Rapid repeat pregnancy (RRP), a pregnancy occurring less than 24 months from a prior birth, is a major public health concern in the U.S. leading to detrimental perinatal outcomes and maternal morbidity. In addition, nearly half of all pregnancies in the U.S. are unintended, and of these 43% end in induced abortions. Reductions in RRP and unintended pregnancy are national priorities in the Health People 2020 goals. Prior research indicates that reproductive control and intimate partner violence (IPV) may contribute to unintended pregnancies, poor birth spacing, and other adverse sexual health outcomes. Further research is needed that assess the role of male partners in the reproductive decision-making process to enhance current understanding of discordance in couple pregnancy intentions, reproductive control, and reproductive health. The proposed study will utilize multiple nationally representative data from the Centers of Disease Control and Prevention called the National Survey of Family Growth (2006-2010), and the national Pregnancy Risk Assessment Monitoring System (2004-2008). This study will evaluate the extent to which discordance in couple pregnancy intentions is associated with RRP and induced abortions among women of childbearing age in the U.S. RRP (defined as a second pregnancy onset within 24 months of the first pregnancy outcome) and induced abortions (of first pregnancies) will be self-reported. Couple pregnancy intentions will be based on women's feelings about getting pregnant (intended vs. unintended) and their partners'pregnancy motivations (intended vs. unintended). From these, four dyads will be created to assess all possible combinations of couple pregnancy intentions. The proposed study will also assess the extent to which IPV around the time of pregnancy (before and during pregnancy) is associated with decreased postpartum contraceptive use among women with live births in the U.S. and determine whether this association differs by race/ethnicity and receipt of birth control counseling during prenatal care. Findings may have policy and clinical implications by highlighting the important role of male partners in reproductive decisions and family planning. Results may encourage clinicians and public health workers to improve perinatal and interconception care by considering male partners or discordant couple pregnancy intentions in discussions about effective and long-acting contraceptive methods, particularly in the context of abusive relationships and other high-risk populations.

Public Health Relevance

(Relevance to Public Health) Reducing the prevalence of rapid repeat and unintended pregnancies are national priorities in Healthy People 2020 goals. Results may have policy and clinical implications by highlighting the important role of male partners in reproductive decisions and family planning. Findings may also encourage clinicians and public health workers to improve perinatal and interconception care by considering male partners or discordant couple pregnancy intentions in discussions about effective and long-acting contraceptive methods particularly in the context of abusive relationships.

Agency
National Institute of Health (NIH)
Type
Dissertation Award (R36)
Project #
1R36HS023724-01
Application #
8843593
Study Section
HSR Health Care Research Training SS (HCRT)
Program Officer
Willis, Tamara
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Virginia Commonwealth University
Department
Family Medicine
Type
Schools of Medicine
DUNS #
City
Richmond
State
VA
Country
United States
Zip Code
23298