Published in:
01-02-2010 | Original Article
Unintended Pregnancy Influences Racial Disparity in Tubal Sterilization Rates
Authors:
Sonya Borrero, MD, MS, Charity G. Moore, PhD, MSPH, Li Qin, PhD, Eleanor B. Schwarz, MD, MS, Aletha Akers, MD, MPH, Mitchell D. Creinin, MD, Said A. Ibrahim, MD, MPH
Published in:
Journal of General Internal Medicine
|
Issue 2/2010
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Abstract
BACKGROUND
Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.
OBJECTIVE
To examine the associations among race/ethnicity, unintended pregnancy, and tubal sterilization.
DESIGN AND PARTICIPANTS
Cross-sectional analysis of data from a nationally representative sample of women aged 15–44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth.
MAIN MEASURES
Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization.
KEY RESULTS
Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6–2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80–1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3–1.9 and OR: 1.4; 95% CI: 1.2–1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95–1.4 for AA women and OR: 1.3; 95% CI: 1.0–1.6 for Hispanic women).
CONCLUSION
Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.