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      Unintended pregnancy and the changing demography of American women, 1987–2008

      research-article
      1 , 2
      Demographic research

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          Abstract

          BACKGROUND

          In 1987, the U.S. unintended pregnancy rate was 59 per 1,000 women aged 15–44; the rate fell to 54 in 2008. Over this period, American women experienced dramatic demographic shifts, including an aging population that was better educated and more racially and ethnically diverse.

          OBJECTIVE

          This study aims to explain trends in unintended pregnancy and understand what factors contributed most strongly to changes in rates over time, focusing on population composition and group-specific changes.

          METHODS

          We used the 1988 and 2006–10 waves of the National Survey of Family Growth and employed a decomposition approach, looking jointly at age, relationship status, and educational attainment.

          RESULTS

          When we decomposed by the demographic factors together, we found that changes in population composition contributed to an increase in the overall rate, but this was more than offset by group-specific rate declines, which had an impact nearly twice as great in the downward direction. Increases in the share of the population that was cohabiting and the share that was Hispanic were offset by declines in rates among married women.

          CONCLUSIONS

          Our findings suggest that a combination of compositional shifts and changes in group-specific rates drove unintended pregnancy, sometimes acting as counterbalancing forces and at other times operating in tandem.

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          Most cited references31

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          Demographic Trends in the United States: A Review of Research in the 2000s.

          Demographic trends in the 2000s showed the continuing separation of family and household due to factors such as childbearing among single parents, the dissolution of cohabiting unions, divorce, repartnering, and remarriage. The transnational families of many immigrants also displayed this separation, as families extended across borders. In addition, demographers demonstrated during the decade that trends such as marriage and divorce were diverging according to education. Moreover, demographic trends in the age structure of the population showed that a large increase in the elderly population will occur in the 2010s. Overall, demographic trends produced an increased complexity of family life and a more ambiguous and fluid set of categories than demographers are accustomed to measuring.
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            Underreporting of induced and spontaneous abortion in the United States: an analysis of the 2002 National Survey of Family Growth.

            Underreporting of induced abortions in surveys is widespread, both in countries where the procedure is illegal or highly restricted and in those where it is legal. In this study, we find that fewer than one half of induced abortions performed in the United States in 1997-2001 (47 percent) were reported by women during face-to-face interviews in the 2002 National Survey of Family Growth (NSFG). Hispanic and black women and those with low income were among the least likely to report their experience of abortion. Women were also less likely to report abortions that occurred when they were in their 20s. Second-trimester abortions were more likely to be reported than first-trimester terminations. The levels of recent spontaneous abortion reported in the 2002 NSFG were consistent with the accumulated body of clinical research, although substantially more lifetime pregnancy losses were reported on self-administered surveys than in face-to-face interviews. Subsequent research should explore strategies to improve information collected on abortion, and, in the interim, research involving pregnancy outcomes should be adjusted for unreported induced abortions.
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              Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.

              Many pregnancies are unintended, particularly in certain population groups. Determining whether unintended pregnancy rates and disparities in rates between subgroups are changing may help policymakers target reproductive health services to those women most in need. To calculate rates of unintended pregnancy and related outcomes, data on pregnancy intendedness from the 2002 National Survey of Family Growth were combined with birth, abortion and population data from federal, state and nongovernmental sources. In 2001, 49% of pregnancies in the United States were unintended. The unintended pregnancy rate was 51 per 1,000 women aged 15-44, meaning that 5% of this group had an unintended pregnancy. This level was unchanged from 1994. The rate of unintended pregnancy in 2001 was substantially above average among women aged 18-24, unmarried (particularly cohabiting) women, low-income women, women who had not completed high school and minority women. Between 1994 and 2001, the rate of unintended pregnancy declined among adolescents, college graduates and the wealthiest women, but increased among poor and less educated women. The abortion rate and the proportion of unintended pregnancies ending in abortion among all women declined, while the unintended birth rate increased. Forty-eight percent of unintended conceptions in 2001 occurred during a month when contraceptives were used, compared with 51% in 1994. More research is needed to determine the factors underlying the disparities in unintended pregnancy rates by income and other characteristics. The findings may reflect a need for increased and more effective contraceptive use, particularly among high-risk groups.
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                Author and article information

                Journal
                100964435
                29912
                Demogr Res
                Demogr Res
                Demographic research
                1435-9871
                3 February 2016
                30 January 2015
                9 December 2015
                02 May 2016
                : 33
                : 1257-1270
                Affiliations
                [1 ]Guttmacher Institute, U.S.A.
                [2 ]Guttmacher Institute, U.S.A.
                Author notes
                Article
                NIHMS755701
                10.4054/DemRes.2015.33.45
                4852306
                27147904
                38e99686-3341-48bf-9bb5-77b0435acc78

                This open-access work is published under the terms of the Creative Commons Attribution NonCommercial License 2.0 Germany, which permits use, reproduction & distribution in any medium for non-commercial purposes, provided the original author(s) and source are given credit. See http://creativecommons.org/licenses/by-nc/2.0/de/

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