Household bargaining power and birth outcomes: the joint effect of parental pregnancy intention on voluntary and involuntary pregnancy loss in the United States 2006-2010

Laura Kelly, University of Pennsylvania

Pregnancy behaviors offer a unique opportunity to examine household decision-making, as fertility choices are determined at the couple level. Intention to become pregnant associates strongly with prenatal behaviors and consequently health outcomes of the fetus, child, and mother. The role of couple agreement is largely ignored in the literature on pregnancy intentions, with marital status often serving as the only indication of couple context. Union formation and fertility are drastically changing in the American family, with more couples childbearing out of wedlock. This paper utilizes detailed couple pregnancy intentions from the 2006-2010 National Survey of Family Growth to evaluate consequences of parental pregnancy intentions on the birth outcomes of pregnancy loss, both involuntary and voluntary. Couple pregnancy intentions associate significantly with the probability of pregnancy loss, particularly induced abortion, with the lack of paternal intention increasing the risk of pregnancy loss. The loss of mother intent appears seems more detrimental than the loss of father intent. In the decision to abort a pregnancy, paternal intention appears to play a reduced role relative to the maternal intention suggesting that access to family planning services has increases female empowerment over fertility control.