No abstract

In heterosexual couples, both partners’ intentions to have a baby (or not) are associated with the likelihood of a subsequent birth, yet most studies only measure women’s intentions. Therefore, little is known about the potential association of couple agreement or disagreement on intentions or on such values as importance of parenthood, career, and leisure and the implications for childbearing. The goal of this article is to assess whether couple-level agreement or disagreement in fertility intentions and values are associated with the likelihood of a subsequent birth. Guided by the Theory of Conjunctural Action, we use couple data from two waves of the U.S. National Survey of Fertility Barriers for our analysis. Based on logistic regression analysis, we find that if either partner intends a child, the odds of having a baby within 3 years are higher than if neither partner intends and that the odds are substantially higher when both partners intend a child. Couples in whom both partners and couples in whom only the woman has a high value on career success are less likely to have a baby. Our findings suggest that agreement on fertility intentions is associated with considerably higher birth probability and that values about life domains matter as well. Couple disagreement on intentions and values are related in different ways to birth outcomes depending on which partner holds which value as important. Using data from both partners allows us to examine the patterns of couple agreement, values, and gendered influences related to birth outcomes.

BACKGROUND Demographers typically ask about societal, not personal, fertility ideals. Societal ideals are probably more stable than personal ideals. Assessing whether personal fertility ideals are as stable as societal ideals could inform models of population fertility change and models of well-being associated with fertility outcomes. METHODS We use the two-wave National Survey of Fertility Barriers (NSFB) to model stability and change in fertility ideals among 879 women in heterosexual couples that persisted for both waves. RESULTS Personal fertility ideals are stable for most (69%) women, but roughly one-third adjust their ideal number between waves. Of the women who changed their personal fertility ideal, approximately half increase and half decrease their personal fertility ideal over time. Multinomial logistic regression indicates that women with a higher fertility ideal at Wave 1 had higher odds of increasing and lower odds of decreasing their fertility ideal by Wave 2. Higher education was associated with lower likelihood of increasing fertility ideals. In addition, full-time employment at the initial interview was associated with higher likelihood of decreasing fertility ideals.

Background: Fewer than 50% of women who meet the medical/behavioral criteria for infertility receive medical services. Estimating the number of women who both meet the medical/behavioral criteria for infertility and who have pro-conception attitudes will allow for better estimates of the potential need and unmet need for infertility services in the United States. Methods: The National Survey of Fertility Barriers was administered by telephone to a probability sample of 4,712 women in the United States. The sample for this analysis was 292 women who reported an experience of infertility within 3 years of the time of the interview. Infertile women were asked if they were trying to conceive at the time of their infertility experience and if they wanted to have a child to determine who could be considered in need of services. Results: Among U.S. women who have met medical criteria for infertility within the past three years, 15.9% report that they were neither trying to have a child nor wanted to have a child and can be classified as not in need of treatment. Of the 84.9% of infertile women in need of treatment, 58.1% did not even talk to a doctor about ways to become pregnant. Discussion: Even after taking into account that not all infertile women are in need of treatment, there is still a large unmet need for infertility treatment in the United States. Conclusion: Studies of the incidence of infertility should include measures of both trying to have a child and wanting to have a child.

This study models associations between pregnancy intendedness and prenatal maternal-fetal bonding with postnatal maternal-infant bonding. Unintended pregnancies are associated with disruptions in maternal-infant bonding, which has long-term adverse implications for maternal and child well-being. Given the high proportion of births that are unintended in the United States, identifying protective factors is critical. Pregnant women (ages 16-38) were recruited from two prenatal clinics in a metropolitan city in the South Central United States at their first prenatal visit and followed throughout pregnancy and postbirth. Multiple regression analyses examined associations, mediation, and moderation. Results indicate that the more unintended/unwanted women reported their pregnancies to be, the lower they reported their maternal-infant bonding postbirth, and higher maternal-fetal bonding scores are associated with higher postnatal maternal-infant bonding. An interaction revealed that a higher level of prenatal bonding is protective for postnatal bonding among those with unintended/unwanted pregnancies. Because prenatal bonding can be enhanced through intervention, it is a promising target to reduce the risks associated with unintended pregnancy.

Objective To examine maternal childhood adversity in relation to increased risk for maternal and infant perinatal complications and newborn Neonatal Intensive Care Unit (NICU) admittance. Methods A sample of 164 women recruited at their first prenatal appointment participated in a longitudinal study through 6 weeks postdelivery. Participants self-reported on their adverse childhood experiences (ACEs), negative health risks (overweight/obesity, smoking, and alcohol use), adverse infant outcomes, NICU admittance, and maternal perinatal complications across three pregnancy assessments and one post-birth assessment. Logistic binomial regression analyses were used to examine associations between maternal ACEs and adverse infant outcomes, NICU admittance, and maternal perinatal complications, controlling for pregnancy-related health risks. Results Findings showed that women with severe ACEs exposure (6+ ACEs) had 4 times the odds of reporting at least one adverse infant outcome (odds ratio [OR] = 4.33, 95% CI: 1.02–18.39), almost 9 times the odds of reporting a NICU admission (OR = 8.70, 95% CI: 1.34–56.65), and 4 times the odds of reporting at least one maternal perinatal outcome (OR = 4.37, 95% CI: 1.43–13.39). Conclusions The findings demonstrate the extraordinary risk that mothers’ ACEs pose for infant and maternal health outcomes over and above the associations with known maternal health risks during pregnancy, including overweight/obesity, smoking, and alcohol use. These results support a biological intergenerational transmission framework, which suggests that risk from maternal adversity is perpetuated in the next generation through biophysical and behavioral mechanisms during pregnancy that negatively affect infant health outcomes.

Background The study was conducted to prospectively examine how pregnancy intendedness and prenatal provider counseling about postpartum contraceptive options are associated with lack of contraception use at 6 months post-birth (e.g., increased risk for a short interpregnancy interval). Methods Logistic regression models were used to examine risk for no postpartum contraception use among a sample of low-income and racially/ethnically diverse women recruited from two metropolitan perinatal clinics in Tulsa, OK. Results Women who reported that they were trying to get pregnant or “okay either way” about getting pregnant had significantly lower odds of using contraception at 6 months post childbirth than those who had unintended pregnancies. Having providers who discussed postpartum contraceptive options during pregnancy significantly increased the odds of contraceptive uptake among those who were planning or ambivalent about their pregnancies. Conclusions Intentions of a current pregnancy and provider contraceptive counseling matter for postpartum contraceptive use and the associated risk for a short interval subsequent pregnancy. Provider contraceptive counseling that accounts for the intendedness of a current pregnancy may offer a more targeted approach to prevent a short interval subsequent pregnancy.

Childhood exposure to adversity may increase an individual's reactivity to subsequent stressors. In this paper, we examine how adverse childhood experiences (ACEs) are associated with experiencing greater perceived distress during the pandemic. In this volunteer clinical cohort study, 177 pregnant women (ages 16-38) were recruited from two university-affiliated perinatal clinics located in a small metropolitan city between October 2017 and May 2018. Longitudinal data collection is ongoing. The current study includes the 101 women who participated through the eighth and most recent survey conducted in mid-April 2020. OLS regression analyses were used to examine the association between childhood adversity and pandemic-related distress. We found that ACE scores were associated with higher levels of distress (b = .08; se = .03; p < .01) when controlling for demographic characteristics. The addition of loneliness to the model fully mediates the association between ACEs score and distress. Findings suggest that adverse childhood experiences influence COVID-19-related distress due to greater social isolation. Those who had greater adversity during childhood may be less likely to have the social connectedness needed to reduce distress due to the pandemic.