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Contraceptive Consistency and Poverty After Birth

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Abstract

Unplanned pregnancies in the U.S. disproportionately occur among poor, less educated, and minority women, but it is unclear whether poverty following a birth is itself an outcome of this pregnancy planning status. Using the National Longitudinal Survey of Youth 1997 (n = 2101) and National Survey of Family Growth (n = 778), we constructed 2-year sequences of contraceptive use before a birth that signal an unplanned versus a planned birth. We regressed poverty in the year of the birth both on this contraceptive-sequence variable and on sociodemographic indicators including previous employment and poverty status in the year before the birth, race/ethnicity, education, partnership status, birth order, and family background. Compared to sequences indicating a planned birth, sequences of inconsistent use and non-use of contraception were associated with a higher likelihood of poverty following a birth, both before and after controlling for sociodemographic variables, and before and after additionally controlling for poverty status before the birth. In pooled-survey estimates with all controls included, having not used contraception consistently is associated with a 42% higher odds of poverty after birth. The positive association of poverty after birth with contraceptive inconsistency or non-use, however, is limited to women with low to medium educational attainment. These findings encourage further exploration into relationships between contraceptive access and behavior and subsequent adverse outcomes for the mother and her children.

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Notes

  1. If the respondent is not independent from their parents, but their parents did not fill out a “Parent Interview” we do not know the income and poverty status of the respondent, and therefore have missing poverty information. 27.4% of women had missing data on either the year of the birth or the year before the birth.

  2. We also compared standard error inflation between incorporating PSU versus individual woman clusters and found similar magnitudes.

  3. White, married, first birth, 24.6 years old, have had a full-time job, did live with biological parents at 18 years old, high school or less education, mom completed high school or less education.

  4. In an alternate, expanded classification, we also included separately a “non-use, unmarried” category of women. They are included among the never-consistent group in the results presented in Table 4 in Appendix. The never-consistent odds of poverty in Model 3 were little changed by this re-categorization (1.40 in place of 1.42 in the NSFG + NSLY97 estimate, and 1.20 in place of 1.25 in the NLSY97-only estimate). The alternate NSFG-only Model 2a, moreover, shows that the never-consistent category that retains the “non-use, unmarried” in it, while separating out sometimes-consistent contraceptive users exhibits a stronger contrast between never-consistent and ever-consistent women’s post-birth poverty risk.

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Acknowledgements

We are grateful for comments received from the discussant and participants at the 2019 Population Association of America Annual Meeting, and for support from the National Science Foundation BIGDATA: Applications program, Grant NSF IIS-1546259, and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Grants R03-HD084974 and P2C-HD041041.

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Authors and Affiliations

  1. Department of Sociology and Maryland Population Center, University of Maryland, College Park, MD, USA

    Polina Zvavitch, Michael S. Rendall & Constanza Hurtado-Acuna

  2. Maryland Population Research Center, University of Maryland, College Park, MD, USA

    Rachel M. Shattuck

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  1. Polina Zvavitch
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  2. Michael S. Rendall
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  3. Constanza Hurtado-Acuna
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  4. Rachel M. Shattuck
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Correspondence to Polina Zvavitch.

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Appendices

Appendix A1

See Table 3.

Table 3 Contraceptive-consistency category by contraceptive sequence, NLSY97
Full size table

Appendix A2

See Table 4

Table 4 Contraceptive-consistency category by contraceptive sequence, NSFG
Full size table

Appendix A3: Contraceptive Consistency for Model 2a, NSFG

Based on the information of contraceptive use per month for years (t-3,t-2, and t-2,t-1), we break down the Never- and Ever-consistent categories into three categories: Always, Sometimes, and Never consistent. Then we analyze the sequences of contraceptive use per month between (t-3,t-2) and the month of conception. The month of conception is available on the Female Pregnancy data for both rounds (2002 and 2006–2010). The number of months with information is conditional on the number of months with sexual intercourse. That is, when selecting the months for input to sequence coding, we essentially skip over months in which there is no sexual intercourse reported. For example, in identifying the use of contraception in the first 6 months beginning in the first month of year (t-3,t-2), we use as input to the sequence coding the first 6 months in which she reports sexual intercourse. If in these first 6 months of reported sexual intercourse, she used contraception in all six months, her sequence will either be coded as always-consistent or sometimes-consistent. If in any of these first 6 months of reported sexual intercourse, she reported not using contraception, her sequence will be coded as never-consistent.

To code these variables, we use the sequence commands in STATA (SQ-Ados). We classify women following these rules:

  1. 1

    Always Consistent

    • Beginning in the first month of year (t-3,t-2) a sequence of use every month for at least 6 months AND beginning with the first month of non-use, a sequence of non-use for every month up to and including the month of conception.

      Example (1 = use; 0 = non-use):

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      0

      0

      0

      0

    • If they were classified as never-consistent on the original annual variable, but they start with at least 6 consecutive months of use on (t-3,t-2), and between (t-2, t-1) and the month of conception, all months in which she had sex they were non-users.

      Example:

      1

      1

      1

      1

      1

      1

      0

      0

      0

      0

      0

      0

      OR

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      0

  2. 2.

    Sometimes Consistent Beginning in the first month of the year (t-3,t-2) a sequence of use every month for at least 6 months; AND in the sequence of months beginning with the first month of non-use and ending in the month of conception, at least 1 month of contraceptive use. Example 1:

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    1

    0

    1

    0

    0

    • In the above example, she is a contraceptive user since first month with information in year (t-3,t-2), and she has at least one ‘0′ (non-use) followed by a ‘1′ (use) up to and including the month of conception. The woman is an ever-consistent contraceptive user under the annual definition, and is a sometimes-consistent user under the monthly definition. Example 2:

      1

      1

      1

      1

      1

      1

      1

      1

      1

      1

      0

      1

      1

      1

      1

      1

      1

      1

      1

      0

      1

      0

      0

    • In the above example, she is a contraceptive user in all of the first 6 months with information in year (t-3,t-2), but has at least one month without contraceptive use in year (t-3,t-2), and she has at least one ‘0′ (non-use) followed by a ‘1′ (use) up to and including the month of conception. She is a sometimes-consistent on a monthly basis, whereas she is never-consistent on an annual basis.

  3. 3.

    Never Consistent: The never-consistent monthly-basis cases start off with at least one 0 in the first 6 months of (t-3,t-2). Example:

    0

    1

    0

    0

    1

    1

    0

    0

    0

    0

    0

    0

    OR

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    1

Appendix A4

See Table 5

Table 5 Model-fit statistics for pooled logistic regressions of poverty on contraceptive consistency
Full size table

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Zvavitch, P., Rendall, M.S., Hurtado-Acuna, C. et al. Contraceptive Consistency and Poverty After Birth. Popul Res Policy Rev 40, 1277–1311 (2021). https://doi.org/10.1007/s11113-020-09623-6

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