This research aims to explain persistent and gendered socioeconomic differentials in U.S. contraceptive sterilization, gaining fresh insights by considering U.S. sterilization patterns in comparative context. The first research aim will examine the place of contraceptive sterilization, and its links with socioeconomic status, in the U.S. and other low-fertility countries which gathered data on contraceptive use as part of the Generations and Gender Programme (GGP); Australia, Austria, Belgium, Bulgaria, France, Georgia, Germany, Romania, and Russia. The goal is to determine whether the negative socioeconomic gradient in female sterilization and the positive socioeconomic gradient in male sterilization are specific to the U.S. context, or general phenomena of low-fertility countries. Th second research aim will examine if observed associations between contraceptive sterilization and socioeconomic status can be explained by socioeconomic differentials in demographic background factors, and union stability. For example, does a disproportionate reliance on contraceptive sterilization among disadvantaged women appear to be primarily an artifact of an accelerated childbearing schedule, higher achieved parity, and less stable union histories? In addition, we will consider if these individual correlates of contraceptive sterilization operate ina similar fashion for women versus men, and across low-fertility countries. The third research aim will examine if differentials in partners' socioeconomic resources are associated with decisions regarding contraceptive sterilization at the couple-level, net of other background factors. Decisions regarding sterilization are most commonly made within the context of an individual couple relationship, and are likely to be affected by resource-based power differentials between partners. We will examine whether sterilization should be considered a sign of control, or lack of control, over one's fertility within the couple in the U.S., and in other low-fertility countries. Multinomial logistic regression, event history analysis, and diagonal reference models will be used to analyze the secondary data of the first wave of the Generations and Gender Programme (2004-10) and the 2006-10 National Survey of Family Growth. Results of the proposed research will have important implications for reproductive health policy, as they will provide crucial input to understanding the persistent and gendered differentials in U.S. contraceptive sterilization, informing general policies and family planning programs addressing these differentials.
Sterilization has been the most prevalent method of contraception in the U.S. for decades, yet continues to be characterized by persistent and gendered socioeconomic differentials. By adopting a comparative and couple perspective, this research will provide crucial input to understanding and addressing these strong inequalities in American reproductive health, which are commonly recognized, but poorly understood.
