Reproductive ambivalence and uncertainty

Trussell et al.’s provocative analysis of women’s classifications of contraceptive failures from the 1995 NSFG found inconsistent retrospective reporting of intentions and feelings. Looking to the 2006-2010 NSFG, we find that such incongruent reporting of happiness about pregnancies resulting from contraceptive failure is more prevalent among Latina women. Is this a function of ambivalence about avoiding pregnancy, retrospective bias, or a meaningful distinction between happiness and intention?
Using prospective data from the Border Contraceptive Access Study, we shed new light on Trussell et al.’s apparent paradox. We find that incongruent happiness and intention, rather than constituting ambivalence, reflect distinct concepts for Latinas. Wanting no more pregnancies, and using contraception to implement such intentions is not incompatible with positive feelings about pregnancy, and such happiness may reflect cultural influence, and the impact of pregnancy on relationship wellbeing. Retrospectively reported intentions show considerable bias, but the majority of retrospective happiness is consistent with prospective feelings, suggesting that happiness is not merely an artifact of retrospective reporting. Findings have implications for the meaning and measurement of unintended pregnancy in national surveys like NSFG and PRAMS.

Despite large differences in total fertility, there are strong similarities in the patterns of family building across sub-Saharan Africa. In this paper we argue that these patterns of family building and the persistence of high to medium-high fertility regimes across the region can be understood better if the institutional context in which African women’s childbearing occurs is not neglected. In this paper, we argue that historical institutions affecting attitudes towards childbearing, combined with contemporary social, political and economic uncertainty and institutional capriciousness, have inhibited the African fertility transition. Until these institutional dynamics are better understood and engaged with, Africa’s fertility decline will remain slow.

Unmet need for family planning (FP) is commonly used as an indicator of gaps in FP services. The measure of unmet need relies on women’s reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm. Our study uses recently collected longitudinal data from four cities in urban Uttar Pradesh India to examine whether women’s fertility desires and contraceptive practices at baseline predict pregnancy/birth experience in the two-year follow-up period. We demonstrate that those women who at baseline reported a desire to stop childbearing or a desire to delay childbearing 2+ years and were using any method of FP were the least likely to have experienced a pregnancy/birth by two-year follow-up. Women who were non-users and wanted to delay or limit at baseline were significantly more likely to have had a pregnancy/birth in the two-year follow-up. Ninety percent of pregnancies/births over the follow-up period are considered “wanted then” suggesting post-hoc rationalization of pregnancies/births even among those women who reported a desire to delay or stop childbearing two years earlier. Non-users may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined.

This paper examines changes over time in the proportion of women's non-numeric responses to questions about desired family size. Such responses have often been interpreted through the lens of classical demographic transition theory, as an indication that reproduction has not yet entered into the "calculus of conscious choice" (Coale 1973:65). Yet non-numeric desired family size has rarely been investigated in a cross-national framework, and never across time. Thus we know little about the processes underlying changes in these responses. This study uses over 15 years of DHS data from 33 countries representing three world regions. Taking a multi-level modeling approach, we use country- and individual-level indicators to examine the factors associated with non-numeric IFS. We then examine how the relationship between non-numeric IFS and individual- and country-level predictors changes over time. Results suggest that education and knowledge of contraception have the most salient associations with non-numeric IFS; with both being negatively associated with this type of response. While the overall effect of education remains consistently strong over time, we find evidence to suggest the the association between non-numeric responses and knowledge of modern contraception decreases over time.