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Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use
- American Journal of Public Health
, 2007
"... Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive ri ..."
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Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effec-tiveness of contraceptive use among sexually active adolescents (including nonuse), and the overall pregnancy risk index, calculated according to the contraceptive risk index score and the percentage of individuals reporting sexual activity. Results. The contraceptive risk index declined 34 % overall and 46 % among adolescents aged 15 to 17 years. Improvements in contraceptive use included increases in the use of condoms, birth control pills, withdrawal, and multiple methods and a decline in nonuse. The overall pregnancy risk index declined 38%, with 86 % of the decline attributable to improved contraceptive use. Among ado-lescents aged 15 to 17 years, 77 % of the decline in pregnancy risk was attributa-ble to improved contraceptive use. Conclusions. The decline in US adolescent pregnancy rates appears to be fol-lowing the patterns observed in other developed countries, where improved con-traceptive use has been the primary determinant of declining rates. (Am J Pub-
Planned Parenthood? Fertility Intentions and Experiences Among Cohabiting Couples
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The online version of this article can be found at:
Contraceptive failure rates in France: results from a population-based survey
"... BACKGROUND: Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65 % occur while using contraceptives. In the USA, 49 % of pregnancies are unin-tended, half of which result from contraceptive failure. This study provi ..."
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BACKGROUND: Despite the widespread use of highly effective contraceptive methods in France, one in every three pregnancies is unintended, of which 65 % occur while using contraceptives. In the USA, 49 % of pregnancies are unin-tended, half of which result from contraceptive failure. This study provides estimates of method-specific failure rates among French women. METHODS: We use data from the 2000 Cocon Study, a population-based cohort, comprising a representative sample of 1689 women aged 18–44 years who described their contraceptive history. Piecewise-constant hazards models were used to estimate method-specific contraceptive failure rates during the first 5 years of contraceptive use. A random effect was introduced to take into account the fact that somewomen contributemore than 1 contraceptive episode. These same models were used to assess the effects of socio-demographic characteristics on the probability of contraceptive failure among pill, intrauterine device (IUD) and condom users. RESULTS: Overall, 2.9 % of women experienced a contraceptive failure in the first year of use and 8.4 % in the first 5 years of use. The IUD had the lowest first year failure rate (1.1%), followed by the pill (2.4%), the condom (3.6%), fertility awareness methods (per-iodic abstinence or safe period by temperature) (7.7%), withdrawal (10.1%) and spermicides (21.7%). These failure rates varied little by user characteristics. CONCLUSIONS: Lower failure rates among French women compared with those reported for US women suggest differences in contraceptive practices which need to be further explored.
Contraception at the time of abortion: high-risk time or high-risk women?
"... BACKGROUND: Despite the widespread use of highly effective contraception in France, the incidence of abortion is high. A retrospective population-based cohort study was designed to analyse women’s contraceptive history. METHOD: We compared the contraceptive use of 163 women, whose last pregnancy end ..."
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BACKGROUND: Despite the widespread use of highly effective contraception in France, the incidence of abortion is high. A retrospective population-based cohort study was designed to analyse women’s contraceptive history. METHOD: We compared the contraceptive use of 163 women, whose last pregnancy ended in abortion, 6 months before, at the time of, 1 month and 6 months after the event with that of 1787 women who had never had an abortion. RESULTS: A total of 46 % of women who experienced an abortion used a highly effective form of contraception 6 months before the event (versus 76 % among women who had never had an abortion, P < 0.001). This proportion dropped to 33 % at the time of the abortion and increased to 71%, 1 month after. In addition, 50 % of women who had an abortion had changed their contraceptive method in the 6 months before the event (compared with 16 % in the 6 months before the interview in women who had not had an abortion, P < 0.001). Women with socially deprived back-grounds were less likely to use a highly effective contraception after an abortion. CONCLUSIONS: Abortion is a good opportunity for intervention, but especially so for socially disadvantaged women. It is essential to draw the
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"... Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive ri ..."
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Objectives. We explored the relative contributions of declining sexual activity and improved contraceptive use to the recent decline in adolescent pregnancy rates in the United States. Methods. We used data from 1995 and 2002 for women 15 to 19 years of age to develop 2 indexes: the contraceptive risk index, summarizing the overall effec-tiveness of contraceptive use among sexually active adolescents (including nonuse), and the overall pregnancy risk index, calculated according to the contraceptive risk index score and the percentage of individuals reporting sexual activity. Results. The contraceptive risk index declined 34 % overall and 46 % among adolescents aged 15 to 17 years. Improvements in contraceptive use included increases in the use of condoms, birth control pills, withdrawal, and multiple methods and a decline in nonuse. The overall pregnancy risk index declined 38%, with 86 % of the decline attributable to improved contraceptive use. Among ado-lescents aged 15 to 17 years, 77 % of the decline in pregnancy risk was attributa-ble to improved contraceptive use.
Journal of Family Issues
"... Most research on nonmarital births focuses on disadvantaged populations. This study examined the childbearing expectations and experiences of a working-class sample, drawing on in-depth interviews with 30 cohabiting couples. Few couples in the sample were attempting to conceive; most desired to defe ..."
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Most research on nonmarital births focuses on disadvantaged populations. This study examined the childbearing expectations and experiences of a working-class sample, drawing on in-depth interviews with 30 cohabiting couples. Few couples in the sample were attempting to conceive; most desired to defer parenting. Three responses emerged to how a pregnancy would be resolved. The largest group would be dismayed but would bear the child. A smaller set indicated that it would terminate a pregnancy. The third group disagreed on the outcome. Relationship context and partner attributes were key factors in fertility decisions. Couples who believed that they had a future together were most likely to agree that they would have the child, though not necessarily preceded by marriage; they were the most consistent users of contraception. Couples of the second and third groups (termination, nonconcurrence) were less regular or less effective contraceptors. Results are discussed in light of public policy interest in reducing nonmarital births.
ORIGINAL ARTICLE Fertility control Frequency of discontinuation of
"... contraceptive use: results from a ..."
106 International Family Planning Perspectives
"... In recent decades, abortion has received considerable at-tention, and its legality and availability have often gener-ated controversy. Even in countries where abortion is not a contentious issue, contraception is usually a less expen-sive and less taxing means of avoiding unintended births. Accurate ..."
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In recent decades, abortion has received considerable at-tention, and its legality and availability have often gener-ated controversy. Even in countries where abortion is not a contentious issue, contraception is usually a less expen-sive and less taxing means of avoiding unintended births. Accurate information on abortion levels and trends can help donors, policymakers and program planners assess the ex-tent to which women experience unintended pregnancies, and can facilitate the development of policies and programs to respond to unmet need for effective contraceptive ser-vices. Accurate measures of abortion can also inform the public discourse by providing impartial, empirical evidence of abortion prevalence. The last assessment of abortion levels in countries where legal abortion is generally available * was conducted near-
High rate of unintended pregnancy among pregnant women in a
, 2009
"... maternity hospital in Córdoba, Argentina: a pilot study ..."
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Contraception – Unplanned Pregnancy – Emergent AdulthoodUNLOCKING THE CONTRACEPTION CONUNDRUM Brief Table of Contents Preface
"... Unlocking the contraceptive conundrum ..."
