The Great Recession and American Fertility: Trends in Fertility and Pregnancy Intention, 2001-2009 Open Access

Rai, Ramona (2014)

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OBJECTIVE & BACKGROUND: Economic conditions have been shown to have significant impacts on aggregate fertility. However, the role that pregnancy intention plays in individual-level fertility decision-making has not been explored using epidemiologic analysis. This thesis aims to address this research gap with particular regard to the Great Recession (2007-2009) in the United States for the years 2001-2009.

METHODS: To assess pregnancy intention for this period, the author used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) (n=156,435). Logistic regression was used to assess the effect of giving birth during the recession (during 2008-2009) on birth intention and wantedness using general and race-specific models. The final adjusted models controlled for insurance status; whether the mother resided in a state with high, medium, or low levels of intended pregnancy; low-income status; maternal age; marital status; education level; and maternal race/ethnicity.

RESULTS: Over a fifth of the PRAMS respondents gave birth during the 2008-2009 period, but their demographic characteristics do not differ meaningfully from the respondents who gave birth during the 2001-2007 period. The odds of the birth being intended (aOR = 1.00, 95% CI: 0.96-1.10), given the birth had already taken place, were similar for both the 2001-2007 and 2008-2009 periods. Teenage respondents (15-19 year olds) exhibited a significant effect for birth wantedness: given that they had already given birth, the odds of the birth being wanted in 2008-2009 were 38 percent higher than the odds of the birth being wanted during 2001-2007 (aOR = 1.38, 95% CI: 1.10-1.70). The only race-specific model to return a significant result was for non-Hispanic white (NHW) women, where married women experienced higher odds of birth intention during the 2008-2009 period.

CONCLUSIONS: The Great Recession does not appear to have made a statistically significant impact on the distribution of fertility by wantedness status in the US, except for certain subgroups: married NHW women and teens. This suggests that reductions in recession-specific fertility rates for these groups may reflect either an increased vigilance to prevent unintended pregnancies or an increased use of pregnancy termination for mistimed and unwanted pregnancies in these subgroups.

Table of Contents


Introduction - 1

Literature Review - 3

Notes on Measures - 3

Economics & Fertility - 6

Fertility in the US - 12

Pregnancy Intention - 20

The Great Recession: Findings, 2007 to Present - 24

Conclusion - 28

Selected Literature Review Articles - 28

Materials & Methods - 44

Pregnancy Risk Assessment Monitoring System (PRAMS) - 44

General Fertility Rates - 49

Modeling - 50

Results - 55

Discussion - 61

Conclusion - 83

Cited References - 84

Appendices - 89

Appendix I - 90

Appendix II - 114

Appendix III - 122

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