Akilah Wise1, Arline T Geronimus2, Pamela J Smock2. 1. Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan. Electronic address: amwise@umich.edu. 2. Population Studies Center, University of Michigan, Ann Arbor, Michigan.
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 a 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 with 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 (relative risk ratio, 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. CONCLUSIONS: These findings highlight the need to incorporate structural factors that condition perceptions of pregnancy intention in the study of unintended pregnancy and to critically reevaluate the conceptualization and interpretation of pregnancy intention measures.
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 a 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 with 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 (relative risk ratio, 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. CONCLUSIONS: These findings highlight the need to incorporate structural factors that condition perceptions of pregnancy intention in the study of unintended pregnancy and to critically reevaluate the conceptualization and interpretation of pregnancy intention measures.
Authors: Sajeevika S Daundasekara; Daniel P O'Connor; Jodi Berger Cardoso; Tracey Ledoux; Daphne C Hernandez Journal: Int J Environ Res Public Health Date: 2020-09-04 Impact factor: 3.390