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Are Uncertain Fertility Intentions a Temporary or Long-term Outlook? Findings from a Panel Study.

ABSTRACT: Research suggests that a substantial minority of women are unsure if they want to have (more) children. This study examines whether this is a temporary or long-term outlook and which characteristics are associated with uncertainty about future childbearing intentions.Panel data from a national sample of 2,353 nonsterilized U.S. women aged 18 to 39 years were gathered at three points in time between 2012 and 2013. Women who indicated they were "not sure" if they wanted to have any (more) children were classified as uncertain. Random effects and fixed effects logistic regression were used to determine which baseline and time-varying characteristics were associated with fertility uncertainty and changes in uncertainty.Although 39% of the sample reported uncertain fertility intentions on at least one survey, only 9% were uncertain at all three. Characteristics associated with uncertainty included being ages 30 and older, having one or more children, perceiving one's partner to have uncertain childbearing intentions, and having a strong desire to avoid pregnancy. Characteristics associated with a decreased likelihood of uncertainty included relationship happiness and having a recent discussion about childbearing intentions with a health care provider.At a given point in time, a substantial minority of women is uncertain whether they want to have more children, but it seems to be a temporary or transitional stage for most.

SUBMITTER: Jones RK

PROVIDER: S-EPMC5289295 | biostudies-literature | 2017 Jan - Feb

REPOSITORIES: biostudies-literature

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Are Uncertain Fertility Intentions a Temporary or Long-term Outlook? Findings from a Panel Study.

Jones Rachel K RK

Women's health issues : official publication of the Jacobs Institute of Women's Health 20161109 1

<h4>Objectives</h4>Research suggests that a substantial minority of women are unsure if they want to have (more) children. This study examines whether this is a temporary or long-term outlook and which characteristics are associated with uncertainty about future childbearing intentions.<h4>Methods</h4>Panel data from a national sample of 2,353 nonsterilized U.S. women aged 18 to 39 years were gathered at three points in time between 2012 and 2013. Women who indicated they were "not sure" if they ...[more]

PMID: 27838033

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Project description:BackgroundIntegrating family planning interventions with HIV studies in developing countries has been shown to prevent mother-to-child HIV transmission and simultaneously reduce HIV and unintended pregnancy in high-risk populations. As part of a prospective cohort study on HIV incidence and risk factors in Zambian women having unprotected sex, we also offered family planning counseling and immediate access to long-acting reversible contraceptives. Although long-acting reversible contraceptives are the most effective form of contraception, many Zambian women are limited to oral or injectable methods because of a lack of knowledge or method availability. This project offers to single mothers who are enrolled in a cohort study information about and access to long-acting reversible contraceptives at enrollment and at each follow-up visit.ObjectiveThis study evaluates how fertility intentions affect long-acting reversible contraceptive use in HIV-negative single mothers in Zambia. Our primary outcome was long-acting reversible contraceptive use throughout the study participation. We also estimated rates of long-acting reversible contraceptive uptake and discontinuation. We specifically studied single mothers because they are at high risk for unintended pregnancy, which can have significant negative ramifications on their financial, social, and psychologic circumstances.Study designFrom 2012-2017, Zambia Emory HIV Research Project recruited 521 HIV-negative single mothers ages 18-45 years from government clinics in Lusaka and Ndola, Zambia's 2 largest cities. Participants were followed every 3 months for up to 5 years. At each visit, we discussed fertility goals and contraceptive options and offered a long-acting reversible method to any woman who was not pregnant or who already was using a long-acting reversible or permanent contraceptive method. Data were collected on demographic factors, sexual behavior, and reproductive history. Multivariable logistic regression was used to model baseline fertility intentions with long-acting reversible contraceptive use.ResultsWe enrolled 518 women; 57 women did not return for any follow-up visits. There was a significant increase in long-acting reversible contraceptive use during the study. At baseline, 93 of 518 women (18%) were using a long-acting reversible method, and 151 of 461 women (33%) used a long-acting reversible method at the end of follow-up period (P<.0001). Four women chose an intrauterine device, and 91 women chose an implant for their first uptake event. After we adjusted the data for other confounders, we found that women in Ndola who did not desire any more children were more likely to use a long-acting reversible contraceptive (adjusted prevalence ratio, 2.02; 95% confidence interval, 1.88-3.42). During follow up, 37 of 183 long-acting reversible contraceptive users (20%) discontinued their method; women who desired future children at baseline were more likely to discontinue earlier (P=.016).ConclusionThis study demonstrates that integrated family planning services can increase long-acting reversible contraceptive use successfully among Zambian single mothers, who are a vulnerable population that disproportionately is affected by unintended pregnancy. A steady increase in use over time confirms the importance of repeated messaging about these unfamiliar methods. Thus, it is imperative that family planning interventions target single mothers in developing countries to promote effective contraceptive use.

Project description:Incidence of acute respiratory infections (ARI) and gastrointestinal infections (GII) are difficult to assess due to high frequency episodes, limited severity and short duration. Retrospective assessments therefore are particularly prone to recall bias, while prospective assessment with conventional questionnaires requires high discipline from participants which is difficult to maintain over longer time periods. Web-based questionnaires (WQ) allow integration of a recall system and thus carry the potential to prospectively capture acute infections. We investigated the feasibility of a weekly WQ assessing symptoms of ARI and GII among participants of the German National Cohort (GNC).In the study centres Hamburg and Bremen of the GNC participants of the Pretest 1 phase (September to November 2011) were invited to additionally take part in this feasibility study testing the WQ. Every Monday participants received an e-mail, containing a link to the WQ, asking for occurrence of ARI or GII symptoms during the past 7 days. The study took place from the beginning of February until mid-July 2012. We calculated the overall proportion of participation, weekly participation and the number of weekly reports per participant and we estimated incidences of ARI, ILI and GII.Of 200 Pretest 1 participants 171 (86?%) reported having an email address and thus were eligible for the web-based study. A total of 167 (98?%) agreed to participate. Participants of the web-based study were younger and better educated than non-participants. Access to Internet decreased with increasing age. Of the 167 participants in the feasibility study, 144 (86?%) responded at least once during the study period of 23 weeks, 5 persons (3?%) had non-functioning email addresses and 18 (11?%) did not respond at all. The weekly response varied between 62?% and 81?%, the median was 74?% (IQR: 71-77?%). Weekly median reports per person were 20 (IQR: 14-22; range 1-23). More than 90?% of participants responded during the first 3 days. The following mean incidence rates were found: ARI, 12?%; ILI, 0.49?%; and GII, 3?%.Use of WQ in prospective studies seems well possible, as Internet access is frequent among study participants and major technical problems did not occur. We observed high participation during the study period of 6 months and low drop out numbers. Participants of the web-based study were slightly younger and better educated than non-participants, so selection bias is possible and must be kept in mind when discussing generalizability of the results.

Dataset Information

Are Uncertain Fertility Intentions a Temporary or Long-term Outlook? Findings from a Panel Study.

Publications

Are Uncertain Fertility Intentions a Temporary or Long-term Outlook? Findings from a Panel Study.

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