Sexual initiation and first birth: Exploring factors associated with the gap in Uganda

Abstract

Abstract Background Early childbirth has a detrimental impact on population growth and the total fertility rate. Additionally, it is among the leading factors associated with cardiovascular disease, maternal and pediatric morbidity, and mortality. The objective of this study is to estimate the timing of first childbirth and factors that influence the timing of first childbirth following sexual initiation among Ugandan women aged 15–35 years. Method Self-reported data were extracted from the 2016 Uganda Demographic and Health Survey (UDHS), with a sub-sample of 9,196 women from the individual women file. Kaplan-Meier survival curve, decrement life-table analysis, and a discrete-time logit model were used to examine the timing of first childbirth and associated factors. Results The mean time to first childbirth was 6.6 years and the median time was 6.5 years, and all women had experienced their first childbirth by the end of the fifteenth year following sexual initiation. Significant factors found to influence the timing of first childbirth following sexual initiation include primary level (OR = 1.148; 95% CI = 1.02–1.28, p = 0.019); and higher education (OR = .697; 95% CI = .57-.84, p < 0.001), residing in Northern region (OR = 1.258; 95% CI = 1.05–1.50, p = 0.012), and having access to mass media (OR = 1.170; 95% CI = 1.07–1.26, p < 0.001). Conclusion These findings are expected to be valuable for policymakers and other stakeholders involved in efforts to delay childbirth. This research provides a solid foundation for evidence-based decision-making in the field of reproductive health and family planning. Both government and non-governmental organizations should prioritize the implementation of programs aimed at reducing the age at sexual initiation, thereby lowering the age at which women experience their first childbirth, taking into account the factors identified in this study.