Contraceptive Consistency and Poverty after Birth.

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=2,101) and National Survey of Family Growth (n=778), we constructed two-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.

Women's Use of Long-Acting Reversible Contraception for Birth Timing and Birth Stopping.

The use of long-acting reversible contraceptive (LARC) methods-intrauterine devices (IUDs) and implants-has recently expanded rapidly in the United States, and these methods together approach the contraceptive pill in current prevalence. Research on LARCs has analyzed their use to reduce unintended pregnancies but not their use to enable intended pregnancies. Knowledge of both is necessary to understand LARCs' potential impacts on the reproductive life courses of U.S. women. We combine data from two nationally representative surveys to estimate women's likelihood and timing of subsequent reproductive events, including births resulting from an intended pregnancy up to nine years after discontinuing LARC use. We estimate that 62% of women will give birth, and 45% will give birth from an intended pregnancy. Additionally, 18% will have a new LARC inserted, and 13% will transition to sterilization. Most of these reproductive events occur within two years after discontinuing LARC use. Births from an intended pregnancy are especially common when no intervening switch to another contraceptive method occurs. We infer that women's motives for using LARC are varied but include the desire to postpone a birth, to postpone a decision about whether to have a(nother) birth, and to transition definitively to the completion of childbearing.