Pathways to reproductive autonomy

Using path analysis to predict family planning outcomes in the United States

Bibliographic Data

ID12288194
AuthorsLaura E T Swan (0000-0002-1371-3582, Department of Population Health Sciences University of Wisconsin‐Madison Madison Wisconsin USA, corresponding author), Shelby E Mcdonald (0000-0001-6094-6234, Virginia Commonwealth University Clark‐Hill Institute for Positive Youth Development Richmond Virginia USA), Sarah Price (0000-0003-2343-5181, Virginia Commonwealth University), Sarah K Price (Virginia Commonwealth University School of Social Work Richmond Virginia USA)
Year2022
Volume30
Issue6
Pagese6487-e6499
Publication date2022-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth & Social Care in the Community (JOURNAL)
Journal identifiersISSN: 0966-0410 • E-ISSN: 1365-2524
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hsc.14094
PMID36317755
OpenAlexW4307844233
LanguageEN
Citations received2
References cited56

In the United States, about half of pregnancies are unintended, and most women of reproductive age are at risk of unintended pregnancy. Research has explored predictors of contraceptive use and unintended pregnancy, but there is a lack of research regarding access to preferred contraceptive method(s) and the complex pathways from sociodemographic factors to these family planning outcomes. This study applied Levesque et al.'s (2013) healthcare access framework to investigate pathways from sociodemographic factors and indicators of access to family planning outcomes using secondary data. Data were collected at four time points via an online survey between November 2012 and June 2014. Participants were US women of reproductive age who were seeking to avoid pregnancy (N = 1036; M age = 27.91, SD = 5.39; 6.9% Black, 13.6% Hispanic, 70.2% white, 9.4% other race/ethnicity). We conducted mediational path analysis, and results indicated that contraceptive knowledge (β = 0.116, p = 0.004), insurance coverage (β = 0.423, p < 0.001), and relational provider engagement (β = 0.265, p = 0.011) were significant predictors of access to preferred contraceptive method. Access to preferred contraceptive method directly predicted use of more effective contraception (β = 0.260, p < 0.001) and indirectly predicted decreased likelihood of experiencing unintended pregnancy via contraceptive method(s) effectiveness (β = -0.014, 95% confidence interval: -0.041, -0.005). This study identifies pathways to and through access to preferred contraceptive methods that may be important in determining family planning outcomes such as contraceptive use and unintended pregnancy. This information can be used to improve access to contraception, ultimately increasing reproductive autonomy by helping family planning outcomes align with patients' needs and priorities

Environmental health · Ethnic group · Family medicine · Family planning · Fertility · National Survey of Family Growth · Political science · Population · Pregnancy · Reproductive health · Research methodology · Unintended pregnancy · Demography · Global Maternal and Child Health · Maternal and Perinatal Health Interventions · Medicine · Reproductive Health and Contraception