 40.0 47.0 622 700 736 686 

Tanzania 2010 9.2 18.1 24.0 28.4 1,630 7.2 25.0 27.7 37.5 778 804 724 714 Uganda 2011 4.9 11.3 16.9 21.5 1,536 5.5 20.5 26.8 25.7 810 824 776 795 

Zambia 2007 19.7 29.6 41.2 46.3 1,347 17.7 36.5 45.9 48.3 600 666 622 596 

Zimbabwe 2010-2011 42.8 57.5 61.5 62.1 1,121 39.8 72.9 74.3 76.9 441 603 527 495 Middle East and North AfricaEgypt 2008 43.1 76.3 76.4 75.0 2,246 31.8 71.8 73.7 74.2 905 1,006 1,124 862 

Jordan 2012 51.6 80.2 78.3 73.7 2,064 46.5 77.0 77.1 67.2 769 899 928 882 

South and Southeast Asia Bangladesh 2011 13.2 38.3 50.7 57.9 1,608 19.9 44.6 58.0 57.5 587 593 590 628 

Cambodia 2010 3.2 14.5 31.0 41.2 1,685 8.0 20.9 39.6 43.4 531 641 623 633 

India 2005-2006 10.9 21.8 29.2 32.7 10,022 9.6 21.5 29.5 34.8 3,651 4,800 4,487 3,936 Indonesia 2012 35.3 69.9 76.7 78.2 3,604 35.3 76.2 75.8 80.1 1,161 1,274 1,311 1,299 

(Continued...)

6 
Table 2. – Continued

Tabulations based on use of family planning 

obtained from the reproductive calendar 

(average of use in time span postpartum), 

births 12 to 23 months preceding the interview 

Number 

of 

births 

Tabulations based on use of family planning 

at time of interview 

Numbers of women for tabulations based on 

currently married women at time of interview 

1-2 

months 

postpartum 

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum

1-2 

months 

postpartum

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum 

1-2 

months 

postpartum

3-5 

months 

postpartum

6-8 

months 

postpartum

9-11 

months 

postpartum

Maldives 2009 17.0 26.5 33.6 35.0 824 8.3 21.8 23.9 36.6 200 352 296 283 Nepal 2011 4.9 15.5 24.4 29.9 973 6.9 16.8 29.9 36.9 365 462 462 363 Pakistan 2012-2013 16.0 31.7 34.3 33.2 2,187 12.9 37.1 34.0 38.6 1,039 1,246 1,015 992 

Timor-Leste 2009-2010 5.1 12.2 16.3 17.9 1,904 2.8 13.3 22.3 18.4 857 1,190 936 916 

Eastern Europe and Central Asia

Albania 2008-2009 45.8 66.9 68.9 70.3 289 42.2 59.5 71.5 72.6 93 120 103 88 

Armenia 2010 31.2 52.5 58.3 61.3 323 28.0 50.2 50.7 57.6 121 109 100 116 Azerbaijan 2006 28.5 47.3 48.8 46.2 473 25.0 43.4 48.9 49.2 188 192 196 147 Kyrgyz Republic 2012 8.3 16.2 21.0 25.4 878 7.0 16.0 24.2 28.6 333 426 411 431 

Moldova 2005 60.0 74.4 73.8 72.3 344 52.2 74.1 65.4 77.7 81 121 87 112 Tajikistan 2012 9.1 15.0 16.1 18.2 1,056 5.2 11.5 12.6 12.0 348 444 464 450 

Ukraine 2007 14.0 45.3 63.3 70.9 224 15.4 40.6 48.9 64.9 48 73 78 75 Latin America and the Caribbean

Bolivia 2008 16.1 27.2 37.4 43.8 1,826 17.8 38.0 41.9 46.4 615 714 715 680 

Colombia 2010 40.0 66.2 72.3 73.8 3,537 43.5 70.5 80.9 79.0 1,005 1,268 1,297 1,283 Guyana 2009 15.0 28.5 36.1 38.8 452 14.1 43.5 47.5 49.3 159 231 202 176 

Honduras 2011-2012 33.6 62.6 67.8 68.4 2,332 38.9 64.5 73.4 73.9 733 918 808 817 Peru 2012 41.1 57.7 68.2 71.8 1,896 42.9 55.2 68.0 72.3 532 699 648 664 

Note: The tabulations based on the reproductive calendar are based on births 12 to 23 months before the survey to assure that the observational period is not truncated for 12 months postpartum. Use of postpartum family planning for the 2- or 3-three month periods is based upon averages of the use at each of the months postpartum, e.g., use at 1-2 months is the average of use at one month postpartum 

and two months postpartum. The tabulations based on current use of family planning are cross tabulations of current family planning use among currently married women aged 15-49 versus the number of months since her last birth. 

7 

9 

3. Results 

3.1. Evolution of Family Planning Use across the Postpartum Period 

Table 3 presents the month-by-month evolution of postpartum family planning use by country for births 

from 12 to 36 months before the survey, using the reproductive calendar. At one month postpartum the 

results vary widely, from less than 1 percent in Burkina Faso to more than 50 percent in Moldova. At 12 

months postpartum the results vary as well, from less than 10 percent in Benin, Mozambique, and Sierra 

Leone to more than 70 percent in Colombia, Egypt, Indonesia, Moldova, Peru, and Ukraine. 

Table 3. Postpartum family planning use (any method) at one-month intervals in the postpartum 

period for births 12-23 months preceding the survey, tabulated using the reproductive calendar, 

43 DHS surveys, 2005–2013 

 Number of months postpartum Number 

of 

 1 2 3 4 5 6 7 8 9 10 11 12 births 

West and Central 

Africa 

Benin 2011-2012 2.2 2.6 3.6 5.3 6.3 7.1 7.9 8.2 8.6 9.0 9.1 9.3 4,913 

Burkina Faso 2010 0.6 1.9 3.6 5.0 6.2 7.2 8.3 9.1 9.5 10.0 10.5 11.5 6,001 

Ghana 2008 2.1 3.5 5.2 7.8 9.2 12.5 15.5 17.0 18.5 19.3 19.8 21.3 1,138 

Niger 2012 12.8 17.1 19.4 20.3 20.6 20.9 20.8 20.6 20.6 20.4 19.8 19.6 4,932 

Nigeria 2008 3.4 4.6 6.1 8.1 9.3 10.2 10.7 11.3 11.8 12.1 12.3 12.7 12,288 

Senegal 2010-2011 4.1 7.2 10.3 12.1 13.3 14.4 15.3 15.6 15.7 16.8 17.0 17.5 2,743 

Sierra Leone 2008 3.8 4.0 4.2 4.2 4.3 4.5 4.4 4.8 5.1 5.1 5.2 5.9 2,135 

East and South Africa 

Burundi 2010 4.5 5.8 7.5 8.7 9.6 10.8 11.2 12.1 12.9 13.5 14.3 15.3 3,252 

Comoros 2012 4.3 6.4 9.2 11.8 13.4 14.5 15.4 16.2 16.5 16.9 17.4 17.8 1,240 

Ethiopia 2011 2.6 8.2 11.5 12.7 14.2 15.2 16.1 16.6 17.2 17.4 17.7 18.6 4,344 

Kenya 2008-2009 8.7 16.6 22.7 27.1 28.6 30.8 32.7 34.1 35.1 35.8 35.4 35.8 2,426 

Lesotho 2009 13.9 20.6 24.5 27.5 30.1 32.9 35.3 36.9 38.5 39.7 40.4 41.8 1,579 

Madagascar 2008-2009 8.3 9.8 12.3 15.4 18.0 20.4 21.0 23.0 24.8 26.1 27.1 29.3 4,787 

Malawi 2010 7.5 13.2 18.1 24.5 29.2 33.3 38.0 40.1 42.3 43.3 44.1 45.8 8,162 

Mozambique 2011 1.3 2.3 3.4 4.7 5.5 6.0 6.7 7.3 7.9 8.1 8.1 8.7 4,493 

Namibia 2006-2007 20.2 24.3 28.7 32.0 35.3 36.8 38.7 39.9 41.3 42.1 42.7 44.0 2,104 

Rwanda 2010 7.5 14.0 19.1 22.7 24.8 27.0 29.3 30.9 32.9 35.1 36.7 39.2 3,612 

Tanzania 2010 7.8 11.8 15.2 19.0 21.1 23.0 25.1 26.4 27.6 28.3 28.8 30.3 3,169 

Uganda 2011 4.0 6.3 8.9 12.0 13.5 15.2 16.5 18.2 20.0 20.7 21.3 22.4 3,089 

Zambia 2007 18.5 21.8 25.5 30.4 34.2 38.0 41.2 42.1 43.6 44.5 44.6 45.0 2,617 

Zimbabwe 2010-2011 37.6 46.7 53.5 57.8 58.8 59.8 60.7 60.6 61.0 61.1 60.8 61.7 2,201 

Middle East and North 

Africa 

 

Egypt 2008 13.4 73.2 75.6 76.4 76.1 76.2 76.4 75.7 75.0 74.6 73.6 72.7 4,317 

Jordan 2012 27.9 75.9 78.6 79.0 78.0 77.6 75.5 74.0 72.2 71.2 70.1 68.7 4,214 

(Continued...)
10 

Table 3. – Continued

 Number of months postpartum Number 

of 

 1 2 3 4 5 6 7 8 9 10 11 12 births 

South and Southeast 

Asia 

 

Bangladesh 2011 2.2 23.2 31.3 39.3 42.4 46.1 50.3 52.6 54.5 56.5 57.8 59.3 3,279 

Cambodia 2010 2.5 5.0 8.4 14.3 19.2 24.2 30.2 33.2 36.3 37.6 39.1 41.4 3,348 

India 2005-2006 9.3 13.4 18.3 22.2 24.7 27.0 29.3 30.6 31.5 32.3 32.9 34.0 20,438 

Indonesia 2012 20.6 50.7 65.8 71.2 73.0 74.7 75.5 76.0 76.3 76.3 76.2 76.3 7,141 

Maldives 2009 15.1 18.4 22.4 26.5 29.1 31.9 33.0 33.8 34.1 34.2 34.6 35.9 1,557 

Nepal 2011 3.1 6.9 11.2 15.1 18.2 21.3 24.2 25.2 27.0 28.7 30.5 32.1 2,060 

Pakistan 2012-2013 9.6 22.9 29.0 31.7 32.7 33.1 34.1 33.8 33.6 32.9 32.3 32.9 4,592 

Timor-Leste 2009-2010 2.7 6.5 9.6 11.7 13.2 14.2 15.4 16.2 16.5 17.0 17.4 18.3 3,952 

Eastern Europe and 

Central Asia 

 

Albania 2008-2009 33.8 53.9 64.5 66.4 67.8 68.2 69.2 68.5 68.2 68.4 68.5 67.5 614 

Armenia 2010 24.8 38.3 49.3 53.5 56.0 57.1 57.7 58.9 59.3 59.4 59.0 58.7 605 

Azerbaijan 2006 24.1 32.6 41.1 44.2 46.8 47.5 46.5 46.4 46.2 45.9 45.0 44.2 929 

Kyrgyz Republic 2012 6.7 9.5 13.8 15.6 17.3 18.9 20.5 22.6 23.9 24.8 26.0 27.2 1,725 

Moldova 2005 52.7 62.2 72.2 72.4 72.9 73.6 71.6 71.8 71.6 71.2 71.3 70.9 674 

Tajikistan 2012 7.7 11.2 14.8 16.1 17.2 17.7 17.9 18.8 19.6 20.6 20.7 21.5 2,170 

Ukraine 2007 9.3 23.5 35.1 47.3 53.5 57.2 60.8 65.8 67.3 69.5 69.2 70.6 489 

Latin America and the 

Caribbean 

 

Bolivia 2008 14.5 18.3 22.8 27.0 29.7 33.0 36.3 38.6 41.0 42.4 43.1 45.7 3,528 

Colombia 2010 30.8 46.9 60.7 66.8 69.1 71.0 71.9 72.5 72.9 72.2 72.5 72.9 7,153 

Guyana 2009 16.7 21.7 26.9 32.5 34.4 36.7 37.2 38.2 37.8 38.0 39.4 40.7 935 

Honduras 2011-2012 22.6 47.1 58.8 64.0 65.0 66.9 67.8 67.6 67.9 67.8 67.8 68.1 4,460 

Peru 2012 35.6 46.0 55.3 59.2 62.3 67.4 69.4 71.2 72.3 72.4 72.5 76.4 3,908 

Figure 1 presents the evolution of family planning for seven countries that might be viewed as having 

typical patterns. The lower portion of the graph shows that Bangladesh, Ghana, and Benin have very low 

levels of family planning use in the first month postpartum. However, they have distinctly different 

results at 12 months. In Bangladesh family planning use grows to almost 60 percent by 12 months 

postpartum. In Ghana it grows modestly, and in Benin it is still at less than 10 percent at 12 months 

postpartum. Moving up the graph, the next country, Niger, starts with a moderate level of family planning 

use at one month postpartum, but then does not increase appreciably over the next 12 months. Next are 

Azerbaijan and Armenia, both with moderate levels of family planning use at one month postpartum. 

Azerbaijan then sees modest growth in family planning use over the next 12 months, while Armenia sees 

relatively brisk growth. Finally, in the top line in the graph, Moldova has strong family planning use in 

the first month postpartum, followed by strong increases up to a high level of use at 12 months. 
11 

Figure 1. Evolution of family use (any method) in the postpartum period for Armenia, Azerbaijan, 

Bangladesh, Benin, Ghana, Moldova, and Niger 

Table 4 aligns each of the countries in Table 3 with the patterns illustrated in Figure 1. The majority of 

countries have less than 10 percent use of family planning at one month postpartum. By any reasonable 

measure, these countries are underperforming. About half of these countries make moderate gains in 

family planning use by 12 months postpartum. The countries that do not make progress are mostly in 

West Africa and are very poor. The countries with moderate progress are largely in Asia and East Africa. 

Bangladesh and Ukraine are the sole countries that move from very low levels of use at one month 

postpartum to high use by 12 months. The countries in the bottom two rows do not show any particular 

regional pattern, except that West African countries are largely missing from these categories. Niger, the 

exception, is a clear anomaly. 

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

1 2 3 4 5 6 7 8 9 10 11 12

Percent of postpartum women using any family planning method

Benin 2011-2012 Ghana 2008 Niger 2012 Bangladesh 2011

Armenia 2010 Azerbaijan 2006 Moldova 2005
12 

Table 4. Surveys categorized by levels of family planning use at one month and 12 months 

postpartum 

 

Use of any family 

planning method at 12 

months postpartum 

less than 20 percent 

Use of any family planning 

method at 12 months 

postpartum between 20 

percent and 50 percent 

Use of any family 

planning method at 12 

months postpartum 

greater than 50 percent

Use of any family planning 

method at one month 

postpartum less than 10 

percent 

Benin, Burkina Faso, 

Burundi, Comoros, 

Ethiopia, Mozambique, 

Nigeria, Sierra Leone, 

Senegal, Timor-Leste 

Ghana, India, Kenya, 

Cambodia, Kyrgyz Republic, 

Madagascar, Malawi, Nepal, 

Pakistan, Rwanda, Tajikistan, 

Tanzania, Uganda 

Bangladesh, Ukraine 

Use of any family planning 

method at one month 

postpartum between 10 

percent and 30 percent 

Niger Azerbaijan, Bolivia, Guyana, 

Lesotho, Maldives, Namibia, 

Zambia 

Armenia, Egypt, 

Honduras, Indonesia, 

Jordan 

Use of any family planning 

method at one month 

postpartum greater than 

30 percent 

 Albania, Colombia, 

Moldova, Peru, 

Zimbabwe 

Note: Countries indicated in bold type are the countries presented in Figure 1. 

3.2. Family Planning Methods in the Postpartum Period 

Table 5 presents the use of postpartum family planning disaggregated by method used. The results are 

presented such that each row sums to 100 percent. For purposes of comparison, the family planning 

method mix of all currently married women is presented for each country. Figure 2 presents three typical 

cases, which are discussed below. 

Two major differences in the method mix for a given country are easily explained. First (see Niger, 

Figure 2), one would expect the level of use of the lactational amenorrhea method (LAM) to be much 

higher for postpartum women than for all currently married women because LAM is recommended only 

for postpartum women. Examples include Bolivia, Madagascar, Moldova, Nigeria, Sierra Leone, 

Tanzania, and Zambia. 

Second (see India, Figure 2), the level of use of female sterilization is lower among postpartum women 

than among all currently married women. Examples include Colombia, Honduras, India, Nepal, Pakistan, 

and Zimbabwe. Sterilization builds prevalence in the population by steady accretion of acceptors. At any 

given time, sterilization acceptors are a relatively small proportion of all acceptors. Since postpartum 

family planning are acceptors by the common definition of family planning programs, sterilization will be 

a relatively low proportion of all postpartum family planning use. To a somewhat lesser extent the same is 

true of IUDs and implants, which after insertion are used for many years. Thus, in general, IUD use is less 

prevalent in the method mix among postpartum women than among all currently married women (e.g., 

Moldova and Jordan). 

A third interesting case (see Peru, Figure 2) is that in a few countries (including Nepal as well as Peru) the 

level of injectable use is higher among postpartum method users than it is among all currently married 

family planning users. 
Table 5. Postpartum family planning method mix and method mix among currently married women, 43 DHS surveys, 2005–2013 

Pill IUD 

Injectables 

Diaphragm, 

foam or 

jelly 

Male 

condom

Female 

sterlization

Male 

sterilization Implant LAM Female condom Other modern Periodic abstinence Withdrawal Other traditional

Any 

folkloric 

method

All 

methods

Number of 

births or 

Number of 

currently 

married 

women 

WEST AND CENTRAL AFRICA Benin 2011-2012 Births in the postpartum period 16.2 2.9 17.1 0.6 13.9 0.0 0.0 7.4 11.4 0.0 0.0 20.6 5.8 4.2 100.0 4,913 Currently married women 10.2 3.9 15.6 0.0 14.1 0.8 0.0 7.8 3.9 0.0 4.7 22.7 6.3 0.0 10.2 100.0 11,680 

Burkina Faso 2010 Births in the postpartum period 25.2 1.2 30.5 0.0 12.3 0.6 0.0 18.4 1.4 0.0 0.0 9.7 0.2 0.4 100.0 6,001 Currently married women 19.9 1.9 38.5 0.0 9.9 1.2 0.0 21.1 0.6 0.0 0.0 6.2 0.6 0.0 0.0 100.0 13,563 

Ghana 2008 Births in the postpartum period 21.4 0.0 19.8 0.0 14.3 10.5 0.0 5.2 0.0 1.7 0.0 14.2 12.4 0.5 100.0 1,138 Currently married women 20.2 0.9 26.6 1.3 10.3 6.9 0.0 3.9 0.0 0.4 0.0 20.2 6.0 0.0 3.4 100.0 2,876 

Niger 2012 Births in the postpartum period 31.1 0.0 9.3 0.0 0.1 0.3 0.0 0.9 46.8 0.0 0.0 0.4 0.2 10.9 100.0 4,932 Currently married women 40.6 0.7 15.2 0.0 0.0 0.7 0.0 2.2 28.3 0.0 0.0 0.7 0.0 0.0 11.6 100.0 9,881 

Nigeria 2008 Births in the postpartum period 9.5 2.1 9.3 0.0 11.1 1.9 0.0 1.5 33.5 0.0 0.7 9.4 16.3 4.7 100.0 12,288 Currently married women 11.6 6.8 17.7 0.0 16.3 2.7 0.0 0.0 10.9 0.0 0.0 14.3 13.6 0.0 6.1 100.0 23,578 

Senegal 2010-2011 Births in the postpartum period 27.1 2.8 38.2 0.0 5.0 1.6 0.0 10.8 3.2 0.0 0.0 0.0 3.7 7.6 100.0 2,743 Currently married women 31.5 4.6 40.0 0.0 4.6 1.5 0.0 8.5 1.5 0.0 0.0 2.3 1.5 0.0 3.8 100.0 10,347 

Sierra Leone 2008 Births in the postpartum period 7.7 0.5 7.2 0.0 0.6 0.0 0.0 0.0 61.3 0.0 0.0 1.7 0.4 20.7 100.0 2,135 Currently married women 28.4 2.5 35.8 0.0 7.4 0.0 0.0 0.0 8.6 0.0 0.0 2.5 0.0 0.0 14.8 100.0 5,525 

EAST AND SOUTHERN AFRICA Burundi 2010 Births in the postpartum period 9.7 2.2 59.8 0.0 3.3 1.8 0.0 1.2 5.7 0.0 0.0 6.0 10.3 0.0 100.0 3,252 Currently married women 11.0 12.3 47.5 0.0 4.6 2.7 0.0 2.7 0.0 0.0 0.0 8.7 10.5 0.0 0.0 100.0 5,421 

Comoros 2012 Births in the postpartum period 10.8 0.2 21.9 0.0 5.9 3.2 0.0 7.3 8.9 0.0 0.0 21.7 18.2 2.0 100.0 1,240 Currently married women 16.1 0.5 29.0 0.0 10.9 4.1 0.0 8.3 4.1 0.0 0.0 16.6 9.8 0.5 0.0 100.0 3,261 

Ethiopia 2011 Births in the postpartum period 10.0 0.1 79.7 0.0 0.4 0.7 0.0 4.7 0.0 0.0 0.0 2.7 0.1 1.7 100.0 4,344 Currently married women 7.3 1.0 72.7 0.0 0.7 1.7 0.0 11.9 0.0 0.0 0.0 3.1 1.0 0.0 0.3 100.0 10,287 

(Continued...)

13 
Table 5. – Continued

 Pill IUD 

Injectables 

Diaphragm, 

foam or 

jelly 

Male 

condom

Female 

sterlization

Male 

sterilization Implant LAM Female condom Other modern Periodic abstinence Withdrawal Other traditional

Any 

folkloric 

method

All 

methods

Number of 

births or 

Number of 

currently 

married 

women 

Kenya 2008-2009 Births in the postpartum period 16.8 0.8 58.2 0.0 4.1 4.9 0.0 2.3 4.9 0.2 0.0 5.1 1.6 1.1 100.0 2,426 Currently married women 15.8 3.5 47.5 0.0 4.0 10.5 0.0 4.2 1.1 0.0 0.0 10.3 1.5 0.0 1.5 100.0 4,928 

Lesotho 2009 Births in the postpartum period 0.9 0.0 47.9 1.8 22.9 4.2 0.0 21.0 0.0 0.4 0.0 1.0 0.0 0.0 100.0 1,579 Currently married women 26.5 4.0 41.0 0.0 20.0 5.1 0.0 0.2 0.0 0.2 0.0 0.2 1.5 0.0 1.3 100.0 4,049 

Madagascar 2008-09 Births in the postpartum period 7.1 0.4 17.6 0.0 2.0 1.7 0.0 1.9 53.9 0.0 0.6 12.7 1.2 1.0 100.0 4,787 Currently married women 15.1 1.0 45.0 0.0 2.8 2.8 0.3 3.8 2.5 0.0 0.0 24.4 2.0 0.0 0.5 100.0 12,039 

Malawi 2010 Births in the postpartum period 5.7 0.1 62.4 0.0 4.3 14.1 0.1 1.8 0.0 0.2 0.0 1.9 6.1 3.1 100.0 8,162 Currently married women 5.4 0.7 56.1 0.0 5.2 21.1 0.2 2.8 0.0 0.2 0.0 1.7 3.9 0.0 2.6 100.0 15,528 

Mozambique 2011 Births in the postpartum period 38.5 0.9 37.1 0.0 11.4 3.2 0.0 0.9 6.0 0.0 0.0 0.0 0.0 2.0 100.0 4,493 Currently married women 38.8 0.9 44.0 0.0 9.5 1.7 0.0 0.0 1.7 0.9 0.0 0.9 0.9 0.0 0.9 100.0 9,332 

Namibia 2006-2007 Births in the postpartum period 14.0 0.1 51.0 0.3 22.2 10.4 0.0 0.0 0.0 0.1 0.0 0.4 0.5 0.9 100.0 2,104 Currently married women 15.6 2.5 39.6 0.0 19.2 18.7 0.7 0.4 0.0 0.2 0.0 0.7 0.5 0.0 1.6 99.8 3,451 

Rwanda 2010 Births in the postpartum period 17.7 1.1 53.4 0.1 4.0 2.4 0.0 8.0 4.6 0.0 0.3 3.7 4.6 0.0 100.0 3,612 Currently married women 13.8 1.0 51.1 0.0 5.6 1.6 0.0 12.2 1.0 0.0 1.2 5.6 6.8 0.0 0.2 100.0 6,897 

Tanzania 2010 Births in the postpartum period 13.5 0.0 22.5 0.0 6.2 6.2 0.0 4.1 25.9 0.0 0.0 9.4 9.8 2.5 100.0 3,169 Currently married women 19.6 1.8 31.0 0.0 6.7 10.2 0.0 6.7 3.8 0.0 0.0 9.1 8.5 0.0 2.6 100.0 6,412 

Uganda 2011 Births in the postpartum period 14.8 0.2 46.2 0.0 6.0 7.1 0.0 3.7 3.5 0.0 0.0 5.9 12.4 0.2 100.0 3,089 Currently married women 9.6 1.7 46.8 0.0 9.0 9.6 0.3 9.0 0.7 0.0 0.0 4.7 7.0 0.0 1.7 100.0 5,418 

Zambia 2007 Births in the postpartum period 12.0 0.0 7.5 0.0 6.4 1.5 0.0 0.5 60.2 0.0 0.0 1.0 8.7 2.2 100.0 2,617 Currently married women 70.6 0.3 14.2 0.0 5.3 1.9 0.0 4.6 0.3 0.5 0.0 0.2 1.7 0.0 0.3 100.0 4,402 

Zimbabwe 2010-2011 Births in the postpartum period 79.5 0.0 11.4 0.0 4.5 0.3 0.0 1.2 0.8 0.0 0.0 0.2 1.7 0.5 100.0 2,201 Currently married women 44.8 17.0 16.4 0.0 3.9 13.0 0.9 0.0 0.0 0.0 0.0 0.6 0.9 1.5 0.9 100.0 5,703 

(Continued...)

14 
Table 5. – Continued

 Pill IUD 

Injectables 

Diaphragm, 

foam or 

jelly 

Male 

condom

Female 

sterlization

Male 

sterilization Implant LAM Female condom Other modern Periodic abstinence Withdrawal Other traditional

Any 

folkloric 

method

All 

methods

Number of 

births or 

Number of 

currently 

married 

women 

MIDDLE EAST AND NORTH AFRICA Egypt 2008 Births in the postpartum period 21.8 52.1 12.1 0.0 0.9 1.0 0.0 0.5 0.0 0.0 10.8 0.4 0.3 0.0 100.0 4,317 Currently married women 19.8 60.0 12.3 0.0 1.2 1.7 0.0 0.8 0.0 0.0 0.0 0.7 0.3 3.3 0.0 100.0 15,396 

Jordan 2012 Births in the postpartum period 17.0 17.7 2.1 0.0 11.5 1.2 0.0 0.3 21.3 0.0 0.0 5.2 23.2 0.5 100.0 4,214 Currently married women 13.3 34.9 1.5 0.0 13.0 3.6 0.0 0.5 2.1 0.0 0.3 5.7 23.4 0.0 1.6 100.0 10,801 

EASTERN EUROPE AND CENTRAL ASIA Albania 2008-2009 Births in the postpartum period 3.3 0.0 0.6 0.0 5.9 3.8 0.0 0.0 7.3 0.0 0.0 1.7 77.4 0.0 100.0 614 Currently married women 2.3 1.3 1.0 0.0 5.8 4.3 0.0 0.0 0.6 0.0 0.0 1.2 83.5 0.0 0.0 100.0 5,001 

Armenia 2010 Births in the postpartum period 1.2 6.8 0.0 0.0 26.3 0.2 0.0 0.0 11.5 0.0 0.0 4.3 49.0 0.8 100.0 605 Currently married women 2.7 17.5 0.0 0.2 26.6 0.4 0.0 0.0 1.5 0.0 0.7 4.4 44.6 0.0 1.5 100.0 3,626 

Azerbaijan 2006 Births in the postpartum period 4.0 3.1 0.0 3.1 4.0 0.0 0.0 0.0 17.3 0.0 0.0 3.4 65.1 0.0 100.0 929 Currently married women 2.2 18.0 0.0 0.4 4.3 0.8 0.0 0.0 2.2 0.0 0.0 7.8 63.7 0.0 0.6 100.0 5,269 

Kyrgyz Republic 2012 Births in the postpartum period 2.2 43.1 0.5 0.0 31.1 3.3 0.0 0.0 8.8 0.0 0.0 0.8 10.3 0.0 100.0 1,725 Currently married women 4.1 61.0 1.4 0.0 21.3 4.4 0.0 0.0 0.6 0.0 0.0 0.6 6.4 0.0 0.3 100.0 5,256 

Moldova 2005 Births in the postpartum period 2.5 15.0 0.0 1.4 13.5 2.0 0.0 0.0 36.4 0.0 0.0 3.7 25.2 0.2 100.0 674 Currently married women 5.3 37.1 0.1 0.0 10.9 6.9 0.0 0.0 1.9 0.0 0.0 5.2 28.9 0.0 1.3 97.6 4,937 

Tajikistan 2012 Births in the postpartum period 9.2 52.5 4.3 0.0 15.2 2.1 0.0 0.0 10.3 0.0 0.0 0.0 6.2 0.2 100.0 2,170 Currently married women 8.3 66.8 7.2 0.0 7.9 2.2 0.0 0.0 0.4 0.0 0.0 0.4 6.9 0.0 0.0 100.0 6,504 

Ukraine 2007 Births in the postpartum period 4.3 14.2 0.0 0.0 48.3 0.7 0.0 0.0 0.0 0.0 0.0 9.6 21.0 1.9 100.0 489 Currently married women 7.2 26.6 0.0 0.8 35.8 0.9 0.0 0.0 0.0 0.0 0.0 10.8 15.5 0.0 2.4 100.0 4,116 

(Continued...)

15 
Table 5. – Continued

 Pill IUD 

Injectables 

Diaphragm, 

foam or 

jelly 

Male 

condom

Female 

sterlization

Male 

sterilization Implant LAM Female condom Other modern Periodic abstinence Withdrawal Other traditional

Any 

folkloric 

method

All 

methods

Number of 

births or 

Number of 

currently 

married 

women 

SOUTH AND SOUTHEAST ASIA Bangladesh 2011 Births in the postpartum period 54.5 0.4 16.1 0.0 10.0 5.4 1.5 0.7 0.0 0.0 0.0 8.3 2.8 0.4 100.0 3,279 Currently married women 44.5 1.1 18.3 0.0 9.0 8.2 2.0 1.8 0.0 0.0 0.0 11.3 3.1 0.0 0.7 100.0 16,635 

Cambodia 2010 Births in the postpartum period 30.6 5.5 21.6 0.0 3.2 7.5 0.0 0.9 0.1 0.0 0.0 7.2 23.4 0.0 100.0 3,348 Currently married women 31.3 6.1 20.6 0.0 5.3 4.8 0.0 0.8 0.0 0.0 0.0 7.7 23.2 0.0 0.2 100.0 11,626 

India 2005-06 Births in the postpartum period 7.0 4.5 0.3 0.0 16.2 51.6 0.4 0.0 0.0 0.0 0.0 13.4 5.9 0.7 100.0 20,438 Currently married women 5.5 3.0 0.2 0.0 9.3 66.5 1.8 0.0 0.0 0.0 0.0 8.7 4.5 0.0 0.5 100.0 93,089 

Indonesia 2012 Births in the postpartum period 12.5 4.0 69.0 0.0 3.1 2.8 0.0 3.2 0.5 0.0 0.0 1.6 2.7 0.5 100.0 7,141 Currently married women 22.0 6.3 51.5 0.0 2.9 5.2 0.3 5.3 0.0 0.0 0.0 2.1 3.7 0.0 0.6 100.0 33,465 

Maldives 2009 Births in the postpartum period 16.3 1.9 4.0 0.0 25.3 22.1 0.3 1.6 0.0 0.0 0.0 11.9 16.6 0.0 100.0 1,557 Currently married women 13.3 2.3 3.5 0.0 26.8 29.1 1.4 1.4 0.0 0.0 0.0 9.8 12.1 0.0 0.3 100.0 6,500 

Nepal 2011 Births in the postpartum period 8.4 1.2 34.8 0.0 19.2 19.5 3.3 0.0 0.0 0.0 0.0 2.2 11.4 0.0 100.0 2,060 Currently married women 8.3 2.6 18.5 0.0 8.7 30.6 15.7 2.4 0.0 0.0 0.0 2.2 10.9 0.0 0.0 100.0 9,608 

Pakistan 2012-13 Births in the postpartum period 5.3 3.6 8.4 0.0 29.3 10.0 0.0 0.2 15.8 0.0 0.0 2.4 24.7 0.3 100.0 4,592 Currently married women 4.5 6.5 7.9 0.0 24.8 24.5 0.8 0.3 4.2 0.0 0.3 2.0 23.9 0.0 0.3 100.0 12,937 

Timor-Leste 2009-10 Births in the postpartum period 6.2 5.4 71.3 0.0 2.7 3.6 0.0 2.8 2.7 0.0 0.0 2.1 1.7 1.5 100.0 3,952 Currently married women 7.7 5.9 70.7 0.0 0.9 3.6 0.0 3.6 0.0 0.0 1.8 2.7 1.8 0.0 1.4 100.0 7,906 

LATIN AMERICA AND THE CARIBBEAN Bolivia 2008 Births in the postpartum period 4.6 9.9 13.7 0.1 5.4 12.9 0.0 0.0 26.6 0.0 0.0 19.1 7.7 0.1 100.0 3,528 Currently married women 5.5 13.9 18.7 0.2 6.6 10.7 0.2 0.0 1.3 0.0 0.0 34.4 8.1 0.2 0.3 100.0 10,162 

Colombia 2010 Births in the postpartum period 9.8 6.5 30.2 0.1 12.7 26.1 1.5 3.1 0.0 2.8 0.0 1.6 4.9 0.8 100.0 7,153 Currently married women 9.6 9.5 11.6 0.1 8.8 44.1 4.3 3.9 0.3 0.0 0.0 2.9 4.4 0.0 0.4 100.0 26,247 

(Continued...)

16 
Table 5. – Continued

 Pill IUD 

Injectables 

Diaphragm, 

foam or 

jelly 

Male 

condom

Female 

sterlization

Male 

sterilization Implant LAM Female condom Other modern Periodic abstinence Withdrawal Other traditional

Any 

folkloric 

method

All 

methods

Number of 

births or 

Number of 

currently 

married 

women 

Guyana 2009 Births in the postpartum period 20.0 12.8 12.8 1.1 40.4 5.0 0.0 0.1 3.5 0.1 0.0 1.1 2.9 0.2 100.0 935 Currently married women 21.7 17.2 11.3 0.0 30.4 12.5 0.0 0.5 0.5 0.0 0.0 1.7 3.3 0.0 0.9 100.0 2,920 

Honduras 2011-12 Births in the postpartum period 11.0 9.2 44.6 0.0 6.4 18.0 0.0 0.0 1.4 0.0 0.0 1.7 7.4 0.4 100.0 4,460 Currently married women 16.3 9.3 24.8 0.0 5.9 30.5 0.4 0.0 0.0 0.0 0.0 3.8 8.8 0.1 0.1 100.0 12,847 

Peru 2012 Births in the postpartum period 5.9 1.9 50.0 0.1 8.3 7.0 0.0 0.0 4.2 0.0 0.2 6.6 9.2 6.4 100.0 3,908 Currently married women 12.5 3.7 24.1 0.5 16.3 10.7 0.7 0.0 0.1 0.0 0.0 19.9 10.1 0.0 1.5 100.0 13,624 

Note: Postpartum method mix is based upon family planning use three months after birth. Universe is all births four to 37 months preceding the survey. Method mix for currently married women aged 15-49 

is based on family planning at the time of the survey. 

17 
18 

Figure 2. Use of pills, injectables, female sterilization, LAM, and periodic abstinence as a 

percentage of all family planning use for postpartum women and currently married women, Niger 

2012, India 2005-2006, and Peru 20122

3.3. Differences in Postpartum Family Planning Use by Demographic Factors, Socioeconomic 

Factors, Fertility Preferences, and Use of Maternal Health Services 

Prevalence of postpartum family planning will vary according to background characteristics of women 

and use of health services. The following sections show differences in postpartum family planning use 

according to demographic characteristics, socioeconomic characteristics, fertility preferences, and use of 

key maternal health services. 

3.3.1. Demographic characteristics 

Table 6 presents postpartum family planning use disaggregated by the age of the mother at the birth of the 

child, birth order of the child, and number of children born to the woman who are under age 5 (including 

the newly born child). 

 

2

 The sum of the bars for any grouping will not sum to 100 percent. Only the most prevalent methods are presented 

in the chart to facilitate easy interpretation. 

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

Niger

Postpartum

Niger All

Currently

Married

India

Postpartum

India All

Currently

Married

Peru

Postpartum

Peru All

Currently

Married

Percent of contracepting women who are using a particular method

Pill Injectables Female sterlization LAM Periodic abstinence
19 

In most cases there are not large differentials in postpartum family planning based on the age of the 

mother at birth. In a few countries women age 25-34 have higher levels of postpartum family planning 

use than either younger or older women. Guyana, Kenya, Lesotho, and Namibia are notable examples. 

This strong pattern was partially replicated in Albania, Armenia, Azerbaijan, and Moldova, but there were 

insufficient observations to present results for the oldest group of women. 

Parity is expected to be positively related to family planning use in general. At higher levels of parity, 

women are closer to their ideal family size and therefore perhaps more likely to use family planning. 

Presumably, this motive will operate for postpartum family planning specifically, as well as for family 

planning in general. However, only in the Maldives is the level of postpartum family planning use greater 

among women with two to four children relative to women with one child or no children, and for women 

with five or more children relative to women with two to four children (taking a 5 percent differential as a 

programmatically significant difference). In contrast, there are many cases where family planning use 

among middle parity women is more prevalent than among women with either fewer or more births. 

Examples include Colombia, Honduras, Lesotho, and Namibia. 

The two columns in Table 6 on number of children under age 5 show that in most cases women with one 

child under age 5 use postpartum family planning more frequently than women with two or more children 

under age 5. 

Table 6. Postpartum family planning use (any method) by age of mother at birth, birth order, and 

number of children under age 5, 43 DHS surveys, 2005–2013 

 

Age of mother at birth Birth order of child 

Number of children 

under age 5 

10-14 25-34 35-49 0-1 2-4 5+ 1 2 

West and Central Africa 

Benin 2011-2012 3.5 3.8 3.3 4.1 3.5 2.5 3.9 2.4 

Burkina Faso 2010 3.5 3.8 3.1 4.0 3.8 2.5 4.0 1.7 

Ghana 2008 4.1 5.9 5.6 3.6 7.7 3.8 5.7 2.8 

Niger 2012 16.5 21.0 23.6 19.2 19.2 19.7 20.5 16.4 

Nigeria 2008 4.4 7.8 5.9 6.8 6.8 4.1 6.1 6.3 

Senegal 2010-2011 7.8 11.1 13.8 9.6 11.7 9.3 10.5 9.5 

Sierra Leone 2008 4.6 3.8 4.0 4.9 3.7 3.5 4.1 4.4 

East and Southern Africa 

Burundi 2010 8.2 8.0 5.0 8.6 8.0 4.7 8.4 4.6 

Comoros 2012 8.3 9.6 10.1 9.9 8.8 8.3 11.2 4.1 

Ethiopia 2011 14.3 11.0 4.3 17.5 9.4 6.3 13.1 6.0 

Kenya 2008-2009 21.1 26.9 14.8 26.2 23.6 12.9 24.7 15.9 

Lesotho 2009 20.2 32.1 20.0 23.9 29.4 11.2 26.9 8.6 

Madagascar 2008-2009 11.8 13.6 10.5 13.2 12.5 10.2 14.0 6.2 

Malawi 2010 18.1 16.8 21.9 17.5 18.0 19.4 19.2 13.1 

Mozambique 2011 2.7 4.2 3.4 3.0 3.6 3.7 3.8 1.9 

Namibia 2006-2007 24.2 35.9 22.0 26.9 34.3 20.8 29.9 22.5 

Rwanda 2010 20.3 19.6 15.3 21.0 20.1 12.8 21.7 7.5 

Tanzania 2010 13.4 16.1 17.8 14.1 16.8 13.9 17.0 8.9 

Uganda 2011 8.3 9.5 9.1 8.4 9.7 8.4 10.2 5.6 

Zambia 2007 24.7 25.9 26.8 23.4 26.2 27.5 24.7 27.8 

(Continued...)
20 

Table 6. – Continued

 

Age of mother at birth Birth order of child 

Number of children 

under age 5 

10-14 25-34 35-49 0-1 2-4 5+ 1 2 

Zimbabwe 2010-2011 52.4 56.6 47.1 55.1 53.2 41.2 55.2 42.7 

Middle East and North Africa 

Egypt 2008 72.6 78.2 76.9 73.4 79.9 72.5 80.3 55.5 

Jordan 2012 79.8 77.5 80.0 74.1 81.7 83.4 84.6 61.2 

South and Southeast Asia 

Bangladesh 2011 31.2 31.2 33.2 31.1 32.5 24.8 32.7 19.4 

Cambodia 2010 7.5 8.2 11.6 7.9 9.2 8.8 8.7 6.2 

India 2005-2006 16.8 21.3 15.6 17.1 21.7 13.9 21.0 8.1 

Indonesia 2012 68.7 66.2 58.3 67.4 64.2 45.7 68.5 40.9 

Maldives 2009 18.9 22.5 33.7 18.4 28.0 40.4 23.1 16.2 

Nepal 2011 12.5 10.1 6.8 10.3 14.5 5.3 13.0 3.0 

Pakistan 2012-2013 24.3 32.9 28.9 24.5 33.4 31.0 33.0 19.6 

Timor-Leste 2009-2010 8.1 10.0 10.8 7.6 10.4 10.9 12.7 1.9 

Eastern Europe and Central 

Asia 

Albania 2008-2009 61.1 67.2 * 62.6 68.8 * 66.7 * 

Armenia 2010 45.8 55.3 * 49.2 * * 52.3 * 

Azerbaijan 2006 35.0 50.4 * 37.3 53.9 * 45.8 26.5 

Kyrgyz Republic 2012 13.3 14.8 11.6 12.6 16.0 * 14.9 9.7 

Moldova 2005 68.5 76.5 * 71.5 * * 74.2 * 

Tajikistan 2012 10.6 18.7 21.4 10.4 21.6 20.2 17.8 6.2 

Ukraine 2007 36.9 33.1 * 34.9 * * 36.2 * 

Latin America and the 

Caribbean 

Bolivia 2008 21.5 24.6 21.9 23.8 24.2 16.8 24.7 15.0 

Colombia 2010 55.9 65.8 66.9 59.0 67.1 53.4 63.4 40.5 

Guyana 2009 25.4 32.1 17.3 28.2 27.6 15.1 30.0 14.0 

Honduras 2011-2012 55.1 64.1 59.1 57.2 64.5 49.8 61.1 42.8 

Peru 2014 54.8 56.7 52.6 55.6 58.4 39.7 56.1 48.1 

Note: Postpartum family planning evaluated at three months after birth. Universe is all births 4 to 37 months 

preceding the survey. 

Asterisk (*) indicates that fewer than 100 observations are available for tabulation. 

3.3.2. Socioeconomic characteristics 

Table 7 presents postpartum family planning use disaggregated by location and wealth status as measured 

by DHS household wealth quintiles3

 and women’s education status. In contrast to the indicators in the 

previous table that were measured at the time of the child’s birth, the indicators in this table were assessed 

at the time of the interview. These variables pose some conceptual issues. It is likely that some of the 

women will have moved from rural areas to urban areas, have improved or diminished their economic 

situation relative to other women in the sample, or improved their educational status since the birth of the 

 

3

 See Rutstein and Johnson 2004. 
21 

child. In general, migration would have been from rural to urban areas, although migration in the other 

direction is possible. Overall, changes in economic status as measured by the wealth index would be a net 

zero, since this index is a relative measure. An improvement in status for one household would be 

accompanied by a relative decline for at least one other household. Educational status can only improve 

and is in fact an area for potential concern. Many of the younger women in the sample might still be in 

school and could have moved up a level in educational status since the child’s birth. Alternatively, the 

effect of education on family planning use may be more related to educational aspirations or abilities than 

to actual attainment. The educational status at the time of the interview would be the most recent measure 

of these aspirations or abilities. 

The usual expectation is that family planning use will be greater in urban areas than rural areas. In Table 7 

the results follow this expectation, except for Azerbaijan, Cambodia, Moldova, Maldives, and Zambia. 

Overall levels of family planning use among all currently married women in Azerbaijan, Cambodia, 

Moldova, and Maldives are approximately the same in both urban and rural areas. In Zambia the higher 

level of use of postpartum family planning in rural areas may have something to do with the very high 

levels of use for LAM. 

Concerning wealth status, the usual expectation is that women from wealthier households will be more 

likely to use family planning than women from poorer households. It has also been observed for currently 

married women that the differences in family planning use by wealth status are less among countries with 

relatively high levels of family planning use (Winfrey et al. 2014). In high-prevalence countries including 

Bangladesh and Indonesia, differences in family planning use by wealth status have been largely 

eliminated4

 (NIPORT et al. 2011; Stati (Badan Pusat Statistik—BPS) et al. 2013). Most of the recent 

increases in family planning in Bangladesh and Indonesia have tended to be more rapid at lower 

socioeconomic levels, bringing them closer to the wealthier groups. 

For most countries we observe the expected pattern of more postpartum family planning use in the 

wealthier quintiles. Extreme examples of disparity include Bolivia, Ethiopia, and Kenya. Notable 

exceptions are the East European and Central Asian countries in our sample. In most of these countries 

maternal health care services are near universal, meaning that women have equal access to postpartum 

family planning counseling and services. Also in this region, given the relatively low rates of fertility in 

these countries there is a near universal demand for small families. Other exceptions are the countries 

where the levels of postpartum family planning use are low and the absolute disparities are low (e.g., 

Benin, Burkina Faso, Ghana, and Sierra Leone). 

For many of the countries with high or moderately high levels of family planning use, the differences in 

postpartum family planning are quite large by wealth status—in contrast to what is seen for family 

planning use among all women or all currently married women. At the latest survey there was virtually no 

inequality in use of family planning across wealth quintiles in Bangladesh and Indonesia. The results in 

Table 7 show that there are notable differences in postpartum family planning use across the wealth 

quintiles for these two countries. Figure 3 makes the difference by wealth quintile clear. 

For education, again the expectation is that family planning use will be greater among more highly 

educated women. This pattern is followed by most of the countries; however, there are a few exceptions. 

The Eastern European and Central Asian countries either do not follow the pattern or have too few 

observations for some of the educational status categories to allow analysis. Cambodia and Zambia are 

also exceptions to the general pattern. Again, for Zambia, the high level of use of LAM accounts for the 

anomaly. 

 

4

 For Bangladesh see: NIPORT et al. 2011. For Indonesia see: Statistics Indonesia (Badan Pusat Statistik—BPS) et 

al. 2013. 
Table 7. Postpartum family planning use (any method) by urban-rural location, wealth status, and educational attainment, 43 DHS

surveys, 2005–2013 

Location Wealth status Highest level of education 

Urban Rural Poorest Second Third Fourth Richest None Primary Secondary Higher 

West and Central Africa Benin 2011-2012 5.2 2.5 1.6 1.9 2.6 4.6 7.3 2.3 6.0 7.9 * 

Burkina Faso 2010 9.3 2.3 1.9 1.6 2.3 3.5 10.0 2.6 5.4 14.5 * 

Ghana 2008 5.7 4.9 2.3 4.8 5.2 6.7 9.1 2.4 5.3 7.4 * Niger 2012 40.9 15.9 15.9 13.8 15.2 18.1 35.3 17.1 27.2 39.2 * 

Nigeria 2008 11.0 3.5 1.2 2.0 4.8 9.4 16.2 1.4 6.5 11.5 19.2 Senegal 2010-2011 19.9 5.2 3.2 3.4 9.9 13.8 25.8 6.9 14.9 19.8 * Sierra Leone 2008 5.1 3.8 4.8 2.4 3.1 5.7 5.1 3.3 8.5 5.6 * 

East and Southern Africa Burundi 2010 13.1 7.0 5.8 5.7 9.3 6.5 10.9 5.5 8.7 16.6 * Comoros 2012 15.0 7.1 4.8 12.5 9.3 10.6 9.2 7.1 6.1 13.3 * 

Ethiopia 2011 39.2 7.1 1.8 7.3 6.8 12.6 37.0 8.4 13.0 55.7 * Kenya 2008-2009 34.0 20.1 9.7 21.3 23.9 27.8 35.0 4.9 21.4 32.8 44.8 

Lesotho 2009 40.5 19.3 13.3 15.3 21.7 29.8 44.6 * 16.8 33.2 * Madagascar 2008-2009 26.0 10.7 4.9 7.2 12.4 17.8 26.9 4.5 12.2 21.4 * 

Malawi 2010 25.6 16.9 15.0 16.9 19.6 18.2 21.9 16.0 17.2 24.3 * 

Mozambique 2011 5.9 2.4 2.0 2.1 2.3 3.8 8.0 2.4 3.1 7.2 * Namibia 2006-2007 38.4 21.9 17.1 19.8 27.6 38.8 43.4 16.5 20.1 34.1 * 

Rwanda 2010 28.1 17.9 13.9 16.8 17.8 22.1 28.2 14.8 18.9 29.2 * 

Tanzania 2010 21.6 13.5 8.9 12.4 16.5 16.5 24.6 9.3 16.5 23.5 * 

Uganda 2011 17.9 7.5 3.3 5.1 7.3 12.9 18.1 3.6 7.4 15.2 22.2 

Zambia 2007 24.8 25.8 33.7 22.5 19.9 24.2 26.7 24.9 25.1 26.5 * 

Zimbabwe 2010-2011 59.2 50.9 41.3 54.4 55.5 57.8 60.4 * 45.8 56.5 * 

Middle East and North Africa Egypt 2008 79.5 73.1 66.7 72.4 77.2 79.4 82.6 68.5 78.5 77.6 79.6 Jordan 2012 78.8 77.8 74.9 78.5 78.9 82.3 79.9 70.4 70.2 78.1 81.9 

(Continued...)

22 
Table 7. – Continued

Location Wealth status Highest level of education 

Urban Rural Poorest Second Third Fourth Richest None Primary Secondary Higher 

South and Southeast Asia Bangladesh 2011 37.8 29.3 27.5 30.1 32.1 30.2 37.6 28.1 31.7 30.7 40.5 

Cambodia 2010 7.6 8.5 6.4 7.8 8.8 11.2 8.9 9.8 7.8 8.8 * 

India 2005-2006 25.6 15.8 11.6 16.0 18.9 22.3 27.8 13.4 19.3 23.8 29.3 Indonesia 2012 71.9 59.9 52.3 65.6 66.4 72.7 73.6 30.4 62.5 69.0 65.7 Maldives 2009 19.3 23.7 21.7 24.1 23.4 24.5 18.0 26.5 25.4 20.5 * 

Nepal 2011 18.5 10.5 7.0 10.0 10.6 14.2 18.6 9.6 11.4 13.2 14.9 Pakistan 2012-2013 40.7 24.3 16.1 25.0 30.0 36.0 44.2 21.5 31.1 42.8 44.1 Timor-Leste 2009-2010 16.5 7.4 4.6 5.7 8.1 10.8 19.6 6.7 9.4 11.6 * Eastern Europe and Central Asia Albania 2008-2009 72.0 60.2 61.5 68.9 62.3 58.0 * * 63.9 63.2 * Armenia 2010 56.2 38.6 41.3 32.1 57.2 53.0 * * * 47.0 52.8 Azerbaijan 2006 39.7 42.6 40.8 38.2 40.3 35.0 53.1 * * 39.8 * Kyrgyz Republic 2012 16.8 12.5 12.1 14.6 11.3 14.0 17.1 * * 12.8 15.3 

Moldova 2005 71.4 72.8 * 74.0 68.6 75.9 71.7 * * 71.2 76.8 

Tajikistan 2012 18.6 13.8 13.7 13.5 10.4 16.3 21.8 * 9.3 14.2 23.6 

Ukraine 2007 35.4 34.6 * 32.9 33.9 * 34.6 * * 32.0 37.2 Latin America and the Caribbean Bolivia 2008 30.8 13.7 10.2 16.5 26.2 30.9 42.8 14.6 16.4 30.0 39.5 

Colombia 2010 62.4 56.4 50.0 60.1 62.6 69.8 67.2 32.3 59.3 61.6 63.3 

Guyana 2009 36.4 24.2 13.8 23.5 30.7 38.4 39.1 * 13.3 30.7 * Honduras 2011-2012 65.9 52.7 43.2 55.2 62.4 70.1 69.3 45.8 55.4 64.5 73.0 

Peru 2012 61.4 43.7 41.4 51.4 63.0 62.6 64.4 38.1 45.6 59.0 61.4 

Note: Postpartum family planning evaluated at three months after birth (any method). Universe is all births 12 to 37 months preceding the survey. Indicators for cross-tabulation are evaluated at the time of the survey. Asterisk (*) indicates that fewer than 100 observations are available for tabulation. 

23 
24 

Figure 3. Postpartum family planning use (any method) and family planning use by currently 

married women (any method) disaggregated by wealth index, Bangladesh 2011 and Indonesia 

2012 

3.3.3. Fertility preferences 

Establishing fertility preferences for women based on the reproductive calendar is difficult, and perhaps 

impossible. In this section three measures are presented. First, postpartum family planning use is 

evaluated based upon the wantedness of the birth. There are three possibilities: 1) the woman wanted the 

birth at the time of the birth; 2) the woman wanted the birth but would have preferred to wait; and 3) the 

birth was not wanted at all. The usual interpretation of such a measure is that it indicates motivation to use 

family planning. However, it could just as well be an indication of inability or unwillingness to use family 

planning. For instance, if a woman mistimed a birth in the past or did not want the birth, she might persist 

in not using family planning in the future. 

The second measure of fertility preferences is an evaluation of the number of children born to a woman at 

the time of the birth relative to her current expression of ideal family size. The measure can have three 

values: the parity at birth is less than the woman’s current ideal family size, the parity at birth is equal to 

her ideal family size, or the parity at birth is greater than her ideal family size. This measure’s 

appropriateness is limited by the fact that the statement of ideal family size is made during the 

interview—that is, retrospectively rather than at the time of the birth. A woman’s estimation of ideal 

0

10

20

30

40

50

60

70

Bangladesh 2011:

Postpartum

Bangladesh 2011:

Currently married women

Indonesia 2012:

Postpartum

Indonesia 2012:

Currently married women

Percent of women using family planning

Lowest Second Third Fourth Highest
25 

family size may be fluid. Ideal family size could very well increase as the birth order of children 

increases. 

The third measure of fertility preferences is based on whether a woman wants another birth or not. It is 

possible to establish a further disaggregation—wanting to delay a birth or not among women who want 

another child. It was decided not to use this distinction because the birth being evaluated for postpartum 

family planning likely occurred many months before the interview. The assessment of wanting to delay or 

not delay a pregnancy is time sensitive. The temporal disconnect between the birth and the interview 

would likely render the measure invalid for the purposes of this study. 

Table 8 presents use of postpartum family planning disaggregated for the three measures of fertility 

preferences described above. The use of postpartum family planning does not show a consistent pattern 

by the wantedness status of the birth. Bangladesh, Jordan, and Pakistan are the only countries that show 

strongly differentiated postpartum family planning use based on this indicator. 

The second measure of preferences, parity relative to current ideal family size, shows a much more 

distinct pattern of results. In 37 out of 42 surveys with data, women who have achieved their ideal family 

size with the birth are more likely to use postpartum family planning than women who have not yet 

achieved their ideal family size. In 23 of these 37 surveys, women who have exceeded their ideal family 

size are more likely to use postpartum family planning that women who have not yet reached their ideal 

family size. 

The third measure of fertility preferences is based on the preferences of women at the time of the 

interview (as opposed to preferences at the time of birth). In 32 of the 43 surveys studied, this measure 

matches expectations in that women who at the time of the survey report that they do not want any more 

children are more likely to be using postpartum family planning compared with women who want more 

children. This is despite the fact that the point in time at which the woman stated her fertility preference is 

different from the time of the birth. 
Table 8. Postpartum family planning use (any method) by wantedness of the birth, birth order relative to ideal family size, and desire to 

have another child, 43 DHS surveys, 2005–2013 

Wantedness status of birth Birth order relative to ideal family size Desire to have another child 

Then Later No more Less Same Greater 

Nonnumerical Wants no more Wants more Not established

West and Central Africa Benin 2011-2012 3.4 5.0 2.8 3.8 2.5 3.4 4.1 4.0 4.2 2.6 Burkina Faso 2010 3.4 4.5 * 3.7 3.0 3.5 2.8 4.2 3.8 6.4 Ghana 2008 4.9 6.8 * 4.8 4.9 8.1 * 8.7 4.1 * 

Niger 2012 18.8 25.4 * 19.1 21.3 20.3 17.3 29.9 20.1 19.2 Nigeria 2008 5.7 11.3 * 6.1 8.3 5.6 3.8 12.3 5.1 6.2 

Senegal 2010-2011 9.7 11.4 * 9.9 12.0 11.1 10.5 12.1 10.5 * 

Sierra Leone 2008 3.0 6.3 9.0 4.4 2.9 4.4 * 4.6 4.1 4.7 East and Southern Africa Burundi 2010 7.2 9.4 * 8.1 9.5 6.4 2.9 8.0 8.8 * 

Comoros 2012 7.5 14.6 * 8.7 17.2 5.8 * 10.5 7.7 29.4 

Ethiopia 2011 11.1 13.8 9.7 13.3 9.1 9.5 6.5 13.1 13.5 8.3 

Kenya 2008-2009 24.1 22.6 19.1 23.6 24.9 20.2 17.1 23.9 24.6 * Lesotho 2009 27.2 21.9 22.5 24.2 28.9 22.9 * 26.7 26.6 * 

Madagascar 2008-2009 11.7 17.7 * 11.8 14.9 12.6 9.7 16.7 12.4 8.1 

Malawi 2010 17.4 16.3 20.8 16.4 19.7 21.1 19.5 20.7 18.3 14.5 

Mozambique 2011 2.9 5.7 * 2.9 4.0 4.8 4.0 5.5 3.2 3.0 

Namibia 2006-2007 31.1 25.2 28.0 25.4 33.2 33.4 * 32.7 27.2 25.8 

Rwanda 2010 18.1 22.8 15.7 19.9 21.6 16.8 14.2 19.6 24.0 * 

Tanzania 2010 14.6 16.2 * 14.3 19.2 17.1 12.2 20.9 15.6 * 

Uganda 2011 9.1 8.9 7.6 8.3 10.3 9.3 9.7 11.5 8.9 * 

Zambia 2007 28.3 20.4 24.0 24.2 25.0 31.7 23.6 26.9 24.2 20.8 

Zimbabwe 2010-2011 56.9 48.5 * 54.1 57.2 48.0 * 51.5 58.2 53.8 Middle East and North Africa Egypt 2008 75.2 * 80.5 70.5 82.6 81.3 * 83.7 77.1 68.3 

Jordan 2012 76.9 85.3 79.8 75.0 82.5 83.8 86.2 87.8 82.2 66.4 

(Continued...)

26 
Table 8. – Continued

Wantedness status of birth Birth order relative to ideal family size Desire to have another child 

Then Later No more Less Same Greater 

Nonnumerical Wants no more Wants more Not established

South and Southeast Asia Bangladesh 2011 29.1 36.6 36.7 28.8 31.6 34.5 * 33.6 32.1 25.0 

Cambodia 2010 8.1 10.5 8.4 7.9 8.4 11.0 * 9.8 7.8 6.0 India 2005-2006 17.2 23.6 21.9 9.2 25.6 23.5 10.4 28.3 9.0 6.2 

Indonesia 2012 65.6 65.4 70.0 65.4 69.3 63.4 * 70.0 68.0 61.4 Maldives 2009 20.2 * * 20.0 21.9 34.3 * 30.8 17.5 16.3 

Nepal 2011 11.4 14.2 * 8.7 13.9 12.1 * 13.6 11.5 * 

Pakistan 2012-2013 27.0 35.0 46.1 23.3 38.3 36.7 30.9 41.3 26.0 23.7 

Timor-Leste 2009-2010 8.7 15.5 * 8.3 11.4 12.7 11.0 15.9 12.7 8.2 

Eastern Europe and Central Asia Albania 2008-2009 63.6 * * 60.7 72.9 * * 69.3 65.5 * Armenia 2010 46.3 * * 44.7 56.8 * * 61.2 48.3 44.7 

Azerbaijan 2006 39.9 * * 34.6 47.2 56.8 * 47.6 47.2 * Kyrgyz Republic 2012 13.9 * * 13.6 16.3 * * 15.7 16.1 11.3 

Moldova 2005 72.8 * * * * * * 76.3 71.3 * Tajikistan 2012 14.0 * * 11.2 21.2 23.6 * 23.3 12.4 19.4 

Ukraine 2007 33.5 * * 32.2 36.9 * * 38.5 40.3 * 

Latin America and the Caribbean Bolivia 2008 27.4 20.5 19.7 25.6 23.7 20.1 19.9 23.7 28.2 * 

Colombia 2010 62.1 58.2 61.2 55.6 64.7 64.5 * 67.0 57.8 51.0 

Guyana 2009 27.3 * * 27.6 30.9 22.6 * 27.1 34.7 * Honduras 2011-2012 60.6 56.9 55.9 56.1 63.8 61.2 49.1 64.3 58.0 * Peru 2012 58.0 55.1 50.5 56.3 57.3 53.1 * 55.6 58.0 * 

Note: Postpartum family planning (any method) evaluated at three months after birth. Wantedness in first three columns queried at the time of birth. Universe is all births 12 to 37 months preceding the survey. Ideal family size is queried at time of survey. The number of children that is compared to the ideal family size is based on number of children at birth. Universe is all births 12 to 37 months preceding the survey. Wantedness in the final three columns is evaluated at the time of the survey. Universe is most recent births 4 to 37 months preceding the survey. Asterisk (*) indicates that fewer than 100 observations are available for tabulation. 

27 
28 

3.3.4. Use of maternal health services 

Table 9 presents use of postpartum family planning services disaggregated by use of antenatal care 

services and by place of delivery (facility versus home delivery). The universe for these tabulations 

differs from the previous tabulations. Instead of any birth between 12 months and 36 months ago, the 

universe is defined as the most recent birth between 4 months and 36 months. The exclusion of births 

prior the most recent birth is because information on maternal health services is available only for the 

most recent birth. The additional inclusion of the births from 4 to 11 months was done to increase the 

sample size of the most recent births. 

In all countries, except for some in East Europe and Central Asia, at three months postpartum women 

with antenatal care are more likely to use family planning. In most of the countries with moderately high 

levels of postpartum family planning use, the level is at least 15 points higher among women having four 

to six antenatal care visits versus having none at all. Examples include Bolivia, India, Kenya, and 

Madagascar. The countries with low levels of postpartum family planning also exhibit more postpartum 

family planning use with higher levels of antenatal care, but the pattern is less clear. For example, Niger 

shows a strong relationship between postpartum family planning use and number of antenatal care visits, 

while Sierra Leone shows little relationship between the two. 

Bangladesh is an interesting case. As mentioned, Bangladesh shows an extremely low level of postpartum 

family planning use at one month postpartum, but rapid increases in use as the postpartum period extends. 

As Table 9 shows, in Bangladesh the number of antenatal care visits bears little relationship to use of 

family planning at three months postpartum. 

In all countries where comparisons are possible, women who deliver their baby in a medical facility are 

more likely to use family planning in the postpartum period than women who deliver outside a medical 

facility. In some cases, the differential is modest, as in Azerbaijan and Jordan. In other cases, the 

differential is very large. In Colombia and Guyana the differential exceeds 20 percent. 

Table 9. Postpartum family planning use (any method) by use of antenatal care and place of 

delivery, 43 DHS surveys, 2005–2013 

 Prenatal care Delivery care 

 

No 

prenatal 

care 

1-3 

visits 

4-6 

visits 

7+ 

visits 

Don’t 

know or 

missing Home Facility 

Don’t 

know or 

missing 

West and Central Africa 

Benin 2011-2012 1.7 4.4 4.3 5.4 5.5 2.6 4.5 * 

Burkina Faso 2010 1.4 4.1 5.2 * * 1.5 5.5 * 

Ghana 2008 * 1.3 5.3 7.8 * 3.7 6.6 * 

Niger 2012 9.9 22.2 24.7 * * 16.6 30.6 * 

Nigeria 2008 2.1 4.4 6.7 14.5 9.7 3.3 13.7 * 

Senegal 2010-2011 6.4 8.3 15.1 * * 3.9 14.7 * 

Sierra Leone 2008 3.3 2.2 3.9 6.2 4.8 3.5 5.8 * 

East and Southern Africa 

Burundi 2010 * 9.4 11.3 * * 6.7 11.7 11.4 

Comoros 2012 * 7.4 16.2 19.9 12.5 8.8 14.0 * 

Ethiopia 2011 7.2 13.5 28.4 37.9 * 8.9 44.5 * 

(Continued...)
29 

Table 9. – Continued

 Prenatal care Delivery care 

 

No 

prenatal 

care 

1-3 

visits 

4-6 

visits 

7+ 

visits 

Don’t 

know or 

missing Home Facility 

Don’t 

know or 

missing 

Kenya 2008-2009 13.2 19.3 28.7 37.8 * 15.5 33.8 * 

Lesotho 2009 21.4 24.8 28.7 35.6 * 19.9 34.1 * 

Madagascar 2008-2009 5.5 12.5 16.3 23.4 * 10.6 20.0 * 

Malawi 2010 20.4 19.4 22.6 22.5 * 18.3 21.7 16.2 

Mozambique 2011 0.8 3.6 4.4 11.3 * 1.9 5.5 2 

Namibia 2006-2007 21.4 32.8 30.6 40.4 32.2 20.3 36.3 * 

Rwanda 2010 * 22.3 25.2 * * 14.5 25.8 * 

Tanzania 2010 * 16.1 17.7 * * 14.2 19.7 * 

Uganda 2011 10.0 8.1 13.1 13.2 * 6.1 13.6 * 

Zambia 2007 * 28.6 26.4 31.3 * 25.9 28.7 * 

Zimbabwe 2010-2011 40.4 57.6 63.1 63.9 * 51.4 63.5 * 

Middle East and North 

Africa 

Egypt 2008 74.1 74.7 77.6 81.4 * 73.6 80.2 * 

Jordan 2012 * 73.5 83.8 83.4 * * 83.4 * 

South and Southeast Asia 

Bangladesh 2011 29.8 33.6 32.1 39.9 * 32.3 33.5 * 

Cambodia 2010 5.4 8.9 10.1 9.4 * 7.5 10.2 * 

India 2005-2006 11.4 17.9 28.5 31.3 21.9 15.0 28.9 * 

Indonesia 2012 33.8 57.6 65.8 71.0 * 64.4 69.2 * 

Maldives 2009 * * 23.8 21.9 19.8 * 22.0 * 

Nepal 2011 10.1 11.1 13.9 17.3 * 10.6 15.9 * 

Pakistan 2012-2013 20.5 32.2 37.9 46.0 * 27.8 37.5 * 

Timor-Leste 2009-2010 5.3 11.5 12.7 19.7 * 9.4 20.5 * 

Eastern Europe and Central 

Asia 

Albania 2008-2009 * 64.0 67.9 73.3 * * 67.9 * 

Armenia 2010 * * 44.5 54.4 * * 49.6 * 

Azerbaijan 2006 48.3 45.4 45.2 46.0 * 46.3 46.7 * 

Kyrgyz Republic 2012 * 14.2 15.1 14.9 * * 14.7 * 

Moldova 2005 * * 81.5 74.2 * * 75.2 * 

Tajikistan 2012 11.0 14.9 17.5 17.8 * 13.3 16.2 * 

Ukraine 2007 * * * 37.2 * * 35.5 * 

Latin America and the 

Caribbean 

Bolivia 2008 13.3 15.8 25.2 34.9 * 11.2 31.2 * 

Colombia 2010 45.2 55.1 61.6 69.4 53.5 38.4 65.8 * 

Guyana 2009 * * 29.2 36.5 22.8 12.2 33.4 * 

Honduras 2011-2012 40.8 44.9 56.3 68.6 * 39.4 65.4 * 

Peru 2012 40.1 42.1 49.5 58.5 * 39.7 58.2 * 

Asterisk (*) indicates that fewer than 100 observations are available for tabulation. 

31 

4. Discussion 

The study used the reproductive calendar from surveys in 43 countries to analyze levels of family 

planning in the postpartum period. The analysis looked at the method mix of postpartum women versus 

currently married women in a given country, and examined differences in postpartum family planning use 

disaggregated by potentially influential factors, including demographic and socioeconomic 

characteristics, fertility preferences, and the use of maternal health services. 

In a report covering 43 countries across six diverse regions, there can be few sweeping conclusions. Indepth analysis of any given country was not the intent of the study. However, the report does offer several 

general findings concerning postpartum family planning: 

• The use of postpartum family planning generally increases with time since the birth, at least up to 

five or six months postpartum. 

• Method mix for postpartum family planning use is generally different from method mix among 

all women, with more LAM and injectable use and less sterilization. 

• In most countries use of postpartum family planning is not strongly related to the age of the 

mother, parity, or the wantedness of the last birth. 

• In most countries use of postpartum family planning is positively related to urban location, wealth 

quintile, education level, achievement of desired family size, and current fertility desires. It is 

negatively related to the number of children under age 5 born to the woman. 

• There is a strong correlation between the use of maternal health care (including antenatal care and 

facility-based births) and postpartum family planning. 

This report also points to some promising areas for further research and analysis and suggests how the 

reproductive calendar can be used to analyze postpartum family planning: 

• In-depth analysis and interpretation of report results on a country-by-country basis. Each survey 

in this report has an interesting story of its own to tell. Country policymakers and program 

managers would find it useful to extract the results from this report and use them to inform future 

decisions. For example, analysis of family planning use month by month could help planners 

understand opportunities along the continuum of care. 

• Further comparison of overall family planning use compared with postpartum use. In several 

countries, with Bangladesh as the most notable example, early initiation of family planning 

postpartum use lags significantly behind overall family planning use in the country. However this 

observation is partly method-specific and varies across the entire postpartum period. Therefore, 

program planners and policymakers might want to create “user profiles” to help analyze the 

differences between the women who use family planning early in the postpartum period and those 

who delay initiation of use. This is an important difference, as fecundity can return quickly in the 

absence of exclusive breastfeeding. 

• Examination of the relationship between postpartum family planning use and birth intervals. In 

most of sub-Saharan Africa, birth spacing is the most likely motivation for using family planning. 

Longer or shorter birth intervals are determined by a complicated set of factors. Among these 

factors are postpartum abstinence, breastfeeding practices, and use of family planning in the 
32 

postpartum period, as well as later use. Unfortunately, the reproductive calendar does not help 

with analyzing breastfeeding practices or postpartum abstinence. Nonetheless, in a 

comprehensive analysis it would be useful to draw on available data in the DHS for postpartum 

abstinence and breastfeeding in conjunction with a detailed analysis linking postpartum family 

planning and birth intervals.

• Facilitation of use of the reproductive calendar. The DHS Program may want to facilitate easier 

access to the reproductive calendar. Currently use of the calendar requires data manipulation 

skills beyond the abilities of the typical analyst. 

• DHS final reports. Final reports for DHS may want to include a section on postpartum family 

planning. For improved birth spacing, postpartum family planning is likely the sine qua non. 

• Multivariate analysis. This report does not claim to have found root causes for use or non-use of 

family planning in the postpartum period. In fact, some of the results might be surprising. For 

example, the report found little evidence that the wantedness status of the birth is related to 

postpartum family planning use. Well-designed multivariate analysis frequently generates results 

that are more robust in establishing causality or plausible correlations. 

 
33 

References

Akinlo, A., A. Bisiriyu, and O. Esimai. 2013. Influence of Use of Maternal Health Care on Postpartum 

Contraception in Nigeria. DHS Working Papers No. 92. Calverton, Maryland, USA: ICF International. 

Borda, M., W. Winfrey, and C. McKaig. 2010. “Return to Sexual Activity and Modern Family Planning 

Use in the Extended Postpartum Period: An Analysis of Findings from Seventeen Countries.” African 

Journal of Reproductive Health 14(4): 75-82. 

Do, M., and D. Hotchkiss. 2013. “Relationships between Antenatal and Postnatal Care and Post-Partum 

Modern Contraceptive Use: Evidence from Population Surveys in Kenya and Zambia.” BMC Health 

Services Research 13: 6. 

Gebreselassie, T., S.O. Rutstein, and V. Mishra. 2008. Contraceptive Use, Breastfeeding, Amenorrhea 

and Abstinence. During the Postpartum Period: An Analysis of Four Countries. DHS Analytical Studies 

No. 14. Calverton, Maryland, USA: Macro International Inc. 

National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF 

International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and 

Calverton, Maryland, USA: NIPORT, Mitra and Associates, and ICF International. 

Ross, J.A., and W. Winfrey. 2001. “Contraceptive Use, Intention to Use, and Unmet Need during the 

Extended Postpartum Period.” International Family Planning Perspectives 27(1): 20-7. 

Rutstein, S.O., and K. Johnson. 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. 

Calverton, Maryland, USA: ORC Macro. 

Statistics Indonesia (Badan Pusat Statistik—BPS), National Population and Family Planning Board 

(BKKBN), Kementerian Kesehatan (Kemenkes—MOH), and ICF International. 2013. Indonesia 

Demographic and Health Survey 2012. Jakarta, Indonesia: BPS, BKKBN, Kemenkes, and ICF 

International. 

United Nations Population Division, Department of Economic and Social Affairs. 2012. World 

Population Prospects: The 2012 Revision. New York, New York, USA: United Nations. 

Winfrey, W., P. Emmart, J. Davis, E. Sonneveldt, and W. Brown. 2014. Attributions of Family Planning 

Improvements. Unpublished manuscript available from the authors. 

Zerai, A., and A.O. Tsui. 2001. “The Relationship between Antenatal Care and Subsequent Modern 

Contraceptive Use in Bolivia, Egypt and Thailand.” African Reproductive Health 5(2): 68-82. 

Appendix 

Appendix Table A1. Numbers of births for Table 6, postpartum family planning use disaggregated by demographic factors 

Age of mother at birth Birth order of child 

Number of children 

under age 5 

Total 10-14 25-34 35-49 0-1 2-4 5+ 1 2 

West and Central Africa Benin 2011-2012 1,983 2,306 624 1,970 2,166 777 4,030 883 4,913 

Burkina Faso 2010 2,500 2,540 961 2,228 2,333 1,440 5,001 1,000 6,001 Ghana 2008 436 514 188 514 433 191 925 213 1,138 

Niger 2012 2,161 2,104 667 1,516 1,870 1,546 3,626 1,306 4,932 

Nigeria 2008 4,912 5,431 1,945 4,512 4,667 3,109 9,418 2,870 12,288 

Senegal 2010-2011 1,107 1,162 474 1,020 1,060 663 2,149 594 2,743 

Sierra Leone 2008 962 893 280 903 875 357 1,725 410 2,135 East and Southern Africa Burundi 2010 1,235 1,401 616 1,310 1,244 698 2,521 731 3,252 Comoros 2012 476 586 178 532 476 232 879 361 1,240 Ethiopia 2011 1,864 1,906 574 1,620 1,607 1,117 3,425 919 4,344 Kenya 2008-2009 1,185 952 289 1,069 893 464 1,834 592 2,426 Lesotho 2009 832 556 191 964 482 133 1,363 216 1,579 Madagascar 2008-2009 2,311 1,775 701 2,114 1,667 1,006 3,736 1,051 4,787 

Malawi 2010 3,855 3,259 1,048 3,096 3,384 1,682 6,628 1,534 8,162 

Mozambique 2011 2,102 1,768 623 1,911 1,776 806 3,594 899 4,493 

Namibia 2006-2007 909 868 327 1,171 709 224 1,786 318 2,104 Rwanda 2010 1,251 1,704 657 1,662 1,253 697 2,942 670 3,612 Tanzania 2010 1,293 1,323 553 1,160 1,278 731 2,443 726 3,169 

Uganda 2011 1,438 1,252 399 1,099 1,161 829 2,200 889 3,089 

Zambia 2007 1,218 1,036 363 982 1,055 580 1,982 635 2,617 Zimbabwe 2010-2011 1,129 858 214 1,328 718 155 1,900 301 2,201 

(Continued...)

35 
Appendix Table A1. – Continued

Age of mother at birth Birth order of child 

Number of children 

under age 5 

Total 10-14 25-34 35-49 0-1 2-4 5+ 1 2 

Middle East and North Africa Egypt 2008 1,947 1,967 403 2,523 1,494 300 3,457 860 4,317 

Jordan 2012 1,193 2,275 746 1,773 1,830 611 3,097 1,117 4,214 South and Southeast Asia Bangladesh 2011 2,156 981 142 2,149 993 137 2,923 356 3,279 Cambodia 2010 1,393 1,475 480 1,995 1,058 295 2,886 462 3,348 India 2005-2006 11,751 7,726 961 12,430 6,390 1,618 16,212 4,226 20,438 Indonesia 2012 2,539 3,462 1,140 4,698 2,095 348 6,304 837 7,141 

Maldives 2009 640 727 190 1,012 434 111 1,401 156 1,557 Nepal 2011 1,196 728 136 1,252 658 150 1,725 335 2,060 Pakistan 2012-2013 1,806 2,224 562 1,974 1,719 899 3,335 1,257 4,592 

Timor-Leste 2009-2010 1,295 1,729 928 1,318 1,486 1,148 2,820 1,132 3,952 

Eastern Europe and Central Asia Albania 2008-2009 228 329 57 414 185 15 532 82 614 

Armenia 2010 354 217 34 514 87 4 511 94 605 Azerbaijan 2006 504 353 72 707 213 9 706 223 929 Kyrgyz Republic 2012 764 760 201 1,011 651 63 1,302 423 1,725 Moldova 2005 352 283 39 581 87 6 619 55 674 Tajikistan 2012 1,072 907 191 1,310 735 125 1,632 538 2,170 

Ukraine 2007 235 223 31 433 52 4 439 50 489 Latin America and the Caribbean Bolivia 2008 1,572 1,409 547 1,801 1,176 551 2,869 659 3,528 Colombia 2010 3,837 2,590 726 4,786 1,950 417 6,247 906 7,153 

Guyana 2009 457 364 114 480 341 114 726 209 935 

Honduras 2011-2012 2,379 1,623 458 2,691 1,347 422 3,871 589 4,460 Peru 2014 1,574 1,669 665 2,294 1,276 338 3,486 422 3,908 

Note: Postpartum family planning evaluated at three months after birth. Universe is all births 4 to 37 months preceding the survey. 

36 
Appendix Table A2. Numbers of births for Table 7, postpartum family planning use disaggregated by socioeconomic factors 

Location Wealth status Highest level of education 

Urban Rural Poorest Second Third Fourth Richest None Primary Secondary Higher 

West and Central Africa Benin 2011-2012 1,819 3,094 1,092 1,020 1,074 960 767 3,585 773 520 35 

Burkina Faso 2010 1,355 4,646 1,126 1,251 1,333 1,283 1,008 4,928 728 324 19 Ghana 2008 382 756 368 246 206 188 130 412 288 414 24 Niger 2012 1,122 3,810 863 835 925 1,031 1,278 4,023 583 286 29 

Nigeria 2008 4,071 8,217 2,709 2,888 2,423 2,272 1,996 5,674 2,506 3,297 811 

Senegal 2010-2011 814 1,929 763 711 573 414 282 1,946 579 196 22 Sierra Leone 2008 726 1,409 465 400 424 457 389 1,567 293 245 30 East and Southern Africa Burundi 2010 569 2,683 645 644 582 600 781 1,577 1,354 277 44 Comoros 2012 423 817 321 270 242 207 200 504 298 352 82 Ethiopia 2011 798 3,546 1,308 763 686 727 860 2,981 1,119 157 87 

Kenya 2008-2009 582 1,844 703 427 419 382 495 482 1,409 409 126 Lesotho 2009 270 1,309 473 347 295 247 217 33 943 543 60 Madagascar 2008-2009 823 3,964 1,346 1,042 854 794 751 1,307 2,512 895 73 

Malawi 2010 738 7,424 1,887 1,888 1,838 1,522 1,027 1,357 5,702 1,063 40 Mozambique 2011 1,454 3,039 768 894 871 984 976 1,506 2,281 666 40 Namibia 2006-2007 803 1,301 441 401 544 466 252 279 632 1,111 82 Rwanda 2010 479 3,133 863 760 727 666 596 662 2,643 263 44 Tanzania 2010 600 2,569 630 712 685 639 503 787 2,017 354 11 Uganda 2011 629 2,460 811 611 552 484 631 531 1,872 563 123 Zambia 2007 859 1,758 563 564 595 567 328 343 1,640 575 59 Zimbabwe 2010-2011 658 1,543 513 445 422 491 330 34 691 1,410 66 Middle East and North Africa Egypt 2008 1,611 2,706 1,010 889 871 788 759 1,205 427 2,144 541 Jordan 2012 2,875 1,339 1,153 1,112 969 680 300 119 302 2,347 1,446 

(Continued...)

37 
Appendix Table A2. – Continued

Location Wealth status Highest level of education 

Urban Rural Poorest Second Third Fourth Richest None Primary Secondary Higher 

South and Southeast Asia Bangladesh 2011 1,050 2,229 707 640 619 631 682 584 985 1,408 302 Cambodia 2010 869 2,479 858 648 565 563 714 673 1,779 838 58 India 2005-2006 7,816 12,622 3,587 3,782 4,220 4,505 4,344 8,149 2,886 7,798 1,605 

Indonesia 2012 3,267 3,874 2,187 1,419 1,320 1,179 1,036 217 2,199 3,764 961 

Maldives 2009 186 1,371 351 440 430 213 123 202 592 681 57 Nepal 2011 427 1,633 646 419 358 352 285 930 429 582 119 Pakistan 2012-2013 1,904 2,688 1,090 911 864 861 866 2,557 681 825 529 

Timor-Leste 2009-2010 900 3,052 933 805 862 753 599 1,308 1,142 1,441 61 Eastern Europe and Central Asia Albania 2008-2009 258 356 154 124 124 113 99 10 378 166 60 Armenia 2010 396 209 108 127 137 142 91 0 35 214 356 Azerbaijan 2006 441 488 234 223 215 147 110 14 18 799 98 Kyrgyz Republic 2012 434 1,291 393 373 393 323 243 0 5 973 747 Moldova 2005 371 303 91 115 141 141 186 4 7 518 145 Tajikistan 2012 679 1,491 367 424 431 411 537 44 123 1,697 306 Ukraine 2007 287 202 89 123 102 74 101 1 2 224 262 Latin America and the Caribbean Bolivia 2008 1,788 1,740 1,019 758 717 592 442 200 1,866 1,025 437 

Colombia 2010 4,599 2,554 2,650 1,848 1,321 821 513 204 2,143 3,688 1,118 

Guyana 2009 163 772 407 146 162 112 108 29 218 642 46 Honduras 2011-2012 1,535 2,925 1,458 1,030 831 646 495 238 2,792 1,255 175 

Peru 2012 2,271 1,637 1,142 1,073 797 566 330 140 1,232 1,693 843 

Note: Postpartum family planning evaluated at three months after birth (any method). Universe is all births 12 to 37 months preceding the survey. Indicators for cross-tabulation are evaluated at the time of the survey. 

38 
Appendix Table A3. Numbers of births for Table 8, postpartum family planning use disaggregated by fertility preferences 

Wantedness status of 

birth 

Ideal family size relative to birth 

order Desire to have another child 

Then Later 

No 

more Less Same Greater

Nonnumerical Wants no more Wants more Not established

West and Central Africa Benin 2011-2012 1,420 297 121 3,258 634 823 198 800 2,720 605 

Burkina Faso 2010 1,875 184 31 4,177 701 753 370 935 4,069 108 

Ghana 2008 259 116 74 776 154 164 44 277 618 48 

Niger 2012 1,571 164 13 3,335 486 734 377 240 3,349 108 

Nigeria 2008 4,076 459 82 8,557 1,288 1,669 774 1,368 7,343 884 

Senegal 2010-2011 686 236 43 1,966 242 368 167 393 1,758 46 

Sierra Leone 2008 633 151 135 1,514 274 261 86 477 1,091 195 

East and Southern Africa Burundi 2010 658 350 51 1,950 374 736 192 839 1,628 89 Comoros 2012 299 134 47 888 127 161 64 185 607 106 Ethiopia 2011 1,138 293 113 2,733 408 904 299 1,077 2,262 145 Kenya 2008-2009 504 225 164 1,416 373 521 116 815 969 78 

Lesotho 2009 248 202 143 856 314 383 26 887 467 22 

Madagascar 2008-2009 1,508 160 99 3,188 665 713 221 1,394 2,255 126 

Malawi 2010 1,443 577 793 4,723 1,365 1,645 429 2,926 3,609 238 

Mozambique 2011 1,318 263 78 2,981 640 657 215 1,142 2,254 285 Namibia 2006-2007 345 228 218 1,112 482 453 57 1,079 575 155 Rwanda 2010 650 338 152 1,896 587 929 200 1,497 1,424 62 Tanzania 2010 784 304 36 2,136 374 488 171 666 1,766 51 

Uganda 2011 566 427 128 1,874 363 645 207 872 1,288 86 Zambia 2007 464 262 205 1,725 317 422 153 654 1,213 168 

Zimbabwe 2010-2011 642 266 79 1,540 350 277 34 729 1,081 108 

Middle East and North Africa Egypt 2008 1,481 93 158 2,350 1,053 841 73 1,941 1,383 198 

Jordan 2012 952 252 114 2,384 676 1,003 151 1,404 1,624 128 

(Continued...)

39 
Appendix Table A3. – Continued

Wantedness status of 

birth 

Ideal family size relative to birth 

order Desire to have another child 

Then Later 

No 

more Less Same Greater

Nonnumerical Wants no more Wants more Not established

South and Southeast Asia Bangladesh 2011 823 206 135 1,293 1,029 926 31 1,701 1,141 109 Cambodia 2010 907 112 105 1,986 807 464 91 1,423 1,331 154 India 2005-2006 5,529 806 710 8,435 6,107 5,516 380 10,215 5,514 602 

Indonesia 2012 2,200 218 175 4,195 1,669 1,189 88 2,469 3,389 506 

Maldives 2009 465 61 92 1,038 300 190 29 587 683 137 

Nepal 2011 513 107 99 667 693 666 34 1,188 496 52 Pakistan 2012-2013 1,212 159 120 2,644 754 937 257 1,470 1,563 338 

Timor-Leste 2009-2010 1,130 172 48 2,501 532 632 287 785 1,516 551 

Eastern Europe and Central Asia Albania 2008-2009 143 26 9 324 189 99 2 265 200 72 Armenia 2010 207 12 1 412 166 26 1 159 252 104 Azerbaijan 2006 238 35 33 512 288 127 2 422 202 89 Kyrgyz Republic 2012 681 23 2 1,414 197 98 16 233 810 273 

Moldova 2005 181 23 18 308 269 44 

Tajikistan 2012 679 20 15 1,490 427 219 34 621 711 314 Ukraine 2007 140 9 17 287 167 34 1 169 189 88 Latin America and the Caribbean Bolivia 2008 453 325 397 1,275 795 1,344 114 2,053 789 46 Colombia 2010 1,048 713 637 2,965 2,227 1,862 99 4,106 2,005 180 

Guyana 2009 176 84 66 474 213 214 34 440 252 41 

Honduras 2011-2012 844 471 203 2,468 926 966 100 1,942 1,866 88 Peru 2012 535 434 314 1,591 985 1,249 83 2,216 1,265 35 Note: Postpartum family planning (any method) evaluated at three months after birth. Wantedness in first three columns queried at the time of birth. Universe is all births 12 to 37 months preceding the survey. Ideal family size is queried at time of survey. The number of children that is compared to the ideal family size is based on number of children at birth. Universe is all births 12 to 37 months preceding the survey. Wantedness in the final three columns is evaluated at the time of the survey. Universe is most recent births 4 to 37 months preceding the survey. 

40 
Appendix Table A4. Numbers of births for Table 9, postpartum family planning use disaggregated by use of antenatal care and place of 

birth delivery 

Prenatal care Delivery care 

Total 

No prenatal 

care 1-3 visits 4-6 visits 7+ visits 

Don’t know 

or missing Home Facility 

Don’t know 

West and Central Africa Benin 2011-2012 741 1,579 2,651 876 253 757 5,325 18 6,100 Burkina Faso 2010 289 4,569 2,519 38 5 1,862 5,530 28 7,420 

Ghana 2008 52 257 631 454 38 623 803 6 1,432 Niger 2012 807 2,917 1,881 42 31 3,380 2,277 21 5,678 Nigeria 2008 4,875 1,829 3,365 4,311 390 9,148 5,575 47 14,770 Senegal 2010-2011 168 1,664 1,334 47 48 1,001 2,226 34 3,261 Sierra Leone 2008 147 527 1,047 554 497 1,932 794 46 2,772 East and Southern Africa Burundi 2010 35 2,400 1,253 25 10 1,096 2,453 174 3,723 Comoros 2012 91 398 469 266 202 299 1,120 7 1,426 Ethiopia 2011 2,877 1,208 806 294 15 4,325 817 58 5,200 Kenya 2008-2009 263 1,222 1,120 194 36 1,526 1,304 5 2,835 Lesotho 2009 159 471 986 391 37 818 1,184 42 2,044 Madagascar 2008-2009 586 2,300 2,547 246 52 3,558 2,133 40 5,731 

Malawi 2010 139 5,366 4,067 192 76 2,182 7,380 278 9,840 

Mozambique 2011 392 2,079 2,767 231 70 1,870 3,563 106 5,539 

Namibia 2006-2007 119 463 1,145 700 251 516 2,152 10 2,678 Rwanda 2010 70 2,621 1,539 14 6 921 3,244 85 4,250 Tanzania 2010 60 2,056 1,513 78 23 1,802 1,881 47 3,730 

Uganda 2011 127 1,531 1,604 155 58 1,303 2,139 33 3,475 Zambia 2007 66 1,123 1,694 166 34 1,521 1,549 13 3,083 Zimbabwe 2010-2011 305 746 1,528 372 29 997 1,939 44 2,980 Middle East and North Africa Egypt 2008 1,351 383 993 2,641 34 1,471 3,927 4 5,402 Jordan 2012 31 212 816 3,564 0 36 4,587 0 4,623 

(Continued...)

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Appendix Table A4. – Continued

Prenatal care Delivery care 

Total 

No prenatal 

care 1-3 visits 4-6 visits 7+ visits 

Don’t know 

or missing Home Facility 

Don’t know 

South and Southeast Asia Bangladesh 2011 1,323 1,732 788 404 3 2,959 1,281 10 4,250 

Cambodia 2010 486 1,230 1,736 721 14 1,652 2,516 19 4,187 

India 2005-2006 4,521 8,625 5,271 5,472 236 12,572 11,508 45 24,125 Indonesia 2012 440 1,042 2,062 5,653 84 3,892 5,341 48 9,281 Maldives 2009 5 51 176 1,616 246 48 2,027 19 2,094 

Nepal 2011 358 783 1,089 302 0 1,423 1,056 53 2,532 Pakistan 2012-2013 1,271 1,854 1,055 848 13 2,345 2,683 13 5,041 

Timor-Leste 2009-2010 531 1,316 1,963 494 27 3,363 967 1 4,331 Eastern Europe and Central Asia Albania 2008-2009 21 232 296 177 5 25 704 2 731 Armenia 2010 4 29 340 372 18 1 760 2 763 Azerbaijan 2006 228 342 269 190 33 190 869 3 1,062 Kyrgyz Republic 2012 42 252 871 898 50 7 2,103 3 2,113 Moldova 2005 16 47 241 532 38 7 866 1 874 

Tajikistan 2012 463 630 865 489 22 510 1,948 11 2,469 Ukraine 2007 6 14 40 480 92 0 630 2 632 

Latin America and the Caribbean Bolivia 2008 345 732 1,743 1,361 12 1,142 3,032 19 4,193 Colombia 2010 530 950 3,119 4,232 112 806 8,119 18 8,943 Guyana 2009 30 80 294 504 184 179 898 15 1,092 Honduras 2011-2012 200 485 2,058 2,843 5 1,062 4,510 19 5,591 Peru 2012 113 233 935 3,655 7 715 4,191 37 4,943 Note: Postpartum family planning (any method) evaluated at three months after birth. Universe is most recent births 4 to 37 months preceding the survey. 

42