Ilene S Speizer1, Lisa M Calhoun, Theresa Hoke, Ranajit Sengupta. 1. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA; Measurement, Learning, & Evaluation Project, Carolina Population Center, University of North Carolina at Chapel Hill, NC, USA. Electronic address: speizer@email.unc.edu.
Abstract
BACKGROUND: The measure of unmet need relies on women's reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. STUDY DESIGN: Our study uses recently collected longitudinal data from four cities in Uttar Pradesh, India, to examine whether women's fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the 2-year follow-up period. RESULTS: Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the 2-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP, did not distinguish pregnancy/birth experience. Ninety-two percent of pregnancies/births over the follow-up period were considered "wanted then" suggesting post-hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing 2 years earlier. CONCLUSIONS: More nuanced assessments of fertility intentions may be needed to adequately gauge latent FP needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined.
BACKGROUND: The measure of unmet need relies on women's reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. STUDY DESIGN: Our study uses recently collected longitudinal data from four cities in Uttar Pradesh, India, to examine whether women's fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the 2-year follow-up period. RESULTS: Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the 2-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP, did not distinguish pregnancy/birth experience. Ninety-two percent of pregnancies/births over the follow-up period were considered "wanted then" suggesting post-hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing 2 years earlier. CONCLUSIONS: More nuanced assessments of fertility intentions may be needed to adequately gauge latent FP needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined.
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