Wise Akilah, Geronimus Arline T, Smock Pamela J
Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan.
Population Studies Center, University of Michigan, Ann Arbor, Michigan.
Womens Health Issues. 2017 Jan-Feb;27(1):5-13. doi: 10.1016/j.whi.2016.10.006. Epub 2016 Nov 29.
Births to less educated women are more likely to be classified as unintended than other births. We question a common interpretation that this association reflects a lack of contraceptive knowledge or self-efficacy among less educated women. We theorize that differences in early life educational advantages structure pregnancy desires and the salience and opportunity costs of precise fertility timing. We hypothesize that net of covariates indicative of early educational disadvantage, mothers with less education are not more likely to report births as unintended compared with mothers who have attained higher levels of education before becoming mothers.
Using multivariate regression, we analyze a sample of women in the National Longitudinal Survey of Youth (1979) who had their first births by 1994. We test whether an index measure of educational advantage in youth predicts unintended first birth.
Unadjusted results confirm well-documented associations between educational disadvantage and greater likelihood of unintended pregnancy. However, once covariates are controlled, those with high educational advantage in youth are more likely to report their first birth as mistimed (relative risk ratio, 1.57).
Educational advantage captures expectations about how much education a young woman will obtain before giving birth and is a structural dynamic that precedes proximate factors related to family planning access and behaviors.
These findings highlight the need to incorporate structural factors that condition perceptions of pregnancy intention in the study of unintended pregnancy and to critically reevaluate the conceptualization and interpretation of pregnancy intention measures.
与其他分娩相比,受教育程度较低的女性所生的孩子更有可能被归类为意外生育。我们对一种常见的解释提出质疑,即这种关联反映了受教育程度较低的女性缺乏避孕知识或自我效能感。我们提出理论,认为早年教育优势的差异塑造了怀孕意愿以及精确生育时间的显著性和机会成本。我们假设,在扣除表明早期教育劣势的协变量后,与在成为母亲之前获得较高教育水平的母亲相比,受教育程度较低的母亲报告意外生育的可能性并不更高。
我们使用多元回归分析了1979年全国青年纵向调查中截至1994年生育第一胎的女性样本。我们测试青年时期教育优势的指数衡量指标是否能预测意外的第一胎生育。
未经调整的结果证实了教育劣势与意外怀孕可能性更大之间有充分记录的关联。然而,一旦控制了协变量,青年时期具有高教育优势的女性更有可能将其第一胎生育报告为时机不当(相对风险比为1.57)。
教育优势反映了对年轻女性在分娩前将获得多少教育的期望,并且是一个先于与计划生育获取和行为相关的近端因素的结构动态。
这些发现凸显了在意外怀孕研究中纳入影响怀孕意愿认知的结构因素的必要性,并批判性地重新评估怀孕意愿测量的概念化和解释。