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Reconsidering (in)equality in the use of IUDs in the United States: A closer look across the reproductive life course

Author

Listed:
  • Megan Sweeney

    (University of California, Los Angeles)

  • Mieke Eeckhaut

    (University of Delaware)

  • Jessica D. Gipson

    (University of California, Los Angeles)

Abstract

Background: Long-acting reversible contraceptives (LARCs), such as the intrauterine device (IUD), have received increased attention for their contraceptive effectiveness and reversibility. Although demographers have long acknowledged the importance of parity and childbearing intentions for contraceptive choice, we know little about how contraceptive use varies across the reproductive life course. Objective: Guided by the expectation that contraceptive method characteristics (e.g., reversibility, effectiveness) contribute to method choice ‒ and that the salience of method characteristics vary by reproductive life stage and education ‒ we investigate variability in IUD use patterns. Methods: We use 2008–2010 and 2011–2013 National Survey of Family Growth data to compare women’s IUD-use patterns across educational groups and at three reproductive life stages: before a first birth occurs (“starters”), between births (“spacers”), and after planned childbearing ends altogether (“limiters”). Results: IUD use is more common among spacers than among starters or limiters. Moreover, IUD use is associated with educational advantage among starters and limiters, but not among spacers. Educational differences in IUD use among starters and limiters persist when demographic background characteristics are controlled. Conclusions: Our understanding of variability in IUD use changes considerably when viewing educational gradients through the lens of the reproductive life course. Contribution: We shed new light on variability in IUD use across the reproductive life course. To best support women’s contraceptive preferences, it is important to consider the ways in which structural determinants (e.g., education, reproductive health policies and programs) shape women’s contraceptive choices at various stages of the reproductive life course.

Suggested Citation

  • Megan Sweeney & Mieke Eeckhaut & Jessica D. Gipson, 2020. "Reconsidering (in)equality in the use of IUDs in the United States: A closer look across the reproductive life course," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 43(35), pages 1049-1066.
    • Handle: RePEc:dem:demres:v:43:y:2020:i:35
    DOI: 10.4054/DemRes.2020.43.35
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    References listed on IDEAS

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    1. Ronald Rindfuss & S. Morgan & Kate Offutt, 1996. "Education and the changing age pattern of American fertility: 1963–1989," Demography, Springer;Population Association of America (PAA), vol. 33(3), pages 277-290, August.
    2. Adeline Delavande, 2008. "Pill, Patch, Or Shot? Subjective Expectations And Birth Control Choice," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 49(3), pages 999-1042, August.
    3. Krystale Littlejohn, 2012. "Hormonal Contraceptive Use and Discontinuation Because of Dissatisfaction: Differences by Race and Education," Demography, Springer;Population Association of America (PAA), vol. 49(4), pages 1433-1452, November.
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    Cited by:

    1. Mieke C. W. Eeckhaut, 2022. "Can LARC Fulfill Its Potential to Reduce U.S. Women’s Unintended Pregnancy Risk? Examining Women’s Contraception and Childbearing in the Year Before Initiating LARC," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(3), pages 789-799, June.

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    More about this item

    Keywords

    contraceptive intention; inequality; pregnancy intentions; pregnancy; United States of America;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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