Recorded presentation

Diana Romero, PhD, MA and Christine Rinki, MPH. Department of Population and Family Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032, 212-304-5809, car2032@columbia.edu

Objective: Determine whether birth intentions, contraceptive behavior, and other reproductive healthcare utilization differed between welfare recipients and nonrecipients prior to passage of welfare reform legislation. Methods: The National Survey of Family Growth (NSFG) is a nationally representative sample of women ages15-45. Bivariate analysis of the 1995 NSFG (n=10,847) was conducted for select reproductive health outcomes by welfare status (AFDC vs. non-AFDC). Results: Among unmarried women with at least one child (ie, AFDC eligibility criteria), women receiving AFDC were less likely to intend to have a baby (49% vs. 55%, p<.001), were more likely to be certain of pregnancy intentions (53% vs. 48%, p<.001), yet reported larger “ideal” family sizes (p<.001) and had more live births than non-recipients (2.2 vs. 1.5, p<.001). Although there were no differences in contraception receipt by welfare status, AFDC recipients were less likely to use contraception every time (57% vs. 61%, p<.001), more likely to have had an abortion (3.8 vs. 1.7, p<.05), and less likely to have received postpartum care (62% vs. 72%, p<.001). Conclusions: This analysis highlights the paradox between larger actual and ideal family sizes among poor women, fewer and more certain intentions for future pregnancies, and their use of contraception and abortion, compared to non-poor women. Improved understanding of this paradox is necessary, since welfare policies implemented after 1995 included components focused on reproductive behaviors. Planned analyses of the 2002 NSFG (release later in 2004) will permit evaluation of the impact of welfare reform policies implemented after 1996 on women’s reproductive health.

Learning Objectives: At the conclusion of this session, participants in this session will be able to

• Recognize the utility and potential of the National Survey of Family Growth in analyzing reproductive health of women in general, and related to their participation in welfare programs specifically
• Identify at least five reproductive health outcome differences or similarities between poor and non-poor women
• Challenge assumptions concerning contraceptive use and child-bearing among poor women
• Understand the implications of poverty and welfare policy for women’s reproductive health

Keywords: Reproductive Health Research, Welfare Reform

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation