PART 1

CHAPTER X

FERTILITY AND REPRODUCTIVE OUTCOMES

1.10.1. Fertility

Fertility can be defined as the ability of a couple to achieve conception and to bring a pregnancy to term. At a point known as replacement fertility level, each couple has only two children, on average, to replace themselves in the population.

The reproductive period of men is started at the age at first pollution that suggests of beginning of spermatogenesis and lasts longer than in women. The natural fertility rate in women corresponds to 10-12 live born children in 25 years of their reproductive life span. For men this measurement is not applicable since they are able to have children from several partners.

Population growth and socio-economic development are strongly interrelated. In developing countries, as aspects of socio-economic development improve, fertility levels tend to decrease. In Armenia, according to the official estimates, the average number of children born per woman during her reproductive life (total fertility rate) decreased from 4.7 per 1000 population, in 1959, to 2.5 in 1988. In the last decade of the socio-economic crisis, fertility has declined to 1.6 per 1000 in 1996, which is below the replacement fertility level.  

In this survey sample, the great majority of spouses (partners) of the respondents (92%) have been ever pregnant,  (83%) conceived in the past and about 9% were pregnant at the time of survey-interview. However, the spouses (partners) of 108 men (7.7%) had never been pregnant  (Figure 1.10.1.).

The partners of the majority of men (80%) have had more than one pregnancy during their life span and an average number of conceptions was about 4.5 per man (Mean = 4.51±4.69). The frequency distribution of men according to the number of conceptions is demonstrated in Table 1.10.1.

1.10.2.  Pregnancy Outcomes

A total number of 6309 conceptions was mentioned by the survey respondents, but only 2784 (44.1%) resulted in live births. The most frequent pregnancy outcome was induced abortion (46.5%) as demonstrated in Figure 1.10.2 and Table 1.10.2.

The most frequent pregnancy outcome in the current marriage/union is live birth while in others it is induced abortion. The proportion of live births and induced abortions to total pregnancy outcomes as differentiated in the current and other marriages (unions) is given in Figure 1.10.3.

The partners of the majority of survey respondents have had at least one live birth (87%). In the average, there were about 2 live births per couple:

Figure 1.10.4. describes the frequency distribution of the survey sample by the number of live births. The partners of more than 13% of men never had a live birth, and 18% have had only one. 

The proportion of men whose partner had at least one stillbirth was (3%). Seven men mentioned more than one stillbirth (0.5%). There were 51 stillbirths in total or about 4 stillbirths per 100 respondents (Mean=0.04±0.21). Stillbirths constitute 1.8% of the total 2835 births (Figure 1.10.5.). 

Partners of 273 men (19.5%) had a history of at least one spontaneous abortion. Eighty-seven men (6.2%) reported more than one spontaneous abortion in their partners and 19 men (1.3%) reported more than two (Figure 1.10.6.).

There were 379 spontaneous abortions in total or about 27 per 100 respondents (Mean=0.27±0.62). The recurrent spontaneous abortion (more than 2) to total spontaneous abortion ratio was about 10% (Figure 1.10.7.).

1.10.3.   Childhood Survival

There are some positive changes in the dynamics of infant mortality rate in Armenia, however, these indicators are still very high as compared to the average and the WHO target for Europe. In this study we found that 7% of men who have live born child (children), have had at least one deceased child at the time of interview (Figure 1.10.8).  

Ninety-seven  (3.5%) out of the total number of 2805 live born children of survey respondents died. By the time of this survey there were in total 2708 living children: