Week 9: Fertility Preferences and Intentions, Contraception, Nonmarital Childbearing

Soc 971

Week 9: Fertility Preferences and Intentions, Contraception, Nonmarital childbearing

Trends and differentials

Jen & So Jung

Ι. Fertility Preferences and Intentions

1. The relationship between fertility preferences/ intentions and fertility

Many research found that Individual intentions about future fertility are significant predictors about future behavior. (Bumpass, 1987; Rindfuss. et al., 1997; Thomson, 1997, etc) Also the level of certainty with fertility intentions are strongly associated with the probability of having a birth. (Schoen. et al, 1999)
Transition from being childless to the first birth is the most important decision for a woman in terms of fertility.

: Childless women who desire to remain childless are less likely to have unpredicted births than those who already have children and who also say that they want no more children. (Williams, Abma, and Piccinino, 1999)

Marriage and childbearing have become increasingly separate, by the late 1

980s 27 percent of births occurred to unmarried women” (NCHS, 1991 from Pagnini & Rindfuss 1993). About half of reent births to unmarried women are the result of planned pregnancies (Abma et al, 1997)

2. Differentials

Age: With the delay in marriage, there was a rising birth expectation at older ages. (Casper & Bianchi, 2002)

Education: Women with more years of schooling at each age are more likely to expect future birth. (Casper & Bianchi, 2002)
Race:

* Blacks are more tolerant of nonmarital fertility (Oropesa, 1996; Trent & South,

1992) and are more willing to consider having a child outside of marriage

(Abrahamse, et al, 1988; Trent & Crowder, 1997)

* However, magnitude in the attitudinal differences bet blacks and whites is

smaller than the behavioral differences. (different normative structures

regulating the social necessity of marriage for parenthood for blacks and

whites: Solinger, 1992)

Union type:

* Cohabitors are more likely to plan births than single women and less likely than

married women

* Tthe association between cohabitation and planning varies by race and

ethnicity (higher among Hispanic cohabitors than whites and blacks; Manning, 1999)

3. Unintended childbearing:

Estimates suggest that ½ of pregnancies unintended—but a number of problems with such a measure including underestimated due to underreporting of abortions.

(Fu, Darroch, Henshaw & Kolb 1998)

About 14 percent of recent births to women 15-44 years of age in 2002 were unwanted at time of conception, an increase from the 9 percent seen for recent births in 1995.
About 61 percent of women 25-44 years of age with less than a high school degree reported having had an unintended birth (either mistimed or unwanted at time of conception), compared with 18 percent of women with college degrees.

Π. Nonmarital childbearing

1. General trend

“Divorce of marriage and childbearing” : More than one-third of births today are to unmarred women, compared with 15 percent in the mid-1970s. (Casper & Bianchi, 2002); Among recent births, 64 percent occurred within marriage, 14 percent within cohabiting unions, and 21 percent to women who were neither married nor cohabiting.
Increase in terms of exposure of nonmarital childbearing: due to the age at marriage and divorce rates ↑ & remarriage rates ↓; therefore, women spend more time while being unmarried.

2. Differentials:

Race: Smith, Morgan and Koropeckyj-Cox (1996)

Decompositions on: Age distribution

Proportion unmarried

Age-specific birth rates of married women

Age-specific birth rates of unmarried women

Nonmarital fertility ratios much higher for blacks but…

Ratios have increased monotonically from 1960 to 1992 for both blacks and whites—incrasing nearly 10 percentage points

The increase for blacks can be attributed to increases in the proportion of unmarried women across the period.

For white women, increase can be attributed to:

1960-75: declines in married fertility

1975-92: increases in unmarried women’s birth rates

declines in the proportion of women married.

Education: Musick (2002)

Education reduces planned and unplanned fertility (contraceptive efficacy and orientations toward marriage, family and career)

HS completion: stronger effect on planned fertility (for Whites and Hispanics)

Family Structure: Musick (2002)

Cohabitation: Central to this effect is the meaning of cohabitation

Broadly, cohabitation increases unmarried planned fertility, but not unplanned but…

Racial differentials, perhaps related to differences in meaning:

Blacks: childbearing occurs overwhelmingly outside of coresidential unions

Hispanics: sharp increase in having a birth (especially a planned birth)—suggesting that cohabitation is well integrated into family life.

Whites: increases in both planned and unplanned childbearing—suggesting cohabitation is a step on the way to marriage.

Childhood family structure:

Growing up in a single-parent family increases both planned and unplanned nonmarital fertility for Whites. However the effects were modest for Blacks and negligible for Hispanics.

Ш. Contraception

1. Use in the US(from the Guttmacher Instiute:

62 million women in childbearing years (15-44)
43 million of these women (70%) are sexually active and do not want to become pregnant
Of these 62 million women in childbearing years…

* 62% use a contraceptive method

* 31% do not need a method because they are: infertile, pregnant, postpartum, or are trying to become pregnant, have never had intercourse, or are not sexually active.

* THUS… 7% are at risk for unwanted births but are not using

contraceptives (Unmet Need)

2. Trends in Use

The proportion of women aged 15-44 currently using a contraceptive increased from 56% in 1982 to 64% in 1995, and then declined slightly to 62% in 2002.
Proportion of women at risk of unwanted pregnancy but not using method increased from 5% in 1995 to 7% in 2002.—Among teenagers, this group has remained steady at 7% but older women have experienced an increase: for 25-29 year-olds: 5% in 1995 to 8% 2002; for 30-34 year-olds: 4% in 1995 to 7% in 2002.

3. Types of methods: Of contracepting women, 64% use reversible methods (oral contraceptive, condoms, etc)

4. Differentials in types of methods:

* Age

* Race and Ethnicity;

* SES

5. Probability of Failure

Risk of failure much higher that reflected by clinical trials, reflecting imperfect use of methods (rather than overall efficacy):
Within one year of starting contraception (reversible): 9% failure

T&V (NSFG)FDA Typical UseClinical Trials

7% the Pillvs.5%vs. .1%

9% male condomvs.14%vs. 3%

19% withdrawlvs.19%vs.4%

Lifetime failures: 1.8
Failure rates higher for: low-income women; Hispanic women.

(Trussell & Vaughan, 1999; FDA, 1997: “Consumer-Friendly Birth Control Information.”

6. Probability of Discontinuing Use

31% discontinue use w/i six months (method-related reason; reversible)
44% discontinue use w/i one year (method-related reason; reversible)

(Trussell & Vaughan, 1999)

7. Probability of Resuming Use Once Discontinued

68% resume use within one month
76% resume use within one month
Low-income women less likely to resume use after discontinuation.

(Trussell & Vaughan, 1999)

8. But… “Are All Contraceptive Failures Unintended Pregnancies?”

Of pregnancies classified as contraceptive failures, only 68% are classified as unintended pregnancies.
Feelings about the pregnancy:

*59% of women with contraceptive failures that are classified as uninented pregnancies are very unhappy or unhappy about their pregnancy

* 90% of contraceptive failures that are classified as indended pregnancies report being happy or very happy.

(Trussell, Vaughan & Stanford 1999, FPP 31(5)).