Examining the Association between Socio-Demographic Variables and the Use of Contraception Before and After Abortion in the United States Using the 2006-2010 National Survey of Family Growth Open Access

Hoyte, Tiffany (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/9k41zd98q?locale=en



Background: Unintended pregnancies present a significant cost to the health care system in the U.S. that can be markedly reduced by improving access to and utilization of effective contraception. Nearly half of all pregnancies in the U.S. are unintended and of these 43% end in abortion with 47% of all abortions being repeat procedures. Use of effective contraception post-abortion is essential in preventing a repeat unintended pregnancy and repeat abortion.
Objective: To determine the contraceptive prevalence of women pre and post abortion and determine which socio-demographic factors are associated with using more effective contraceptive methods post-abortion compared to pre-abortion using data from the 2006 to 2010 National Survey of Family Growth (NSFG).
Methods: Data was obtained from the 2006-2010 NSFG, which conducted a nationally representative, area probability sample of 12,279 women age 15-44 years in the U.S. Multivariate linear regression was performed to determine which selected socio-demographic factors are the best predictors of the use or non-use of contraception pre-abortion and post-abortion and of the effectiveness of contraception used before and after abortion. Chi-square tests were also performed to determine if there was an association between each socio-demographic variable and the effectiveness of contraception used.
Results: Most (56.1%) women at risk of unintended pregnancy in the U.S. use a moderately effective form of contraception and among those who have had an abortion 39.2% use a highly effective form of contraception. It is concerning that 31.4% of women chose to use no method of contraception post-abortion. Informal marital status and total number of births were associated with the effectiveness of contraception chosen pre-abortion and race and total number of births were associated with effectiveness of contraception chosen post-abortion.
Discussion: The association of higher abortion rates and higher rates of unintended pregnancies occurring among women of certain socio-demographic characteristics suggests that the key to reducing abortion rates lies in improving family planning among these vulnerable groups. Emphasis should be placed on reducing barriers to contraceptive access especially for these groups of women and family planning providers should help clients to identify methods that they are most likely to use successfully.

Table of Contents

Table of Contents

Chapter 1: Introduction 1

1.1 Background 1

1.2 Problem Statement 3

1.3 Purpose 4

1.4 Research Questions 4

1.5 Significance 5

Chapter 2: Literature Review 9

2.1 Unintended Pregnancy and Induced Abortion in the U.S. 9

2.2 Role of Contraception in Preventing Unintended Pregnancy and Induced Abortion 15

2.3 Pre and Post Abortion Contraceptive use in the U.S. 20

Chapter 3: Methodology 24

3.1 The National Survey of Family Growth 24

3.2 Sampling Design 24

3.3 Data Collection 26

3.4 Data Analysis 27

Chapter 4: Results 31

4.1 Induced Abortions 31

4.2 Socio-demographic Characteristics 34

4.3 Use of Contraception 36

Chapter 5: Discussion 40

5.1 Discussion 40

5.2 Limitation 46

Chapter 6: Conclusion and Recommendations 48

References 50

Appendix 54

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