Prospective versus retrospective measurement of unwanted fertility: Strengths, weaknesses, and inconsistencies assessed for a cohort of US women.

BACKGROUND: Unwanted fertility is the key concept necessary to assess the potential impact of more perfect fertility control. Measuring this continues to be a significant challenge, with several plausible competing measurement strategies. Retrospective strategies ask respondents, either during pregnancy or after birth, to recall if they wanted a(nother) birth at conception; these reports are likely to be biased by an unwillingness to label a pregnancy or birth as unwanted (rationalization bias). Prospective strategies avoid this bias by questioning respondents prior to pregnancy, but reports are obtained months or years before pregnancy and so may not accurately reflect wantedness at conception. OBJECTIVE: We describe systematic errors associated with each strategy, show correspondence between strategies, and examine predictors of inconsistency. METHODS: Using the 1979 National Longitudinal Survey of Youth, we compare retrospective and prospective reports for 6,495 births from 3,578 women. RESULTS: The prospective strategy produces a higher percentage of unwanted births than the retrospective strategy. But the two reports of wantedness are strongly associated - especially for the second birth (vs. other births) and for women with stable (vs. unstable) expectation patterns. Nevertheless, discordant reports are common and are predicted by women's characteristics. CONCLUSIONS: Retrospective measures are biased by rationalization; prospective measures are biased when women change their expectations prior to conception. For practical and theoretical reasons, we argue that retrospective measurement is more promising for assessing wantedness. CONTRIBUTION: We highlight shortcomings in both approaches. Demographers may find ways to measure wantedness more accurately, but many of the measurement problems seem intractable.

Trends in Abortion Incidence and Availability in North Carolina, 1980-2013.

OBJECTIVES: Abortion incidence has declined nationally during the last decade. In recent years, many states, including North Carolina, have passed legislation related to the provision of abortion services. Despite the changing political environment, there is no comprehensive analysis on past and current trends related to unintended pregnancy and abortion in North Carolina. METHODS: This study is a secondary analysis of vital registration data made publicly available by the North Carolina State Center for Health Statistics. Birth and induced abortion records were obtained for the years 1980 to 2013. We describe abortion incidence and demographic characteristics of women obtaining abortions over time. RESULTS: The number of North Carolina abortions declined 36% between 1980 and 2013. The abortion ratio declined from 26/100 pregnancies (live births and abortions) in 1980 to just 14/100 in 2013. These ratios, however, vary across demographic subgroups. In 2013, the abortion ratio was more than 2 times greater for non-Hispanic black women than non-Hispanic white women (22 and 9, respectively). Among non-Hispanic black and Hispanic women, the abortion ratio is greater among women with a previous pregnancy as compared with women in their first pregnancy. For non-Hispanic white women, the abortion ratios are similar for first and higher-order pregnancies. CONCLUSIONS: Trends in North Carolina are similar to national trends; however, detailed analyses by race/ethnicity, age, and parity demonstrate important distinctions among abortion patients over time in the state. We discuss these trends in relation to policy changes and increased access to effective contraceptives.

Childless Expectations and Childlessness Over the Life Course.

Using nineteen panels of the 1979 National Longitudinal Survey of Youth (NLSY-79), we construct life-lines characterizing women's childless expectations and fertility behavior. One-quarter of women in the NLSY-79 cohort ever reported an expectation for childlessness but only 14.8 percent of women remain childless. Childless women follow two predominant life course paths: (1) repeated postponement of childbearing and the subsequent adoption of a childless expectation at older ages or (2) indecision about parenthood signaled through vacillating reports of childless expectations across various ages. We also find that more than one in ten women became a mother after considering childlessness: an understudied group in research on childlessness and childbearing preferences. These findings reaffirm that it is problematic to assign expected and unexpected childlessness labels to the reproductive experience of childless women. In addition, despite their variability over time, childless expectations strongly predict permanent childlessness, regardless of the age when respondents offer them. Longitudinal logistic regression analysis of these childless expectations indicates a strong effect of childbearing postponement among the increasingly selective group of childless women. However, net of this postponement, few variables commonly associated with childlessness are associated with reports of a childless expectation. We thus conclude that the effects of socio-demographic and situational factors on childless expectations are channeled predominantly through repeated childbearing postponement.

Selective Versus Generalized Gender Bias in Childhood Health and Nutrition: Evidence from India.

We use data from India's National Family Health Survey (conducted in 1992-93, 1998-99, and 2005-06) to study gender discrimination across India among children aged 0-35 months. We focus on four measures of parental investment: (1) immunization, (2) received medical treatment for acute respiratory infection (ARI), (3) breastfed beyond 17 months, and (4) severe stunting. We contrast generalized discrimination that affects all daughters (vs. sons) with selective discrimination that posits enhanced discrimination among daughters who have sisters. We test which form of discrimination dominates and whether their effects are reinforcing. The main finding from this study is consistent and straightforward: daughters face discrimination relative to sons regardless of sibling composition and at both low and high birth orders. Further, net of general discrimination against daughters, we find little evidence of selective gender discrimination by birth order or sibling composition.

Smoking and Variation in the Hispanic Paradox: A Comparison of Low Birthweight Across 33 US States.

The Hispanic Paradox in birth outcomes is well documented for the US as a whole, but little work has considered geographic variation underlying the national pattern. This inquiry is important given the rapid growth of the Hispanic population and its geographic dispersion. Using birth records data from 2014 through 2016, we document state variation in birthweight differentials between US-born white women and the three Hispanic populations with the largest numbers of births: US-born Mexican women, foreign-born Mexican women, and foreign-born Central and South American women. Our analyses reveal substantial geographic variation in Hispanic immigrant-white low birthweight disparities. For example, Hispanic immigrants in Southeastern states and in some states from other regions have reduced risk of low birthweight relative to whites, consistent with a "Hispanic Paradox." A significant portion of Hispanic immigrants' birthweight advantage in these states is explained by lower rates of smoking relative to whites. However, Hispanic immigrants have higher rates of low birthweight in California and several other Western states. The different state patterns are largely driven by geographic variation in smoking among whites, rather than geographic differences in Hispanic immigrants' birthweights. In contrast, US-born Mexicans generally have similar or slightly higher odds of low birthweight than whites across the US. Overall, we show that the Hispanic Paradox in birthweight varies quite dramatically by state, driven by geographic variation in low birthweight among whites associated with white smoking disparities across states.

Pathways of Health and Human Capital from Adolescence into Young Adulthood.

Social inequalities in health and human capital are core concerns of sociologists, but little research examines the developmental stage when such inequalities are likely to emerge-the transition to adulthood. With new data and innovative statistical methods we conceptually develop, and empirically operationalize, pathways of physical health and human capital accumulation from adolescence into young adulthood, using an autoregressive cross-lagged structural equation model. Results reveal that pathways of health and human capital accumulate at differential rates across the transition to adulthood; evidence of cross-lagged effects lend support for both social causation and health selection hypotheses. We then apply this model to assess the presence of social inequality in metabolic syndrome-the leading risk factor of cardiovascular disease in the U.S. Findings document social stratification of cardiovascular health that is robust to both observed and unobserved social and health selection mechanisms. We speculate that this social stratification will only increase as this cohort ages.

The relationship between early childhood blood lead levels and performance on end-of-grade tests.

BACKGROUND: Childhood lead poisoning remains a critical environmental health concern. Low-level lead exposure has been linked to decreased performance on standardized IQ tests for school-aged children. OBJECTIVE: In this study we sought to determine whether blood lead levels in early childhood are related to educational achievement in early elementary school as measured by performance on end-of-grade (EOG) testing. METHODS: Educational testing data for 4th-grade students from the 2000-2004 North Carolina Education Research Data Center were linked to blood lead surveillance data for seven counties in North Carolina and then analyzed using exploratory and multivariate statistical methods. RESULTS: The discernible impact of blood lead levels on EOG testing is demonstrated for early childhood blood lead levels as low as 2 microg/dL. A blood lead level of 5 microg/dL is associated with a decline in EOG reading (and mathematics) scores that is roughly equal to 15% (14%) of the interquartile range, and this impact is very significant in comparison with the effects of covariates typically considered profoundly influential on educational outcomes. Early childhood lead exposures appear to have more impact on performance on the reading than on the mathematics portions of the tests. CONCLUSIONS: Our emphasis on population-level analyses of children who are roughly the same age linked to previous (rather than contemporaneous) blood lead levels using achievement (rather than aptitude) outcome complements the important work in this area by previous researchers. Our results suggest that the relationship between blood lead levels and cognitive outcomes are robust across outcome measures and at low levels of lead exposure.

THE SECOND DEMOGRAPHIC TRANSITION THEORY: A Review and Appraisal.

References to the second demographic transition (SDT) concept/theoretical framework have increased dramatically in the last two decades. The SDT predicts unilinear change toward very low fertility and a diversity of union and family types. The primary driver of these changes is a powerful, inevitable and irreversible shift in attitudes and norms in the direction of greater individual freedom and self-actualization. First, we describe the origin of this framework and its evolution over time. Second, we review the empirical fit of the framework to major changes in demographic and family behavior in the U.S., the West, and beyond. As has been the case for other unilinear, developmental theories of demographic/family change, the SDT failed to predict many contemporary patterns of change/difference. Finally, we review previous critiques and identify fundamental weaknesses of this perspective, and provide brief comparisons to selected alternative approaches.

Trajectories of Unintended Fertility.

Having an unintended birth is strongly associated with the likelihood of having later unintended births. We use detailed longitudinal data from the Add Health Study (N=8,300) to investigate whether a host of measured sociodemographic, personality, and psychosocial characteristics select women into this "trajectory" of unintended childbearing. While some measured characteristics and aspects of the unfolding life course are related to unintended childbearing, explicitly modeling these effects does not greatly attenuate the association of an unintended birth with a subsequent one. Next, we statistically control for unmeasured time invariant covariates that affect all birth intervals, and again find that the association of an unintended birth with subsequent ones remains strong. This persistent, strong association may be the direct result of experiencing an earlier unplanned birth. We propose several mechanisms that might explain this strong association.

In the Pursuit of Sons: Additional Births or Sex-Selective Abortion in Pakistan?

Even though Pakistan is a highly patriarchal society, it has not featured prominently in studies focusing on sex-selective abortion and sex ratios at birth. But with fertility declining and existing strong son preference-Pakistan has one of the highest desired sex ratios in the world-how will Pakistani families respond? In the pursuit of sons, will they have additional children or resort to sex-selective abortions? Or is there evidence that the pursuit of sons is weakening? Using data from three rounds of the demographic and health survey, we show clear evidence of son preference in fertility intentions, patterns of contraceptive use and parity progression ratios. More specifically, we find pervasive evidence that Pakistanis continue childbearing to have a son, to have more than one son and to have at least one daughter. We do not find consistent and convincing evidence that sex ratios at birth (which indicate sex-selective abortion) are increasing.

A Case for "Reverse One-Child" Policies in Japan and South Korea? Examining the Link between Education Costs and Lowest-Low Fertility.

Household spending on children's pre-tertiary education is exceptionally high in Japan and South Korea, and has been cited as a cause of low fertility. Previous research attributes this high spending to a cultural emphasis on education in East Asian countries. In this paper, we argue that institutional factors, namely higher education and labor market systems, play an important role in reinforcing the pressure on parents to invest in their children's education. We review evidence showing that graduating from a prestigious university has very high economic and social returns in Japan and South Korea, and examine the implications for fertility within the framework of quantity-quality models. Finally, we put forward 'reverse one-child' policies that directly address the unintended consequences of these institutional factors on fertility. These policies have the additional virtues of having very low fiscal requirements and reducing social inequality.

EMERGING PARENTAL GENDER INDIFFERENCE? SEX COMPOSITION OF CHILDREN AND THE THIRD BIRTH.

For much of the twentieth century, parents in the United States with two children of the same sex were more likely to have a third child than were parents with one son and one daughter, that is, there was an effect of the sex of previous children on the occurrence of a third birth. Using multiple cycles of the Current Population Survey and National Survey of Family Growth, the authors examine the strength of this effect on both fertility behavior and intentions over multiple decades. Changes in the societal gender system are expected to weaken this pronatalist effect in recent periods. Consistent with this expectation, there has been some attenuation of the effect of sex composition of previous children on the third birth, suggesting declining salience of children's gender for parents.

The determinants of low fertility in India.

Using a conceptual framework focusing on factors that enhance or reduce fertility relative to desired family size (see Bongaarts 2001), we study fertility variation across time (1992-2006) and space (states) in India. Our empirical analyses use data from three waves of the Indian National Family Health Surveys. We find that this framework can account for a substantial portion of the variation in the total fertility rate (TFR) over time and across states. Our estimates focus attention on the critical components of contemporary Indian fertility, especially desired family size, unwanted fertility, son preference, and fertility postponement.

A Cognitive-Social Model of Fertility Intentions.

We examine the use and value of fertility intentions against the backdrop of theory and research in the cognitive and social sciences. First, we draw on recent brain and cognition research to contextualize fertility intentions within a broader set of conscious and unconscious mechanisms that contribute to mental function. Next, we integrate this research with social theory. Our conceptualizations suggest that people do not necessarily have fertility intentions; they form them only when prompted by specific situations. Intention formation draws on the current situation and on schemas of childbearing and parenthood learned through previous experience, imbued by affect, and organized by self-representation. Using this conceptualization, we review apparently discordant knowledge about the value of fertility intentions in predicting fertility. Our analysis extends and deepens existing explanations for the weak predictive validity of fertility intentions at the individual level and provides a social-cognitive explanation for why intentions predict as well as they do. When focusing on the predictive power of intentions at the aggregate level, our conceptualizations lead us to focus on how social structures frustrate or facilitate intentions and how the structural environment contributes to the formation of reported intentions in the first place. Our analysis suggests that existing measures of fertility intentions are useful but to varying extents and in many cases despite their failure to capture what they seek to measure.

A Multistate Life Table Analysis of Union Regimes in the United States: Trends and Racial Differentials, 1970-2002.

We estimate trends and racial differentials in marriage, cohabitation, union formation and dissolution (union regimes) for the period 1970-2002 in the United States. These estimates are based on an innovative application of multistate life table analysis to pooled survey data. Our analysis demonstrates (1) a dramatic increase in the lifetime proportions of transitions from never-married, divorced or widowed to cohabiting; (2) a substantial decrease in the stability of cohabiting unions; (3) a dramatic increase in mean ages at cohabiting after divorce and widowhood; (4) a substantial decrease in direct transition from never-married to married; (5) a significant decrease in the overall lifetime proportion of ever marrying and re-marrying in the 1970s to 1980s but a relatively stable pattern in the 1990s to 2000-2002; and (6) a substantial decrease in the lifetime proportion of transition from cohabiting to marriage. We also present, for the first time, comparable evidence on differentials in union regimes between four racial groups.

Below replacement fertility preferences in Shanghai.

China has joined the group of low-fertility countries; it has a TFR somewhere in the range of 1.4 to 1.6. Much speculation about China's future fertility depends on whether individual's fertility intentions and preferences are much higher than the state's fertility goals. If so, then a relaxation of family planning restrictions could lead to a substantial fertility increase. We directly ask a probability sample of Shanghai registered residents and migrants whether a policy relaxation would lead them to have additional children. Our results show that small families (one or two children) are intended in this urban setting. If family planning policy were relaxed, a relatively small fraction (fewer than 14%) reports that they would revise their intentions upward. Even this modest increase (as much as 10%) is suspect because factors that can deflate fertility relative to intentions are likely more powerful than the inflationary ones (in Shanghai). These empirical findings help ground speculations on the future of fertility in the hypothetical absence of policy constraints.

Child-care availability and fertility in Norway.

The child-care and fertility hypothesis has been in the literature for a long time and is straightforward: As child care becomes more available, affordable, and acceptable, the antinatalist effects of increased female educational attainment and work opportunities decrease. As an increasing number of countries express concern about low fertility, the child-care and fertility hypothesis takes on increased importance. Yet data and statistical limitations have heretofore limited empirical tests of the hypothesis. Using rich longitudinal data and appropriate statistical methodology, We show that increased availability of child care increases completed fertility. Moreover, this positive effect of child-care availability is found at every parity transition. We discuss the generalizability of these results to other settings and their broader importance for understanding variation and trends in low fertility.

Family Change and Continuity in Iran: Birth Control Use Before First Pregnancy.

Using data from the 2002 Iran Fertility Transition Survey, we examined birth control use between marriage and first pregnancy. We focused on the post-1990 increase in birth control use and develop two explanations. The first posits that birth control use reflects a new marriage form, the conjugal marriage, which places a heightened value on the spousal relationship while deemphasizing the centrality of parenthood. A second explanation stresses the use of a new resource, effective birth control, within an Iranian-Islamist view of marriage. Key to this explanation is the role of the state-Iranian political/religious actors encourage early marriage and the use of birth control. Although the explanations could be complementary, evidence provides more support for the latter.

The quality of retrospective data on cohabitation.

We assess the quality of retrospective data on cohabitation by comparing data collected in four major U.S. family surveys: the National Survey of Families and Households and three rounds of the National Survey of Family Growth. We use event-history analysis to analyze rates of entry into cohabitation in age-period-cohort segments captured by multiple surveys. We find consistent discrepancies among the four surveys. The pattern of differences suggests that cohabitation histories underestimate cohabitation rates in distant periods relative to rates estimated closer to the date of survey. We conclude with cautions regarding the use of retrospective data on cohabitation.

Intergenerational fertility among Hispanic women: new evidence of immigrant assimilation.

In recent decades, rapid growth of the U.S. Hispanic population has raised concerns about immigrant adaptation, including fertility. Empirical research suggests that Hispanics, especially Mexicans, might not be following the historical European pattern of rapid intergenerational fertility decline (and convergence toward native levels). If confirmed, continued high Hispanic fertility could indicate a broader lack of assimilation into mainstream American society. In this paper, we reexamine the issue of Hispanic and Mexican fertility using an approach that combines biological and immigrant generations to more closely approximate a comparison of immigrant women with those of their daughters' and granddaughters' generation. Contrary to cross-sectional results, our new analyses show that Hispanic and Mexican fertility is converging with that of whites, and that it is similarly responsive to period conditions and to women's level of education. In addition, we employ a mathematical simulation to illustrate the conditions under which cross-sectional analyses can produce misleading results. Finally, we discuss the import of the fertility convergence we document for debates about immigrant assimilation.