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Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates

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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.

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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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Authors and Affiliations

  1. Divison of General Internal Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA

    Sonya Borrero MD, MS, Charity G. Moore PhD, MSPH, Li Qin PhD, Eleanor B. Schwarz MD, MS & Said A. Ibrahim MD, MPH

  2. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA

    Sonya Borrero MD, MS & Said A. Ibrahim MD, MPH

  3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine and Magee Women’s Research Institute, Pittsburgh, PA, USA

    Eleanor B. Schwarz MD, MS, Aletha Akers MD, MPH & Mitchell D. Creinin MD

  4. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

    Mitchell D. Creinin MD

Authors
  1. Sonya Borrero MD, MS
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  2. Charity G. Moore PhD, MSPH
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  3. Li Qin PhD
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  6. Mitchell D. Creinin MD
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  7. Said A. Ibrahim MD, MPH
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Correspondence to Sonya Borrero MD, MS.

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Borrero, S., Moore, C.G., Qin, L. et al. Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates. J GEN INTERN MED 25, 122–128 (2010). https://doi.org/10.1007/s11606-009-1197-0

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  • DOI: https://doi.org/10.1007/s11606-009-1197-0

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