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  1. Article ; Online: Pregnancies in the United States by Desire for Pregnancy: Estimates for 2009, 2011, 2013, and 2015.

    Kost, Kathryn / Zolna, Mia / Murro, Rachel

    Demography

    2023  Volume 60, Issue 3, Page(s) 837–863

    Abstract: We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by retrospectively reported pregnancy desires: pregnancies reported as having occurred at ... ...

    Abstract We examine whether changes in U.S. pregnancy, birth, and abortion rates between 2009 and 2015 reflect underlying change in the incidence of pregnancies classified by retrospectively reported pregnancy desires: pregnancies reported as having occurred at about the right time, later than wanted, too soon, or not wanted at all, and those for which individuals expressed other feelings, including uncertainty, ambivalence, or indifference. We calculate the proportionate distributions of these pregnancies and rates among U.S. women aged 15-44, as well as change over time, overall and among age groups. Characterization of desires for a past pregnancy shifted in a number of ways between 2009 and 2015, and changes across age groups were not uniform. Rates of pregnancies reported as occurring later than wanted increased among older women, while rates of pregnancies reported as occurring too soon decreased among all women. These findings shed light on previous research documenting an increasing age at first birth, increasing rates of pregnancy and childbearing among the oldest age groups, and changes in patterns of contraceptive use, particularly among young women. Our analysis explores limitations and challenges of two major sources of data on pregnancies in the United States and their measures of retrospectively reported pregnancy desires.
    MeSH term(s) Aged ; Female ; Humans ; Pregnancy ; Abortion, Induced ; Contraceptive Agents ; Retrospective Studies ; United States/epidemiology ; Pregnancy, Unplanned ; Pregnancy, Unwanted
    Chemical Substances Contraceptive Agents
    Language English
    Publishing date 2023-05-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 280612-5
    ISSN 1533-7790 ; 0070-3370
    ISSN (online) 1533-7790
    ISSN 0070-3370
    DOI 10.1215/00703370-10690005
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  2. Article ; Online: Effect of Changes in Response Options on Reported Pregnancy Intentions: A Natural Experiment in the United States.

    Maddow-Zimet, Isaac / Kost, Kathryn

    Public health reports (Washington, D.C. : 1974)

    2020  Volume 135, Issue 3, Page(s) 354–363

    Abstract: Objectives: The Pregnancy Risk Assessment Monitoring System (PRAMS), conducted by the Centers for Disease Control and Prevention in collaboration with state health departments, is the largest state-level surveillance system that includes a question on ... ...

    Abstract Objectives: The Pregnancy Risk Assessment Monitoring System (PRAMS), conducted by the Centers for Disease Control and Prevention in collaboration with state health departments, is the largest state-level surveillance system that includes a question on the intention status of pregnancies leading to live birth. In 2012, the question was changed to include an additional response option describing uncertainty before the pregnancy about the desire for pregnancy. This analysis investigated how this additional response option affected women's responses.
    Methods: We used the change in the pregnancy intention question in 2012 as a natural experiment, taking advantage of relatively stable distributions of pregnancy intentions during short periods of time in states. Using PRAMS data from 2009-2014 (N = 222 781), we used a regression discontinuity-in-time design to test for differences in the proportion of women choosing each response option in the periods before and after the question change.
    Results: During 2012-2014, 13%-15% of women chose the new response option, "I wasn't sure what I wanted." The addition of the new response option substantially affected distributions of pregnancy intentions, drawing responses away from all answer choices except "I wanted to be pregnant then." Effects were not uniform across age, parity, or race/ethnicity or across states.
    Conclusions: These effects could influence estimated levels and trends of the proportion of births that are characterized as intended, mistimed, or unwanted, as well as estimates of differences between demographic groups. These findings will help to inform new strategies for measuring pregnancy and childbearing desires among women.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Centers for Disease Control and Prevention, U.S. ; Continental Population Groups ; Female ; Humans ; Intention ; Pregnancy ; Pregnant Women/psychology ; Public Health Surveillance/methods ; Risk Assessment ; Socioeconomic Factors ; Surveys and Questionnaires/standards ; United States ; Young Adult
    Language English
    Publishing date 2020-04-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 120953-x
    ISSN 1468-2877 ; 0033-3549
    ISSN (online) 1468-2877
    ISSN 0033-3549
    DOI 10.1177/0033354920914344
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  3. Article ; Online: Challenging unintended pregnancy as an indicator of reproductive autonomy: a response.

    Kost, Kathryn / Zolna, Mia

    Contraception

    2019  Volume 100, Issue 1, Page(s) 5–9

    MeSH term(s) Contraception Behavior ; Female ; Humans ; Pregnancy ; Pregnancy, Unplanned
    Language English
    Publishing date 2019-05-03
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80106-9
    ISSN 1879-0518 ; 0010-7824
    ISSN (online) 1879-0518
    ISSN 0010-7824
    DOI 10.1016/j.contraception.2019.04.010
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  4. Article ; Online: The Impact of Abortion Underreporting on Pregnancy Data and Related Research.

    Desai, Sheila / Lindberg, Laura D / Maddow-Zimet, Isaac / Kost, Kathryn

    Maternal and child health journal

    2021  Volume 25, Issue 8, Page(s) 1187–1192

    Abstract: Introduction: The impact on research findings that use pregnancy data from surveys with underreported abortions is not well-established. We estimate the percent of all pregnancies missing from women's self-reported pregnancy histories because of ... ...

    Abstract Introduction: The impact on research findings that use pregnancy data from surveys with underreported abortions is not well-established. We estimate the percent of all pregnancies missing from women's self-reported pregnancy histories because of abortion underreporting.
    Methods: We obtained abortion and fetal loss data from the 2006-2015 National Survey of Family Growth (NSFG), annual counts of births from US vital statistics, and external abortion counts from the Guttmacher Institute. We estimated the completeness of abortion reporting in the NSFG as compared to the external counts, the proportion of pregnancies resolving in abortion, and the proportion of pregnancies missing in the NSFG due to missing abortions. Each measure was examined overall and by age, race/ethnicity, union status, and survey period.
    Results: Fewer than half of abortions (40%, 95% CI 36-44) that occurred in the five calendar years preceding respondents' interviews were reported in the NSFG. In 2006-2015, 18% of pregnancies resolved in abortion, with significant variation across demographic groups. Nearly 11% of pregnancies (95% CI 10-11) were missing from the 2006-2015 NSFG due to abortion underreporting. The extent of missing pregnancies varied across demographic groups and was highest among Black women and unmarried women (18% each); differences reflect both the patterns of abortion underreporting and the share of pregnancies ending in abortion.
    Discussion: Incomplete reporting of pregnancy remains a fundamental shortcoming to the study of US fertility-related experiences. Efforts to improve abortion reporting are needed to strengthen the quality of pregnancy data to support maternal, child, and reproductive health research.
    MeSH term(s) Abortion, Induced/statistics & numerical data ; Black or African American ; Data Collection ; Female ; Humans ; Pregnancy ; Surveys and Questionnaires
    Language English
    Publishing date 2021-04-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-021-03157-9
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  5. Article: Pregnancy intentions, maternal behaviors, and infant health: investigating relationships with new measures and propensity score analysis.

    Kost, Kathryn / Lindberg, Laura

    Demography

    2015  Volume 52, Issue 1, Page(s) 83–111

    Abstract: The premise that unintended childbearing has significant negative effects on the behavior of mothers and on the health of infants strongly influences public health policy and much of current research on reproductive behaviors. Yet, the evidence base ... ...

    Abstract The premise that unintended childbearing has significant negative effects on the behavior of mothers and on the health of infants strongly influences public health policy and much of current research on reproductive behaviors. Yet, the evidence base presents mixed findings. Using data from the U.S. National Survey of Family Growth, we employ a measure of pregnancy intentions that incorporates the extent of mistiming, as well as the desire scale developed by Santelli et al. (Studies in Family Planning, 40, 87-100, 2009). Second, we examine variation in the characteristics of mothers within intention status groups. Third, we account for the association of mothers' background characteristics with their pregnancy intentions and with the outcomes by employing propensity score weighting. We find that weighting eliminated statistical significance of many observed associations of intention status with maternal behaviors and birth outcomes, but not all. Mistimed and unwanted births were still less likely to be recognized early in pregnancy than intended ones. Fewer unwanted births received early prenatal care or were breast-fed, and unwanted births were also more likely than intended births to be of low birth weight. Relative to births at the highest level of the desire scale, all other births were significantly less likely to be recognized early in pregnancy and to receive early prenatal care.
    MeSH term(s) Adult ; Age Factors ; Birth Weight ; Breast Feeding/statistics & numerical data ; Female ; Health Status ; Humans ; Infant ; Infant, Newborn ; Intention ; Male ; Maternal Behavior/psychology ; Pregnancy ; Pregnancy Outcome/epidemiology ; Pregnancy, Unplanned/psychology ; Pregnancy, Unwanted/psychology ; Prenatal Care/statistics & numerical data ; Propensity Score ; Socioeconomic Factors ; Time Factors ; United States ; Young Adult
    Language English
    Publishing date 2015-01-09
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 280612-5
    ISSN 1533-7790 ; 0070-3370
    ISSN (online) 1533-7790
    ISSN 0070-3370
    DOI 10.1007/s13524-014-0359-9
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  6. Article ; Online: Abortion Reporting in the United States: An Assessment of Three National Fertility Surveys.

    Lindberg, Laura / Kost, Kathryn / Maddow-Zimet, Isaac / Desai, Sheila / Zolna, Mia

    Demography

    2020  Volume 57, Issue 3, Page(s) 899–925

    Abstract: Despite its frequency, abortion remains a highly sensitive, stigmatized, and difficult-to-measure behavior. We present estimates of abortion underreporting for three of the most commonly used national fertility surveys in the United States: the National ... ...

    Abstract Despite its frequency, abortion remains a highly sensitive, stigmatized, and difficult-to-measure behavior. We present estimates of abortion underreporting for three of the most commonly used national fertility surveys in the United States: the National Survey of Family Growth, the National Longitudinal Survey of Youth 1997, and the National Longitudinal Study of Adolescent to Adult Health. Numbers of abortions reported in each survey were compared with external abortion counts obtained from a census of all U.S. abortion providers, with adjustments for comparable respondent ages and periods of each data source. We examined the influence of survey design factors, including survey mode, sampling frame, and length of recall, on abortion underreporting. We used Monte Carlo simulations to estimate potential measurement biases in relationships between abortion and other variables. Underreporting of abortion in the United States compromises the ability to study abortion-and, consequently, almost any pregnancy-related experience-using national fertility surveys.
    MeSH term(s) Abortion, Induced/statistics & numerical data ; Adolescent ; Adult ; Data Collection/methods ; Data Collection/standards ; Data Collection/statistics & numerical data ; Documentation/methods ; Documentation/standards ; Documentation/statistics & numerical data ; Female ; Humans ; Longitudinal Studies ; Monte Carlo Method ; Social Stigma ; Socioeconomic Factors ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2020-05-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 280612-5
    ISSN 1533-7790 ; 0070-3370
    ISSN (online) 1533-7790
    ISSN 0070-3370
    DOI 10.1007/s13524-020-00886-4
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  7. Article: The Role of Men's Childbearing Intentions in Father Involvement.

    Lindberg, Laura Duberstein / Kost, Kathryn / Maddow-Zimet, Isaac

    Journal of marriage and the family

    2017  Volume 79, Issue 1, Page(s) 44–59

    Abstract: An expanding body of research has investigated factors that influence fathers' involvement with their children. Generally overlooked has been the role of pregnancy intentions on men's fathering behaviors. In this study, the authors used nationally ... ...

    Abstract An expanding body of research has investigated factors that influence fathers' involvement with their children. Generally overlooked has been the role of pregnancy intentions on men's fathering behaviors. In this study, the authors used nationally representative data from men interviewed in the 2002 and 2006-2010 National Survey of Family Growth to examine relationships between fathers' pregnancy intentions and multiple aspects of their parental involvement. Using propensity score methods to control for confounding, they found that men were less likely to live with a young child from a mistimed than intended pregnancy and that among nonresident fathers, mistimed pregnancies were associated with lower levels of visitation and consequently reduced participation in caregiving and play. Among both resident and nonresident fathers, mistimed pregnancies were also associated with lower self-appraisals of fathering quality when compared with intended pregnancies; for nonresident fathers, however, this association was moderated by other involvement.
    Language English
    Publishing date 2017-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2066605-6
    ISSN 1741-3737 ; 0022-2445
    ISSN (online) 1741-3737
    ISSN 0022-2445
    DOI 10.1111/jomf.12377
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  8. Article ; Online: Exploring U.S. men's birth intentions.

    Lindberg, Laura Duberstein / Kost, Kathryn

    Maternal and child health journal

    2013  Volume 18, Issue 3, Page(s) 625–633

    Abstract: While recently there have been renewed interest in women's childbearing intentions, the authors sought to bring needed research attention to understanding men's childbearing intentions. Nationally representative data from the 2006-2010 National Survey of ...

    Abstract While recently there have been renewed interest in women's childbearing intentions, the authors sought to bring needed research attention to understanding men's childbearing intentions. Nationally representative data from the 2006-2010 National Survey of Family Growth (NSFG) was used to examine pregnancy intentions and happiness for all births reported by men in the 5 years preceding the interview. We used bivariate statistical tests of associations between intention status, happiness about the pregnancy, and fathers' demographic characteristics, including joint race/ethnicity and union status subgroups. Multivariate logistic regressions were used to calculate adjusted odds ratios of a birth being intended, estimated separately by father's union status at birth. Using comparable data and measures from the male and female NSFG surveys, we tested for gender differences intentions and happiness, and examined the sensitivity of our results to potential underreporting of births by men. Nearly four out of ten of births to men were reported as unintended, with significant variation by men's demographic traits. Non-marital childbearing was more likely to be intended among Hispanic and black men. Sixty-two percent of births received a 10 on the happiness scale. Happiness about the pregnancy varied significantly by intention status. Men were significantly happier than women about the pregnancies, with no significant difference in intention status. Potential underreporting of births by men had little impact on these patterns. This study brings needed focus to men's childbearing intentions and improves our understanding of the context of their role as fathers. Men need to be included in strategies to prevent unintended pregnancy.
    MeSH term(s) Adult ; Fathers/psychology ; Female ; Happiness ; Humans ; Intention ; Logistic Models ; Male ; Men/psychology ; Pregnancy ; Pregnancy, Unplanned/psychology ; Surveys and Questionnaires ; United States ; Young Adult
    Language English
    Publishing date 2013-06-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-013-1286-x
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  9. Article ; Online: Unintended pregnancy rates at the state level.

    Finer, Lawrence B / Kost, Kathryn

    Perspectives on sexual and reproductive health

    2011  Volume 43, Issue 2, Page(s) 78–87

    Abstract: Context: Unintended pregnancy is a key reproductive health indicator, but rates have never been calculated for all 50 states.: Methods: State-level estimates of unintended pregnancy rates in 2006 were calculated using data from several sources. The ... ...

    Abstract Context: Unintended pregnancy is a key reproductive health indicator, but rates have never been calculated for all 50 states.
    Methods: State-level estimates of unintended pregnancy rates in 2006 were calculated using data from several sources. The proportion of births resulting from unintended pregnancies was obtained from the Pregnancy Risk Assessment Monitoring System and similar state surveys, and the intention status of pregnancies ending in abortion from a national survey of abortion patients. These proportions were applied to birth and abortion counts for each state, and fetal losses were estimated. Rates of unintended pregnancy were obtained by dividing relevant figures by the number of women aged 15-44 in each state. Six states and the District of Columbia had no appropriate survey data; their rates were predicted using multivariate linear regression.
    Results: In 2006, the median state unintended pregnancy rate was 51 per 1,000 women aged 15-44. Most rates fell within a range of 40-65 unintended pregnancies per 1,000 women. The highest rate was in Mississippi (69); the lowest rate was in New Hampshire (36). Rates were generally highest in the South and Southwest, and in states with large urban populations. In 29 states and the District of Columbia, more than half of pregnancies were unintended; in nine, a consistent upward trend in unintended pregnancy rates between 2002 and 2006 was apparent; no state had a consistent decline.
    Conclusions: These rates provide benchmarks for measuring the impact on unintended pregnancy of state policies and practices, such as those governing sex education and the funding of contraceptive services.
    MeSH term(s) Abortion, Induced/statistics & numerical data ; Adolescent ; Adult ; Contraception ; Data Collection ; Family Planning Policy ; Family Planning Services/methods ; Family Planning Services/standards ; Female ; Humans ; Intention ; Pregnancy ; Pregnancy Outcome/epidemiology ; Pregnancy Rate ; Pregnancy, Unwanted ; Pregnant Women/psychology ; Reproductive Medicine/standards ; Reproductive Medicine/statistics & numerical data ; Risk Factors ; Sex Education ; Socioeconomic Factors ; United States/epidemiology
    Language English
    Publishing date 2011-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2075205-2
    ISSN 1931-2393 ; 1538-6341
    ISSN (online) 1931-2393
    ISSN 1538-6341
    DOI 10.1363/4307811
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  10. Article ; Online: Cost-effectiveness of two interventions for the prevention of postpartum hemorrhage in Senegal.

    Vlassoff, Michael / Diallo, Alioune / Philbin, Jesse / Kost, Kathryn / Bankole, Akin

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2016  Volume 133, Issue 3, Page(s) 307–311

    Abstract: Objective: To compare, at the community level, the cost-effectiveness of oxytocin and misoprostol for the prevention of postpartum hemorrhage (PPH).: Methods: The present cost-effectiveness study used data collected during a randomized trial that ... ...

    Abstract Objective: To compare, at the community level, the cost-effectiveness of oxytocin and misoprostol for the prevention of postpartum hemorrhage (PPH).
    Methods: The present cost-effectiveness study used data collected during a randomized trial that compared the prophylactic effectiveness of misoprostol and oxytocin for the prevention of PPH in a rural setting in Senegal between June 6 and September 21 2013. The two interventions were compared, with referral to a higher level facility owing to PPH being the outcome measure. The costs and effects were calculated for two hypothetical cohorts of patients delivering during a 1-year period, with each cohort receiving one intervention. A comparison with a third hypothetical cohort receiving the current standard of care was included. A sensitivity analysis was performed to estimate the impact of variations in model assumptions.
    Results: The cost per PPH referral averted was US$ 38.96 for misoprostol and US$ 119.15 for oxytocin. In all the scenarios modeled the misoprostol intervention dominated, except in the worst-case scenario, where the oxytocin intervention demonstrated slightly better cost-effectiveness.
    Conclusion: The use of misoprostol for PPH prophylaxis could be cost effective and improve maternal outcomes in low-income settings.
    MeSH term(s) Cost-Benefit Analysis ; Female ; Humans ; Misoprostol/economics ; Misoprostol/therapeutic use ; Oxytocics/economics ; Oxytocics/therapeutic use ; Oxytocin/economics ; Oxytocin/therapeutic use ; Postpartum Hemorrhage/prevention & control ; Pregnancy ; Referral and Consultation ; Senegal
    Chemical Substances Oxytocics ; Misoprostol (0E43V0BB57) ; Oxytocin (50-56-6)
    Language English
    Publishing date 2016-06
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1016/j.ijgo.2015.10.015
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