In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level.

Demographic literature is replete with observations of an inverse relation between certain attributes of modernity and family size (Thompson 1929; Notestein 1945; Coale and Hoover 1958; Leiberman 1980, Srinivasan 1986).