Number and percentage of live births, by age group of mother, 1991 to most recent year.

In 2023, there were five countries, where the average woman of childbearing age can expect to have over six children throughout their lifetime. In fact, of the 20 countries in the world with the highest fertility rates, Afghanistan and Yemen are the only countries not found in Sub-Saharan Africa. High fertility rates in Africa With a fertility rate of 6.13 and 6.12 children per woman, Somalia and Chad were the countries with the highest fertility rate in the world. Population growth in Chad is among the highest in the world. Lack of healthcare access, as well as food instability, political instability, and climate change, are all exacerbating conditions that keep Chad's infant mortality rates high, which is generally the driver behind high fertility rates. This situation is common across much of the continent, and, although there has been considerable progress in recent decades, development in Sub-Saharan Africa is not moving as quickly as it did in other regions. Demographic transition While these countries have the highest fertility rates in the world, their rates are all on a generally downward trajectory due to a phenomenon known as the demographic transition. The third stage (of five) of this transition sees birth rates drop in response to decreased infant and child mortality, as families no longer feel the need to compensate for lost children. Eventually, fertility rates fall below replacement level (approximately 2.1 children per woman), which eventually leads to natural population decline once life expectancy plateaus. In some of the most developed countries today, low fertility rates are creating severe econoic and societal challenges as workforces are shrinking while aging populations are placin a greater burden on both public and personal resources.

This is a publication on maternity activity in English NHS hospitals. This report examines data relating to delivery and birth episodes in 2021-22, and the booking appointments for these deliveries. This annual publication covers the financial year ending March 2022. Data is included from both the Hospital Episodes Statistics (HES) data warehouse and the Maternity Services Data Set (MSDS). HES contains records of all admissions, appointments and attendances for patients admitted to NHS hospitals in England. The HES data used in this publication are called 'delivery episodes'. The MSDS collects records of each stage of the maternity service care pathway in NHS-funded maternity services, and includes information not recorded in HES. The MSDS is a maturing, national-level dataset. In April 2019 the MSDS transitioned to a new version of the dataset. This version, MSDS v2.0, is an update that introduced a new structure and content - including clinical terminology, in order to meet current clinical practice and incorporate new requirements. It is designed to meet requirements that resulted from the National Maternity Review, which led to the publication of the Better Births report in February 2016. This is the third publication of data from MSDS v2.0 and data from 2019-20 onwards is not directly comparable to data from previous years. This publication shows the number of HES delivery episodes during the period, with a number of breakdowns including by method of onset of labour, delivery method and place of delivery. It also shows the number of MSDS deliveries recorded during the period, with breakdowns including the baby's first feed type, birthweight, place of birth, and breastfeeding activity; and the mothers' ethnicity and age at booking. There is also data available in a separate file on breastfeeding at 6 to 8 weeks. The count of Total Babies includes both live and still births, and previous changes to how Total Babies and Total Deliveries were calculated means that comparisons between 2019-20 MSDS data and later years should be made with care. The MethodfDelivery measure counting babies has been replaced by the DeliveryMethodBabyGroup measure which counts deliveries, and the smoking at booking and folic acid status measures have been renamed - these changes have been made to better align this annual publication with the Maternity Services Monthly Statistics publication. Information on how all measures are constructed can be found in the HES Metadata and MSDS Metadata files provided below. In this publication we have also included an interactive Power BI dashboard to enable users to explore key NHS Maternity Statistics measures. The purpose of this publication is to inform and support strategic and policy-led processes for the benefit of patient care. This report will also be of interest to researchers, journalists and members of the public interested in NHS hospital activity in England. Any feedback on this publication or dashboard can be provided to enquiries@nhsdigital.nhs.uk, under the subject “NHS Maternity Statistics”.

Live births and stillbirths annual summary statistics, by sex, age of mother, whether within marriage or civil partnership, percentage of non-UK-born mothers, birth rates and births by month and mothers' area of usual residence.

The average for 2022 based on 196 countries was 18.19 births per 1000 people. The highest value was in the Central African Republic: 45.42 births per 1000 people and the lowest value was in Hong Kong: 4.4 births per 1000 people. The indicator is available from 1960 to 2023. Below is a chart for all countries where data are available.

This is a publication on maternity activity in English NHS hospitals. This report examines data relating to delivery and birth episodes in 2023-24, and the booking appointments for these deliveries. This annual publication covers the financial year ending March 2024. Data is included from both the Hospital Episodes Statistics (HES) data warehouse and the Maternity Services Data Set (MSDS). HES contains records of all admissions, appointments and attendances for patients admitted to NHS hospitals in England. The HES data used in this publication are called 'delivery episodes'. The MSDS collects records of each stage of the maternity service care pathway in NHS-funded maternity services, and includes information not recorded in HES. The MSDS is a maturing, national-level dataset. In April 2019, the MSDS transitioned to a new version of the dataset. This version, MSDS v2.0, is an update that introduced a new structure and content - including clinical terminology, in order to meet current clinical practice and incorporate new requirements. It is designed to meet requirements that resulted from the National Maternity Review, which led to the publication of the Better Births report in February 2016. This is the fifth publication of data from MSDS v2.0 and data from 2019-20 onwards is not directly comparable to data from previous years. This publication shows the number of HES delivery episodes during the period, with a number of breakdowns including by method of onset of labour, delivery method and place of delivery. It also shows the number of MSDS deliveries recorded during the period, with a breakdown for the mother's smoking status at the booking appointment by age group. It also provides counts of live born term babies with breakdowns for the general condition of newborns (via Apgar scores), skin-to-skin contact and baby's first feed type - all immediately after birth. There is also data available in a separate file on breastfeeding at 6 to 8 weeks. For the first time information on 'Smoking at Time of Delivery' has been presented using annual data from the MSDS. This includes national data broken down by maternal age, ethnicity and deprivation. From 2025/2026, MSDS will become the official source of 'Smoking at Time of Delivery' information and will replace the historic 'Smoking at Time of Delivery' data which is to become retired. We are currently undergoing dual collection and reporting on a quarterly basis for 2024/25 to help users compare information from the two sources. We are working with data submitters to help reconcile any discrepancies at a local level before any close down activities begin. A link to the dual reporting in the SATOD publication series can be found in the links below. Information on how all measures are constructed can be found in the HES Metadata and MSDS Metadata files provided below. In this publication we have also included an interactive Power BI dashboard to enable users to explore key NHS Maternity Statistics measures. The purpose of this publication is to inform and support strategic and policy-led processes for the benefit of patient care. This report will also be of interest to researchers, journalists and members of the public interested in NHS hospital activity in England. Any feedback on this publication or dashboard can be provided to enquiries@nhsdigital.nhs.uk, under the subject “NHS Maternity Statistics”.

Number and percentage of live births, by characteristics of the mother (age, parity, marital status, birthplace) and child (sex, single or multiple births, birth weight) based on weeks of gestation, 2000 to most recent year.

The total fertility rate of the world has dropped from around 5 children per woman in 1950, to 2.2 children per woman in 2025, which means that women today are having fewer than half the number of children that women did 75 years ago. Replacement level fertility This change has come as a result of the global demographic transition, and is influenced by factors such as the significant reduction in infant and child mortality, reduced number of child marriages, increased educational and vocational opportunities for women, and the increased efficacy and availability of contraception. While this change has become synonymous with societal progress, it does have wide-reaching demographic impact - if the global average falls below replacement level (roughly 2.1 children per woman), as is expected to happen in the 2050s, then this will lead to long-term population decline on a global scale. Regional variations When broken down by continent, Africa is the only region with a fertility rate above the global average, and, alongside Oceania, it is the only region with a fertility rate above replacement level. Until the 1980s, the average woman in Africa could expect to have 6-7 children over the course of their lifetime, and there are still several countries in Africa where women can still expect to have 5 or more children in 2025. Historically, Europe has had the lowest fertility rates in the world over the past century, falling below replacement level in 1975. Europe's population has grown through a combination of migration and increasing life expectancy, however even high immigration rates could not prevent its population from going into decline in 2021.

This statistical release makes available the most recent monthly data on NHS-funded maternity services in England, using data submitted to the Maternity Services Data Set (MSDS). This is the latest report from the newest version of the data set, MSDS.v.2, which has been in place since April 2019. The new data set was a significant change which added support for key policy initiatives such as continuity of carer, as well as increased flexibility through the introduction of new clinical coding. This was a major change, so data quality and coverage has initially reduced from the levels seen in earlier publications. We expect the completeness to improve over time as occurred with the previous version of the MSDS, and are looking at ways of supporting improvements. This month three new measures have been included in this publication for the first time: the proportion of women placed under the care of a Family Nurse Partnership, the proportion of women recorded as not smoking during pregnancy as measured at booking and 36 weeks gestation, and the proportion of women with cephalic presentation who went on to have a spontaneous birth. Two measures were new in the publication last month: the proportion of women booking onto maternity services who have a valid London Measure of Unplanned Pregnancy score recorded, and the proportion of women who meet the criteria to be recommended aspirin during pregnancy. Most of these new measures are included in the new 'Pregnancy' grouping. This new data can be found in the Measures file available for download and further information on these new measures can be found in the accompanying Metadata file. The data derived from SNOMED codes is being used in some measures such as those for smoking at booking and birth weight, and others will follow in later publications. SNOMED data is also included in some of the published Clinical Quality Improvement Metrics (CQIMs), where rules have been applied to ensure measure rates are calculated only where data quality is high enough. System suppliers are at different stages of developing their new solution and delivering that to trusts. In some cases, this has limited the aspects of data that could be submitted to NHS Digital. To help Trusts understand to what extent they met the Clinical Negligence Scheme for Trusts (CNST) Data Quality Criteria for Safety Action 2, we previously produced data files during the scheme months which contained information for data providers showing their performance against all MSDS-derived Safety Action 2 criteria. We are reviewing how similar data quality information may be more regularly included in publications in the future. These statistics are classified as experimental and should be used with caution. Experimental statistics are new official statistics undergoing evaluation. More information about experimental statistics can be found on the UK Statistics Authority website. Please note that the percentages presented in this report are based on rounded figures and therefore may not total to 100%.

Number of live births and fetal deaths (stillbirths), by type of birth (single or multiple), 1991 to most recent year.

Since 1980, the U.S. birth rate for twins has risen significantly. As of 2023, the birth rate for twins in the U.S. was 30.7 per 1,000 live births. It is believed that an increase in the twin birth rate may be associated with an increased use of in vitro fertilization and other assisted reproductive technologies in recent years. U.S. twin births Across the U.S. twin birth rates vary in many ways. The U.S. states with the highest twin birth rates are Michigan and Mississippi. Ethnicity is another factor to be considered when investigating the twin birth rate. Since 1980, the U.S. twin birth rate has increased among all ethnicities; however, it has increased more among non-Hispanic black mothers and less among Hispanic mothers. And finally, age is another important factor in twin birth rates. As of 2023, mothers between the ages of 45-54 had the highest twin birth rates in the United States. Assisted reproductive technology Assisted reproductive technology (ART) is a treatment used to treat infertility among men and women. A common complication associated with ART is multiple births (twins, triplets, etc.). In the U.S., among all ART pregnancies, the most common outcome was a still single infant birth, followed by miscarriage. However, multiple births accounted for nearly five percent of all outcomes. This percentage would increase if multiple birth rate per live birth was considered. ART is also most common among older mothers.

ART data are made available as part of the National ART Surveillance System (NASS) that collects success rates, services, profiles and annual summary data from fertility clinics across the U.S. There are four datasets available: ART Services and Profiles, ART Patient and Cycle Characteristics, ART Success Rates, and ART Summary. All four datasets may be linked by “ClinicID.” ClinicID is a unique identifier for each clinic that reported cycles. The Success Rates dataset contains success rates for ART cycles started during the year indicated. Since ART success depends on whether patients are using their own eggs or donor eggs, success rates are included separately for these two groups. Success rates for patients using their own eggs are shown per intended retrieval, per actual retrieval, and per transfer. These success rates are reported as cumulative success rates, which take into account transfers that occur within 1 year after an egg retrieval. Since ART success depends on whether patients are using ART for the first time or had prior ART cycles, users can examine success rates for all “Patients using their own eggs” or for “Patients with no prior ART using their own eggs.” For new patients using ART for the first time, the success rates are also shown after 1, 2, or all intended egg retrievals during the reporting year. In addition, the average number of transfers per intended retrieval and the average number of intended retrievals per live-birth delivery are shown. Success rates for ART cycles that involve the transfer of embryos created from donor eggs or donated embryos are shown and are not cumulative. They are based on donor cycles started in the year indicated that had embryo transfers, regardless of when the donor eggs were retrieved. Success rates in this section are not presented by patient age group because previous data show that an intended parent’s age does not substantially affect success when using donor eggs or donated embryos. The success rates are presented by types of embryos and eggs used in the transfer. This dataset excludes cycles that were considered research—that is, cycles performed to evaluate new procedures.

Data were updated on September 11, 2024. ART data are made available as part of the National ART Surveillance System (NASS) that collects success rates, services, profiles and annual summary data from fertility clinics across the U.S. There are four datasets available: ART Services and Profiles, ART Patient and Cycle Characteristics, ART Success Rates, and ART Summary. All four datasets may be linked by “ClinicID.” ClinicID is a unique identifier for each clinic that reported cycles. The Success Rates dataset contains success rates for ART cycles started during the year indicated. Since ART success depends on whether patients are using their own eggs or donor eggs, success rates are included separately for these two groups. Success rates for patients using their own eggs are shown per intended retrieval, per actual retrieval, and per transfer. These success rates are reported as cumulative success rates, which take into account transfers that occur within 1 year after an egg retrieval. Since ART success depends on whether patients are using ART for the first time or had prior ART cycles, users can examine success rates for all “Patients using their own eggs” or for “Patients with no prior ART using their own eggs.” For new patients using ART for the first time, the success rates are also shown after 1, 2, or all intended egg retrievals during the reporting year. In addition, the average number of transfers per intended retrieval and the average number of intended retrievals per live-birth delivery are shown. Success rates for ART cycles that involve the transfer of embryos created from donor eggs or donated embryos are shown and are not cumulative. They are based on donor cycles started in the year indicated that had embryo transfers, regardless of when the donor eggs were retrieved. Success rates in this section are not presented by patient age group because previous data show that an intended parent’s age does not substantially affect success when using donor eggs or donated embryos. The success rates are presented by types of embryos and eggs used in the transfer. This dataset excludes cycles that were considered research—that is, cycles performed to evaluate new procedures.

Maternity Services Monthly Statistics January 2022, experimental statistics This is a report on NHS-funded maternity services in England for January 2022, using data submitted to the Maternity Services Data Set (MSDS). This is the latest report from the new version of the data set, MSDSv2. The new data set is a significant change which adds support for key policy initiatives such as personalised care plans and continuity of carer, as well as increased flexibility through the introduction of new clinical coding. This is a major change, so data quality and coverage has reduced from the levels seen in previous publications. The data derived from SNOMED codes is still being developed. We have included data on smoking at booking and birth weight and others such as BMI and alcohol consumption will follow in later publications. SNOMED data is also included in some of the published Clinical Quality Improvement Metrics (CQIMs) where rules have been applied to ensure rates are calculated only where data quality is high enough. System suppliers are at different stages of developing their new solution and delivering that to trusts. In some cases this has limited the aspects of data that could be submitted to NHS Digital. These statistics are classified as experimental and should be used with caution. Experimental statistics are new official statistics undergoing evaluation. More information about experimental statistics can be found on the UK Statistics Authority website. Updated versions of these files were added to this publication on 22 June 2022 to include a correction to the Ethnicity DQ outputs, as 32 providers had previously been incorrectly showing in the files as having met this criteria when they had not.

The number of maternal deaths and maternal mortality rates for selected causes, 2000 to most recent year.

BackgroundThe Maternal Mortality Ratio in Mozambique has stagnated at 405 deaths per 100,000 live births with virtually no progress over the last 15 years. Low Institutional Birth Rates (IBRs) levelling around 50% in many rural areas constitute one of the contributing reasons. Demand-side financing has successfully increased usage of maternal health services in other countries, but little information exists on in-kind incentives in rural Africa. The objective was to test the impact on Institutional Birth Rates of giving a USD 5.50 baby package incentive to every woman who came to give birth in a health centre in a rural, poor district of Cabo Delgado, Mozambique.Methods and findingsThe intervention was implemented in one district in 2010 with the remaining 15 districts serving as controls. The total population in the 16 districts in 2006 was just under 1.5 million people. IBRs were observed from 2006 to 2013 (53 months before and 55 months after the intervention began). The non-intervention districts showed a slight increase, from a mean IBR of 0.39 (SD = 0.10) in 2006 to 0.67 (SD = 0.13) in 2014. The intervention district had a dramatic increase in IBRs within six months of the start of the intervention in 2010, which was sustained until the end of the study. Adjusting for the background increase and for confounders, including health facilities and health personnel per district, and taking clustering in districts into account, the estimated rate ratio of institutional births in the intervention district was 1.80 (95% CI 1.72, 1.89 p

Ratio: Percent of live births occurring at "Baby Friendly" Facilities

Definition: Percent of live births occurring at "Baby Friendly" Facilities, which are delivery facilities that provide maternal and newborn care consistent with the WHO/UNICEF Ten Steps to Successful Breastfeeding

Data Source:

(1) Baby-Friendly USA;

(2) Centers for Disease Control and Prevention; Division of Nutrition, Physical Activity, and Obesity; Breastfeeding Report Card

Explore World Bank Health, Nutrition and Population Statistics dataset featuring a wide range of indicators such as School enrollment, UHC service coverage index, Fertility rate, and more from countries like Bahrain, China, India, Kuwait, Oman, Qatar, and Saudi Arabia.

School enrollment, tertiary, UHC service coverage index, Wanted fertility rate, People with basic handwashing facilities, urban population, Rural population, AIDS estimated deaths, Domestic private health expenditure, Fertility rate, Domestic general government health expenditure, Age dependency ratio, Postnatal care coverage, People using safely managed drinking water services, Unemployment, Lifetime risk of maternal death, External health expenditure, Population growth, Completeness of birth registration, Urban poverty headcount ratio, Prevalence of undernourishment, People using at least basic sanitation services, Prevalence of current tobacco use, Urban poverty headcount ratio, Tuberculosis treatment success rate, Low-birthweight babies, Female headed households, Completeness of birth registration, Urban population growth, Antiretroviral therapy coverage, Labor force, and more.

Bahrain, China, India, Kuwait, Oman, Qatar, Saudi Arabia

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BackgroundAcupuncture is frequently employed during the process of embryo transfer. Nevertheless, its precise function in enhancing the likelihood of successful clinical pregnancy or live birth remains ambiguous.ObjectiveTo evaluate the efficacy of acupuncture as a complementary intervention to embryo transfer in managing female subfertility, compare the effects of acupuncture vs. sham acupuncture on clinical pregnancy rate in assisted reproductive technology, and clarify the optimal timing of acupuncture administration within in vitro fertilization protocols.MethodsAll literatures which described randomized controlled trials of acupuncture during the process of embryo transfer were obtained through searches of Cochrane Central, PubMed and Embase database (all to May 2025). Eleven randomized controlled trials were incorporated into the review. Selection of studies, quality assessment and data extraction were carried out independently by two review authors. Meta analysis was conducted, incorporating both risk ratios and 95% confidence intervals. The primary outcome measure was the clinical pregnancy rate, defined as the proportion of patients with an intrauterine gestational sac confirmed by ultrasound with or without a fetal heart. The secondary outcome measure was the live birth rate, defined as the proportion of patients with a pregnancy lasting ≥20 weeks or a birth weight of at least 400 g.ResultsEleven studies were selected for review, and nine of these were deemed acceptable based on their discussion of clinical pregnancy rate. By combining the studies and analyzing the results, it was concluded that acupuncture has demonstrated a positive impact on clinical pregnancy rate in contrast with the blank control group [1.25 (1.05–1.50), P = 0.013]. A statistical analysis revealed no significant differences between the sham acupuncture group and the acupuncture group [1.01(0.87–1.17), P = 0.907]. No statistically significant discrepancy between the Pulus Protocol [1.083(0.946–1.240)] and Delphi Consensus [1.164(0.938–1.445)]. Acupuncture has no positive impact on live birth rate during embryo transfer [1.01(0.88–1.15), P = 0.930]).ConclusionsThe results of this meta-analysis suggest that a positive correlation has been demonstrated between acupuncture and clinical pregnancy rate during embryo transfer when compared to the blank control group; however, this advantage does not hold when compared to the use of sham acupuncture. The Delphi Consensus revealed no discrepancy in clinical pregnancy rate when compared with the Pulus Protocol. It should be noted that the impact of acupuncture on live birth rate remains to be elucidated.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251067805, identifier (CRD420251067805).

The Sudan Demographic and Health Survey (SDHS) was conducted in two phases between November 15, 1989 and May 21, 1990 by the Department of Statistics of the Ministry of Economic and National Planning. The survey collected information on fertility levels, marriage patterns, reproductive intentions, knowledge and use of contraception, maternal and child health, maternal mortality, and female circumcision. The survey findings provide the National Population Committee and the Ministry of Health with valuable information for use in evaluating population policy and planning public health programmes. A total of 5860 ever-married women age 15-49 were interviewed in six regions in northern Sudan; three regions in southern Sudan could not be included in the survey because of civil unrest in that part of the country. The SDHS provides data on fertility and mortality comparable to the 1978-79 Sudan Fertility Survey (SFS) and complements the information collected in the 1983 census. The primary objective of the SDHS was to provide data on fertility, nuptiality, family planning, fertility preferences, childhood mortality, indicators of maternal health care, and utilization of child health services. Additional information was coUected on educational level, literacy, source of household water, and other housing conditions. The SDHS is intended to serve as a source of demographic data for comparison with the 1983 census and the Sudan Fertility Survey (SFS) 1978-79, and to provide population and health data for policymakers and researchers. The objectives of the survey are to: assess the overall demographic situation in Sudan, assist in the evaluation of population and health programmes, assist the Department of Statistics in strengthening and improving its technical skills for conducting demographic and health surveys, enable the National Population Committee (NPC) to develop a population policy for the country, and measure changes in fertility and contraceptive prevalence, and study the factors which affect these changes, and examine the basic indicators of maternal and child health in Sudan. MAIN RESULTS Fertility levels and trends Fertility has declined sharply in Sudan, from an average of six children per women in the Sudan Fertility Survey (TFR 6.0) to five children in the Sudan DHS survey flTR 5.0). Women living in urban areas have lower fertility (TFR 4.1) than those in rural areas (5.6), and fertility is lower in the Khartoum and Northern regions than in other regions. The difference in fertility by education is particularly striking; at current rates, women who have attained secondary school education will have an average of 3.3 children compared with 5.9 children for women with no education, a difference of almost three children. Although fertility in Sudan is low compared with most sub-Saharan countries, the desire for children is strong. One in three currently married women wants to have another child within two years and the same proportion want another child in two or more years; only one in four married women wants to stop childbearing. The proportion of women who want no more children increases with family size and age. The average ideal family size, 5.9 children, exceeds the total fertility rate (5.0) by approximately one child. Older women are more likely to want large families than younger women, and women just beginning their families say they want to have about five children. Marriage Almost all Sudanese women marry during their lifetime. At the time of the survey, 55 percent of women 15-49 were currently married and 5 percent were widowed or divorced. Nearly one in five currently married women lives in a polygynous union (i.e., is married to a man who has more than one wife). The prevalence of polygyny is about the same in the SDHS as it was in the Sudan Fertility Survey. Marriage occurs at a fairly young age, although there is a trend toward later marriage among younger women (especially those with junior secondary or higher level of schooling). The proportion of women 15-49 who have never married is 12 percentage points higher in the SDHS than in the Sudan Fertiliy Survey. There has been a substantial increase in the average age at first marriage in Sudan. Among SDHS. Since age at first marriage is closely associated with fertility, it is likely that fertility will decrease in the future. With marriages occurring later, women am having their first birth at a later age. While one in three women age 45-49 had her first birth before age 18, only one in six women age 20-24 began childbearing prior to age 18. The women most likely to postpone marriage and childbearing are those who live in urban areas ur in the Khartoum and Northern regions, and women with pest-primary education. Breastfeeding and postpartum abstinence Breastfeeding and postpartum abstinence provide substantial protection from pregnancy after the birth uf a child. In addition to the health benefits to the child, breastfeeding prolongs the length of postpartum amenorrhea. In Sudan, almost all women breastfeed their children; 93 percent of children are still being breastfed 10-11 months after birth, and 41 percent continue breastfeeding for 20-21 months. Postpartum abstinence is traditional in Sudan and in the first two months following the birth of a child 90 percent of women were abstaining; this decreases to 32 percent after two months, and to 5 percent at~er one year. The survey results indicate that the combined effects of breastfeeding and postpartum abstinence protect women from pregnancy for an average of 15 months after the birth of a child. Knowledge and use of contraception Most currently married women (71 percent) know at least one method of family planning, and 59 percent know a source for a method. The pill (70 percent) is the most widely known method, followed by injection, female sterilisation, and the IUD. Only 39 percent of women knew a traditional method of family planning. Despite widespread knowledge of family planning, only about one-fourth of ever-married women have ever used a contraceptive method, and among currently married women, only 9 percent were using a method at the time of the survey (6 percent modem methods and 3 percent traditional methods). The level of contraceptive use while still low, has increased from less than 5 percent reported in the Sudan Fertility Survey. Use of family planning varies by age, residence, and level of education. Current use is less than 4 percent among women 15-19, increases to 10 percent for women 30-44, then decreases to 6 percent for women 45-49. Seventeen percent of urban women practice family planning compared with only 4 percent of rural women; and women with senior secondary education are more likely to practice family planning (26 percent) than women with no education (3 percent). There is widespread approval of family planning in Sudan. Almost two-thirds of currently married women who know a family planning method approve of the use of contraception. Husbands generally share their wives's views on family planning. Three-fourths of married women who were not using a contraceptive method at the time of the survey said they did not intend to use a method in the future. Communication between husbands and wives is important for successful family planning. Less than half of currently married women who know a contraceptive method said they had talked about family planning with their husbands in the year before the survey; one in four women discussed it once or twice; and one in five discussed it more than twice. Younger women and older women were less likely to discuss family planning than those age 20 to 39. Mortality among children The neonatal mortality rate in Sudan remained virtually unchanged in the decade between the SDHS and the SFS (44 deaths per 1000 births), but under-five mortality decreased by 14 percent (from 143 deaths per 1000 births to 123 per thousand). Under-five mortality is 19 percent lower in urban areas (117 per 1000 births) than in rural areas (144 per 10(30 births). The level of mother's education and the length of the preceding birth interval play important roles in child survival. Children of mothers with no education experience nearly twice the level of under-five mortality as children whose mother had attained senior secondary or nigher education. Mortality among children under five is 2.7 times higher among children born after an interval of less than 24 months than among children born after interval of 48 months or more. Maternal mortality The maternal mortality rate (maternal deaths per 1000 women years of exposure) has remained nearly constant over the twenty years preceding the survey, while the maternal mortality ratio (number of maternal deaths per 100,000 births), has increased (despite declining fertility). Using the direct method of estimation, the maternal mortality ratio is 352 maternal deaths per 100,000 births for the period 1976-82, and 552 per 100,000 births for the period 1983-89. The indirect estimate for the maternal mortality ratio is 537. The latter estimate is an average of women's experience over an extended period before the survey centred on 1977. Maternal health care The health care mothers receive during pregnancy and delivery is important to the survival and well-being of both children and mothers. The SDHS results indicate that most women in Sudan made at least one antenatal visit to a doctor or trained health worker/midwife. Eighty-seven percent of births benefitted from professional antenatal care in urban areas compared with 62 percent in rural areas. Although the proportion of pregnant mothers seen by trained health workers/midwives are similar in urban and rural areas, doctors provided antenatal care for 42 percent and 19 percent of births in urban and rural areas, respectively. Neonatal tetanus, a major cause of infant deaths in developing countries, can be prevented if mothers receive tetanus toxoid vaccinations.