Department of Sociology and Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson Street, Room 2267, Ann Arbor, MI, 48106-1248, USA.
Demography. 2020 Dec;57(6):2057-2084. doi: 10.1007/s13524-020-00922-3.
Decades of research have attempted to understand the paradox of stubbornly high unintended pregnancy rates despite widespread use of contraception. Much of this research has focused on socioeconomic disparities in rates of unintended pregnancy, finding that economically disadvantaged women tend to use less effective contraceptive methods and use them less consistently. Building on this research, this study examines how material hardship is associated with less consistent contraceptive use among women who do not desire to become pregnant. Using the Relationship Dynamics and Social Life (RDSL) Study, a weekly longitudinal survey, I find lower levels of contraceptive use and less consistent use of contraception among women experiencing material hardship, relative to those without hardship experiences. I also investigate the extent to which this association is explained by access barriers and lower contraceptive efficacy among women experiencing hardship. Using structural equation modeling, I find that these mediators significantly explain the relationship between hardship and risky contraceptive behaviors, suggesting that hardship creates mental and resource constraints that impede successful implementation of contraception. However, net of these mediators, material hardship remains associated with riskier contraceptive behaviors among young women, calling for further research on how hardship exposes women to greater risk of unintended pregnancies.
几十年来的研究试图理解这样一个悖论,即尽管广泛使用了避孕措施,但意外怀孕的比率仍然居高不下。这项研究的很大一部分都集中在意外怀孕率的社会经济差异上,发现经济处于不利地位的女性往往使用效果较差的避孕方法,而且使用的一致性也较差。在此基础上,本研究考察了物质困难如何与那些不希望怀孕的女性在避孕方面的使用不一致性相关。本研究使用关系动态与社会生活(RDSL)研究的每周纵向调查数据,发现与没有经历困难的女性相比,经历物质困难的女性的避孕措施使用水平较低,且避孕措施的使用一致性也较差。我还调查了在经历困难的女性中,由于获得避孕措施的机会有限以及避孕措施效果降低,这种关联在多大程度上可以得到解释。通过结构方程模型,我发现这些中介因素显著解释了困难与风险避孕行为之间的关系,这表明困难会造成心理和资源方面的限制,从而阻碍了避孕措施的有效实施。然而,在这些中介因素之外,物质困难仍然与年轻女性的风险较高的避孕行为相关,这需要进一步研究困难如何使女性面临更大的意外怀孕风险。