Findings

Fertile minds

Kevin Lewis

January 12, 2016

Adolescent Determinants of Abortion Attitudes: Evidence from the Children of the National Longitudinal Survey of Youth

Julianna Pacheco & Rebecca Kreitzer
Public Opinion Quarterly, forthcoming

Abstract:
The stability of abortion opinions suggests that pre-adult factors influence these attitudes more than contemporaneous political events. Surprisingly, however, we know little about the origins of abortion opinions, no doubt because the majority of research focuses on cross-sectional analyses of patterns across cohorts. We use a developmental model that links familial and contextual factors during adolescence to abortion attitudes years later when respondents are between 21 and 38 years old. Findings show that religious adherence and maternal gender role values are significant predictors of adult abortion opinions, even after controlling for contemporaneous religious adherence and the respondents’ own views on gender roles. Adolescent religious adherence matters more than religious denomination for adult abortion attitudes. The results have important implications for future trends in abortion attitudes in light of declining religiosity among Americans.

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The Effect of Parental Involvement Laws on Teen Birth Control Use

Joseph Sabia & Mark Anderson
Journal of Health Economics, January 2016, Pages 55–62

Abstract:
In Volume 32, Issue 5 of this journal, Colman, Dee, and Joyce (CDJ) used data from the National Youth Risk Behavior Surveys (NYRBS) and found that parental involvement (PI) laws had no effect on the probability that minors abstain from sex or use contraception. We re-examine this question, augmenting the NYRBS with data from the State Youth Risk Behavior Surveys (SYRBS), and use a variety of identification strategies to control for state-level time-varying unmeasured heterogeneity. Consistent with CDJ, we find that PI laws have no effect on minor teen females’ abstinence decisions. However, when we exploit additional state policy variation unavailable to CDJ and use non-minor teens as a within-state control group, we find evidence to suggest that PI laws are associated with an increase in the probability that sexually active minor teen females use birth control.

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First-birth Timing, Marital History, and Women’s Health at Midlife

Kristi Williams et al.
Journal of Health and Social Behavior, December 2015, Pages 514-533

Abstract:
Despite evidence that first-birth timing influences women’s health, the role of marital status in shaping this association has received scant attention. Using multivariate propensity score matching, we analyze data from the National Longitudinal Survey of Youth 1979 to estimate the effect of having a first birth in adolescence (prior to age 20), young adulthood (ages 20–24), or later ages (ages 25–35) on women’s midlife self-assessed health. Findings suggest that adolescent childbearing is associated with worse midlife health compared to later births for black women but not for white women. Yet, we find no evidence of health advantages of delaying first births from adolescence to young adulthood for either group. Births in young adulthood are linked to worse health than later births among both black and white women. Our results also indicate that marriage following a nonmarital adolescent or young adult first birth is associated with modestly worse self-assessed health compared to remaining unmarried.

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Divorce, abortion, and the child sex ratio: The impact of divorce reform in China

Ang Sun & Yaohui Zhao
Journal of Development Economics, forthcoming

Abstract:
This paper estimates the effect of China’s pro-women divorce reform on sex-selection behavior within marriages. The 2001 reform liberalized divorce in favor of women and secured women’s property rights after separation. The paper applies a regression discontinuity analysis on the child sex ratio and finds that the likelihood of having a son after a firstborn daughter decreased by 8.1 percentage points, amounting to a reduction of 11.7 percent compared with the prior proportion of male children. Further analyses provide evidence in support of the hypothesis that improved divorce options empower women within marriage, and enable them to avoid health-damaging sex-selective abortion. The effect of the divorce reform is stronger in provinces where divorce is comparatively viable because of more lenient family planning policies governing fertility in the next marriage. The effect is also stronger among women who face higher health costs of abortion.

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Broken Promises: Abstinence Pledging and Sexual and Reproductive Health

Anthony Paik, Kenneth Sanchagrin & Karen Heimer

Journal of Marriage and Family, forthcoming

Abstract:
Approximately 12% of girls and young women in the United States pledge abstinence. Yet most break their pledges, engaging in first intercourse before marriage. The extant literature reports few differences between pledge breakers and nonpledgers in sexually transmitted infections and nonmarital pregnancies. The present research maintains that previous studies may have obscured important differences in exposure risk and hypothesizes that female pledge breakers who have higher exposure risk are more likely to experience human papillomavirus (HPV) and nonmarital pregnancies. To test this hypothesis, this study uses the National Longitudinal Study of Adolescent to Adult Health, logistic regression, and event history modeling. The results show that, after accounting for differences in exposure risk, pledge breakers have higher risk of HPV and nonmarital pregnancy. As a set, the results are consistent with the argument that pledgers use condoms and contraceptives less consistently and highlight unintended consequences of abstinence promotion.

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The Value of Children: Inter-Generational Support, Fertility, and Human Capital

Jaqueline Oliveira
Journal of Development Economics, forthcoming

Abstract:
This paper offers robust empirical evidence of a Darwinian pro-natalist mechanism: parents can improve their old-age support with an additional child. Using the incidence of first-born twins as an instrument for fertility outcomes, I find that Chinese senior parents with more children receive more financial transfers and are more likely to co-reside with an adult child. They are also less likely to work past retirement age. The estimated effects are large, despite the evidence that adult children from larger families are less educated and earn significantly less. Interestingly, the effect of an increase in the number of children on old-age support does not depend on the child’s gender.

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Children of a (Policy) Revolution: The Introduction of Universal Child Care and Its Effect on Fertility

Stefan Bauernschuster, Timo Hener & Helmut Rainer

Journal of the European Economic Association, forthcoming

Abstract:
What role does affordable and widely available public child care play for fertility? We exploit a major German reform generating large temporal and spatial variation in child care coverage for children under the age of three. Our precise and robust estimates on birth register data reveal that increases in public child care have significant positive effects on fertility. The fertility effects are more pronounced at the intensive than at the extensive margin, and are not driven by changes in the timing of births or selective migration. Our findings inform policy makers concerned about low fertility by suggesting that universal early child care holds the promise of being an effective means of increasing birth rates.

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Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers

Jeannette Ickovics et al.
American Journal of Public Health, forthcoming

Objectives: We compared an evidence-based model of group prenatal care to traditional individual prenatal care on birth, neonatal, and reproductive health outcomes.

Methods: We performed a multisite cluster randomized controlled trial in 14 health centers in New York City (2008–2012). We analyzed 1148 pregnant women aged 14 to 21 years, at less than 24 weeks of gestation, and not at high obstetrical risk. We assessed outcomes via medical records and surveys.

Results: In intention-to-treat analyses, women at intervention sites were significantly less likely to have infants small for gestational age (< 10th percentile; 11.0% vs 15.8%; odds ratio = 0.66; 95% confidence interval = 0.44, 0.99). In as-treated analyses, women with more group visits had better outcomes, including small for gestational age, gestational age, birth weight, days in neonatal intensive care unit, rapid repeat pregnancy, condom use, and unprotected sex (P = .030 to < .001). There were no associated risks.

Conclusions: CenteringPregnancy Plus group prenatal care resulted in more favorable birth, neonatal, and reproductive outcomes. Successful translation of clinical innovations to enhance care, improve outcomes, and reduce cost requires strategies that facilitate patient adherence and support organizational change.


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