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Title: Understanding U.S. fertility: continuity and change in the National Survey of Family Growth, 1988-1995.
Author: Mosher WD, Bachrach CA.
Journal: Fam Plann Perspect; 1996; 28(1):4-12. PubMed ID: 8822409.
Abstract:
About 50 studies based on the 1988 National Survey of Family Growth (NSFG) and a telephone reinterview conducted with the same women two years later provide continuing information about the fertility and health of American women. Among the findings of these studies are that black women have almost twice as many pregnancies as do white women (5.1 vs. 2.8), with nearly all of the difference being unintended pregnancies. Unwanted births increased between 1982 and 1988, particularly among less-educated, poor and minority women. This increase in the proportion of unwanted births may have prompted the increase in female sterilization among these groups. Concern with the AIDS epidemic led to increases in condom use between 1982 and 1990, especially among the partners of teenagers and college-educated women. Rates of teenage pregnancy were fairly stable during the period 1980-1988, as increases in the proportion of teenagers having intercourse were offset by increases in condom use. Rates of infertility did not change significantly in the 1980s, but because of delayed childbearing and the aging of the baby-boom cohort, the number of older childless women increased substantially. The 1995 NSFG was redesigned in a number of ways in order to answer a new generation of questions about fertility and women's health in the United States. US fertility surveys were conducted during 1955-70 and were formally instituted under the National Survey of Family Growth (NSFG) during 1973-88. Telephone reinterviews were conducted in 1990. This paper reviews findings from about 50 studies based on the NSFG in 1988 and 1990 and identifies changes in survey data and methods. Findings pertain to variables on intercourse and union formation, conception and contraceptive use, gestation, and fertility-related issues. Policy issues are discussed that relate to adolescent pregnancy, adoption, use of family planning services, maternal-child health, and HIV and sexually transmitted disease prevention. Cycle 5, which is scheduled for the NSFG in 1995, will be redesigned to accommodate policy needs. Changes will include increased coverage of explanatory patterns, such as family background, and inclusion of event histories for cohabitation and marriage, sexual partnerships, work, education, and past living arrangements with parents and grandparents. Measurement will improve for fertility-related variables that may explain unintended pregnancy. Such measures will cover consistency of contraceptive use, characteristics of sexual partners, women's attitudes about their pregnancies, family planning and infertility services, and other health care use measures. The 1995 survey will make a qualitative shift to computer-assisted personal interviewing. Abortion reporting will be more complete, due, in part, to the use of audio-assisted computer interviewing. Data collection occurred during January-October 1995. Trends during 1988-90 include higher rates of cohabitation, and large racial differences in the proportions who never married. There were increases in premarital sex behavior and in births to unmarried women. Perception of economic opportunity was associated with a greater likelihood of contraceptive use at first intercourse. Female sterilization was the leading method among women aged 30-34 years. First year failure rates were higher among low income women. Infertility and teenage pregnancy remained stable. Unintended fertility, which was strongly related to low education and income, older age, and Black race, was very high at 57% of all pregnancies.

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