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Context: Mistimed and unwanted pregnancies that result in live births are commonly considered together as unintended pregnancies but they may have different precursors and outcomes. Methods: Data from 15 states participating in the 1998 Pregnancy Risk Assessment Monitoring System were used to calculate the prevalence of intended mistimed and unwanted conceptions by selected variable. Associations between unintendedness and womens behaviors and experiences before during and after the pregnancy were assessed through unadjusted relative risks. Results: The distribution of intended mistimed and unwanted pregnancies differed on nearly every variable examined; risky behaviors and adverse experiences were more common among women with mistimed than intended pregnancies and were most common among those whose pregnancies were unwanted. The likelihood of having an unwanted rather than mistimed pregnancy was elevated for women 35 or older (relative risk 2.3) and was reduced for those younger than 25 (0.8); the pattern was reversed for the likelihood of mistimed rather than intended pregnancy (0.5 vs. 1.7-2.7). Parous women had an increased risk of an unwanted pregnancy (2.1-4.0) but a decreased risk of a mistimed one (0.9). Women who smoked in the third trimester received delayed or no prenatal care did not breastfeed were physically abused during pregnancy said their partner had not wanted a pregnancy or had a low-birth-weight infant had an increased risk of unintended pregnancy; the size of the increase depended on whether the pregnancy was unwanted or mistimed. Conclusion: Clarifying the difference in risk between mistimed and unwanted pregnancies may help guide decisions regarding services to women and infants. (authors)

Background To determine differences among persons who provided blood specimens for HIV testing compared with those who did not among those interviewed for the population-based Zimbabwe Young Adult Survey (YAS). Methods Chi-square analysis of weighted data to compare demographic and behavioral data of persons interviewed who provided specimens for anonymous testing with those who did not. Prevalence estimation to determine the impact if persons not providing specimens had higher prevalence rates than those who did. Results Comparing those who provided specimens with those who did not, there was no significant difference by age, residence, education, marital status, perceived risk, sexual experience or number of sex partners for women. A significant difference by sexual experience was found for men. Prevalence estimates did not change substantially when prevalence was assumed to be two times higher for persons not providing specimens. Conclusion When comparing persons who provided specimens for HIV testing with those who did not, few significant differences were found. If those who did not provide specimens had prevalence rates twice that of those who did, overall prevalence would not be substantially affected. Refusal to provide blood specimens does not appear to have contributed to an underestimation of HIV prevalence.

Mistimed and unwanted pregnancies that result in live births are commonly considered together as unintended pregnancies, but they may have different precursors and outcomes.Data from 15 states participating in the 1998 Pregnancy Risk Assessment Monitoring System were used to calculate the prevalence of intended, mistimed and unwanted conceptions, by selected variables. Associations between unintendedness and women's behaviors and experiences before, during and after the pregnancy were assessed through unadjusted relative risks.The distribution of intended, mistimed and unwanted pregnancies differed on nearly every variable examined; risky behaviors and adverse experiences were more common among women with mistimed than intended pregnancies and were most common among those whose pregnancies were unwanted. The likelihood of having an unwanted rather than mistimed pregnancy was elevated for women 35 or older (relative risk, 2.3) and was reduced for those younger than 25 (0.8); the pattern was reversed for the likelihood of mistimed rather than intended pregnancy (0.5 vs. 1.7-2.7). Parous women had an increased risk of an unwanted pregnancy (2.1-4.0) but a decreased risk of a mistimed one (0.9). Women who smoked in the third trimester, received delayed or no prenatal care, did not breast-feed, were physically abused during pregnancy, said their partner had not wanted a pregnancy or had a low-birth-weight infant had an increased risk of unintended pregnancy; the size of the increase depended on whether the pregnancy was unwanted or mistimed.Clarifying the difference in risk between mistimed and unwanted pregnancies may help guide decisions regarding services to women and infants.

Objective: Physician-specific surveys are a frequently used tool in health services research, but attempts at ensuring adequate response rates are rarely reported. We reviewed literature of survey methodology specific to physician surveys and report those found to be most effective. Data Sources: Studies were identified by searching MEDLINE and PSYCHInfo from 1967 through February 1999. We included all English-language studies that randomized physician survey respondents to an experimental or control group. The authors independently extracted data from 24 studies examining survey methodology of physician-specific surveys. We included Mantel–Haenszel chi-squares comparing treatment groups, if present. If not, these were calculated from study data. Results: Pre-notification of survey recipients, personalizing the survey mailout package, and nonmonetary incentives were not associated with increased response rates. Monetary incentives, the use of stamps on both outgoing and return envelopes, and short questionnaires did increase response rates. Few differences were reported in response rates of phone surveys compared with mail surveys and between the demographics and practice characteristics of early survey respondents and late respondents. Conclusions: We report some simple approaches that may significantly increase response rates of mail surveys. Surprisingly, the response rates of mail surveys of physicians compared favorably with those from telephone and personal interview surveys. Nonresponse bias may be of less concern in physician surveys than in surveys of the general public. Future research steps include specifically testing the more compelling results to allow for better control of confounders.

This study analysed factors associated with unintended pregnancy among adolescent and young adult women in Santiago, Chile. Three variations of a behavioural model were developed. Logistic regression showed that the effect of sex education on unintended pregnancy works through the use of contraception. Other significant effects were found for variables reflecting socioeconomic status and a woman's acceptance of her sexuality. The results also suggested that labelling affects measurement of 'unintended' pregnancy.Using data from the Santiago Young Adult Reproductive Health Survey on 306 females aged 15-24 years living in greater Santiago in 1988 and having experienced premarital intercourse, the authors model the relationship of sex education and unintended pregnancy using social learning theory which posits that any health behavior is part of a dynamic model in which an individual's behavior is determined by the interaction of personal factors and environmental influences. Three variations of a behavioral model are developed. They found that women who had sex education before first intercourse and used contraception at that intercourse were one-third as likely to have a later unintended pregnancy as those with sex education who did not use contraception at first intercourse. Women who did not have sex education and who did not use contraception at first intercourse, however, were less likely to have an unintended pregnancy than women with no sex education who did use contraception. Across all models, moral ambivalence about premarital sexual activity is related to having an unintended pregnancy, Catholic women are twice as likely to have an unintended pregnancy as non-Catholics, and women from poorer backgrounds are less likely to use contraception and more likely to have early pregnancies. How women define their pregnancies can also affect the measurement of unintended pregnancy. It is important to effectively teach the use of contraceptives to reduce unintended pregnancies among adolescents and young adults who have premarital sexual intercourse.

The 1st-time effort the Santiago Young Adult Reproductive Health Survey 1988 was used to examine the levels of premarital sexual activity contraceptive use and unintended pregnancy among youth 15-24 years in Santiago Chile and the sociodemography associated with these levels. Questionnaires from the self-weighted probability sample were completed by 865 females and 800 males. Characteristics of respondents were as follows: 18% of the females and 9% of the males were in a union; about 40% had at least a high school education and 11% of females and 14% of males had more than secondary school. 31% of females and 8% of males neither attended school nor worked. 74% of females and 62% of males reported Catholicism as their religion but

This paper examines the association between fertility and religious affiliation among Puerto Ricans. Bongaarts' proximate determinants framework is used to compare religious categories on behaviors that directly affect fertility. We found no difference in recent fertility between Catholics and non-Catholics in Puerto Rico (total fertility rate = 2.5). We also found Catholics and non-Catholics to be similar on age at first marriage (23.3 and 23.4 years, respectively), contraceptive use (71 percent and 69 percent of married women currently contracepting), and breast-feeding practices (mean duration of breast-feeding of 4.4 and 4.3 months). Differences were observed between less committed and more committed Catholics in total fertility rate, age at first marriage, and contraceptive use, but these differences were not large and were in the opposite direction from the expected. Our findings support the theory of convergence of Catholic and non-Catholic fertility for the US. Our discrepancy with findings from the National Survey of Family Growth is evidence of the cultural diversity in the US Hispanic population and indicates the importance of disaggregating by ethnicity or national origin when studying this population.

This paper examines inter-provincial female migration in Chile for the 1965–1970 period, with a view to describing socioeconomic characteristics of migrant women and to determining differences and similarities in age, educational level, occupation, and type of move (first, return, or repeat) between movers to the capital and to other urban areas. Data are from a five percent sample of the 1970 Chilean census. Findings reveal that non-return migrants to other urban areas are differentiated from those to Santiago by an older age structure, higher educational levels, higher status occupations, and are more likely to be making a second (or higher-order) move. Moreover, educational measures suggest that recent female migration to urban Chile is more prevalent among the upper than the lower strata of the society.

The relationships between self-reported general health, employment, and attitudes toward the employment of married women have been analyzed for a representative sample of married, middle-aged women in the United States. The cross-sectional data indicate that women who were in the labor force had better health than women who were out of the labor force. In addition, women whose labor force status was compatible with their attitudes toward employment tended to have better health than women for whom there was a discrepancy between labor force status and attitudes. Analysis of the longitudinal data indicate that several causal mechanisms contributed to the relationships observed in the cross-sectional data. For the women with favorable attitudes toward employment, it appears that being a housewife had more detrimental effects on health than being employed. In contrast, for the women with unfavorable or neutral attitudes toward employment, it appears that employment status did not affect health. For healthy women, being employed may have contributed to more favorable attitudes toward employment. Healthy women were more likely than unhealthy women to stay in the labor force. Thus, it appears that there are multiple causal relationships linking employment status, attitudes toward employment and women's health.

For a sample of white women aged 45-64, women who were out of the labor force had poorer self-reported health and higher mortality than women who were in the labor force. It has been hypothesized that women who are out of the labor force may tend to exaggerate their poor health in self-report data. However, no evidence of bias of this type was found in an analysis of the relationships between self-reported health and subsequent mortality. The validity of self-reports of illness as a reason for not seeking work has been assessed using data for a sample of 30-44 year old women who were out of the labor force. Over 90% of the women who gave illness or disability as their main reason for not seeking work had previous or contemporaneous independent, self-report evidence of poor health. The findings of this study and previous evidence indicate that poor health reduces the likelihood that a woman will join the labor force, and this is a major reason why women who are not in the labor force have poorer health than those who are in the labor force.

In 1982, 69 percent of Puerto Rican women in union were practicing contraception. Forty-five percent relied on contraceptive sterilization (40 percent, female, and five percent, male), eight percent were using the pill, four percent each, the IUD and the condom, five percent relied on rhythm, and three percent were using other methods. Thus, sterilization is the dominant form of fertility regulation in Puerto Rico, and there is relatively little use of reversible methods for childspacing. Reliance on female sterilization peaks among women in union in the age-group 35-44 (54 percent), whereas pill use is highest among those aged 15-24 (approximately 23 percent). Overall, eight percent of all women aged 15-49 are at risk of unintended pregnancy because they are fecund, sexually active, not pregnant or seeking pregnancy and not using any kind of contraceptive method. However, among women in union, this risk ranges from nine percent among those aged 30-39 to 22 percent among women aged 15-19. Reliance on sterilization rather than reversible methods of contraception is strongly influenced by socio-demographic variables. Women with less than a high school education, the wives of blue-collar workers, women living outside of the major cities and those born in Puerto Rico depend upon sterilization more than do women with a college education, the wives of white-collar employees, women living in cities and those born outside of the country. These findings point to the need for improved availability of reversible family planning services, especially for young women, and those whose childbearing is incomplete.