Journal of General Internal Medicine

, Volume 25, Issue 2, pp 122–128 | Cite as

Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

  • Sonya Borrero
  • Charity G. Moore
  • Li Qin
  • Eleanor B. Schwarz
  • Aletha Akers
  • Mitchell D. Creinin
  • Said A. Ibrahim
Original Article

Abstract

BACKGROUND

Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.

OBJECTIVE

To examine the associations among race/ethnicity, unintended pregnancy, and tubal sterilization.

DESIGN AND PARTICIPANTS

Cross-sectional analysis of data from a nationally representative sample of women aged 15–44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth.

MAIN MEASURES

Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization.

KEY RESULTS

Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6–2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80–1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3–1.9 and OR: 1.4; 95% CI: 1.2–1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95–1.4 for AA women and OR: 1.3; 95% CI: 1.0–1.6 for Hispanic women).

CONCLUSION

Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.

KEY WORDS

unintended pregnancy minority women tubal sterilization 

Notes

Acknowledgements

This manuscript was made possible by Dr. Borrero’s grant (05 KL2 RR024154-04) from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official view of NCRR or NIH.

Conflict of Interest

None disclosed.

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Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Sonya Borrero
    • 1
    • 2
  • Charity G. Moore
    • 1
  • Li Qin
    • 1
  • Eleanor B. Schwarz
    • 1
    • 3
  • Aletha Akers
    • 3
  • Mitchell D. Creinin
    • 3
    • 4
  • Said A. Ibrahim
    • 1
    • 2
  1. 1.Divison of General Internal MedicineUniversity of Pittsburgh School of MedicinePittsburghUSA
  2. 2.Center for Health Equity Research and PromotionVA Pittsburgh Healthcare SystemPittsburghUSA
  3. 3.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of Medicine and Magee Women’s Research InstitutePittsburghUSA
  4. 4.Department of EpidemiologyUniversity of Pittsburgh Graduate School of Public HealthPittsburghUSA

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