Abstract: The impact of high levels of fertility on women’s health later in life in low and middle income countries (LMICs) is understudied. The cumulative impact of the reproductive burden could lead to higher risk of mortality and disability in older ages due to the stress of pregnancy complications and lack of postpartum care in low resource settings. Evidence in high income countries shows a U shape relationship between parity and mortality risk and higher risks of ill health for women that started childbearing before the age of 20. Less is known about miscarriages and abortion.
Using the first five waves of the Indonesian Family Life Survey (1993-2014) this study analyses the effect that the outcome of conceptions (live births, stillbirths and miscarriages) have on women’s allostatic load (AL) after the age of 40. AL is a measure of body’s wear and tear shown to predict accurately the risk of mortality and disability later on in life and often used to study the impact of stress on individuals bodies. We use path analysis to account for possible mediators and confounders such as childhood illnesses, health risks and socio-economic characteristics.
Nulliparous women and women with two or more miscarriages/stillbirths show a higher allostatic load later on in life. Low fertility women have a lower AL to demonstrate a possible protecting effect of childbearing as compared to nulliparous. The SES gradient is positively correlated to AL revealing a possible lifestyle effect (AL higher in urban areas as well). Above all, differences are reported between women below the age of 60 and those above who are the ones with the highest levels of fertility. This study highlights the importance of analysing women’s health beyond the reproductive period in LMICs in order to determine the potential impact that recent high fertility could have on the ageing process.
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