Suchergebnisse

Power dynamics in social interactions likely affect individuals' ability to use their preferred contraception, yet research has primarily emphasized financial barriers. Using data from a national survey of people assigned female at birth, we apply a social-ecological framework to assess a broader range of factors shaping nonpreferred use. Over one-quarter of respondents were not using their preferred method; among them, nearly half preferred vasectomy, condoms, or withdrawal. Partner disagreement was the most common reason for nonpreferred use and was associated with experiencing partner contraceptive coercion. Black women, who face structural racism in the health care system, were more likely to attribute their nonpreferred use to a provider's recommendation. These findings demonstrate how gender and power shape contraceptive use despite the preferences of those at risk of pregnancy, highlighting the need for cultural, policy, and health care shifts to resolve contraceptive preference-use discordance and increase gender equity in the responsibility of pregnancy prevention.

Widely used dichotomous categorical measures of pregnancy intentions do not represent well the complexity of factors involved in women's intentions. We used a variety of exploratory statistical methods to examine measures of pregnancy intention in the 2002 National Survey of Family Growth (N = 3,032 pregnancies). Factor analyses identified two key dimensions of pregnancy intentions (desire and mistiming) and two smaller nondimensional categories (overdue and don't care). Desire included both affective and cognitive variables, as well as partner‐specific factors. Similar pregnancy‐intention dimensions were found for adolescent and adult women, across socioeconomic status, and among racial and ethnic groups. Both desire and mistiming were highly predictive of the decision to abort or continue the pregnancy. These analyses strongly support prior demographic thinking about the importance of both the timing of pregnancy and wanting a baby, but suggest that multidimensional rather than simple categorical measures of pregnancy intentions should be used.