Skip to main content

Advertisement

Log in

Intentionally or Ambivalently Risking a Short Interpregnancy Interval: Reproductive-Readiness Factors in Women’s Postpartum Non-Use of Contraception

  • Published:
Demography

Abstract

A focus of research on short interpregnancy intervals (IPI) has been on young disadvantaged women whose births are likely to be unintended. Later initiation of family formation in the United States and other high-income countries points to the need to also consider a woman’s attributes indicative of readiness for purposefully accelerated family formation achieved through short IPIs. We test for whether factors indicating “reproductive readiness”—including being married, being older, and having just had a first birth or a birth later than desired—predict a woman’s non-use of contraception in the postpartum months. We also test for whether this contraceptive non-use results explicitly from wanting to become pregnant again. The data come from the 2012–2015 Pregnancy Risk Assessment Monitoring System, representing women who recently gave birth in any of 35 U.S. states and New York City (N = 120,111). We find that these reproductive-readiness factors are highly predictive of women’s postpartum non-use of contraception because of a stated desire to become pregnant and are moderately predictive of contraceptive non-use without an explicit pregnancy intention. We conclude that planning for, or ambivalently risking, a short IPI is a frequent family-formation strategy for women whose family formation has been delayed. This is likely to become increasingly common as family formation in the United States is initiated later in the reproductive life course.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Our aims here were to err on the side of inclusivity of women who may be ambivalently risking a short IPI and to avoid selectively excluding women who did not report using another contraceptive method when they marked abstinence as a contraceptive method. As a sensitivity check, we reran our regressions excluding the 3,301 women in our analytical sample (a weighted 2.6% of the total) who reported that they were using abstinence as a contraceptive method and who marked no other method. The results were very similar to those from our reported models.

References

  • Ball, S. J., Pereira, G., Jacoby, P., de Klerk, N., & Stanley, F. J. (2014). Re-evaluation of link between interpregnancy interval and adverse birth outcomes: Retrospective cohort study matching two intervals per mother. BMJ, 349, g4333. https://doi.org/10.1136/bmj.g4333

    Article  Google Scholar 

  • Barclay, K. J., & Kolk, M. (2018). Birth intervals and health in adulthood: A comparison of siblings using Swedish register data. Demography, 55, 929–955.

    Article  Google Scholar 

  • Beaujouan, E., & Berghammer, C. (2019). The gap between lifetime fertility intentions and completed fertility in Europe and the United States. Population Research and Policy Review, 38, 507–535.

    Article  Google Scholar 

  • Boardman, L. A., Allsworth, J., Phipps, M. G., & Lapane, K. L. (2006). Risk factors for unintended versus intended rapid repeat pregnancies among adolescents. Journal of Adolescent Health, 39, 597.e1–597.e8.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2019). PRAMS [Data set]. Retrieved from https://www.cdc.gov/prams/prams-data/researchers.htm

  • Cheslack-Postava, K., & Winter, A. S. (2015). Short and long interpregnancy intervals: Correlates and variations by pregnancy timing among U.S. women. Perspectives on Sexual and Reproductive Health, 47, 19–26. https://doi.org/10.1363/47e2615

  • Class, Q. A., Rickert, M. E., Ogberg, A. S., Sujan, A. S., Almqvist, C., Larsson, H.,... D’Onofrio, B. M. (2017). Within-family analysis of interpregnancy interval and adverse birth outcomes. Obstetrics and Gynecology, 130, 1304–1311.

  • Conzuelo-Rodriguez, G., & Naimi, A. I. (2018). The impact of computing interpregnancy intervals without accounting for intervening pregnancy events. Paediatric and Perinatal Epidemiology, 32, 141–148.

    Article  Google Scholar 

  • Gemmill, A., & Lindberg, L. D. (2013). Short interpregnancy intervals in the United States. Obstetrics and Gynecology, 122, 64–71.

    Article  Google Scholar 

  • Gough, M. (2017). Birth spacing, human capital, and the motherhood penalty at midlife in the United States. Demographic Research, 37, 363–416. https://doi.org/10.4054/DemRes.2017.37.13

    Article  Google Scholar 

  • Guzzo, K. B., Eickmeyer, K., & Hayford, S. R. (2018). Does postpartum contraceptive use vary by birth intendedness? Perspectives on Sexual and Reproductive Health, 50, 129–138. https://doi.org/10.1363/psrh.12074

  • Guzzo, K. B., & Hayford, S. R. (2014). Revisiting retrospective reporting of first-birth intendedness. Maternal and Child Health Journal, 18, 2141–2147.

    Article  Google Scholar 

  • Hanley, G. E., Hutcheon, J. A., Kinniburgh, B. A., & Hanley, L. L. (2017). Interpregnancy interval and adverse pregnancy outcomes: An analysis of successive pregnancies. American Journal of Obstetrics and Gynecology, 129, 408–415.

    Article  Google Scholar 

  • Hartnett, C. S., & Margolis, R. (2019). Births that are later-than-desired: Correlates and consequences. Population Research and Policy Review, 38, 483–505.

    Article  Google Scholar 

  • Herr, J. L. (2016). Measuring the effect of the timing of first birth on wages. Journal of Population Economics, 29, 39–72.

    Article  Google Scholar 

  • Klebanoff, M. A. (2017). Interpregnancy interval and pregnancy outcomes: Causal or not? American Journal of Obstetrics and Gynecology, 129, 405–407.

    Article  Google Scholar 

  • Kost, K., & Lindberg, L. (2015). Pregnancy intentions, maternal behaviors, and infant health: Investigating relationships with new measures and propensity score analysis. Demography, 52, 83–111.

    Article  Google Scholar 

  • Koullali, B., Kamphuis, E. I., Hof, M. H. P., Robertson, S. A., Pajkrt, E., de Groot, C. J. M.,... Ravelli, A. C. J. (2017). The effect of interpregnancy interval on the recurrence rate of spontaneous preterm birth: A retrospective cohort study. American Journal of Perinatology, 34, 174–182.

    Google Scholar 

  • Martin, J. A., Hamilton, B. E., Osterman, M. J. K., Driscoll, A. K., & Drake, P. (2018). Births: Final data for 2016 (National Vital Statistics Reports Vol. 67, No. 1). Hyattsville, MD: National Center for Health Statistics.

  • McQuillan, J., Greil, A. L., & Shreffler, K. M. (2011). Pregnancy intentions among women who do not try: Focusing on women who are okay either way. Maternal and Child Health Journal, 15, 178–187.

    Article  Google Scholar 

  • Miller, W., Barber, J. S., & Gatny, H. (2013). Ambivalent fertility desires: Effects on pregnancy risk in young women. Population Studies, 67, 25–38.

    Article  Google Scholar 

  • Molitoris, J., Barclay, K. J., & Kolk, M. (2019). When and where birth spacing matters for child survival: An international comparison using the DHS. Demography, 56, 1349–1370.

    Article  Google Scholar 

  • Rendall, M. S., & Smallwood, S. (2003). Higher qualifications, first-birth timing, and further childbearing in England and Wales. Population Trends, 111, 18–26.

    Google Scholar 

  • Sacher, B. Z., Mayo, J. A., Lyell, D. J., Baer, R. J., Jeliffe-Pawlowski, L. L., Stevenson, D. K., & Shaw, G. M. (2016). Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: A retrospective cohort study. BJOG: An International Journal of Obstetrics and Gynecology, 123, 2009–2017.

    Article  Google Scholar 

  • Teitler, J. O., Das, D., Kruse, L., & Reichman, N. E. (2012). Prenatal care and subsequent birth intervals. Perspectives on Sexual and Reproductive Health, 44, 13–21.

    Article  Google Scholar 

  • Tocce, K. M., Sheeder, J. L., & Teal, S. B. (2012). Rapid repeat pregnancy in adolescents: Do immediate postpartum contraceptive implants make a difference? American Journal of Obstetrics and Gynecology, 206, 481.e1–481.e7.

    Article  Google Scholar 

  • Troske, K. R., & Voicu, A. (2013). The effect of the timing and spacing of births on the level of labor market involvement of married women. Empirical Economics, 45, 483–521.

    Article  Google Scholar 

  • Trussell, J. R. (2011). Contraceptive failure in the United States. Contraception, 83, 397–404.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services. (n.d.). Healthy People 2020 topics & objectives: Family planning. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives

  • White, K., Teal, S. B., & Potter, J. E. (2015). Contraception after delivery and short interpregnancy intervals among women in the United States. Obstetrics & Gynecology, 125, 1471–1477.

    Article  Google Scholar 

  • Williams, L., Abma, J., & Piccinino, L. J. (1999). Repeat unintended, unwanted and seriously mistimed childbearing in the United States. Perspectives on Sexual and Reproductive Health, 31, 220–227.

    Google Scholar 

  • Wilson, E. K., Fowler, C. I., & Koo, H. P. (2013). Postpartum contraceptive use among adolescent mothers in seven states. Journal of Adolescent Health, 52, 278–283.

    Article  Google Scholar 

  • World Health Organization (WHO). (2007). Report of a WHO technical consultation on birth spacing (Report No. WHO/RHR/07.1). Geneva, Switzerland: World Health Organization.

Download references

Acknowledgments

The data and documentation are provided by the PRAMS Working Group and the Centers for Disease Control and Prevention. We thank Michel Boudreaux and Julia Steinberg, and participants at the annual meeting of the 2018 Population Association of America and the Johns Hopkins University Population, Family and Reproductive Health seminar series, for comments on earlier versions. This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, population research infrastructure grant P2C-HD041041, and a research grant from a private philanthropic foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael S. Rendall.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(PDF 105 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rendall, M.S., Harrison, E.Y. & Caudillo, M.L. Intentionally or Ambivalently Risking a Short Interpregnancy Interval: Reproductive-Readiness Factors in Women’s Postpartum Non-Use of Contraception. Demography 57, 821–841 (2020). https://doi.org/10.1007/s13524-020-00859-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13524-020-00859-7

Keywords

Navigation