RACIAL DIFFERENCES IN PROTECTIONS AGAINST PREGNANCY: COMPETING GOALS AND DECISIONS

Abstract

Racial disparities in unintended pregnancy are largely related to differences in contraceptive practices. Black women are less likely to use an effective contraceptive and more likely to discontinue a method compared to their White counterparts. More concerning is that the Black-White gap in these protections against unintended pregnancy may have widened over time. Reasons for these racial disparities and the pathways to contraceptive practices that leave at-risk women vulnerable to unintended pregnancy are unexplained This project addresses some of the existing gaps in the literature by using a mixed-methods approach to 1) investigate the various factors contributing to Black-White differences in contraceptive practices over time and 2) explore the contraceptive decision-making of women at high risk of unintended pregnancy. Using multinomial logistic regression and a Fairlie decomposition on data from the National Survey of Family Growth 1988 and 2011-2015 survey cycles, I analyze contraceptive use and effective method choice of young adult women. Results reveal that the Black-White gap in contraceptive practices in 2011-2015 are 2-3 times larger than in 1988. Very few factors were statistically significant at explaining the 13% Black-White difference in 2011-2015. Interviews with Black women in Philadelphia were used to improve our understanding of contraceptive practices that are less effective at protecting against pregnancy. Findings highlight criteria for method selection, concern for STDs, and partner trust as key factors guiding contraceptive practices.