Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates
Open Access
- 5 December 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 25 (2), 122-128
- https://doi.org/10.1007/s11606-009-1197-0
Abstract
Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated. To examine the associations among race/ethnicity, unintended pregnancy, and tubal sterilization. Cross-sectional analysis of data from a nationally representative sample of women aged 15-44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth. Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization. Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6-2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80-1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3-1.9 and OR: 1.4; 95% CI: 1.2-1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95-1.4 for AA women and OR: 1.3; 95% CI: 1.0-1.6 for Hispanic women). Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.Keywords
This publication has 50 references indexed in Scilit:
- “Everything I Know I Learned from My Mother...or Not”: Perspectives of African-American and White Women on Decisions About Tubal SterilizationJournal of General Internal Medicine, 2008
- Race, insurance status, and desire for tubal sterilization reversalFertility and Sterility, 2008
- Race, Insurance Status, and Tubal SterilizationObstetrics & Gynecology, 2007
- Advancing Health Disparities Research Within the Health Care System: A Conceptual FrameworkAmerican Journal of Public Health, 2006
- Conspiracy Beliefs About Birth Control: Barriers to Pregnancy Prevention Among African Americans of Reproductive AgeHealth Education & Behavior, 2005
- Understanding pregnancy in a population of inner-city women in New Orleans—results of qualitative researchSocial Science & Medicine (1982), 2005
- A comparison of women's regret after vasectomy versus tubal sterilizationObstetrics & Gynecology, 2002
- Black Women and the PillFamily Planning Perspectives, 2000
- The Best Intentions: Unintended Pregnancy and the Well-Being of Children and FamiliesJournal of Public Health Policy, 1998
- Family planning and female sterilization in the United StatesSocial Science & Medicine (1982), 1983