The literature varies in its characterization of the risk preference variable, even with the same discrete choice questions. My results are similar whether including the full 4-category variable or the linear adjusted risk tolerance measure. Mis-classification of contraceptive consistency as well as contraceptive method could be a concern. There were some discrepancies between women’s reported percent of contraceptive usage and their method type. For example, there were 13 people who reported 0% use of birth control methods and also reported IUD use. This may result from misinterpretation of the question specifically for women using long acting methods. Or those women may have recently switch to IUDs, or use IUDs for other medical issues. It is challenging to determine if this is an error or an accurate response. There may be similar but less outwardly apparent misclassification across all contraceptive groups. The characterization of sexual behavior is limited in NLSY. Notably, respondents were not asked about sexual activity with a same sex partner in the last year. While the results of number of sexual partners are suggestive, future research on risk preference and sexual risk behavior should include a more comprehensive battery of questions. Potential intention-behavior incongruence may lead to the outcome of unintended pregnancy. Novel epidemiologic studies that include models of decision-making could identify antecedents of unintended pregnancy and develop interventions that may be targeted by individual risk preferences. This work provides an initial examination of the relationship between risk preferences and sexual risk behavior and contraceptive use. The findings merit future research with longitudinal samples to explore measure stability over time and in response to life circumstances. If a relationship between risk preferences and reproductive risk behavior, including number of partners and contraceptive use is reinforced,cannabis growing equipment it should inform our models of etiology of unintended pregnancy and also target behavioral interventions.
The goal of this research was to demonstrate the potential contribution of behavioral economics to our understanding of reproductive choices and behavior. Examining people’s decision-making can tell us not only about their likelihood of experiencing outcomes of interest, but also give information about their overall orientation. Preferences and biases may explain behavior and could be integrated into work on psychosocial predictors of health. The link between measured risk aversion and sexual and reproductive outcomes signal the importance of these measures beyond explaining financial behavior. They may, it appears, have implications for our understanding mechanisms underlying choices that drive reproductive health. This is an important step towards predicting who will be at highest risk of adverse outcomes and potentially develop models for intervention. The economic recession in the U.S. prompted increased interest in economic drivers of fertility. Variation in economic conditions may influence pregnancy intentions as well as contraceptive and sexual behavior, thereby altering risk of pregnancy. Additionally, the economic environment may impact individual decision-making on whether to continue a pregnancy. Understanding how economic uncertainty affects fertility intention and decision-making offers insight into the determinants of unintended pregnancy, spontaneous and induced abortion. Unintended pregnancy reduction is a stated national and international public health priority. Nearly half of pregnancies to women aged 15-44 in the United States are unintended, and 40% of those pregnancies end in abortion. Literature links unintended pregnancy to negative health outcomes for mothers and children, making it a significant public health concern and the target of prevention efforts as part of Healthy People 2020. Unintended pregnancy and pregnancy decision-making result from a multidimensional set of economic, cultural, social, psychological and demographic determinants. While risk of unintended pregnancy extends to the majority of women through their reproductive years, age, income, race/ethnicity, and psychosocial factors are associated with occurrence.
There is an educational gradient in unintended pregnancy, with higher incidence among women with lower levels of education. Women who experience unintended pregnancies are more likely have riskier psychosocial profiles prior to pregnancy, including depression, perceived stress, and low social support . Consequences of unintended pregnancy are substantial. There is some evidence of increased maternal risk behavior during pregnancy among those pregnancies that are unintended, including smoking and drinking. Consequences of unintended births include depression, preterm birth and delays in child development. It is estimated that unintended pregnancies cost the US more than $20 billion per year in expenses for births, abortions and miscarriages. Traditional measures of pregnancy intention measure the degree to which a pregnancy was planned or correctly timed. Unintended pregnancies are defined as pregnancies that are mistimed or unwanted at the time of conception. Intended pregnancies include pregnancies that are wanted at the time of conception or happen later than desired. Literature has critiqued this measure as one-dimensional, while asserting that people may feel a complex and multidimensional set of emotions surrounding pregnancy. In addition pregnancy intentions are dynamic and can change prior to and over the course of a pregnancy. Pregnancy intentions are often retrospectively recalled at the time of conception. This can be problematic as participant’s responses of intentions and desires can change depending on when they are assessed. Despite critiques that standard unintended pregnancy measures may not capture there this nuance, they are useful to identify time trends and risk factors. Researchers have long examined the relationship of the economy to fertility. Most studies find evidence for pro-cyclical effects , meaning slowing fertility in an economic downturn. The literature posits several mechanisms through which a worsening economy could affect fertility. First, an income effect from individual economic hardship causes individuals to rationally postpone or revise fertility plans.Becker , for example, suggests that the income effect leads to a quantity-quality trade off in childbearing decisions. Temporary income decreases may cause delays in childbearing whereas more persistent periods of unemployment may reduce the underlying desire to have children.
The economic environment can affect perception of risk in a population, not only among those directly affected by the experience of, for example, unemployment. Uncertainties in the labor market may affect fertility through anticipation of hardship, making fertility planning more challenging. These mechanisms would also yield a pro-cyclical association between the performance of the economy and fertility. Few studies show evidence of counter-cyclical effects, which assume that as employment opportunities decrease, the opportunity costs of time spent raising children decrease as well. This would promote substitution effects of fertility for employment. The recent economic recession in the United States provides opportunity for understanding mechanisms relating the economy and fertility. The Great Recession in the Unites States officially began in December 2007 and ended in June 2009. Unemployment and foreclosures rapidly increased as consumer confidence declined nationwide. During the Great Recession, the fertility rate decreased from 69.6 births per thousand women in 2007 to 66.4 births per thousand women in 2009, and has continued to decline. Several studies have documented a fertility decline in the United States and Europe from 2007-2011. During that time, state level economic indicators were linked to general fertility declines, as well as heterogeneity within subgroups. Schneider found strongest fertility effects of the economic downturn among women aged 20-24, who experienced lower rates of live birth than expected. Decreases in fertility were attributed to increased economic hardship and economic uncertainty which may have affected changes in contraceptive use, increases in abortion, miscarriage, or shifts in pregnancy intentions. Cherlin attributed a greater decline in fertility for young women to postponement rather than elimination of childbearing. Ananat et al. found birthrate declines among black but not white teens following country level job losses. They inferred that changes could be attributed to abortion or pregnancy avoidance based on the timing in gestation at which point the job losses occur. They hypothesized that black teens may be more vulnerable to job loss or uncertainty than white youth and found that the reductions in black teen births may be due to increased pregnancy terminations, reductions in sexual activity and increased contraceptive use. Much of the above work theorizes that fertility decline is due to rational choice to postpone or abstain from childbearing,cannabis plant growing however the ratio of intended and to unintended births during the Great Recession has rarely been examined. There is limited research on how the economic environment may serve as a determinant of unintended pregnancy and pregnancy outcome. Economic uncertainty or income effects may influence decision making prior to pregnancy, including pregnancy planning, sexual behavior and contraceptive use, and decision-making once a pregnancy has occurred, including the decision to abort. A study of institutional and individual economic measures found perception of job and income insecurity as well as aggregate unemployment rates to be associated with decreases short term childbearing intentions. A recent study by Percheski and Kimbo used the National Survey of Family Growth to investigate the risk of unintended pregnancy among women in the great recession. They exploited statewide indicators of unemployment, foreclosure and consumer sentiment and find reductions in both intended and unintended pregnancy among non-college educated women. They investigated the determinants of the decline, but found little evidence that economic indicators reduced sexual activity or increased contraceptive use . Reductions in births observed during the economic downturn may also have resulted from changes in pregnancy outcomes. While challenging to observe given high rates of fetal loss prior to pregnancy recognition, changes in the proportion of pregnancies that are not carried to term can alter fertility rates. A related body of literature establishes the increase of spontaneous abortion, following economic shocks.
Additionally, work demonstrating the shared correlation of spontaneous abortion and induced abortion suggests a positive relationship in response to economic events. Ananat et al.’s finding that teen fertility decreases following job loss that occurs during the first trimester could be explained by either mechanism. Research on abortion patients finds that economic insecurity is often cited as a reason for the decision. In the current investigation, I focus on two primary research questions: i.) Is national economic uncertainty associated with ratio of pregnancies reported as mistimed or unwanted relative to intended pregnancies; and ii) Is national economic uncertainty associated with the ratio of pregnancies ending in abortions or miscarriages relative to live births? Economic uncertainty, measured by changes in national monthly measures of the economy, captures contextual effects beyond effects among individuals who have experienced job loss or economic change. To investigate the relationship of economic uncertainty and reproductive health outcomes, I use data from the National Survey of Family Growth , combined with and monthly national unemployment data from the National Bureau of Labor statistics and the national consumer sentiment index from the Conference Board. The National Survey of Family Growth is a cross sectional, nationally representative survey administered by the National Center for Health Statistics. The Survey, initiated in 1973, collects data on fertility in the United States and contains detailed questions about sexual behavior, contraceptive use, relationship status and pregnancy.The survey collects data on each pregnancy, retrospectively recalled by participants. It is one of the only national surveys to include questions about pregnancy intention and contraception use at the time that the pregnancy occurred, as well as report of pregnancy resolution. This allows for examination of multiple pregnancies. NSFG includes inverse probability selection weighting based on of PSU, segment, housing unit, and person within selected household sampling procedures My analysis uses the 2006-2010 wave, which includes a national sample of 12,279 women and 10,403 men age 15-44 years living in households in the United States. In person interviews were conducted for a total sample size of 22,682. The interviews averaged 80 minutes in length for women. The response rate was 77% overall—78% for women, 75% for men]. To investigate women’s reproductive health outcomes, I use the pregnancy data file from the 2006-2010 survey of women across the US. The pregnancy file contains information on all of the participants’ past and current pregnancies, including date of conception, ‘wantedness’ at the time of conception, and pregnancy outcome. Therefore pregnancy is the unit of analysis. Economic uncertainty, as measured by the unemployment rate, Index of Consumer Sentiment, and timing of recession was associated with increased ratio of unintended compared to intended pregnancy, and abortion and miscarriage compared to live birth. Among unintended pregnancies, the ratio of mistimed pregnancies appeared more strongly and consistently associated with economic indicators than unwanted pregnancies.