Contraception Biographies: Women's Contraceptive Method Switching and Union Status

Larry Gibbs, Bowling Green State University


American women, on average, are having only two children requiring the effective use of contraception for about 30 years. Relatively few women rely on the same type of contraception throughout their entire reproductive life course, meaning a large proportion tend to switch contraception. Prior research has not considered the contemporary context and has been largely limited to married women. This is problematic given shifts in reproductive behaviors of women along with changes in union formation in the United States. Using discrete-time event history analysis and drawing on data from the NSFG 2006-10, (N=12,279) I analyze three-year contraceptive switching behavior for single, cohabiting, and married women. Overall, 40% of women switch methods. While single, cohabiting and married women share similar risks of contraceptive method switching behavior, analyses distinguishing stable users and stable nonusers indicate that single women are more likely than married to switch contraception and also to remain as stable users of contraception relative to stable non-use. Given parity is a strong predictor of method switching, a set of analyses is limited to women at parity zero. However, the findings indicate that across union status, women at parity zero share similar risks contraceptive method switching. In terms of contraception used following switching, a greater proportion of cohabiting women switch to least effective methods, more single women switch to the pill and condom and married women switch to most effective methods. Results indicate that union status differs to an extent depending on the originating contraceptive method. Among initial pill users, cohabiting women compared to married women have lower odds of switching to most effective methods relative to least effective methods and cohabiting women who are initial least effective methods users, compared to married women, have lower risk of switching to most effective methods relative to condom. The results from this dissertation showcase the dynamics of contraceptive behavior and provide evidence that it is important to distinguish unmarried single and cohabiting women in the analysis of contraceptive switching behavior. Attention to contraceptive switching is important in research addressing the correlates and implications of intended and unintended pregnancies as well as studies of the meanings of cohabitation.