Assessing Trends in the Desire to Avoid Pregnancy: A Cautionary Note.

The desire to avoid pregnancy-to delay the next birth or have no further births-is a fundamental sexual and reproductive health indicator. We show that two readily available measures-prospective fertility preferences and the demand for contraception [Demand] construct-provide substantially different portraits of historical trends. They also yield correspondingly different assessments of the sources of contraceptive change.

Traditional supports and contemporary disrupters of high fertility desires in sub-Saharan Africa: a scoping review.

Rationale: The desired number of children is markedly higher in Sub-Saharan Africa (SSA) than in other major regions. Efforts to understand how and why these desires are generated and maintained have yielded a broad research literature. Yet there is no full picture of the range of contextual, cultural, and economic factors that support and disrupt high fertility desires.

Women's beliefs about methods and contraceptive discontinuation: Results from a prospective study from Nairobi and Homa Bay counties in Kenya.

Background: Rates of contraceptive discontinuation are high in many low and middle countries contributing to unmet need for contraception and other adverse reproductive health outcomes. Few studies have investigated how women's beliefs about methods and strength of fertility preferences affect discontinuation rates. This study examines this question using primary data collected in Nairobi and Homa Bay counties in Kenya.

Factors associated with never-use of long-acting reversible contraception among adult reproductive-aged women in Ohio.

Background: The number of women using long-acting reversible contraception (LARC)-intrauterine devices (IUDs) and implants-is increasing and 14% of contraceptive users in the United States adopt LARC. We examined correlates of LARC never-use in a population-based survey of reproductive-aged women in Ohio.

Methods: We analyzed data from the 2018-19 Ohio Survey of Women.

Fertility Preferences and Contraceptive Change in Low- and Middle-Income Countries.

The past four decades have witnessed an enormous increase in modern contraception in most low- and middle-income countries. We examine the extent to which this change can be attributed to changes in fertility preferences versus fuller implementation of fertility preferences, a distinction at the heart of intense debates about the returns to investments in family planning services. We analyze national survey data from five major survey programs: World Fertility Surveys, Demographic Health Surveys, Reproductive Health Surveys, Pan-Arab Project for Child Development or Family Health, and Multiple Indicator Cluster Surveys.

Multiple Perspectives on Recent Trends in Unwanted Fertility in Low- and Middle-Income Countries.

The last four decades have witnessed large declines in fertility globally. This study uses data from 78 low- and middle-income countries to examine concurrent trends in unwanted fertility. Three measures of unwanted fertility are contrasted: the conventional unwanted total fertility rate, a proposed conditional unwanted fertility rate, and the percentage of births unwanted.

Passage of abortion ban and women's accurate understanding of abortion legality.

Background: Legislative and judicial procedures related to banning abortion after 6 weeks of gestation in Ohio occurred from November 2018 to July 2019. These activities could have increased the belief that abortion has become illegal even though the 6-week abortion ban has never been in effect to date.

Objective: We sought to determine the prevalence and correlates of holding the belief that abortion is illegal in Ohio and to evaluate whether this belief increased over the time in which the 6-week abortion ban was introduced, passed twice, and then blocked in Ohio.

Fertility preferences and subsequent childbearing in Africa and Asia: A synthesis of evidence from longitudinal studies in 28 populations.

delay stop .

Contraceptive Method Attributes and Married Women's Intention to Use the Pill or the Injectable in Rural Bangladesh.

Context: The factors underlying contraceptive method choice are poorly understood in many countries, including Bangladesh. It is important to understand how Bangladeshi women's perceptions of a method's attributes are associated with their intention to use that method.

Methods: Data on 2,605 married women aged 15-39 living in rural Matlab were taken from a baseline survey conducted in 2016.

Method-Specific Attributes that Influence Choice of Future Contraception Among Married Women in Nairobi's Informal Settlements.

Despite an extensive evidence base on contraceptive method choice, it remains uncertain which factors are most influential in predisposing women toward certain methods and against others. This paper addresses this gap in knowledge by making use of rarely-measured perceptions about specific methods, perceived social network experience of methods, and women's own past experiences using specific methods. We draw on baseline data from the project, "Improving Measurement of Unintended Pregnancy and Unmet Need for Family Planning.

Women's attitudes and beliefs towards specific contraceptive methods in Bangladesh and Kenya.

Background: Missing from the huge literature on women's attitudes and beliefs concerning specific contraceptive methods is any detailed quantitative documentation for all major methods in low- and middle-income countries. The objectives are to provide such a documentation for women living in Matlab (rural Bangladesh), Nairobi slums and Homa Bay (rural Kenya) and to compare the opinions and beliefs of current, past and never users towards the three most commonly used methods (oral contraceptives, injectables and implants).

Methods: In each site, 2424 to 2812 married women aged 15-39 years were interviewed on reproduction, fertility preferences, contraceptive knowledge and use, attitudes and beliefs towards family planning in general and specific methods.

Reasons for unmet need for family planning, with attention to the measurement of fertility preferences: protocol for a multi-site cohort study.

Background: Unmet need for family planning points to the gap between women's reproductive desire to avoid pregnancy and contraceptive behaviour. An estimated 222 million women in low- and middle-income countries have unmet need for modern contraception. Despite its prevalence, there has been little rigorous research during the past fifteen years on reasons for this widespread failure to implement childbearing desires in contraceptive practice.

Unmet need and fertility decline: a comparative perspective on prospects in sub-Saharan Africa.

This study assesses how changes in unmet need for family planning have contributed to contemporary fertility declines, and the implications of this historical record for further fertility decline, especially in sub-Saharan Africa. We examine joint trends at the national level in fertility, unintended fertility, and unmet need. We bring unintended fertility into the analysis because the underlying rationale for reducing unmet need is to avert unintended pregnancies and births.

Understanding unmet need: history, theory, and measurement.

During the past two decades, estimates of unmet need have become an influential measure for assessing population policies and programs. This article recounts the evolution of the concept of unmet need, describes how demographic survey data have been used to generate estimates of its prevalence, and tests the sensitivity of these estimates to various assumptions in the unmet need algorithm. The algorithm uses a complex set of assumptions to identify women: who are sexually active, who are infecund, whose most recent pregnancy was unwanted, who wish to postpone their next birth, and who are postpartum amenorrheic.

Migration and Marriage: Modeling the Joint Process.

Background: Previous research on inter-relations between migration and marriage has relied on overly simplistic assumptions about the structure of dependency between the two events. However, there is good reason to posit that each of the two transitions has an impact on the likelihood of the other, and that unobserved common factors may affect both migration and marriage, leading to a distorted impression of the causal impact of one on the other.

Objective: We will investigate relationships between migration and marriage in the United States using data from the National Longitudinal Survey of Youth 1979.

The time dynamics of individual fertility preferences among rural Ghanaian women.

Fertility preferences are revised in the light of changing life and reproductive circumstances. Over time, an individual's fertility preferences may fluctuate along a continuum. In this study, we describe typical patterns of change (or stability) in individual fertility preferences over a period of five years using a prospective panel study of women of reproductive age in six communities in southern Ghana.

Examining the predictive value of fertility preferences among Ghanaian women.

Despite extensive research, doubts remain regarding the degree of correspondence between prior stated fertility preferences and subsequent fertility behavior. Preference instability is a factor that potentially undermines predictiveness. Furthermore, if other predictors of fertility substantially explain fertility, then knowledge of preferences may contribute little to explaining or predicting individual fertility behavior.

The estimation of unwanted fertility.

The estimation of unwanted fertility is a major objective of demographic surveys, including DHS surveys conducted in Asia, Africa, and Latin America. Levels and trends in unwanted fertility are important input to the formulation of population policy and the evaluation of family planning programs. Yet existing methods for estimating unwanted fertility are known to be defective, among other reasons because they rely on subjective data whose validity and reliability are questionable.

Unmet need and unintended fertility: longitudinal evidence from upper Egypt.

Context: Although unmet need for family planning is a standard measure for evaluating programs' effectiveness in meeting the reproductive needs of individuals, its validity and accuracy in identifying women most at risk of unintended pregnancy have been questioned.

Methods: Women who participated in the 1995 Egypt Demographic and Health Survey in two governorates in Upper Egypt (Assuit and Souhag) were followed for two years (N=2,444); in-depth data on their fertility preferences, contraceptive use and births were gathered in 1996 and 1997. Transitions among contraceptive need categories from 1995 to 1997 are examined, and rates of unintended (mistimed and unwanted) births are calculated according to contraceptive need status at baseline.