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Lawrence B. Finer - One of the best experts on this subject based on the ideXlab platform.

  • declines in Unintended Pregnancy in the united states 2008 2011
    The New England Journal of Medicine, 2016
    Co-Authors: Lawrence B. Finer, Mia R. Zolna
    Abstract:

    BackgroundThe rate of Unintended Pregnancy in the United States increased slightly between 2001 and 2008 and is higher than that in many other industrialized countries. National trends have not been reported since 2008. MethodsWe calculated rates of Pregnancy for the years 2008 and 2011 according to women’s and girls’ Pregnancy intentions and the outcomes of those pregnancies. We obtained data on Pregnancy intentions from the National Survey of Family Growth and a national survey of patients who had abortions, data on births from the National Center for Health Statistics, and data on induced abortions from a national census of abortion providers; the number of miscarriages was estimated using data from the National Survey of Family Growth. ResultsLess than half (45%) of pregnancies were Unintended in 2011, as compared with 51% in 2008. The rate of Unintended Pregnancy among women and girls 15 to 44 years of age declined by 18%, from 54 per 1000 in 2008 to 45 per 1000 in 2011. Rates of Unintended Pregnancy...

  • young adults contraceptive knowledge norms and attitudes associations with risk of Unintended Pregnancy
    Perspectives on Sexual and Reproductive Health, 2012
    Co-Authors: Jennifer J Frost, Laura Duberstein Lindberg, Lawrence B. Finer
    Abstract:

    CONTEXT: Women aged 18-29 have higher rates of Unintended Pregnancy than any other age-group. Information is needed to understand what characteristics are associated with risky contraceptive use practices among this population and to develop new strategies for reducing these womens risk of Unintended Pregnancy. METHODS: Data related to Unintended Pregnancy risk were collected from a nationally representative sample of 1800 unmarried women and men aged 18-29 surveyed by telephone in 2009. Among those at risk of Unintended Pregnancy multiple logistic regression was used to assess associations between contraceptive knowledge norms and attitudes and selected risky contraceptive behaviors. RESULTS: More than half of young men and a quarter of young women received low scores on contraceptive knowledge and six in 10 underestimated the effectiveness of oral contraceptives. Among women for each correct response on a contraceptive knowledge scale the odds of expecting to have unprotected sex in the next three months decreased by 9% of currently using a hormonal or long-acting reversible method increased by 17% and of using no method decreased by 17%. Fear of side effects norms and attitudes that favor nonmarital Pregnancy or undervalue the importance of contraception Pregnancy ambivalence and mistrust of governments role in promoting contraception were also associated with one or more risky contraceptive use behaviors. CONCLUSIONS: Programs to increase young adults knowledge about contraceptive methods and use are urgently needed. Given the demonstrated link between method knowledge and contraceptive behaviors such programs may be useful in addressing risky behavior in this population. Copyright (c) 2012 by the Guttmacher Institute.

  • Variation in state Unintended Pregnancy rates in the United States.
    Perspectives on sexual and reproductive health, 2012
    Co-Authors: Kathryn Kost, Lawrence B. Finer, Susheela Singh
    Abstract:

    CONTEXT: Newly available data show large differences in rates of Unintended Pregnancy across states. Because key policy and program decisions that could affect these rates are made by state governments it is important to assess whether characteristics of the states are associated with this variation. METHODS: Regression analysis was used to assess the relationship between the variation in state Unintended Pregnancy rates in 2006 and state-level aggregate measures of demographic composition socioeconomic conditions contraceptive use and funding of and access to family planning services. RESULTS: State Unintended Pregnancy rates were positively associated with the proportion of resident women who were black or Hispanic. However these associations were almost entirely accounted for by differences in the age and marital status of women the proportion without health insurance and the proportion receiving Medicaid. In addition these last two measures were strongly associated with state Unintended Pregnancy rates after the other measures were controlled for: An increase in the proportion of women uninsured was associated with elevated Unintended Pregnancy rates and an increase in the proportion receiving Medicaid coverage was associated with reduced rates. CONCLUSIONS: State programs and policies should pay particular attention to increasing support for family planning services for minority groups. Findings also suggest that insurance coverage and receipt of Medicaid among women of reproductive age deserve further exploration as potentially important mechanisms for reducing state Unintended Pregnancy rates. Copyright (c) 2012 by the Guttmacher Institute.

  • Unintended Pregnancy in the United States: incidence and disparities, 2006.
    Contraception, 2011
    Co-Authors: Lawrence B. Finer, Mia R. Zolna
    Abstract:

    Abstract Background The incidence of Unintended Pregnancy is among the most essential health status indicators in the field of reproductive health. One ongoing goal of the US Department of Health and Human Services is to reduce Unintended Pregnancy, but the national rate has not been estimated since 2001. Study Design We combined data on women's Pregnancy intentions from the 2006���2008 and 2002 National Survey of Family Growth with a 2008 national survey of abortion patients and data on births from the National Center for Health Statistics, induced abortions from a national abortion provider census, miscarriages estimated from the National Survey of Family Growth and population data from the US Census Bureau. Results Nearly half (49%) of pregnancies were Unintended in 2006, up slightly from 2001 (48%). The Unintended Pregnancy rate increased to 52 per 1000 women aged 15���44 years in 2006 from 50 in 2001. Disparities in Unintended Pregnancy rates among subgroups persisted and in some cases increased, and women who were 18���24 years old, poor or cohabiting had rates two to three times the national rate. The Unintended Pregnancy rate declined notably for teens 15���17 years old. The proportion of Unintended pregnancies ending in abortion decreased from 47% in 2001 to 43% in 2006, and the Unintended birth rate increased from 23 to 25 per 1000 women 15���44 years old. Conclusions Since 2001, the United States has not made progress in reducing Unintended Pregnancy. Rates increased for nearly all groups and remain high overall. Efforts to help women and couples plan their pregnancies, such as increasing access to effective contraceptives, should focus on groups at greatest risk for Unintended Pregnancy, particularly poor and cohabiting women.

  • Unintended Pregnancy Rates at the State Level
    Perspectives on sexual and reproductive health, 2011
    Co-Authors: Lawrence B. Finer, Kathryn Kost
    Abstract:

    CONTEXT: Unintended Pregnancy is a key reproductive health indicator but rates have never been calculated for all 50 states. METHODS: State-level estimates of Unintended Pregnancy rates in 2006 were calculated using data from several sources. The proportion of births resulting from Unintended pregnancies was obtained from the Pregnancy Risk Assessment Monitoring System and similar state surveys and the intention status of pregnancies ending in abortion from a national survey of abortion patients. These proportions were applied to birth and abortion counts for each state and fetal losses were estimated. Rates of Unintended Pregnancy were obtained by dividing relevant figures by the number of women aged 15-44 in each state. Six states and the District of Columbia had no appropriate survey data; their rates were predicted using multivariate linear regression. RESULTS: In 2006 the median state Unintended Pregnancy rate was 51 per 1000 women aged 15-44. Most rates fell within a range of 40-65 Unintended pregnancies per 1000 women. The highest rate was in Mississippi (69); the lowest rate was in New Hampshire (36). Rates were generally highest in the South and Southwest and in states with large urban populations. In 29 states and the District of Columbia more than half of pregnancies were Unintended; in nine a consistent upward trend in Unintended Pregnancy rates between 2002 and 2006 was apparent; no state had a consistent decline. CONCLUSIONS: These rates provide benchmarks for measuring the impact on Unintended Pregnancy of state policies and practices such as those governing sex education and the funding of contraceptive services. Copyright (c) 2011 by the Guttmacher Institute.

Sonya Borrero - One of the best experts on this subject based on the ideXlab platform.

  • history of Unintended Pregnancy and patterns of contraceptive use among racial and ethnic minority women veterans
    American Journal of Obstetrics and Gynecology, 2020
    Co-Authors: Deirdre A Quinn, Florentina E Sileanu, Xinhua Zhao, Maria K Mor, Colleen P Judgegolden, Lisa S Callegari, Sonya Borrero
    Abstract:

    Abstract Background Nearly half of all pregnancies in the United States each year are Unintended, with the highest rates observed among non-Hispanic black and Hispanic women. Little is known about whether variations in Unintended Pregnancy and contraceptive use across racial and ethnic groups persist among women Veteran VA-users who have more universal access than other populations to health care and contraceptive services. Objectives The objectives of this study were to identify history of Unintended Pregnancy and describe patterns of contraceptive use across racial and ethnic groups among women Veterans accessing VA primary care. Study Design Cross-sectional data from a national random sample of women Veterans (n=2302) ages 18-44 who had accessed VA primary care in the previous 12 month were used to assess history of Unintended Pregnancy (pregnancies reported as either ‘unwanted’ or having occurred ‘too soon’). Any contraceptive use at last sex (both prescription and non-prescription methods) and prescription contraceptive use at last sex were assessed in the subset of women (n=1341) identified as being at risk for Unintended Pregnancy. Prescription contraceptive methods include long acting reversible contraceptive methods (intrauterine devices (IUDs) and subdermal implants), hormonal methods (pill, patch, ring, and injection), and female or male sterilization; non-prescription methods include barrier methods (e.g., condoms, diaphragm), fertility-awareness methods, and withdrawal. Multivariable logistic regression models were used to examine the relationship between race/ethnicity with Unintended Pregnancy and contraceptive use at last sex. Results Overall, 94.4% of women Veterans at risk of Unintended Pregnancy used any method of contraception at last sex. IUDs (18.9%), female surgical sterilization (16.9%), and birth control pills (15.9%) were the three most frequently used methods across the sample. IUDs were the most frequently used method for Hispanic, non-Hispanic White, and other non-Hispanic women, while female surgical sterilization was the most frequently used method among non-Hispanic black women. In adjusted models, Hispanic women (aOR=1.60, 95%CI:1.15,2.21) and non-Hispanic black women (aOR=1.84, 95%CI:1.44,2.36) were significantly more likely than non-Hispanic white women to report any history of Unintended Pregnancy. In the subcohort of 1341 women at risk of Unintended Pregnancy, there were no significant racial/ethnic differences in use of any contraception at last sex. However, significant differences were observed in the use of prescription methods at last sex. Hispanic women (aOR=0.51, 95%CI:0.35,0.75) and non-Hispanic black women (aOR=0.69, 95%CI:0.51,0.95) were significantly less likely than non-Hispanic white women to have used prescription contraception at last sex. Conclusions Significant racial and ethnic differences exist in Unintended Pregnancy and contraceptive use among women Veterans using VA care, suggesting the need for interventions to address potential disparities. Improving access to and delivery of patient-centered reproductive goals assessment and contraceptive counseling that can address knowledge gaps while respectfully considering individual patient preferences is needed to support women Veterans’ decision-making and ensure equitable reproductive health services across VA.

  • Does a History of Unintended Pregnancy Lessen the Likelihood of Desire for Sterilization Reversal
    Journal of women's health (2002), 2013
    Co-Authors: Cynthia D. Grady, Eleanor Bimla Schwarz, Chetachi A. Emeremni, Jonathan G. Yabes, Aletha Y. Akers, Nikki B. Zite, Sonya Borrero
    Abstract:

    Abstract Background: Unintended Pregnancy has been significantly associated with subsequent female sterilization. Whether women who are sterilized after experiencing an Unintended Pregnancy are less likely to express desire for sterilization reversal is unknown. Methods: This study used national, cross-sectional data collected by the 2006–2010 National Survey of Family Growth. The study sample included women ages 15–44 who were surgically sterile from a tubal sterilization at the time of interview. Multivariable logistic regression was used to examine the relationship between a history of Unintended Pregnancy and desire for sterilization reversal while controlling for potential confounders. Results: In this nationally representative sample of 1,418 women who were sterile from a tubal sterilization, 78% had a history of at least one Unintended Pregnancy and 28% expressed a desire to have their sterilization reversed. In unadjusted analysis, having a prior Unintended Pregnancy was associated with higher odd...

  • Unintended Pregnancy and contraception among active duty servicewomen and veterans
    American Journal of Obstetrics and Gynecology, 2012
    Co-Authors: Vinita Goyal, Sonya Borrero, Eleanor Bimla Schwarz
    Abstract:

    The number of women of childbearing age who are active-duty service members or veterans of the US military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector, or through the Department of Veterans Affairs. This article reviews the current data on Unintended Pregnancy and prevalence of and barriers to contraceptive use among active-duty and veteran women. Active-duty servicewomen have high rates of Unintended Pregnancy and low contraceptive use, which may be due to official prohibition of sexual activity in the military, logistic difficulties faced by deployed women, and limited patient and provider knowledge of available contraceptives. In comparison, little is known about rates of Unintended Pregnancy and contraceptive use among women veterans. Based on this review, research recommendations to address these issues are provided.

  • Unintended Pregnancy influences racial disparity in tubal sterilization rates
    Journal of General Internal Medicine, 2010
    Co-Authors: Sonya Borrero, Eleanor Bimla Schwarz, Aletha Y. Akers, Charity G Moore, Li Qin, Mitchell D Creinin, Said A Ibrahim
    Abstract:

    BACKGROUND Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of Unintended Pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.

Eleanor Bimla Schwarz - One of the best experts on this subject based on the ideXlab platform.

  • Does a History of Unintended Pregnancy Lessen the Likelihood of Desire for Sterilization Reversal
    Journal of women's health (2002), 2013
    Co-Authors: Cynthia D. Grady, Eleanor Bimla Schwarz, Chetachi A. Emeremni, Jonathan G. Yabes, Aletha Y. Akers, Nikki B. Zite, Sonya Borrero
    Abstract:

    Abstract Background: Unintended Pregnancy has been significantly associated with subsequent female sterilization. Whether women who are sterilized after experiencing an Unintended Pregnancy are less likely to express desire for sterilization reversal is unknown. Methods: This study used national, cross-sectional data collected by the 2006–2010 National Survey of Family Growth. The study sample included women ages 15–44 who were surgically sterile from a tubal sterilization at the time of interview. Multivariable logistic regression was used to examine the relationship between a history of Unintended Pregnancy and desire for sterilization reversal while controlling for potential confounders. Results: In this nationally representative sample of 1,418 women who were sterile from a tubal sterilization, 78% had a history of at least one Unintended Pregnancy and 28% expressed a desire to have their sterilization reversed. In unadjusted analysis, having a prior Unintended Pregnancy was associated with higher odd...

  • Unintended Pregnancy and contraception among active duty servicewomen and veterans
    American Journal of Obstetrics and Gynecology, 2012
    Co-Authors: Vinita Goyal, Sonya Borrero, Eleanor Bimla Schwarz
    Abstract:

    The number of women of childbearing age who are active-duty service members or veterans of the US military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector, or through the Department of Veterans Affairs. This article reviews the current data on Unintended Pregnancy and prevalence of and barriers to contraceptive use among active-duty and veteran women. Active-duty servicewomen have high rates of Unintended Pregnancy and low contraceptive use, which may be due to official prohibition of sexual activity in the military, logistic difficulties faced by deployed women, and limited patient and provider knowledge of available contraceptives. In comparison, little is known about rates of Unintended Pregnancy and contraceptive use among women veterans. Based on this review, research recommendations to address these issues are provided.

  • Unintended Pregnancy influences racial disparity in tubal sterilization rates
    Journal of General Internal Medicine, 2010
    Co-Authors: Sonya Borrero, Eleanor Bimla Schwarz, Aletha Y. Akers, Charity G Moore, Li Qin, Mitchell D Creinin, Said A Ibrahim
    Abstract:

    BACKGROUND Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of Unintended Pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.

  • measuring the effects of Unintended Pregnancy on women s quality of life
    Contraception, 2008
    Co-Authors: Eleanor Bimla Schwarz, Rachel Smith, Jody Steinauer, Matthew F Reeves, Aaron B Caughey
    Abstract:

    Abstract Background This study was conducted to assess the potential impact of an Unintended Pregnancy on women's quality of life. Study Design We asked 192 nonpregnant women to report how they would feel if they learned that they were pregnant using a visual analog scale (VAS), a time trade-off (TTO) metric, a standard gamble (SG) metric and a willingness-to-pay (WTP) metric. Results Women's anticipated responses to an Unintended Pregnancy varied widely. Using a VAS, 8% reported Pregnancy would make them feel like they were dying. To avoid Pregnancy, 28% of women were willing to trade time from the end of their life (TTO), 16% of women were willing to accept an immediate risk of death (SG) and 60% of women were willing to pay some amount of money (WTP). On average, women, using the VAS, TTO and SG metrics, reported that an Unintended Pregnancy would create a health utility state (where 0 represents death and 1 represents perfect health) of 0.487, 0.992 and 0.997, respectively. Conclusion The anticipated effects of Pregnancy on women's quality of life should be integrated into cost-effectiveness analyses of family planning services.

Jay G Silverman - One of the best experts on this subject based on the ideXlab platform.

  • recent reproductive coercion and Unintended Pregnancy among female family planning clients
    Contraception, 2014
    Co-Authors: Elizabeth Miller, Heather L Mccauley, Daniel J Tancredi, Michele R Decker, Heather Anderson, Jay G Silverman
    Abstract:

    Abstract Objective Reproductive coercion (RC) — birth control sabotage and coercion by male partners to become pregnant and to control the outcome of a Pregnancy — has been associated with a history of both intimate partner physical and sexual violence (IPV) and Unintended Pregnancy among females utilizing reproductive health services. The temporal nature of associations of RC and Unintended Pregnancy (distinct from the impact of IPV), however, has remained less clear. Study Design A survey was administered to females aged 16–29 years seeking care in 24 rural and urban family planning clinics in Pennsylvania ( n = 3539). Results Five percent of respondents reported RC in the past 3 months, and 12% reported an Unintended Pregnancy in the past year. Among those who reported recent RC, 21% reported past-year Unintended Pregnancy. Compared to women exposed to neither condition, exposure to recent RC increased the odds of past-year Unintended Pregnancy, both in the absence of a history of IPV [adjusted odds ratio (AOR) 1.79, 1.06–2.03] and in combination with a history of IPV (AOR 2.00, 1.15–3.48); history of IPV without recent RC was also associated with Unintended Pregnancy (AOR 1.80, 1.42–2.26). Conclusions Findings indicate the temporal proximity of the association of RC and Unintended Pregnancy, with recent RC related to past-year Unintended Pregnancy, both independently and in combination with a history of IPV. Recent RC is relatively prevalent among young women using family planning clinics and is associated with increased risk for past-year Unintended Pregnancy even in the absence of IPV. Implications Recent RC and a history of IPV are prevalent among female family planning clients, particularly younger women, and these experiences are each associated with Unintended Pregnancy. Pregnancy prevention counseling should include not only assessment for physical and sexual partner violence but also specific inquiry about RC.

  • reproductive coercion and partner violence implications for clinical assessment of Unintended Pregnancy
    Expert Review of Obstetrics & Gynecology, 2010
    Co-Authors: Elizabeth Miller, Jay G Silverman
    Abstract:

    Unintended Pregnancy is common, disproportionately affects younger women and is associated with intimate partner violence. Forced sex, fear of negotiating condom and contraceptive use, inconsistent condom use and partner interference with access to healthcare all contribute to this association between Unintended Pregnancy and intimate partner violence. A growing body of literature on male partner influences on contraception and Pregnancy decision-making has identified a range of male partner Pregnancy-controlling behaviors which we have termed reproductive coercion, defined as male partners' attempts to promote Pregnancy in their female partners through verbal pressure and threats to become pregnant (Pregnancy coercion), direct interference with contraception (birth-control sabotage), and threats and coercion related to Pregnancy continuation or termination (control of Pregnancy outcomes). This article examines recent studies on male partner reproductive coercion, underscores the link between Unintended Pregnancy and intimate partner violence and highlights future directions for research as well as implications for clinical practice.

  • Pregnancy coercion intimate partner violence and Unintended Pregnancy
    Contraception, 2010
    Co-Authors: Elizabeth Miller, Heather L Mccauley, Daniel J Tancredi, Michele R Decker, Rebecca R Levenson, Jeffrey Waldman, Phyllis Schoenwald, Jay G Silverman
    Abstract:

    Abstract Background Reproductive control including Pregnancy coercion (coercion by male partners to become pregnant) and birth control sabotage (partner interference with contraception) may be associated with partner violence and risk for Unintended Pregnancy among young adult females utilizing family planning clinic services. Study Design A cross-sectional survey was administered to females ages 16–29 years seeking care in five family planning clinics in Northern California ( N =1278). Results Fifty-three percent of respondents reported physical or sexual partner violence, 19% reported experiencing Pregnancy coercion and 15% reported birth control sabotage. One third of respondents reporting partner violence (35%) also reported reproductive control. Both Pregnancy coercion and birth control sabotage were associated with Unintended Pregnancy (AOR 1.83, 95% CI 1.36–2.46, and AOR 1.58, 95% CI 1.14–2.20, respectively). In analyses stratified by partner violence exposure, associations of reproductive control with Unintended Pregnancy persisted only among women with a history of partner violence. Conclusions Pregnancy coercion and birth control sabotage are common among young women utilizing family planning clinics, and in the context of partner violence, are associated with increased risk for Unintended Pregnancy.

Akira Fukao - One of the best experts on this subject based on the ideXlab platform.

  • factors associated with Unintended Pregnancy in yamagata japan
    Social Science & Medicine, 2002
    Co-Authors: Aya Goto, Seiji Yasumura, Michael Reich, Akira Fukao
    Abstract:

    Data on Unintended Pregnancy are scarce in Japan. The purpose of this study is to examine the association of sociodemographic, reproductive, and other health behavioral factors with Unintended Pregnancy. A survey was conducted from May through November 1999 in Yamagata, Japan. We distributed anonymous self-administered questionnaires to cervical and breast cancer screening participants aged 35–49 years. There were 564 eligible women, and the number of respondents was 421 (74.6%). The proportion of women who had experienced Unintended Pregnancy was 46.2%, and 40.1% of them had repeated experiences. Among 312 pre-menopausal married women who did not want to become pregnant, 15.4% were not using any contraception. Factors that were significantly associated with the experience of Unintended Pregnancy were age of husband being 4 or more years older [Odds ratio (OR)=1.83], and age at initiation of sexual intercourse (OR=1.86) and marriage during teens (OR=11.14). Analysis of 1255 pregnancies that the subjects had experienced showed that 51.2% and 25.9% of mistimed and unwanted pregnancies occurred as a result of no contraceptive use, and 39.5% and 71.1% of these ended in abortions. The number of past Unintended pregnancies was significantly (p<0.001) correlated with the number of pregnancies (rs=0.49), live births (rs=0.20) and abortions (rs=0.63). This is the first epidemiological study in Japan to examine factors associated with Unintended Pregnancy, and also contraceptive use and Pregnancy outcome for each of the Unintended Pregnancy women had experienced. Unintended Pregnancy is not a rare event among our target population, and many Unintended pregnancies leading to abortion could be prevented by effective contraceptive use. Results suggest that Yamagata's family planning strategies need to target both the younger and older generations, and address the role of men. A woman’s Pregnancy history reflecting her past experience of Unintended Pregnancy could be used as an indicator for recognizing the woman's need for appropriate contraceptive counseling for the prevention of repeated Unintended pregnancies.

  • Factors associated with Unintended Pregnancy in Yamagata, Japan.
    Social science & medicine (1982), 2002
    Co-Authors: Aya Goto, Seiji Yasumura, Michael Reich, Akira Fukao
    Abstract:

    Data on Unintended Pregnancy are scarce in Japan. The purpose of this study is to examine the association of sociodemographic, reproductive, and other health behavioral factors with Unintended Pregnancy. A survey was conducted from May through November 1999 in Yamagata, Japan. We distributed anonymous self-administered questionnaires to cervical and breast cancer screening participants aged 35–49 years. There were 564 eligible women, and the number of respondents was 421 (74.6%). The proportion of women who had experienced Unintended Pregnancy was 46.2%, and 40.1% of them had repeated experiences. Among 312 pre-menopausal married women who did not want to become pregnant, 15.4% were not using any contraception. Factors that were significantly associated with the experience of Unintended Pregnancy were age of husband being 4 or more years older [Odds ratio (OR)=1.83], and age at initiation of sexual intercourse (OR=1.86) and marriage during teens (OR=11.14). Analysis of 1255 pregnancies that the subjects had experienced showed that 51.2% and 25.9% of mistimed and unwanted pregnancies occurred as a result of no contraceptive use, and 39.5% and 71.1% of these ended in abortions. The number of past Unintended pregnancies was significantly (p