Unintended pregnancy is a substantial problem in the United States, with adverse consequences for women, their children, and society. Unintended pregnancy is especially prevalent among low-income and minority populations, and such disparities contribute to the cycle of disadvantage experienced by vulnerable populations. Our ongoing work examining how socio-cultural factors contribute to poor contraceptive behaviors among low-income, African-American and white women has revealed that pregnancy-promoting and coercive behavior by their male partners may play a significant role in the high unintended pregnancy rates observed in these populations. National and international family planning advocates and guidelines are calling for engaging men more actively in contraceptive decision making, yet the dearth of literature on men's attitudes towards contraceptive use and pregnancy and how attitudes may vary by race curtails the development of culturally-relevant interventions. Therefore, gaining insight into men's fertility-related attitudes and behaviors is a critical next step. We propose to conduct a qualitative study utilizing in-depth interviews with 60 low-income, adult AA and white men in Pittsburgh to gain insight about men's fertility intentions and behavior in a population that is at high risk of unintended pregnancy. A particular focus of this study will be to examine attitudes and social norms regarding reproductive coercion as one potential end of the spectrum of male fertility behavior. We will also pay close attention to themes that appear to be unique to each of the two racial groups.
The specific aims of the study are to: 1) describe the spectrum of fertility intentions and behaviors among low-income men, 2) explore the relationship between men's fertility intentions and behaviors;and 3) understand how cultural and structural factors shape men's fertility intentions and behaviors. As male partners appear to play a significant role in pregnancy decisions and outcomes, there is a need to better understand their contextualized perspectives on contraception, pregnancy, and parenthood. This study will complement our ongoing qualitative work with women to provide a more complete picture of the factors that influence family planning and allow us to pinpoint specific contextual factors that contribute to poor contraceptive behaviors and risk for unintended pregnancy among low-income, AA and white populations in Pittsburgh, PA. The ultimate goal of this research is to empower women and men, regardless of race or socioeconomic status, to make effective reproductive decisions and reduce unintended and/or unilaterally- desired pregnancies.

Public Health Relevance

Unintended pregnancy is an enormous problem in the United States, and racial/ethnic minorities are at particularly high risk. Given that male partners influence reproductive decisions and outcomes, understanding men's fertility-related attitudes and behaviors and how these vary by race may provide more insights to understand the observed racial disparity in unintended pregnancy rates. This research will lay the groundwork for culturally-relevant programs that seek to bridge men's and women's fertility goals and maximize the potential for increasing the proportion of pregnancies that are congruently and consciously desired.

Agency
National Institute of Health (NIH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HD076327-01A1
Application #
8638089
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Newcomer, Susan
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Craig, Amaranta D; Dehlendorf, Christine; Borrero, Sonya et al. (2014) Exploring young adults' contraceptive knowledge and attitudes: disparities by race/ethnicity and age. Womens Health Issues 24:e281-9