What's Behind the Dramatic Pre-2020 Declines in Hispanic/Latina Adolescent Childbearing? Decomposing Change by Age, Origin, and Nativity.

PURPOSE: To assess whether the large declines in adolescent childbearing among Hispanic adolescents over the period 2000-2019 have been driven by co-occurring changes in the composition of the Hispanic population and, if so, whether they have done so differentially by Hispanic subgroup. METHODS: We use birth counts from the United States vital statistics system and population denominators from the United States decennial census long form 5-percent Public Use Microdata and the American Community Survey to conduct a decomposition analysis apportioning observed declines in Hispanic adolescent childbearing to: (1) compositional shifts in nativity, age, and region-of-origin and (2) subgroup changes in childbearing rates. RESULTS: The Hispanic adolescent fertility rate fell by over 71% from 2000 to 2019, with Mexican-Origin, United States-born, and younger adolescents exhibiting the steepest declines (79%, 70%, and 80% declines, respectively). Results from the decomposition analysis show that almost 90% of the decline is due to within-group rate change, with some variability by subgroup and by decade. Only 10% of the decline was due to compositional changes, with shifts in nativity driving much of the effect. DISCUSSION: Declines in Hispanic adolescent childbearing over the last decades have occurred in spite of substantial shifts in the composition of the Hispanic population, not because of them. These findings set the stage for a more detailed examination of the drivers of change in sexual activity, contraceptive use, and abortion, all of which are proximate determinants of adolescent pregnancy and childbearing. Additionally, a focus on more distal factors is needed, including the role that changing political, societal, and economic conditions in the United States have for early fertility patterns.

Does Context and Adversity Shape Sexual Behavior in Youth? Findings from Two Representative Samples of Puerto Rican Youth.

Sexual risk behaviors often co-occur. Understanding the heterogeneity in patterns of sexual behavior among youth and how context of majority and minoritized status may be related to these behaviors can inform targeted STIs/HIV interventions. Data are from the Boricua Youth Study, a longitudinal study of two probability samples of Puerto Rican youth recruited in the South Bronx (SBx) and the metropolitan area in Puerto Rico (PR). We identified patterns of sexual behaviors among young adults (ages 15-24) with sexual experience (N = 1,203) using latent class analysis. Analyses examined context differences and the prospective relationship between adverse childhood experiences (ACEs) (childhood maltreatment/violence, family/parental dysfunction) and patterns of sexual behaviors (age at first sex, number of sex partners, sex with a high-risk partner, condom use, sex while intoxicated, oral sex, anal sex). We identified five classes of sexual behaviors: (1) currently inactive (16.51%); (2) single partner, low activity (13.49%); (3) single partner, inconsistent condom use (32.19%); (4) single partner, sex without a condom (27.65%); and (5) multirisk (10.16%). Young adults from the SBx (minoritized context), those who identified as male, and those with higher child maltreatment/violence ACEs were more likely to be in the multi-risk class relative to the single partner, inconsistent condom use class. Those from the SBx were also more likely to be in the single partner, sex without condom class, relative to the single partner, inconsistent condom use class. Differences in young adults' patterns of sexual behaviors between the two contexts, one representing the minoritized context (SBx) contrasted to the majority context (PR), were not explained by ACEs. Findings highlight the heterogeneity in the patterns of sexual behaviors among Puerto Rican young adults as well as how such patterns vary based on sociocultural contexts. Exposure to child maltreatment/violence ACEs was related to the riskier patterns; however, they did not explain why riskier patterns of sexual behaviors were found in the SBx compared to PR. Results underscore the need for tailored interventions and more in-depth examination of differences across contexts.

Parent-Teen Communication about Sexual and Reproductive Health: Cohort Differences by Race/Ethnicity and Nativity.

Parent-teen discussions about sexual and reproductive health (SRH) are associated with delayed sex and higher contraceptive use among teens. Using the National Survey of Family Growth, we conducted bivariate and multivariate analyses of different types of parent-teen SRH discussions among two cohorts of teens. We describe differences in patterns for males and females by race/ethnicity and nativity, and test for racial/ethnic interactions within each cohort. Analyses found that the prevalence of parent-teen discussions about SRH increased across cohorts. For males and females, there were increases in parent-teen discussions about condoms, and for males only, there were increases in any SRH discussions and discussions about contraception and STIs. Based on interactions, parent-teen discussions and STI discussions increased most for Hispanic females, and among Hispanics, increased most for the foreign-born. These data indicate increases in different types of parent-teen SRH discussions, particularly for males and foreign-born teens overall, and for Hispanic teen females regarding condom use. Future research should examine what factors are driving these changes, including changes in the structure of U.S. Hispanic communities and expansion of evidence-based teen pregnancy prevention programs.

Do young men's reports of hormonal and long-acting contraceptive method use match their female partner's reports?

OBJECTIVE: To assess whether young men's reports of hormonal and long-acting contraceptive methods match their female partner's reports. STUDY DESIGN: We analyzed a sample of 1096 heterosexual couples (aged 18-26) from the National Longitudinal Study of Adolescent to Adult Health Romantic Pair subsample. We compared male and female partner reports of hormonal/long-acting method use using class of method (hormonal/long-acting) rather than type (e.g., intrauterine device). Regression analyses linked men's reports of individual and relationship characteristics with alignment of reporting. RESULTS: Sixteen percent of young men reported hormonal/long-acting method use at last sex differently than their female partner, that is, had a mismatched report. Men who had fewer lifetime sexual partners, had greater relationship satisfaction, believed their partner was monogamous and had a matched report of condom use at last sex were more likely to match their partner's report of hormonal/long-acting contraceptive use. Men living with children (from either partner) were less likely to have a matched report. Hispanic men were more likely to have a matched report than black men. CONCLUSIONS: Men are an increasingly important part of pregnancy prevention efforts. Pregnancy prevention and healthy relationship programs that incorporate communication skills may also indirectly improve young men's knowledge of their partner's contraceptive use and engagement in contraceptive decision making. IMPLICATIONS: Analyses showed that nearly two thirds of the 16% of young men that did not accurately report their partner's hormonal/long-acting method use at last sex underreport method use. Men at increased risk of misreporting may benefit the most from targeted pregnancy prevention programs.

Relationship characteristics and contraceptive use among dating and cohabiting young adult couples.

CONTEXT: Contraceptive decision making occurs in the context of relationships. Although many individual-level characteristics have been linked to youths' contraceptive use, less is known about associations between contraceptive use and relationship-level characteristics. METHODS: Data from the 2001-2002 romantic pair subsample of the National Longitudinal Study of Adolescent Health were used to describe characteristics of 322 dating relationships and 406 cohabiting relationships among young adults aged at least 18 years. Logistic regression was employed to assess associations between these characteristics and hormonal or long-acting contraceptive use and condom use. Data from both partners allowed discordance in reports between partners in some measures to be examined. RESULTS: Cohabiting couples were less likely than dating couples to have used condoms (19% vs. 37%) and hormonal or long-acting methods (40% vs. 57%) at last sex. In dating relationships, couples reporting discordant levels of intimacy and couples in which neither partner reported a high level of intimacy had greater odds of condom use than couples in which both partners reported high intimacy (odds ratios, 4.5 and 3.3, respectively); mistrust and male problem drinking were negatively associated with condom use (0.3 for each). For cohabiting couples, frequency of sex was negatively associated with condom use and hormonal method use (0.8 for each). CONCLUSIONS: At least for dating couples, contraceptive use is linked to multiple dimensions of relationships, particularly measures reflecting relationship quality-both positive and negative.

Relationship types and contraceptive use within young adult dating relationships.

CONTEXT: Although expanding research has found that relationship characteristics can shape contraceptive use among young adults, limited research has examined how relationship characteristics intersect to form distinct types of relationships and how relationship types are linked to contraceptive use. METHODS: Data from the 2002-2005 rounds of the National Longitudinal Survey of Youth 1997 cohort were used to examine contraceptive use in 3,485 young adult dating relationships. Latent class analysis was employed to develop a typology of relationships using measures of relationship structure (duration) and quality (intimacy, commitment and conflict). Multinomial logistic regression analyses were used to estimate associations between relationship type and contraceptive use and method choice at last sex. RESULTS: Four types of relationships were identified, two shorter term and two longer term, differentiated by levels of intimacy, commitment and conflict. Young adults in longer term relationships with greater conflict and lower intimacy and commitment were less likely than those in other long-term relationships to use hormonal and dual methods versus no method (relative risk ratios, 0.6-0.7). Hormonal method use, versus no method use or condom use, was more prevalent in short-term relationships with greater intimacy and commitment and lower conflict than in other short-term relationships (1.7 and 1.9, respectively). CONCLUSIONS: Classifying short-term relationships as "casual" or long-term ones as "serious" may ignore heterogeneity within these categories that may have implications for contraceptive use. Future qualitative research could provide a better understanding of relationship types and couples' fertility intentions and access to and use of contraceptives.

Racial and ethnic differences in the transition to a teenage birth in the United States.

CONTEXT: Rates of teenage childbearing are high in the United States, and they differ substantially by race and ethnicity and nativity status. METHODS: Data from the National Longitudinal Survey of Youth 1997 cohort were used to link characteristics of white, black, U.S.-born Hispanic and foreign-born Hispanic adolescents to teenage childbearing. Following a sample of 3,294 females aged 12-16 through age 19, discrete-time logistic regression analyses were used to examine which domains of teenagers' lives were associated with the transition to a teenage birth for each racial and ethnic group, and whether these associations help explain racial and ethnic and nativity differences in this transition. RESULTS: In a baseline multivariate analysis controlling for age, compared with whites, foreign-born Hispanics had more than three times the odds of a teenage birth (odds ratio, 3.5), while blacks and native-born Hispanics had about twice the odds (2.1 and 1.9, respectively). Additional controls (for family environments; individual, peer and dating characteristics; characteristics of first sexual relationships; and subsequent sexual experience) reduced the difference between blacks and whites, and between foreign-born Hispanics and whites, and eliminated the difference between U.S.-born Hispanics and whites. Further, if racial or ethnic minority adolescents had the same distribution as did white teenagers across all characteristics, the predicted probability of a teenage birth would be reduced by 40% for blacks and 35% for U.S.-born Hispanics. CONCLUSIONS: Differences in the context of adolescence may account for a substantial portion of racial, ethnic and nativity differences in teenage childbearing.

Relationship Characteristics and the Relationship Context of Nonmarital First Births Among Young Adult Women.

OBJECTIVES: The objectives of this study were to examine whether and how characteristics of the relationship dyad are linked to nonmarital childbearing among young adult women, additionally distinguishing between cohabiting and nonunion births. METHODS: We used the National Longitudinal Survey of Youth, 1997 Cohort and discrete-time event history methods to examine these objectives. RESULTS: Our analyses found that similarities and differences between women and their most recent sexual partner in educational attainment, disengagement from work or school, race/ethnicity, and age were linked to the risk and context of nonmarital childbearing. For example, partner disengagement (from school and work) was associated with increased odds of a nonmarital birth regardless of whether the woman herself was disengaged. Additionally, having a partner of a different race/ethnicity was associated with nonmarital childbearing for whites, but not for blacks and Hispanics. CONCLUSIONS: We conclude that relationship characteristics are an important dimension of the lives of young adults that influence their odds of having a birth outside of marriage.

Family environments and the relationship context of first adolescent sex: Correlates of first sex in a casual versus steady relationship.

Limited research has examined how family environments are associated with the relationship context of first sex, an important indicator of reproductive health risk. We use data from the 1997 National Longitudinal Survey of Youth to assess the association between the family environment - parent-parent relationships, parent-adolescent relationships, and family structure - and relationship context of first heterosexual sexual intercourse, distinguishing between the transition to first sex in serious and casual relationships. Twenty-five percent of females and 43% of males who had sex by age 18 did so in a casual relationship. All dimensions of the family environment were linked to the relationship context of first sex. Notably, higher parental monitoring was associated with a reduced risk of transitioning to first sex in a casual relationship versus no sex, and greater family routines were associated with a reduced risk of transitioning to sex in a steady relationship versus having no sex, for males and females. A strong maternal-adolescent relationship was associated with a reduced risk of first sex in a casual relationship but only for males. Additionally, in two-parent families, a strong father-adolescent relationship was associated with reduced risk of transitioning to casual sex, but only for females. Pregnancy and STI prevention programs should work with parents to foster positive parent-adolescent relationships, to become aware of their adolescents' activities and to recognize that parents are important models for adolescent relationship behaviors.

Union Transitions Following the Birth of a Child to Cohabiting Parents.

Despite a growing interest in the family trajectories of unmarried women, there has been limited research on union transitions among cohabiting parents. Using data from the 2002 National Survey of Family Growth, we examined how family complexity (including relationship and fertility histories), as well as characteristics of the union and birth, were associated with transitions to marriage or to separation among 1,105 women who had a birth in a cohabiting relationship. Cohabiting parents had complex relationship and fertility histories, which were tied to union transitions. Having a previous nonmarital birth was associated with a lower relative risk of marriage and a greater risk of separation. In contrast, a prior marriage or marital birth was linked to union stability (getting married or remaining cohabiting). Characteristics of the union and birth were also important. Important racial/ethnic differences emerged in the analyses. Black parents had the most complex family histories and the lowest relative risk of transitioning to marriage. Stable cohabitations were more common among Hispanic mothers, and measures of family complexity were particularly important to their relative risk of marriage. White mothers who began cohabiting after conception were the most likely to marry, suggesting that ''shot-gun cohabitations'' serve as a stepping-stone to marriage.

Teenage Childbearing Among Youth Born to Teenage Mothers.

Using data from the National Longitudinal Survey of Youth, this article examined how early maternal characteristics, an adolescent's family environment, and the adolescent's own attitudes and behaviors were associated with the odds of a nonmarital teenage birth among youth born to teenage mothers. Multivariate analyses indicated that these domains were closely linked. Early maternal characteristics shaped the later family environment of adolescents (parenting quality and home environment), which, in turn, was associated with the attitudes and behaviors of teens that put them at risk of a nonmarital birth. Notably, there was variation in some of the associations by gender. Increased mother's cognitive ability lowered the risk of a nonmarital birth for boys, but not for girls, whereas fertility expectations were significant for girls, but not for boys. There were no race-ethnic differences in the risk of a teenage birth among girls, although Black boys had a higher risk than White boys.

Nonmarital Fertility, Family Structure, and the Early School Achievement of Young Children from Different Race/Ethnic and Immigration Groups.

Working from a life course perspective, this study examined the links between mothers' fertility and relationship statuses and children's early school achievement and how these links varied by race/ethnicity and immigration status. Analyses of nationally representative data from the Early Childhood Longitudinal Study-Kindergarten Cohort revealed that children born to unmarried women scored lower than children of married women on math tests in kindergarten and first grade. This pattern was most attributable to associated differences in family income and parent education, and it was moderated by women's marital and relationship statuses after having their children. Evidence also suggested that the academic risks of some family structure pattern relative to continuously married parents might have been more pronounced for White children.

Risky adolescent sexual behaviors and reproductive health in young adulthood.

CONTEXT: Little research links adolescent risk behaviors to reproductive health outcomes beyond adolescence, although young adults--men and women in their early 20s--bear a disproportionate burden of STDs and unintended childbearing. METHODS: To assess whether individuals who engaged in risk behaviors during adolescence had increased risk of negative reproductive health outcomes in young adulthood, data from Waves 1-4 of the National Longitudinal Study of Adolescent Health on 5,798 sexually active respondents were analyzed. Logistic and multinomial logistic regressions examined associations between risk behaviors (cumulatively and individually) and each of three outcomes. RESULTS: Four in 10 youth reported at least three risk factors during adolescence. Women who were exposed to an increasing number of risks had an elevated likelihood of having had multiple sex partners in the last year, rather than none (relative risk ratio, 1.3); having had an STD (odds ratio, 1.1); and having had an intended or unintended birth, as opposed to no birth (relative risk ratio, 1.1 for each). Inconsistent contraceptive use and having had multiple partners, a non-monogamous partner or a non-romantic partner were associated with reporting multiple partners in the last year; inconsistent use, sexual debut after age 16 and not discussing contraception with a partner were associated with having any birth. CONCLUSIONS: Teenagers' sexual behaviors have both short-term and long-term consequences, and interventions that focus on multiple domains of risk may be the most effective in helping to promote broad reproductive health among young adults.

Relationship characteristics and contraceptive use among young adults.

CONTEXT: Young adults have high rates of unintended childbearing and STDs, yet little research has examined the role of relationship characteristics in their contraceptive use. METHODS: Data collected from the 2002-2005 rounds of the National Longitudinal Survey of Youth yielded a sample of 4,014 dating relationships among sexually active 18-26-year-olds. Bivariate analysis and multivariate logistic and multinomial logistic regressions assessed associations between relationship characteristics and contraceptive use at last sex. RESULTS: In three-quarters of the relationships, respondents had used some method at last intercourse; respondents in 26% of the relationships had used a condom only, in 26% a hormonal method only and in 23% dual methods. Compared with respondents in relationships in which first sex occurred within two months of starting to date, those who first had sex before dating were more likely to have used any method at last sex (odds ratio, 1.4), particularly condoms or dual methods (relative risk ratio, 1.5 for each). The relative risk of using a hormonal method only, rather than no method or condoms only, increased with relationship duration (1.01) and level of intimacy (1.1-1.2). Discussing marriage or cohabitation was associated with reduced odds of having used any method (0.7) and a reduced relative risk of having used condoms alone or dual methods (0.6 for each). Increasing levels of partner conflict and asymmetry were also linked to reduced odds of any method use (0.97 and 0.90, respectively). CONCLUSIONS: Prevention programs should address relationship context in contraceptive decision making, perhaps by combining relationship and sex education curricula to foster communication and negotiation skills.

Unintended births: patterns by race and ethnicity and relationship type.

CONTEXT: Childbearing intentions vary by race and ethnicity and by relationship type. However, few studies have examined whether they differ by race and ethnicity within relationship type. METHODS: Data from the Early Childhood Longitudinal Study were used to examine the childbearing intentions of 9,100 mothers of a cohort of children born in 2001. Multivariate and multinomial regression analyses were conducted to examine whether relationship type (married, cohabiting or neither) helps explain racial and ethnic differences in childbearing intentions and whether associations between race and ethnicity and childbearing intentions vary by relationship type. RESULTS: Blacks were more likely than whites to have had an unintended birth (odds ratio, 2.5); the relationship held among married (2.6), but not unmarried, mothers. For most relationship types, black mothers had higher relative risks than whites of having had an unwanted birth, rather than an intended or a mistimed one. Asian married mothers were more likely than their white counterparts to have had an unwanted, rather than intended, birth (1.9). The odds of an unintended birth were lower among foreign-born Hispanic cohabiting women than among white cohabiting women (0.6), a finding driven by the lower risk of unwanted than of other births among foreign-born Hispanics (0.3­0.5). Few differences were apparent between native-born Hispanics and white mothers. CONCLUSIONS: Racial and ethnic differences in childbearing intentions are frequently contingent on relationship context. Differences between whites and blacks are largely attributable to married women. Assessment of childbearing intendedness among Hispanics should take nativity into account.

Repeat unintended, unwanted and seriously mistimed childbearing in the United States.

CONTEXT: The high level of unintended fertility in the United States is a serious public health issue. Whether unintended fertility occurs across the population or is concentrated among a subset of women who experience multiple unintended births is unclear. METHODS: Data from the 2002 National Survey of Family Growth were used to determine levels of unintended, unwanted and seriously mistimed childbearing, and chi-square and t tests were used to identify group differences in these measures, in two cohorts of women (those born in 1958-1962 and those born in 1965-1969). Both births (by ages 33-37) and mothers were used as units of analysis. RESULTS: The proportion of births identified as unintended was greater in the 1965-1969 cohort than in the earlier cohort (37% vs. 34%), largely because a higher proportion of births to women in the former cohort were unwanted. In both cohorts, more than a third of women (36-41%) reporting at least one unintended birth had had at least one more, and women reporting unintended or unwanted births had higher overall fertility than others. Levels of repeat unintended fertility were greatest among black women, and the proportion of blacks who reported two or more unwanted births was 94% higher in the 1965-1969 cohort than in the 1958-1962 cohort (19% vs. 10%). CONCLUSIONS: Repeat unintended fertility is common, especially among black women, who may differ from other groups in their contraceptive and fertility decisions as well as in their access to and ability to afford family planning services.

The relationship context of nonmarital childbearing in the U.S.

Using Early Childhood Longitudinal Study-Birth Cohort data, we present estimates of nonmarital births in the United States in 2001, both within and outside of cohabiting unions. We additionally examine how mother and father characteristics are associated with the relationship context at birth, and assess racial/ethnic differences in these relationships. We find that 52% of nonmarital births (and 19% of all births) occur within cohabitating unions-a substantial increase in cohabiting births since the early 1990s. The increase in cohabiting births among white and Hispanic women largely reflects a shift from marital to cohabiting births, while the increase in cohabiting births among black women largely reflects a shift from single to cohabiting births. Mother and father characteristics, including marital and fertility histories, are associated with relationship status at birth. However, with the exception of mother's education, only the association between father characteristics and relationship status at birth vary by race and ethnicity.

Testing the weathering hypothesis among Mexican-origin women.

OBJECTIVE: To examine the "weathering hypothesis," as proposed by Geronimus (1986; 1987; 1992; 1996), among US-born and foreign-born Mexican-origin women. This hypothesis specifically argues that the relationship between age and a variety of reproductively related heath outcomes varies by socioeconomic and environmental context. METHODS: 1989-1991 National Center for Health Statistics (NCHS) linked birth-death files. These files include all women who experienced a live birth in the United States and whose infants were issued a birth certificate during the years 1989 to 1991 (NCHS 1995). Age and nativity specific distributions on infant mortality, low birth weight, anemia, pregnancy related hypertension, and smoking were estimated for Mexican-origin women. RESULTS: For the foreign-born, levels of neonatal mortality are highest for younger women and tend to increase again in women at the oldest ages. For the US born, the lowest levels are for women aged 17 and 18 years, and 27-29 years. Levels for women aged 19-24 years and 30-34 years are higher than those for 17-and 18-year-olds. For both groups of women, giving birth to infants with low birth weight is most common at the earlier ages, declining more or less until the mid twenties when the rate begins to rise again slowly. Patterns for the maternal health indicators vary, with pregnancy related hypertension most strongly following the pattern suggested by weathering. CONCLUSION: Overall, this analysis suggests that there is evidence of weathering within the Mexican-origin population, particularly for the US-born population, and this is most clearly seen in levels of neonatal mortality and pregnancy related hypertension.