Socioeconomic and racial/ethnic disparities in unintended pregnancy among postpartum women in California.
OBJECTIVE
We examined social disparities in unintended pregnancy among postpartum women to better understand 1) the role of socioeconomic factors in racial/ethnic disparities and 2) factors that might explain both socioeconomic and racial/ethnic disparities in the risk for unintended pregnancy among women who give birth.


METHODS
We used 1999 and 2000 data from a statewide-representative mail and telephone survey of postpartum women in California (N = 7044). We examined associations between unintended pregnancy and race/ethnicity (African American, Asian or Pacific Islander, U.S.-born Latina, foreign-born Latina, European or Middle Eastern), three socioeconomic factors (poverty status, maternal education, paternal education), and several potential explanatory factors.


RESULTS
Overall, racial/ethnic disparities in unintended pregnancy were reduced by the three socioeconomic factors individually and collectively (e.g., reducing higher unadjusted odds for African Americans from 3.4 to 1.9); additional adjustment for marital status age, parity, insurance, language, abuse, sense of control, and interaction between marital status and race/ethnicity (each independently associated with unintended pregnancy) reduced the socioeconomic disparities (e.g., reducing odds for the poorest women from 4.1 to 2.3). Although reduced, significant racial/ethnic and socioeconomic disparities remained after adjustment, but generally only among married women. Results for Latinas appeared to vary by nativity, with foreign-born Latinas being at lower odds and U.S.-born Latinas being at higher odds of unintended pregnancy.


CONCLUSIONS
Racial/ethnic disparities in unintended pregnancy are partly explained by the socioeconomic factors we measured. Several additional factors were identified that suggest possible directions for policies and programs to help reduce social disparities in unintended pregnancy among childbearing women.
Cubbin
Catherine
C
Department of Family and Community Medicine, University of California, San Francisco, California 94143, USA. ccubbin@itsa.ucsf.edu
Braveman
Paula A
PA
Marchi
Kristen S
KS
Chavez
Gilberto F
GF
Santelli
John S
JS
Gilbert
Brenda J Colley
BJ
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D003268:Contraception Behavior / Q000208:ethnology; D004522:Educational Status; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007389:Internal-External Control; D017533:Marital Status; D008875:Middle Aged; D011159:Population Surveillance; D049590:Postpartum Period / Q000208:ethnology*; D011203:Poverty; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000208:ethnology*; D015995:Prevalence; D012959:Socioeconomic Factors