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Sub-Saharan Africa (SSA) has a disproportionate burden of both unintended fertility and HIV infection, but the relationship between these two reproductive health risks is not well understood. This paper investigates the association between HIV status and unintended (mistimed and unwanted) fertility and examines multilevel predictors and national variations of unintended fertility among HIV-positive women across countries in SSA. Multilevel multinomial logistic regression models are applied to Demographic and Health Surveys data collected during 2006–2014 from 25 countries of SSA. Overall findings reveal that across countries of SSA, pregnancies of HIV-positive women are, on average, less likely to be mistimed (RR = 0.90, p

Reliance on traditional methods of birth control causes psychological tension in couples because the fear of unwanted pregnancy bars them from experiencing a healthy sexual life. However, in Assam, half of all contraceptive users depend on traditional methods of birth control. The current study used National Family Health Survey 2005–2006 data. Out of 3840 sample women in the age group 15–49 years, 1286 women are filtered for the present study. Most of the demographic and socioeconomic characteristics of traditional method users fall between those of modern spacing method users and terminal method users. Thus, the burden of unwanted fertility is highest among the traditional method users.

The distinction between wanted and unwanted fertility has been crucial in many of the more intense debates in recent decades over the nature of contemporary fertility declines and, in particular, the potential impact of expanded provision of family planning services. In a much-debated article published in 1994, Pritchett argues that decline in desired fertility is overwhelmingly the principal source of fertility decline, with the implication that family planning programmes are of little consequence. I revisit this debate drawing on a far larger body of survey data and, more importantly, an alternative fertility specification which relies on a non-conventional definition of wanted and unwanted fertility rates and which distinguishes rates and composition. Decompositions of fertility decline in the period from the mid-1970s to the present are carried out for 44 countries. The decomposition results indicate that declines in unwanted fertility rates have been at least as important, if not more important, than declines in wanted fertility rates. Surprisingly, shifts in the proportion of women wanting to stop childbearing—i.e., changes in preference composition—has contributed very little to fertility change in this period. Further, decline in wanted fertility and increases in non-marital exposure (due largely to delayed entry into first marriage) have also made substantial contributions, although on average they fall short of the contribution of declines in unwanted fertility rates. That declines in unwanted fertility have been an essential feature of contemporary fertility decline is the main conclusion from this research. This in turn opens the door to new perspectives on fertility pre-, mid-, and post-transition which recognises the inter-dependencies between fertility demand and unwanted fertility rates in the determination of the overall level of fertility. JEL classification: J11, J13, R11 Keywords: Demography, Fertility, Family Planning, Regional Economics

The estimation of unwanted fertility is a major objective of demographic surveys, including DHS surveys conducted in Asia, Africa, and Latin America. Levels and trends in unwanted fertility are important input to the formulation of population policy and the evaluation of family planning programs. Yet existing methods for estimating unwanted fertility are known to be defective, among other reasons because they rely on subjective data whose validity and reliability are questionable. In this article, we propose a new estimator of unwanted fertility—the “aggregate prospective estimator”—so-named because it depends on the stated preference for another child at the time of the survey, the fertility-desires item consistently shown to possess the highest validity and reliability. Under reasonable assumptions, the aggregate prospective estimator produces less biased estimates of unwanted fertility than the most widely used existing methods. The new estimator has the limitation of generating only aggregate-level estimates, but such estimates are the primary data for policy formulation and program evaluation. The new estimator is presented in this article, along with an evaluation of its underlying assumptions and its sensitivity to several sources of error. In an illustrative application to recent DHS data from six countries, the new estimator yields substantially higher estimates of unwanted fertility than existing methods in all six countries.

Using a conceptual framework focusing on factors that enhance or reduce fertility relative to desired family size (see Bongaarts 2001), we study fertility variation across time (1992–2006) and space (states) in India. Our empirical analyses use data from three waves of the Indian National Family Health Surveys. We find that this framework can account for a substantial portion of the variation in the total fertility rate (TFR) over time and across states. Our estimates focus attention on the critical components of contemporary Indian fertility, especially desired family size, unwanted fertility, son preference, and fertility postponement.

This paper uses Demographic and Health Surveys data from about 30 sub-Saharan African countries to investigate the link between the birth of an ?unintended child? and schooling decisions of children (dropout and entry). After controlling for local unobserved heterogeneity, we show that, the birth of an ?unintended child? hinders child schooling. It reduces the probability of current school enrolment. As for school dynamics, it increases the probability that a child aged 6 to 18 years drops out of school and it decreases the probability that a child aged 6 to 9 years starts schooling. This result suggests that, the unexpected birth of a child strengthens household?s resources constraints and reduces human capital investments. The results also highlight the importance of the timing of the unexpected birth and the heterogeneity of the effect according to child characteristics.

1. Setting the scene: disciplines, settings and multi-professional teams 2. Nurses' impact on care, role, training and career pathway 3. The basics 4. Paediatric and adolescent gynaecology 5. Menstrual and bleeding disorders 6. Hormone and endocrine disorders 7. Other disorders of women's health 8. Sexual health 9. Menopause 10. Bladder and urogenital prolapse 11. Gynaecological oncology 12. Nursing care of gynaecological patients in hospital 13. Contraception 14. Unwanted fertility 15. Early pregnancy problems 16. Care of the woman in emergency gynaecology units 17. Fertility and subfertility 18. Colposcopy 19. Breast 20. Lifestyle issues

This study examined unmet need in Morocco. Data were obtained from the 1992 and 1995 Demographic and Health Surveys among 3324 women aged 15-46 years in 1992 and from 1429 new respondents aged 15-17 years in 1995. Analysis is based on a subsample of 1682 women who were interviewed twice. Unmet need excludes the intentions of pregnant or amenorrheic women who desired more children or intended to resume use. During 1992-95 the number of women in need of contraception declined from 21% to 12%. The proportion of women using a contraceptive method increased from 46% to 56%. 84% of women in 1992 with unmet need for spacing gave birth in the following 3 years or were pregnant. 58% of women who had unmet need for limiting gave birth by 1995 or were currently pregnant. Only 33% of these births were reported as unwanted. 15% of the re-interviewed sample wanted no more children but were not using contraception. 25% of women who were using contraception in 1992 and wanted no more children gave birth by 1995; 46% reported the birth as unwanted. 29% of women with unmet need in 1992 had unmet need in 1995. 77% of women who were using a method in 1992 were using a method in 1995. Only 5% stopped using and moved into the unmet need group. 51% of women in the "other" nonuser group were still there in 1995. The authors expressed particular concern about the 5% of all married women (the total re-interview sample) who had unmet need in both years because the women contributed to 66% of unwanted fertility. Opposition to contraception for religious reasons or due to partners objections were the hardest to overcome.

The concepts of pregnancy unwantedness and unwanted fertility have a range of definitions, nor are reports consistent for concept use. This report examines various definitions and their application. Considering a measure of unwantedness as underinvestment in the child, a scale is described which examines the extent to which the unwanted child may be subjected to underinvestment. The hypothesis of an association between unwantedness and underinvestment was not supported. The conclusion is that unwantedness requires conceptual standardization and a behavioral definition for sociological use.

Life-table estimates indicate that one-quarter of U.S. women intend no more births by age 25, one-half by age 27, and three-quarters by age 30. The resulting long period at risk of unwanted fertility is argued to be an important underlying dimension of the revolution in attitudes to and practice of sterilization. Life-table estimates are then considered of the timing of sterilization after the last wanted birth. Almost one-quarter of all couples select sterilization within the first year after they have had the number of children they desire. Recent experience would imply that four-fifths of all couples will eventually use contraceptive sterilization. In order to examine the determinants of men's and women's sterilization, logistic regression is used with a polytomous dependent variable: sterilization of the woman, sterilization of the man, or no sterilization within four years of the last wanted birth. Covariates considered are age and parity at last wanted birth, year and duration of marriage at last wa...

SummaryPatterns of contraceptive method change and their association with reproductive motivation and contraceptive failure are examined using data from a 1986 survey of family planning behaviour of rural Sinhalese married women aged 15–44 in seventeen districts of Sri Lanka. A notable degree of rationality in contraceptive method changes occurs with family formation. The attempt to control unwanted fertility leads to more efficacious use of contraception, including traditional methods. Some methodological improvements to the analysis of contraceptive switching are indicated. Implications of the findings for programmatic emphasis on permanent versus non-permanent modern methods are discussed.

A population simulation (POPSIM) strategy is used to attempt to assess the maximum theoretical impact of a postpartum recruitment program on unwanted fertility. The POPSIM program is a microsimulation routine in which each individual in the program is "aged" individually. The sample used consisted of 1036 white women and 445 nonwhite women aged 18-44 from North Carolina urban areas. Ideally by the end of 5 years this program would avert 90% of the unwanted black births; 90% of the unwanted white births would be averted in 10 years. The implication of these simulations for recruitment strategies is that every program should include a postpartum program as part of its services organization. After 5 years only postpartum recruitment would be needed.

Different teachings on family and procreation make balancing the demands of church and career more difficult for Catholic than Protestant women. Examination of 1965 National Fertility Survey data reveals fertility differences by religious affiliation primarily for women who worked in the past but are not now employed. For Catholics their fertility is high and similar to that of women who have never worked; for Protestants their fertility is low and similar to that of currently employed women. Further analysis of unwanted fertility suggests this pattern occurs because lower contraceptive efficacy leads more Catholic women to leave the labor force. (authors)

2 different data sources were used to determine the answers to the questions: 1) Are the poor less likely to use physician-administered contraception (PAC) than the nonpoor? 2) Are the poor more likely to use drugstore methods than the nonpoor? 3) Do the poor have higher rates of unwanted births than the nonpoor? and 4) Can the higher rates of unwanted births to the poor be attributed to their lower use of PAC? It was determined that there are no important differences in the use of PAC among whites by income but that among blacks PAC is more common among high income women than among low. The poor are not more likely to use drugstore methods than the nonpoor. The poor of each race have higher rates of unwanted births. It is unlikely that the differences in rates of unwanted fertility as large as those observed could be caused by the trivial differences in method use. Increase of the use of PAC among the poor would not substantially reduce the gap in unwanted fertility between the poor and nonpoor.