Defense Date

2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Epidemiology

First Advisor

Saba W. Masho

Abstract

Background: Rapid repeat pregnancy (RRP), a pregnancy occurring less than 24 months from a prior birth, and unintended pregnancy-related induced abortions can be prevented with family planning. However, few studies have adequately addressed the role of male partners in reproductive decision-making. Objectives: The goal of this research is to understand the interrelationships between couple pregnancy intention, intimate partner violence (IPV), reproductive health and behaviors. Specifically, this project aims to: (1) examine the extent to which couple pregnancy intentions are associated with RRP and (2) induced abortions among women in the U.S., and (3) examine the extent to which IPV around the time of pregnancy is associated with postpartum birth control use by race/ethnicity and receipt of prenatal contraceptive counseling among U.S. women with live births. Methods: This project uses data from the 2006-2010 National Survey on Family Growth (NSFG), and the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS). RRP and induced abortion of first pregnancy were self-reported in the NSFG. Couple pregnancy intentions were categorized as: both intended (M+P+), both unintended (M-P-), maternal intended and paternal unintended (M+P-), maternal unintended and paternal intended (M-P+). Multiple logistic regression analysis was used to assess the relationships between couple pregnancy intentions and RRP and induced abortion. Data on IPV and postpartum contraceptive use came from PRAMS. Stratified analyses were conducted to assess differences in the association by race/ethnicity and receipt of prenatal contraceptive counseling. Results: Compared to couples where pregnancy was intended by both, those with discordant pregnancy intentions and both unintended pregnancy had greater odds of induced abortion. The odds of RRP was higher for M-P+ couples and lower for M+P- couples. Abused women were significantly less likely to report postpartum contraceptive use. This was particularly true for Hispanic women who reported no prenatal birth control counseling and all other racial/ethnic groups who received birth control counseling. Conclusion: Health providers may need to consider the interpersonal dynamics of couple-based decision-making and behaviors to prevent RRP and induced abortions due to unintended pregnancy. Providers should discuss contraceptive options that are not partner-dependent within the context of abusive relationships.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

9-13-2015

Available for download on Friday, September 11, 2020

Included in

Public Health Commons

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