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Ramesh Babu Kafle

Agudelo, Rosas-Bermúdez, Castaño, et al., 2012; Fotso, Cleland, Mbreu et al., 2013).
Lower ages at first birth and shorter birth intervals are associated with higher fertility. Age at
first birth influences the effective reproductive period available for a woman’s exposure to the risk
of birth and the momentum by which women progress to successive higher order births represents
the pace of childbearing. Lower risk of transiting to higher order births and delayed transitions to
higher order births indicate a decline in both the pace and level of fertility during fertility transition.
In the past, contraceptives were mainly used to stop child bearing in Nepal, but an increased pro-
portion of couples now use contraceptives to space births (MOHP, New ERA and ICF International,
2012). This behavioral change likely influenced the length of birth intervals. Moreover, evidences
show that birth spacing influences maternal, perinatal and infant and child health through various
mechanisms related to the body physiology of the mother, nutritional depletion, and sibling competi-
tion (Condo-Agudelo, Rosas-Bermúdez, Castaño, et al., 2012). Prior research has found a clear as-
sociation between the length of birth interval and infant and early childhood mortality (Fotso, Clel-
and, Mbreu et al., 2013) and also indicates that appropriate birth spacing helps to prevent adverse
perinatal outcomes (Condo-Agudelo, Rosas-Bermúdez, and Kafury-Goeta, 2006). These empirical
findings highlight the importance of analyzing birth intervals.
A substantial body of research explains the fertility transition in Nepal (Acharya, 1998; Aryal,
1998; CBS, 2003; Das Dangol, Retherford and Thapa, 1997; Karki and Krishna, 2008; Retherford
and Thapa, 2004; Retherford and Thapa, 1999; Retherford and Thapa, 1998; Subedi, 1998). Howev-
er, these studies mainly highlight the trends and patterns of fertility decline along with differentials
and determinants of fertility. Only a few studies have attempted an analysis of birth interval dynam-
ics in Nepal (for example, Rajbhandary, 1999; Suwal, 2001). An assessment of transitions in the
risks of higher order births and their determinants will provide more insight into the family building
process during fertility transition. Analyzing the dynamics of transition to the first and higher or-
der births and the length of birth intervals is important for better understanding the fertility transition
in Nepal.
With this background, this paper examines transitions in age at first birth, in progressions to high-
er order births, and in the lengths of birth intervals in the recent past in Nepal. Lengths of birth in-
tervals are further examined by different socioeconomic and demographic factors. Some socioeco-
nomic and demographic determinants of the risk of higher order births are also analyzed.

1.2 Factors Affecting Birth Intervals
Women of reproductive age of various socioeconomic and cultural backgrounds are differently ex-
posed to the risk of pregnancy due to differences in their behavioral and physiological factors;
these cause fertility differentials. Bongaarts (1978) identified four proximate factors—marriage, pos-
tpartum infecundability, contraception, and abortion—through which all socioeconomic and cultural
factors operate to influence human fertility. However, a direct influence of socioeconomic factors
on birth interval dynamics has been argued by Rindfuss, Palmore and Bumpass (1987). This argu-
ment is supported by Baschieri (2004), who notes that some socioeconomic variables—mainly edu-
cation, work status, and residence—have direct effects on the second birth interval. Although the
differences in birth intervals are explained by differences in fecundity, incidence of abortion, coital
frequency, breastfeeding practices, and contraceptive use (Trussell, Martin, Feldman et al., 1985),
these may also be influenced by different socioeconomic, demographic, and cultural factors.
The risk of birth of different orders and the length of birth intervals are differently influenced by
socioeconomic and demographic factors. A falling proportion of women proceeding to higher pari-
ties after the second parity coupled with widening differential in birth intervals by socioeconomic
and demographic variables at higher order births have been observed in Orissa, India (Ramesh,
2006). The first birth interval is not influenced strongly by factors like modernization and urbaniza-
tion. Rather, it depends more on social norms (Kamal and Pervaiz, 2013). Place of residence may be
a factor that influences the risk of childbirth and the length of birth interval. An urban woman may

International Journal of Population Studies | 2016, Volume 2, Issue 2 59