Similarities and differences in contraceptive use reported by women and men in the National Survey of Family Growth

Abstract

Objective To compare use of contraceptive methods at last heterosexual intercourse among 15–44 year-old women and men at risk of unintended pregnancy in the United States. Study Design We employed data from the National Survey of Family Growth (NSFG) 2006–2013. We considered women and men to be at-risk of unintended pregnancy if they had intercourse in the last month, regardless of contraceptive use, and if they or their partner had the ability to get pregnant and neither was trying to become pregnant. We categorized multiple method use according to the most effective method reported. To explore the contributions of age and relationship status to differences in reporting between women and men, we conducted sensitivity analyses, limiting age to 25–44 years and union status to married and cohabiting. Results Distributions of methods used at last intercourse differed for women and men. A positive difference reflects higher reporting among women, while a negative difference reflects higher reporting among men. Percentage-point differences were largest for reported use of no method (−7.6) and female sterilization (+7.4), each p<0.001. These differences persisted even when the sample was restricted by age and relationship status. Conclusion Estimates of men’s contraceptive use may be subject to underreporting of their partners’ method use, particularly when their female partner is sterilized. Neither older age nor married and cohabiting relationship status accounted for the observed differences. Further research is needed to explore the factors underlying reporting differences between women and men with respect to female sterilization and use of no method.

Standardizing Measurement of Contraceptive Use Among Unmarried Women

“…Therefore, we make 2 recommendations: In the short term, we recommend maintaining the DHS method (sexual activity within the previous 1 month) for reporting mCPR and unmet need among unmarried women to more accurately monitor both indicators. For clarity and messaging, we recommend that the wider family planning community adopt this approach for measuring and reporting mCPR and unmet need among unmarried women.In the longer term, we recommend adding the following 2 questions to the DHS women’s questionnaire and other surveys that capture contraceptive use data: (1) “The last time you had sex, did you or your partner do anything or use any method to avoid or delay pregnancy?” (2) [if yes] “What method did you use?” These questions align with questions already asked in the DHS men’s questionnaire as well as questions included in the U.S. National Survey of Family Growth 25 . Incorporating these questions would help to overcome the measurement misalignment described herein, thereby allowing for improved calculation of mCPR among unmarried women who had sex less recently and allowing for analysts to use contraceptive use data for a larger number of unmarried women, thus, helping to overcome the sample size issue.…”

“…In the longer term, we recommend adding the following 2 questions to the DHS women’s questionnaire and other surveys that capture contraceptive use data: (1) “The last time you had sex, did you or your partner do anything or use any method to avoid or delay pregnancy?” (2) [if yes] “What method did you use?” These questions align with questions already asked in the DHS men’s questionnaire as well as questions included in the U.S. National Survey of Family Growth 25 . Incorporating these questions would help to overcome the measurement misalignment described herein, thereby allowing for improved calculation of mCPR among unmarried women who had sex less recently and allowing for analysts to use contraceptive use data for a larger number of unmarried women, thus, helping to overcome the sample size issue.…”

Reporting sterilization as a current contraceptive method among sterilized women: lessons learned from a population with high sterilization rates, Rajasthan, India

“…Underreporting of contraceptive use is not uncommon, but it has not been studied extensively, potentially because of the lack of relevant data to investigate the research questions [4] . Nevertheless, various studies have investigated potential underreporting based on disagreement in couple data [5] , [12] , underreporting by age [13] , underreporting where contraceptive use is a sensitive and potentially stigmatized issue [4] , [6] and underreporting of traditional methods [3] , [8] . Sterilization and, to a lesser extent, other modern methods are sometimes not reported when asked about the method of current use, which may be a result of imprecision in the understanding of the word “current.” It has been suggested that refining the time metric for what entails “current use” would lead to greater accuracy in reporting of contraceptive use [14] .…”

Access to infertility services: characterizing potentially infertile men in the United States with the use of the National Survey for Family Growth

“…The easiest access to infertile populations comes from reports from infertility clinics across the country, but these data are in no way representative of the socially, economically, and racially diverse group of men in the United States with reduced fertility. A recent study that used the NSFG data to assess contraceptive use among women and men cited the difficulty of defining male fertility potential even with such a targeted and robust dataset (14). As such, many of the epidemiologic studies conducted thus far with the use of the NSFG data for both men and women have focused largely on the subpopulations who have received infertility care (15).…”