Jennifer S. Barber

Ideational influences on the transition to parenthood: Attitudes toward childbearing and competing alternatives

In this paper I propose an expansion of the theory of planned behavior that considers how attitudes toward competing behaviors affect a focal behavior. Specifically, I explore how attitudes toward childbearing and the competing behaviors of educational attainment, career development, and consumer spending affect childbearing behavior. The empirical analyses use data from an eight-wave longitudinal study of mother-child pairs, the Intergenerational Panel Study of Parents and Children. The results indicate that positive attitudes toward children and childbearing increase rates of marital childbearing, while positive attitudes toward careers and luxury goods reduce rates of premarital childbearing. I conclude that theories and models of the attitude-behavior relationship should be expanded to include attitudes toward competing behaviors, and that social scientists who study childbearing behavior would benefit from greater emphasis on social psychological explanations of behavior.

Unwanted childbearing, health, and mother-child relationships.

This paper investigates the relationships among unwanted childbearing, health, and mother-child relationships. We hypothesize that unwanted childbearing affects mother-child relationships in part because of the physical and mental health consequences of unwanted childbearing. Impaired mental health hampers womens interaction with their infants, and these poor neonatal relationships translate into poor mother-adult child relationships. Using the Intergenerational Panel Study of Mothers and Children--a 31-year longitudinal survey of a probability sample of 1,113 mother-child pairs begun in 1961--we demonstrate that mothers with unwanted births have lower quality relationships with their children from late adolescence (age 18) throughout early adulthood (ages 23 and 31). Furthermore, these lower quality relationships are not limited to the child born as a result of the unwanted pregnancy; all the children in the family suffer. Using the 1987-88 wave of the National Survey of Families and Households, a survey of a national probability sample of U.S. households, we show that mothers with unwanted births suffer from higher levels of depression and lower levels of happiness. We also demonstrate that they spank their young children more and spend less leisure time with them. We conclude that experiencing unwanted childbearing reduces the time and attention that mothers give their young children and that these early mother-child interactions set the stage for long-term, lower quality relationships.

Mass education and fertility transition

The relationship between the spread of mass education and fertility-limiting behavior is examined. Existing theories relating education to fertility limitation are integrated, including those relating the presence of educational opportunity to fertility decline, theories relating womens education to their fertility behavior, and theories relating childrens education to the fertility behavior of their parents. Using survey data from a sample of 5,271 residents of 171 neighborhoods in rural Nepal, the individual-level mechanisms linking community-level changes in educational opportunity to fertility behavior are tested. A womans proximity to a school during childhood dramatically increases permanent contraceptive use in adulthood. This finding is largely independent of whether the woman subsequently attended school, whether her husband attended school, whether she lived near a school in adulthood, and whether she sent her children to school. Strong fertility limitation effects were also found for husbands education and for currently living near a school. These effects were independent of other education-related measures. The largest education-related effect is for sending children to school

Discrete-Time Multilevel Hazard Analysis

Combining innovations in hazard modeling with those in multilevel modeling, we develop a method to estimate discrete-time multilevel hazard models. We derive the likelihood of and formulate assumptions for a discrete-time multilevel hazard model with time-varying covariates at two levels. We pay special attention to assumptions justifying the estimation method. Next, we demonstrate file construction and estimation of the models using two common software packages, HLM and MLN. We also illustrate the use of both packages by estimating a model of the hazard of contraceptive use in rural Nepal using time-varying covariates at both individual and neighborhood levels.

The neighborhood history calendar: a data collection method designed for dynamic multilevel modeling.

This paper presents a new data collection method, called the Neighborhood History Calendar, designed to collect event histories of community-level changes over time. We discuss the need for and the uses of this method. We describe issues related to the design of instruments, collection of data, and data entry. We provide detailed examples from an application of this method to the study of marriage, contraception, and fertility in rural Nepal. The paper addresses applications of this same technique to other settings and research problems. We also extend the technique to collection of other forms of contextual-history data, including school histories and health service histories. Finally, we discuss how Geographic Information System (GIS) technology can be used to link together multiple sources of contextual-history data.

Living Arrangements and Family Formation Attitudes in Early Adulthood

This article examines the impact of nonfamily living arrangements and cohabitation on changes in family formation attitudes at the individual level [in the United States]. The theoretical framework focuses on the role of learning processes and cognitive consistency. This framework also draws similarities and differences between the likely impact of cohabitation and that of other living arrangements. Empirical analyses demonstrate that both the experience and duration of cohabiting arrangements have significant effects on family formation attitudes but fail to show significant consequences of premarital nonfamily living arrangements. (EXCERPT)

The effects of ambivalent fertility desires on pregnancy risk in young women in the USA

Many different definitions of the construct of motivational ambivalence have appeared in the literature on reproductive health. Using a theoretical framework in which motivational ambivalence is defined as an interaction between positive and negative pregnancy desires, we propose two hypotheses. The first is that positive and negative pregnancy desires independently predict the risk of an unplanned pregnancy. The second is that ambivalence and three related constructs that are also based on the interaction between positive and negative desires are each important predictors of pregnancy risk. We use weekly journal data collected from a US sample of 1,003 women aged 18–19 years and conduct hazard model analysis to test our hypotheses. Using both dummy and continuous predictors, we report results that confirm both hypotheses. The proposed interaction framework has demonstrated validity, compares favourably with previously reported alternative approaches, and incorporates a set of constructs that have potential importance for further research directed at the prevention of unplanned pregnancy.

Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth.

OBJECTIVE To examine contraceptive practices among diabetic women and obese women. RESEARCH DESIGN AND METHODS We analyzed the responses of 5,955 participants aged 20–44 years in the 2002 National Survey for Family Growth. Diabetes, BMI, desire for pregnancy, history of infertility treatment, sexual activity, parity, and demographic variables (age, race/ethnicity, education, marital status, income, insurance, and smoking history) were obtained by self-report. Lack of contraception was defined as absence of hormonal-, barrier-, or sterilization-based methods. Associations among contraception, diabetes, and BMI category were assessed in multivariable logistic regression models in nonsterile, sexually active women. RESULTS In unadjusted comparisons among sexually active women who were not sterilized, women with diabetes were more likely to lack contraception than women without diabetes (odds ratio [OR] 2.61 [95% CI 1.22–5.58]). Women with BMI ≥35 kg/m2 were more likely to lack contraception than women with BMI <25 kg/m2(1.63 [1.16–2.28]), but associations between contraception use and lesser degrees of overweight and obesity were not significant. In multivariable models, women who were older (aged ≥30 vs. 20–29 years), were of non-Hispanic black race, were cohabitating, had a history of infertility treatment, and desired or were ambivalent about pregnancy were significantly more likely to lack contraception. The associations among diabetes, BMI, and contraception were no longer significant after these adjustments. CONCLUSIONS Older women with diabetes and obesity who desire pregnancy, regardless of pregnancy intention, should be targeted for preconceptive management.

Role of Young Women's Depression and Stress Symptoms in Their Weekly Use and Nonuse of Contraceptive Methods

PURPOSE We prospectively examined the influence of young womens depression and psychological stress symptoms on their weekly contraceptive method use. METHODS We examined data from 689 women ages 18-20 years participating in a longitudinal cohort study. Women completed 8,877 weekly journals over the first year, which assessed reproductive, relationship, and health information. We focused on baseline depression (Center for Epidemiologic Studies-Depression Scale) and stress (Perceived Stress Scale) symptoms and weekly contraceptive method use. Analyses used multivariate random effects and multinomial logistic regression. RESULTS Approximately one quarter of women exhibited moderate/severe depression (27%) and stress (25%) symptoms at baseline. Contraception was not used in 10% of weekly journals, whereas coital and noncoital methods were used in 42% and 48% of weeks, respectively. In adjusted models, women with moderate/severe stress symptoms had more than twice the odds of contraception nonuse than women without stress (odds ratio [OR] 2.23, confidence interval [CI] 1.02-4.89, p = .04). Additionally, women with moderate/severe depression (RR .52, CI .40-.68, p < .001) and stress (relative risk [RR] .75, CI .58-.96, p = .02) symptoms had lower relative risks of using long-acting methods than oral contraceptives (OCs; reference category). Women with stress symptoms also had higher relative risks of using condoms (RR 1.17, CI 1.00-1.34, p = .02) and withdrawal (RR 1.29, CI 1.10-1.51, p = .001) than OCs. The relative risk of dual versus single method use was also lower for women with stress symptoms. CONCLUSION Womens psychological symptoms predicted their weekly contraceptive nonuse and use of less effective methods. Further research can determine the influence of dynamic psychological symptoms on contraceptive choices and failures over time.

Young women's consistency of contraceptive use - Does depression or stress matter?

BACKGROUND We prospectively examined the influence of young womens depression and stress symptoms on their weekly consistency of contraceptive method use. STUDY DESIGN Women ages 18-20 years (n = 689) participating in a longitudinal cohort study completed weekly journals assessing reproductive, relationship and health characteristics. We used data through 12 months of follow-up (n = 8877 journals) to examine relationships between baseline depression (CES-D) and stress (PSS-10) symptoms and consistency of contraceptive methods use with sexual activity each week. We analyzed data with random effects multivarible logistic regression. RESULTS Consistent contraceptive use (72% of weeks) was 10-15 percentage points lower among women with moderate/severe baseline depression and stress symptoms than those without symptoms (p < .001). Controlling for covariates, women with depression and stress symptoms had 47% and 69% reduced odds of contraceptive consistency each week than those without symptoms, respectively (OR 0.53, CI 0.31-0.91 and OR 0.31, CI 0.18-0.52). Stress predicted inconsistent use of oral contraceptives (OR 0.27, CI 0.12-0.58), condoms (OR 0.40, CI 0.23-0.69) and withdrawal (OR 0.12, CI 0.03-0.50). CONCLUSION Women with depression and stress symptoms appear to be at increased risk for user-related contraceptive failures, especially for the most commonly used methods. IMPLICATIONS Our study has shown that young women with elevated depression and stress symptoms appear to be at risk for inconsistent contraceptive use patterns, especially for the most common methods that require greater user effort and diligence. Based upon these findings, clinicians should consider womens psychological and emotional status when helping patients with contraceptive decision-making and management. User-dependent contraceptive method efficacy is important to address in education and counseling sessions, and women with stress or depression may be ideal candidates for long-acting reversible methods, which offer highly effective options with less user-related burden. Ongoing research will provide a greater understanding of how young womens dynamic mental health symptoms impact family planning behaviors and outcomes over time.