Select ALL social or reproductive factors that the lecture identifies as contributing to grandmultiparity.

The lecture presents grandmultiparity as having **interrelated social and reproductive determinants**, rather than a single cause. It lists low educational attainment and low economic empowerment; patriarchal limits on women's reproductive decision-making; non-use of contraception, including barriers to access; preference for a particular sex; divorce and remarriage; competition among wives in a polygamous setting; and perinatal or infant mortality. Routine antenatal screening is not identified as a cause. The listed factors describe the lecture's account of contributing circumstances and should not be used to stereotype individual women or communities. **Key takeaway:** The lecture links grandmultiparity to intersecting educational, economic, cultural, reproductive, and access-related circumstances. **Glossary:** - **Reproductive decision-making**: Choices concerning fertility, contraception, and pregnancy. - **Contraception**: Methods used to prevent pregnancy.