IDEAS home Printed from https://ideas.repec.org/a/dem/demres/v44y2021i37.html
   My bibliography  Save this article

Has contraceptive use at pregnancy an effect on the odds of spontaneous termination and induced abortion? Evidence from Demographic and Health Surveys

Author

Listed:
  • David A. Sánchez-Páez

    (Universidad de Valladolid)

  • José Antonio Ortega

    (Universidad de Salamanca)

Abstract

Background: Contraceptive failure increases the chances of pregnancy termination, including both induced abortions and spontaneous terminations. Proper separation requires accounting for competing risks of pregnancy outcomes. Objective: To measure the differential risk of spontaneous termination and induced abortion according to contraceptive use prior to pregnancy based on pooled Demographic and Health Survey calendar data. Methods: We use multinomial logistic models controlling for demographic and socioeconomic variables to estimate the differential risk of spontaneous termination and induced abortion according to contraceptive use at the time of pregnancy. We address data limitations including recall error, omission error, and possible misclassification of outcomes. Results: We find higher risk of induced abortion (RRR = 7.18, CI = 6.38–8.09) and spontaneous termination (RRR = 1.38, CI = 1.13–1.69) after contraceptive failure, with stronger effect for women under 30. Parity, union status, education, and wealth have a strong effect on induced abortion. Regarding spontaneous termination, age mainly explains the increased risk. Conclusions: Since pregnancies following contraceptive failure are less likely to end in a live birth, aggregate models of the impact of family planning should reflect that contraceptive use and induced abortion conform interdependent strategies and that spontaneous termination is a competing risk of induced abortion. Contribution: This is the first study reporting differences in the risk of spontaneous termination and induced abortion according to contraceptive use prior to pregnancy. We account for competing risks using a multinomial logit model of pregnancy outcomes conditional on pregnancy, new in the literature. Data limitations are addressed in novel ways.

Suggested Citation

  • David A. Sánchez-Páez & José Antonio Ortega, 2021. "Has contraceptive use at pregnancy an effect on the odds of spontaneous termination and induced abortion? Evidence from Demographic and Health Surveys," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 44(37), pages 879-898.
    • Handle: RePEc:dem:demres:v:44:y:2021:i:37
    DOI: 10.4054/DemRes.2021.44.37
    as

    Download full text from publisher

    File URL: https://www.demographic-research.org/volumes/vol44/37/44-37.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.4054/DemRes.2021.44.37?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Salma Ahmed & Ranjan Ray, 2013. "Determinants of Pregnancy, Induced and Spontaneous Abortion in a Jointly Determined Framework: Evidence from a Country wide District Level Household Survey in India," Monash Economics Working Papers 13-13, Monash University, Department of Economics.
    2. Grant Miller & Christine Valente, 2016. "Population Policy: Abortion and Modern Contraception Are Substitutes," Demography, Springer;Population Association of America (PAA), vol. 53(4), pages 979-1009, August.
    3. Grant Miller and Christine Valente, 2016. "Population Policy: Abortion and Modern Contraception are Substitutes - Working Paper 426," Working Papers 426, Center for Global Development.
    4. R. Potter & K. Ford & B. Moots, 1975. "Competition between spontaneous and induced abortion," Demography, Springer;Population Association of America (PAA), vol. 12(1), pages 129-141, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David A Sánchez-Páez & José Antonio Ortega, 2019. "Reported patterns of pregnancy termination from Demographic and Health Surveys," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-25, August.
    2. Catia Nicodemo & Sonia Oreffice & Climent Quintana-Domeque, 2022. "Correlates of repeat abortions and their spacing: Evidence from registry data in Spain," Papers 2208.05567, arXiv.org, revised May 2023.
    3. Bhalotra, Sonia R. & Clarke, Damian & Gomes, Joseph & Venkataramani, Atheendar, 2018. "Maternal Mortality and Women's Political Participation," IZA Discussion Papers 11590, Institute of Labor Economics (IZA).
    4. Sonia Bhalotra & Damian Clarke & Joseph Flavian Gomes & Atheendar Venkataramani, 2023. "Maternal Mortality and Women’s Political Power," Journal of the European Economic Association, European Economic Association, vol. 21(5), pages 2172-2208.
    5. Amanda J. Felkey & Kristina M. Lybecker, 2018. "Do Restrictions Beget Responsibility? The Case of U.S. Abortion Legislation," The American Economist, Sage Publications, vol. 63(1), pages 59-70, March.
    6. Bhalotra, Sonia R. & Clarke, Damian & Mühlrad, Hanna & Fernandez Sierra, Manuel, 2021. "US Presidential Party Switches Are Mirrored in Global Maternal Mortality," IZA Discussion Papers 14915, Institute of Labor Economics (IZA).
    7. Nuevo-Chiquero, Ana & Pino, Francisco J., 2019. "To Pill or Not to Pill? Access to Emergency Contraception and Contraceptive Behaviour," IZA Discussion Papers 12076, Institute of Labor Economics (IZA).
    8. Charles Mode & Roger Avery & Gary Littman & Robert Potter, 1977. "Methodological issues underlying multiple decrement life table analysis," Demography, Springer;Population Association of America (PAA), vol. 14(1), pages 87-96, February.
    9. Thomas Pullum & Stephen Williams, 1977. "A vital statistics-based procedure for estimating conception rates," Demography, Springer;Population Association of America (PAA), vol. 14(2), pages 223-238, May.
    10. Robert Potter & Kathleen Ford, 1976. "Repeat abortion," Demography, Springer;Population Association of America (PAA), vol. 13(1), pages 65-82, February.
    11. Clarke, Damian & Salinas, Viviana, 2020. "Access to The Emergency Contraceptive Pill Improves Women's Health: Evidence from Chile," IZA Discussion Papers 13134, Institute of Labor Economics (IZA).
    12. Kathleen Ford, 1976. "Abortion and family building models: Fertility limitation in Hungary," Demography, Springer;Population Association of America (PAA), vol. 13(4), pages 495-505, November.

    More about this item

    Keywords

    induced abortion; contraceptive use; reproductive health; contraceptive calendar; pregnancy termination;
    All these keywords.

    JEL classification:

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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:dem:demres:v:44:y:2021:i:37. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Editorial Office (email available below). General contact details of provider: https://www.demogr.mpg.de/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.