Unintended pregnancy influences racial disparity in tubal sterilization rates.
BACKGROUND
Minority women are more likely than white women to choose tubal sterilization as a contraceptive method. Disparities in rates of unintended pregnancy may help explain observed racial/ethnic differences in sterilization, but this association has not been investigated.


OBJECTIVE
To examine the associations among race/ethnicity, unintended pregnancy, and tubal sterilization.


METHODS
Cross-sectional analysis of data from a nationally representative sample of women aged 15-44 years [65.7% white, 14.8% Hispanic, and 13.9% African American (AA)] who participated in the 2002 National Survey of Family Growth.


METHODS
Race/ethnicity, history of unintended pregnancy, and tubal sterilization. A logistic regression model was used to estimate the effect of race/ethnicity on unintended pregnancy while adjusting for socio-demographic variables. A series of logistic regression models was then used to examine the role of unintended pregnancy as a confounder for the relationship between race/ethnicity and sterilization.


RESULTS
Overall, 40% of white, 48% of Hispanic, and 59% of AA women reported a history of unintended pregnancy. After adjusting for socio-demographic variables, AA women were more likely (OR: 2.0; 95% CI: 1.6-2.4) and Hispanic women as likely (OR: 1.0; 95% CI: 0.80-1.2) as white women to report unintended pregnancy. Sterilization was reported by 29% of women who had ever had an unintended pregnancy compared to 7% of women who reported never having an unintended pregnancy. In unadjusted analysis, AA and Hispanic women had significantly higher odds of undergoing sterilization (OR: 1.5; 95% CI: 1.3-1.9 and OR: 1.4; 95% CI: 1.2-1.7, respectively). After adjusting for unintended pregnancy, this relationship was attenuated and no longer significant (OR: 1.2; 95% CI: 0.95-1.4 for AA women and OR: 1.3; 95% CI: 1.0-1.6 for Hispanic women).


CONCLUSIONS
Minority women, who more frequently experience unintended pregnancy, may choose tubal sterilization in response to prior experiences with an unintended pregnancy.
Borrero
Sonya
S
Divison of General Internal Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA. borrerosp@upmc.edu
Moore
Charity G
CG
Qin
Li
L
Schwarz
Eleanor B
EB
Akers
Aletha
A
Creinin
Mitchell D
MD
Ibrahim
Said A
SA
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000208:ethnology*; D044469:Racial Groups / Q000208:ethnology; D013246:Sterilization, Tubal / Q000639:trends*; D044465:White People / Q000208:ethnology*; D055815:Young Adult