Kelaher Margaret, Dunt David, Dodson Sarity
Program Evaluation Unit, School of Population Health, University of Melbourne, Carlton Melbourne, Victoria, Australia.
Health Policy. 2007 Jun;82(1):95-101. doi: 10.1016/j.healthpol.2006.08.002. Epub 2006 Oct 11.
To examine whether unemployment and partnership affects pregnancy, live births and terminations among young Australian women. Unemployment has conventionally been used in epidemiological studies to examine the health effects of loss of opportunity, material resources and satisfaction associated with work. During welfare reform in the 1990s it was argued that unemployment and associated welfare receipt could influence reproductive choice.
As part of the Australian Longitudinal Study of Women's Health, information on employment, contraceptive use and pregnancy, live births and terminations was obtained at two time points. Information on partnership, age, parental education, and area economic resources was also obtained. The sample included 9683 women aged 18-23 years in 1996 (time 1) and 2000 (time 2).
Logistic regressions were conducted to assess the relationship between unemployment and contraceptive use at time 1 and the impact of unemployment at time 1 on pregnancy, live births and terminations at time 2. Analyses accounted for partnership, significant differences in contraception, age, parental education and area economic resources.
Despite the absence of differences in overall rates of contraceptive use, rates of pregnancy and live births among young unemployed women were higher than rates among employed women. These differences became non-significant when differences in the need to use contraception and oral contraceptive use were taken into account. There were no differences in terminations due to unemployment overall but partnered unemployed women were more likely to have a termination than other women.
The study did not support the notion that being unemployed provided incentives for single motherhood. However excess terminations suggest that unemployment might provide disincentives to continuing pregnancies among partnered and unemployed women. More detailed examination of contraception and partnership may be key in unraveling inconsistencies in past research.
研究失业和伴侣关系是否会影响澳大利亚年轻女性的怀孕、活产和终止妊娠情况。在流行病学研究中,失业通常被用来考察与工作相关的机会丧失、物质资源和满意度对健康的影响。在20世纪90年代的福利改革期间,有人认为失业及相关福利领取可能会影响生育选择。
作为澳大利亚女性健康纵向研究的一部分,在两个时间点获取了有关就业、避孕措施使用以及怀孕、活产和终止妊娠的信息。还获取了有关伴侣关系、年龄、父母教育程度和地区经济资源的信息。样本包括1996年(时间1)和2000年(时间2)时年龄在18至23岁之间的9683名女性。
进行逻辑回归以评估时间1时失业与避孕措施使用之间的关系,以及时间1时失业对时间2时怀孕、活产和终止妊娠的影响。分析考虑了伴侣关系、避孕措施使用方面的显著差异、年龄、父母教育程度和地区经济资源。
尽管在总体避孕措施使用率方面没有差异,但年轻失业女性的怀孕率和活产率高于就业女性。当考虑到避孕需求和口服避孕药使用方面的差异时,这些差异变得不显著。总体而言,因失业导致的终止妊娠情况没有差异,但有伴侣的失业女性比其他女性更有可能终止妊娠。
该研究不支持失业会促使单身母亲生育这一观点。然而,过多的终止妊娠表明,失业可能会促使有伴侣的失业女性放弃继续怀孕。对避孕措施和伴侣关系进行更详细的研究可能是解开以往研究中不一致之处的关键。