Intersection of fertility desires &FP use on childbearing behaviors: Longitudinal study from urban Uttar Pradesh, India

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.