Fertility and Reproductive Health

Fertility and Contraceptive Use. CCPR researchers have considered long-run fertility and contraceptive use change as well as contemporary reproductive health issues. Martha Bailey (Econ) uses quasi-experimental methods and RCTs to examine how modern contraception and reproductive health policy have shaped U.S. fertility over the 20^th Century. Using new data, she tested a prominent economic explanation for the baby boom and Westoff and Ryder’s influential hypothesis about the transformative role of modern contraception – rejecting the former and validating the latter. She also evaluated the long-run effects of contraceptive access for women and their children. She shows that modern contraception played an important role in narrowing the gender gap in wages and increasing the education and health of children. Megan Sweeney (Soc) and colleagues investigate sterilization and desire for sterilization reversal in the U.S.– both more common for disadvantaged women and women of color. Sweeney and Jessica Gipson (CHS) have collaborated to compare differentials in long-acting reversible contraception (LARC) usage in the U.S. with nine other low-fertility countries to understand how women choose between contraceptive sterilization and LARCs. Bailey is also PI of M-CARES, an RCT examining price subsidies, contraceptive use, unintended pregnancies, and the long-term health and welfare of low-income women. Bailey and coauthors show that making LARCs free for low-income women through M-CARES increases take-up by over 300% overall but has little effect on take-up among Black women.

Reproductive Health Outcomes for Women and Children. Christine Dunkel Schetter (Psych) has shown that mothers’ anxiety during pregnancy increases preterm birth. She also finds that perceptions of partner support in pregnancy predict lower maternal and infant distress. Judith Seltzer (Soc) and colleagues show that positive mother-daughter relationships reduce young women’s risky sexual behavior. In a collaborative study, Corrina Moucheraud (HPM), Manisha Shah (Pub Pol), and Patrick Heuveline (Soc) have shown that the quality of antenatal care that women receive varies by age in three sub-Saharan countries. Adolescents receive more family planning care but less antenatal care than older women.

Social and Policy Contexts of HIV/AIDS. Chandra Ford (CHS) identifies social pathways which shape racial/ethnic and age disparities in HIV diagnosis, care, and prognosis. She finds HIV screening rates are generally below CDC recommendations and that lesbians and bisexual women have greater delays in accessing care than heterosexual women—disparities addressable through modest changes in provider training. Ian Holloway (Soc Wel) studies how individual factors and social networks shape HIV risk. He finds that exposure to illicit substance use and risky sexual behavior influence young men’s risk behavior. He also shows that social media can help prevent HIV by increasing testing among Black and Latino sexual minority men. Jessica Gipson (CHS) shows that persistent gender ideologies and recent social changes in adolescents’ social contexts, such as mass media, influence sexual and reproductive health in the Philippines. Dawn Upchurch (CHS) uses biomarkers to examine both self-reported STIs and STI prevalence in a national sample of adolescents. She finds that the “risk factors” for contracting STIs differed between high- and low-risk populations were different than in low-risk populations. Manisha Shah’s (Pub Pol) work shows that the regulation of sex work reduces the probability of a generalized HIV/AIDS epidemic in Latin America. In the U.S., she finds that decriminalization of sex work is associated with a lower incidence of gonorrhea and sexual violence.