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APHA Scientific Session and Event Listing

Jessica D. Gipson, MPH, PhD and Michelle J. Hindin, PhD. Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, 4109675526, jgipson@jhsph.edu

Objectives: Despite the successes of its national family planning program, current estimates from Bangladesh indicate high levels of unintended pregnancy. We used longitudinal data from Bangladeshi couples to determine to what extent their fertility preferences match subsequent reproductive outcomes. Methods: We analyzed data from 1998–2003 for 2,243 couples to assess the relationship between fertility preferences and odds of contraceptive use, time to subsequent pregnancy and live birth, and odds of induced abortion. We used logistic regression and proportional hazards analyses to control for the effects of other sociodemographic and fertility-related behaviors. Results: In general, fertility preferences were predictive of subsequent behavior; however, several inconsistencies emerged. Among couples in which neither spouse wanted more children, 23% were not using contraception at baseline and 25% had a pregnancy during the study period. Among discordant couples, couples in which only the wife wanted another child had a higher incidence of pregnancy in the first two years; however, couples in which only the husband wanted another child had a significantly higher incidence of pregnancy in the final three years. Additionally, nearly a quarter of pregnancies occurring to couples in which neither spouse wanted another child, and nearly half of all non-live birth outcomes, resulted in induced abortion. Conclusions: Results from this study confirm the importance of collecting longitudinal fertility data from both spouses, especially in contexts in which differential motivations for childbearing exist. Additionally, the high levels of unintended pregnancy and induced abortion indicate that challenges remain in meeting couples' reproductive health needs.

Learning Objectives:

• Describe the association between couples’ stated fertility preferences and subsequent reproductive behavior.
• Recognize the importance of collecting longitudinal fertility data from both spouses.
• Acknowledge the ongoing challenges, as exemplified by levels of unintended pregnancy and induced abortion, in meeting the reproductive health needs of individuals and couples in this context.

Keywords: International Reproductive Health, Gender

Presenting author's disclosure statement:

Not Answered