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Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data

Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data
Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data
Objectives: To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context.

Setting: Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries.

Participants: Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected.

Primary and secondary outcome measures: The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls.

Results: Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36?months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24?months after marriage.

Conclusions: Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear—women with a very high use of abortion tend to have lengthy intervals between marriage and first birth.
1-8
Lyons-Amos, Mark
ceedb006-c671-4e2d-8fed-bef1cf40603d
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Durrant, Gabriele B.
14fcc787-2666-46f2-a097-e4b98a210610
Lyons-Amos, Mark
ceedb006-c671-4e2d-8fed-bef1cf40603d
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Durrant, Gabriele B.
14fcc787-2666-46f2-a097-e4b98a210610

Lyons-Amos, Mark, Padmadas, Sabu S. and Durrant, Gabriele B. (2014) Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data. BMJ Open, 4 (8), 1-8. (doi:10.1136/bmjopen-2014-004834).

Record type: Article

Abstract

Objectives: To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context.

Setting: Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries.

Participants: Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected.

Primary and secondary outcome measures: The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls.

Results: Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36?months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24?months after marriage.

Conclusions: Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear—women with a very high use of abortion tend to have lengthy intervals between marriage and first birth.

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Accepted/In Press date: 4 July 2014
Published date: 11 August 2014
Organisations: Faculty of Social, Human and Mathematical Sciences

Identifiers

Local EPrints ID: 366676
URI: https://eprints.soton.ac.uk/id/eprint/366676
PURE UUID: 1f0797af-2ed2-402e-9d81-e72dbdcfce84
ORCID for Sabu S. Padmadas: ORCID iD orcid.org/0000-0002-6538-9374

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Date deposited: 07 Jul 2014 11:28
Last modified: 20 Jul 2019 01:00

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Author: Mark Lyons-Amos

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