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Assessing Trends in the Desire to Avoid Pregnancy: A Cautionary Note
Studies in Family Planning
|July 24, 2024
Summary
Understanding fertility preferences is key to reproductive health. This study reveals that the "demand for contraception" measure overstates trends, showing actual contraceptive changes stem mainly from better use of existing fertility desires.
Area of Science:
- Reproductive Health
- Demography
- Sociology
Background:
- The desire to avoid pregnancy is a crucial indicator of sexual and reproductive health.
- Existing measures of this desire, such as prospective fertility preferences and the demand for contraception construct, yield different historical trend assessments.
- Discrepancies in these measures impact understanding of contraceptive use changes.
Purpose of the Study:
- To critically evaluate two measures of the desire to avoid pregnancy: prospective fertility preferences and the demand for contraception construct.
- To identify and correct for biases in the demand for contraception measure, particularly "reverse causality."
- To accurately assess the drivers of historical contraceptive change.
Main Methods:
- Comparative analysis of historical trends using prospective fertility preferences and the demand for contraception construct.
- Empirical investigation to demonstrate how the demand for contraception construct is influenced by contraceptive prevalence.
- Decomposition analysis of contraceptive change, first with the distorted measure and then corrected for "reverse causality."
Main Results:
- The demand for contraception construct significantly overstates the historical trend in the desire to avoid pregnancy by approximately 25 percentage points due to "reverse causality."
- Contraceptive change is primarily driven by the more complete implementation of existing fertility preferences, not by changes in preferences themselves.
- Historical fertility preferences have shown surprisingly little change, partly due to a shift towards lower parity births.
Conclusions:
- The demand for contraception construct, as currently formulated, provides a distorted view of historical trends in the desire to avoid pregnancy.
- Accurate assessment reveals that increased contraceptive use is mainly due to better adherence to established fertility intentions.
- Shifts in parity composition towards lower parities contribute to the stability of historical fertility preferences.
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