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Perspectives in Sexual and Reproductive Health

Contraceptive Sterilization: Introducing A Couple Perspective to Examine Sociodemographic Differences in Use
CONTEXT Most studies of contraceptive use have relied solely on the woman's perspective, but because men's attitudes and preferences are also important, analytic approaches based on couples should also be explored. METHODS Data from the 2006–2010 and 2011–2013 rounds of the National Survey of Family Growth yielded a sample of 4,591 men and women who were married or cohabiting with an opposite‐sex partner and who had completed their intended childbearing. Respondents’ reports of both their own and their partners’ characteristics and behaviors were employed in two sets of analyses examining educational and racial and ethnic differences in contraceptive use: an individualistic approach (using multinomial logistic regression) and a couple approach (using multinomial logistic diagonal reference models). RESULTS In the full model using the individualistic approach, respondents with less than a high school education were less likely than those with at least a college degree to rely on male sterilization (odds ratios, 0.1–0.2) or a reversible method (0.4–0.5), as opposed to female sterilization. Parallel analyses limited to couples in which partners had the same educational levels (i.e., educationally homogamous couples) showed an even greater difference between those with the least and those with the most schooling (0.03 for male sterilization and 0.2 for a reversible method). When race and ethnicity, which had a much higher level of homogamy, were examined, the approaches yielded more similar results. CONCLUSIONS Research on contraceptive use can benefit from a couple approach, particularly when focusing on partners’ characteristics for which homogamy is relatively low.

Sexual Orientation Disparities in Mistimed and Unwanted Pregnancy Among Adult Women
CONTEXT Many sexual minority women, regardless of sexual identity, engage in heterosexual behavior across the life course, which provides them opportunities to experience an unintended pregnancy. In addition, sexual minority women are more likely than others to report characteristics that may make them vulnerable to unintended pregnancy. Little research, however, has examined whether the risk of unintended pregnancy is elevated among these women. METHODS Using data from the 2006–2010 National Survey of Family Growth, logistic regression models were fitted to examine sexual orientation disparities in mistimed and unwanted pregnancies among 9,807 women aged 20–45; mixed‐effects hazard models assessed disparities in the intention status of 5,238 pregnancies among these women by maternal sexual orientation. RESULTS Compared with heterosexual women reporting only male partners, heterosexual women who have sex with women had higher odds of reporting a mistimed pregnancy (odds ratio, 1.4), and bisexual women had higher odds of reporting an unwanted pregnancy (1.8). When compared with pregnancies reported by heterosexual women with only male partners, those reported by heterosexual women who have sex with women were more likely to be mistimed (hazard ratio, 1.7), and those reported by bisexual and lesbian women were more likely to be unwanted (1.7–4.4). CONCLUSIONS Compared with heterosexuals who have sex with men only, adult sexual minority women are at equal or greater risk of reporting an unintended pregnancy. More research addressing the reproductive health care needs of sexual minority women is needed to develop strategies to improve family planning for this population.

Guttmacher Policy Report

Guttmacher Institute Announces Fourth Cory L. Richards Memorial Scholarship Recipient

The Guttmacher Institute is pleased to announce Molly Kelly as the recipient of the 2017 Cory L. Richards Memorial Scholarship. Ms. Kelly, who was chosen from an exceptionally strong pool of more than 140 candidates, will use the scholarship to complete her Master’s degree in public policy with a concentration in women’s studies at George Washington University.

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<July 2017>