Policies, Disparities, and Outcomes Affecting Childbearing Restricted; Files Only

Abstract

Over the past 40 years, there has been a dramatic shift in the way America builds families. Improvements in access to contraception and abortion have led to a decline in unwanted and underaged pregnancies, and rising costs, education, and employment have led to delays in motherhood, leading to increases in self-reported infertility. Technology has advanced to medically assist those struggling to conceive, but has policy kept up with these shifts, and is access equitable?

Fundamentally, the methods and age with which women choose to start their families has changed. This dissertation explores various aspects of this new reality: declining teen birth rates and an increasing reliance on fertility treatments to conceive. I examine the policies that have affected these changes, including the HOPE College Scholarship program’s impact on teen births, and private insurance mandates’ impacts on fertility rates and fertility service utilization. I also examine the racial disparities in access to fertility service utilization, and what barriers persist in overcoming these disparities.

Table of Contents

HOPE for a Brighter Future: Evaluating the Impact of the Georgie HOPE Scholarship on Teen Birth Rates 8

Introduction. 8

Literature Review.. 9

Data. 14

Theoretical Basis. 12

Methodology. 16

Results. 18

Discussion. 22

References. 28

Appendix. 31

Planting The Seed: Evaluating Whether Policy Mandates Lead to Growth in Fertility Rates. 43

Introduction. 43

Literature Review.. 44

Data. 48

Theoretical Basis. 52

Methodology. 53

Supplemental Methods. 55

Results. 55

Discussion. 62

References. 67

Appendix. 70

Misconceptions in Conceptions: Evaluating Racial Disparities in Lifetime Utilization of Fertility Treatments 73

Introduction. 73

Literature. 76

Theoretical Basis. 79

Data. 80

Methodology. 85

Results. 86

Discussion. 89

References. 93

About this Dissertation

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School	Laney Graduate School
Department	Health Services and Research Health Policy
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Women's Studies Health Sciences, Public Health
Keyword	Reproductive Fertility Birthrate Health Policy
Committee Chair / Thesis Advisor	Maria Dieci, Emory University Kathleen Adams, Emory University Sarah Markowitz, Emory University

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