Adolescent and sexual history factors influencing reproductive control among women aged 18-44

Reproductive control refers to the ability of a man or woman to control his or her own reproduction. Unintended pregnancy is a commonly used proxy measure for reproductive control.

Using heterosexually active women participating in the National Survey of Family Growth Cycle 6 (n = 4521), we evaluated unintended pregnancy as a proxy measure for reproductive control. We identified four categories of women by self-reported pregnancy intention: (1) women reporting one unintended pregnancy, (2) women reporting two or more unintended pregnancies, (3) women reporting intentionally having no pregnancies and (4) women who reported that all pregnancies were intended (reference category). Polytomous logistic regression, weighted for the complex sampling design, provided estimates of odds ratios (OR) and 95% confidence intervals (CI).

Fifty-one percent of women who reported having one unintended pregnancy went on to experience at least one additional unintended pregnancy. Being black, Hispanic, born to a mother who was <18 years at first birth, having multiple partners and age of first sexual debut (consensual or non-consensual) were significant predictors of multiple unintended pregnancies. Relative to sexual debut after 18 years of age, women reporting a sexual debut at less than 15 years were at increased risk of multiple unintended pregnancies (adjusted OR (reported as consensual): 6.96; 95% CI: 4.26 to 11.39; adjusted OR (reported as non-consensual: 27.10; 95% CI: 11.03-66.57)).

Efforts to delay sexual debut and to protect girls from non-consensual sex are sorely needed to prevent a lifelong trajectory of lack of reproductive control.