The Best of Intentions: A Structural Analysis of the Association between Socioeconomic Disadvantage and Unintended Pregnancy in a Sample of Mothers from the National Longitudinal Survey of Youth (1979)

Abstract

Objectives Births to less-educated women are more likely to be classified as unintended than other births. We question a common interpretation that this association reflects lack of contraceptive knowledge or self-efficacy among less-educated women. We theorize that differences in early life educational advantages structure pregnancy desires and the salience and opportunity costs of precise fertility timing. We hypothesize that net of covariates indicative of early educational disadvantage, mothers with less education are not more likely to report births as unintended compared to mothers who have attained higher levels of education before becoming mothers. Methods Using multivariate regression, we analyze a sample of women in the National Longitudinal Survey of Youth 1979 who had their first births by 1994. We test whether an index measure of educational advantage in youth predicts unintended first birth. Results Unadjusted results confirm well-documented associations between educational disadvantage and greater likelihood of unintended pregnancy. However, once covariates are controlled, those with high educational advantage in youth are more likely to report their first birth as mistimed (RRR: 1.57). Discussion Educational advantage captures expectations about how much education a young woman will obtain before giving birth and is a structural dynamic that precedes proximate factors related to family planning access and behaviors. These findings highlight the need to incorporate structural factors that condition perceptions of pregnancy intention in the study of unintended pregnancy and to critically re-evaluate the conceptualization and interpretation of pregnancy intention measures.

Factors associated with pregnancy desire among adolescent women in five Latin American countries: a multilevel analysis

“…Studying adolescents’ desire for pregnancy and positive or negative attitudes towards childbearing is important from a public health perspective . Identifying characteristics and life contexts of adolescents who desire pregnancy could provide scientific evidence useful for designing health promotion and care programmes adapted to their needs, to support them in deciding on, planning, and receiving care and support for a pregnancy, either during adolescence or later in life.…”

“…Young women may decide to marry or live with a partner once they discover they are pregnant. Adolescent women may also have few alternatives for personal development or in some cases limited personal choice as to whether to marry . The influence of the male partner's reproductive intentions should also be considered when exploring adolescents’ desire for pregnancy, including the possibility of reproductive coercion …”

“…According to the World Health Organization, 75% of adolescent pregnancies are intended . Adolescent attitudes towards pregnancy are complex, and some adolescents report planning and/or desiring pregnancy . Researchers posit that maternity during adolescence can constitute an adaptive response to accumulated disadvantages .…”

Agency‐Without‐Choice: The Visual Rhetorics of Long‐Acting Reversible Contraception Promotion

“…The recent resurgence of LARC promotion must be understood within the context of unintended pregnancy (UP). UP has been defined as a social, economic, and health problem in the United States since 1980 because of its persistent associations with socioeconomic disadvantage, delayed prenatal care, adverse birth outcomes, and other determinants of health (Wise, Geronimus, and Smock ). For example, the U.S. Department Health and Human Services' ongoing Healthy People 2020 initiative suggests reducing UP as a way to improve the health of the nation (Kost ).…”

“…For example, the U.S. Department Health and Human Services' ongoing Healthy People 2020 initiative suggests reducing UP as a way to improve the health of the nation (Kost ). UP is widely considered an important indicator of population health; however, definitions and measurements of UP have been criticized for failing to capture the complexity, nuance, and contradictions inherent in cisgender women's “pregnancy intentions” (Luker ; Santelli et al ; Santelli et al ; Trussell, Vaughn, and Stanford ; Wise, Geronimus, and Smock ). Demographers typically define an UP as either unwanted (i.e., the pregnancy occurred when either no children, or no more children, were desired) or mistimed (i.e., the pregnancy occurred earlier than intended) (Santelli et al ).…”