Understanding racial and ethnic differences in contraceptive use patterns in the contemporary United States

Rebecca DiBennardo, University of California, Los Angeles
Megan M. Sweeney, University of California, Los Angeles
Susan Ettner, University of California, Los Angeles
Carolyn Crandall, University of California, Los Angeles

Rates of unintended pregnancy are considerably higher in North America than in Western or Southern Europe. In the United States, nearly half of all recent pregnancies remain mistimed or unwanted. Yet within the United States’ context, unintended pregnancy varies tremendously across racial and ethnic groups, with unintended pregnancies most common among women of color. Although black and Hispanic women are also less likely than white women to use the most effective reversible contraceptives, existing explanations for these differences fall short. We address two questions about contraceptive use differentials in the United States, using data from the 2006-10 NSFG. First, at what stage(s) of the contraceptive decision-making process do racial and ethnic gaps emerge? Second, what factors explain racial and ethnic group differences in contraceptive use? We consider differentials in: (i) use of any method, (ii) use of a reversible method, and (iii) use of a highly-effective reversible method. We also consider a far wider array of correlates of method choice than prior studies, including factors associated with the risk of sexually transmitted disease infection and factors which increase the risk of negative health side effects associated with combined hormonal contraceptives.