Revisiting retrospective reporting of first-birth intendedness

Because birth intendedness is typically measured retrospectively, researchers have raised concerns about the accuracy of reporting. Our objective was to assess the stability of intendedness reports for women asked about the same birth at different times. We used data from Wave III (2001-2002; ages 18-24) and Wave IV (2007-2008; ages 25-32) of the National Longitudinal Study of Adolescent Health, a nationally representative school-based sample first surveyed in 1995. For the 1,463 women who reported a first birth by Wave III that could be matched with the same birth reported at Wave IV, we examined whether intendedness was characterized consistently at both waves. We constructed descriptive measures of consistency in reporting and estimated logistic regression models predicting changes in reports. Nearly four-fifths of young mothers did not change their reports across waves, with about 60 % reporting their first birth as unintended. However, 22 % of women changed the intendedness categorization of their first birth between surveys. Women who initially reported the birth as intended were more likely to recategorize the birth as unintended than vice versa. With the exception of race and employment, most socioeconomic and demographic characteristics were unrelated to the likelihood of recategorizing first birth intendedness in multivariate models. Most reports of birth intentions are stable, but there is a nontrivial degree of inconsistency. Cross-sectional reports may either under- or overestimate the prevalence of unintended fertility. It remains to be seen whether, and how, consistency of reports is linked to maternal and child health and well-being.