Evolving Fertility Goals and Behaviors in Current U.S. Childbearing Cohorts

In the post-Recession era, U.S. fertility rates have continued to fall. It is unclear if these declines are driven by shifts in fertility goals or growing difficulty in achieving goals. In this paper, we construct synthetic cohorts of men and women to examine both cross-cohort and within-cohort changes in fertility goals using multiple cycles of the National Survey of Family Growth. Although more recent cohorts exhibit lower achieved fertility at younger ages than earlier cohorts at the same age, intended parity remains around two children, and intentions to remain childless rarely exceed 15%. There is weak evidence of a growing fertility gap in the early 30s, suggesting more recent cohorts will need considerable childbearing in the 30s and early 40s to 'catch up' to earlier goals, yet low-parity women in their early 40s are decreasingly likely to have unfulfilled fertility desires or intentions to have children. Low-parity men in their early 40s, though, are increasingly likely to intend children. Declines in U.S. fertility thus seem to be largely driven not by changes in early-life fertility goals so much as either a decreasing likelihood of achieving earlier goals or, perhaps, shifts in the preferred timing of fertility that depress period measures.

Youth's Family and Non-Family Roles as Predictors of Subjective Adulthood in Three Low-Income Agricultural Settings

Subjective adulthood, or feeling like an adult, captures identity development relative to the local context that shapes life course processes. Most research on this topic is conducted in wealthy developed countries. Instead, we draw on household-based survey data from the Family Migration and Early Life Outcomes project (FAMELO) to estimate ordinal logistic regression models predicting how often adolescents aged 11-17 in Jalisco, Mexico (n = 1,567); Gaza Province, Mozambique (n = 1,368); and the Chitwan Valley, Nepal (n = 1,898), identify as adults. The relationships between adult roles, family capital, youth characteristics, and youth's adult identities vary substantially across the sites. The findings highlight how the transition to adulthood reflects the cultural and structural conditions of adult identities.

Desired Fertility and Educational Aspirations: Adolescent Goals in Rapidly Changing Social Contexts

OBJECTIVE

This article analyzes the relationship between educational aspirations and fertility aspirations early in the life course in three different settings.

BACKGROUND

The negative relationship between women's educational attainment and childbearing is one of the most consistent associations in social science. Family scholars have a more limited understanding of the relationship between educational aspirations and fertility aspirations before childbearing or union formation.

METHOD

The authors use data collected in Jalisco, Mexico; Gaza, Mozambique; and Chitwan Valley, Nepal as part of the Family Migration and Early Life Outcomes project. They estimate nested Poisson regressions to model the relationship between adolescent educational aspirations and desired family size, controlling for individual- and household-level sociodemographic variables as well as adolescent beliefs and values.

RESULTS

On average, adolescents who desire more education want fewer children in unadjusted models. In Mozambique and Nepal, this association is attenuated in models accounting for household characteristics. In Mexico, the association persists after incorporating these factors, but the inclusion of individual aspirations attenuates the relationship between educational aspirations and desired family size. In Mozambique, the association of educational aspirations with desired family size is moderated by gender.

CONCLUSION

As young people enter adolescence, their desires for education and childbearing are inversely related, but the mechanisms driving this association vary across contexts. This variation may be related to linkages between education, social status, and family values.

Adolescent reproductive attitudes and knowledge effects on early adult unintended and nonmarital fertility across gender

Theory and evidence suggest strong short-term effects of attitudes toward, and knowledge about, reproduction on women's fertility. Adolescent attitudes and knowledge may also have longer-term implications about the contexts women perceive as appropriate for childbearing and their capacity to manage their preferences. Although previous research on men's fertility is limited, theory would suggest the links between adolescent attitudes and knowledge and subsequent fertility would also exist for men (though perhaps in different ways given the gendered meanings of sex, contraception, and reproduction). We analyze the relationship between reproductive attitudes and knowledge in adolescence and unintended and nonmarital first and second births in early adulthood, using the National Longitudinal Study of Adolescent to Adult Health (N = 9,431). Adolescent reproductive attitudes, especially life course consequences of early childbearing, predict the intendedness and marital status of first and second births. Adolescent reproductive knowledge is more often linked to the context of second births than first births. These associations vary by gender, but the overall results suggest that fertility schemas developed during adolescence predict behavior into early adulthood.

When leaving is normal and staying is novel: Men's labor migration and women's employment in rural Mozambique

Considerable cross-national research has examined the impact of international labor migration on livelihoods in sending households and communities. Although findings vary across contexts, the general underlying assumption of this research is that migration represents a novel income-generating alternative to local employment. While engaging with this assumption, we also argue that in many sending communities where labor migration has been going on for generations, it is the decision not to migrate and instead to pursue local livelihood opportunities that might constitute a true departure from the expected behavior. Importantly, both the decisions to migrate and not to migrate are part of a household strategy shaped by gendered negotiation and bargaining. Building on these propositions, we use rich survey data from rural Mozambique, a typical setting of long-established large-scale international male labor out-migration, to examine married women's gainful employment outside subsistence agriculture as it relates to their husbands' migration or local work. We find a somewhat lower likelihood of employment among migrants' wives, compared with nonmigrants' wives, and this pattern strengthens with increased duration of migration. However, we also find substantial differences among nonmigrants' wives: women married to locally employed men have themselves by far the highest probability of employment, while wives of nonemployed men are no different from migrants' wives, net of other factors. These findings are discussed in light of interconnected gendered complexities of both migration-related and local labor market constraints and choices.

Black-White Differences in Pregnancy Desire During the Transition to Adulthood

This article explores race differences in the desire to avoid pregnancy or become pregnant using survey data from a random sample of 914 young women (ages 18-22) living in a Michigan county and semi-structured interviews with a subsample of 60 of the women. In the survey data, desire for pregnancy, indifference, and ambivalence are very rare but are more prevalent among Black women than White women. In the semi-structured interviews, although few women described fatalistic beliefs or lack of planning for future pregnancies, Black and White women did so equally often. Women more often described fatalistic beliefs and lack of planning when retrospectively describing their past than when prospectively describing their future. Using the survey data to compare prospective desires for a future pregnancy with women's recollections of those desires after they conceived, more Black women shifted positive than shifted negative, and Black women were more likely to shift positive than White women-that is, Black women do not differentially retrospectively overreport prospectively desired pregnancies as having been undesired before conception. Young women's consistent (over repeated interviews) prospective expression of strong desire to avoid pregnancy and correspondingly weak desire for pregnancy, along with the similarity of Black and White women's pregnancy plans, lead us to conclude that a "planning paradigm"-in which young women are encouraged and supported in implementing their pregnancy desires-is probably appropriate for the vast majority of young women and, most importantly, is similarly appropriate for Black and White young women.

Bridewealth Marriage in the 21st Century: A Case Study from Rural Mozambique

OBJECTIVE

This study examines trends over several decades in bridewealth marriage and analyzes the association of bridewealth with women's experiences in marriage in a rural sub-Saharan setting.

BACKGROUND

Bridewealth - payments from the groom's to the bride's family as part of the marriage process - has long been a central element of kinship and marriage systems in patrilineal sub-Saharan Africa. This payment, which symbolizes the transfer of sexual and reproductive rights from the wife's to the husband's family, is grounded in a collectivist-oriented family system that closely ties women's status and value to their reproductive capacity.

METHOD

The study draws on population-based longitudinal survey data collected in 2006, 2009, and 2011 from 1,552 women in rural Mozambique. We use multivariable regression to investigate whether year of marriage predicts being in a bridewealth marriage and whether bridewealth status predicts marital dissolution, women's decision-making autonomy, women's work outside of subsistence agriculture, or modern contraceptive use.

RESULTS

The proportion of marriages involving bridewealth payment has declined over time. While no difference by bridewealth status exists in women's autonomy levels or modern contraceptive use, women in bridewealth marriages are less likely to divorce over a five-year period and less likely to work outside of subsistence agriculture, net of other factors.

CONCLUSION

These findings reflect the complexity of a modernizing marriage system. With the decline of bridewealth marriage, its meaning has evolved, becoming increasingly indicative of individual wealth and status rather than family control.

Men's migration and women's mortality in rural Mozambique

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Gender Differences in Adolescents' Work and Family Orientations in the United States

We use the Education Longitudinal Study: 2002 to compare the perceived importance of work and family achievement among young women and men. We apply latent class analysis to identify distinct configurations of values, then examine associations between latent classes and educational and occupational expectations. Results show high ambitions for both work and family among both young women and men. Although young women are more likely than young men to report that marriage and family relationships are very important, differences are small. Young women are also more likely to value work-related outcomes and to hold high educational and occupational expectations.

Changing Educational Differentials in Female Sterilization

CONTEXT

Female surgical sterilization is widely used in the United States. Educational differentials in sterilization are large, but poorly understood. Improved understanding of these differences is important to ensure that all women have access to the full range of contraceptive methods.

METHODS

Data from the National Survey of Family Growth (1973-2015) from 8,100 women aged 40-44 were used to describe trends in sterilization and other contraceptive methods by educational attainment. Demographic standardization was employed to examine how compositional changes in marital status and age at first birth contribute to aggregate changes in sterilization prevalence.

RESULTS

In 1982, women with a high school diploma and those with at least a bachelor's degree reported similar levels of sterilization use (38% and 32%, respectively), but by 2011-2015, prevalence had declined to 19% among college-educated women and had increased to 44% among those with a diploma. The trend among college graduates was largely attributable to delayed fertility; all other things being equal, if their age at first birth had not increased, the prevalence of sterilization would have declined by approximately 3% instead of 14% between 1982 and 2002. Increased use of sterilization among women with a high school diploma was only weakly related to changes in birth timing and marital status.

CONCLUSIONS

Among women with a high school diploma, elements other than childbearing and marital status-such as contraceptive preferences and access-appeared to influence their contraceptive behavior. Sterilization differentials between high school and college graduates may reflect or exacerbate other socioeconomic disparities that affect women's health and well-being.

Abortion Access in Ohio's Changing Legislative Context, 2010-2018

Objectives. To examine abortion utilization in Ohio from 2010 to 2018, a period when more than 15 abortion-related laws became effective.Methods. We evaluated changes in abortion rates and ratios examining gestation, geographic distribution, and abortion method in Ohio from 2010 to 2018. We used data from Ohio's Office of Vital Statistics, the Centers for Disease Control and Prevention's Abortion Surveillance Reports, the American Community Survey, and Ohio's Public Health Data Warehouse.Results. During 2010 through 2018, abortion rates declined similarly in Ohio, the Midwest, and the United States. In Ohio, the proportion of early first trimester abortions decreased; the proportion of abortions increased in nearly every later gestation category. Abortion ratios decreased sharply in most rural counties. When clinics closed, abortion ratios dropped in nearby counties.Conclusions. More Ohioans had abortions later in the first trimester, compared with national patterns, suggesting delays to care. Steeper decreases in abortion ratios in rural versus urban counties suggest geographic inequity in abortion access.Public Health Implications. Policies restricting abortion access in Ohio co-occur with delays to care and increasing geographic inequities. Restrictive policies do not improve reproductive health.

Community gender systems and a daughter's risk of female genital mutilation/cutting: Multilevel findings from Egypt

We tested a feminist social-ecological model to understand community influences on daughters' experience of female genital mutilation/cutting (FGMC) in Egypt, where over 90% of women ages 15-49 are cut. FGMC has potential adverse effects on demographic and health outcomes and has been defined as a human-rights violation. However, an integrated multilevel-level framework is lacking. We theorized that a more favorable community-level gender system, including stronger gender norms opposing FGMC and expanded extra-familial opportunities for women in the village or neighborhood, would be associated with a daughter's lower risk of FGMC and would strengthen the negative association of a mother's opposition to FGMC with her daughter's risk of cutting. Using a national sample of 14,171 mother-daughter dyads from the 2014 Egypt Demographic and Health Survey, we estimated multilevel discrete-time hazard models to test these relationships. Community gender norms opposing FGMC had significant direct, negative associations with the hazard that a daughter was cut, but women's opportunities outside the family did not. Maternal opposition to FGMC was negatively associated with cutting a daughter, and these associations were stronger where community opposition to FGMC and opportunities for women were greater. Results provided good support for a gender-systems framework of the multilevel influences on FGMC. Integrated, multilevel interventions that address gender norms about FGMC and structural opportunities for women in the community, as well as beliefs about the practice among the mothers of at-risk daughters, may be needed for sustainable declines in the practice.

Community Influences on Female Genital Mutilation/Cutting: A Comparison of Four Francophone West African Countries

Despite long-term efforts to encourage abandonment of female genital mutilation/cutting (FGMC), the practice remains widespread globally. FGMC is situated in specific social and historical contexts, and both prevalence and rates of decline vary widely across practicing countries. However, cross-national comparative research on the determinants of FGMC is sparse. This paper adds to the limited body of rigorous, theoretically grounded quantitative studies of FGMC and takes a step toward advancing cross-national comparative research. We apply an integrated theoretical framework that brings together norms-based and gender-based explanations of community-level influences on FGMC. We test this framework in four francophone West African countries, drawing on comparable nationally representative data from the Demographic and Health Surveys in Burkina Faso (2010), Côte d'Ivoire (2011-2012), Guinea (2012), and Mali (2012-2013). Results show that community-level FGMC norms and community-level gendered opportunities are associated with girls' risk of FGMC, but that the direct and moderating associations vary qualitatively across countries. Our findings highlight the contribution of context-specific social and institutional processes to the decline or persistence of FGMC.

Pathways to Parenthood in Social and Family Context: Decade in Review, 2020

OBJECTIVE

This article reviews research from the past decade on patterns, trends, and differentials in the pathway to parenthood.

BACKGROUND

Whether, and under what circumstances, people become parents has implications for individual identity, family relationships, the well-being of adults and children, and population growth and age structure. Understanding the factors that influence pathways to parenthood is central to the study of families and can inform policies aimed at changing childbearing behaviors.

METHOD

This review summarizes recent trends in fertility as well as research on the predictors and correlates of childbearing, with a focus on the United States and on research most relevant to family scholars. We document fertility differentials and prevailing explanations for variation across sub-groups and discuss alternative pathways to parenthood, such as adoption. The article suggests avenues for future research, outlines emerging theoretical developments, and concludes with a discussion of fertility policy.

RESULTS

U.S. fertility has declined in recent years; whether fertility rates will increase is unclear. Elements of the broader social context such as the Great Recession and increasing economic inequality have impacted pathways to parenthood, and there is growing divergence in behaviors across social class. Scholars of childbearing have developed theories to better understand how childbearing is shaped by life course processes and social context.

CONCLUSION

Future research on the pathways to parenthood should continue to study group differentials, refine measurement and theories, and better integrate men and couples. Childbearing research is relevant for social policy, but ideological factors impact the application of research to policy.

Teen Girls' Reproductive Attitudes and the Timing and Sequencing of Sexual Behaviors

PURPOSE

Teen girls consider not only health outcomes, such as pregnancy or contracting a sexually transmitted infection (STI), but also social outcomes, such as guilt or embarrassment, when making decisions about sexual behaviors.

METHODS

Following a sample of female virgins aged 15-18 years from wave I through wave IV of the National Longitudinal Study of Adolescent to Adult Health (N = 2,376), we tested whether adolescent girls' attitudes toward sex, contraception, pregnancy, and STIs influence the timing of coital debut, using discrete time event history logistic regression, and whether oral sex precedes coital debut, using logistic regression.

RESULTS

Concerns about negative social consequences of sex were associated with later coital debut (adjusted odds ratio [AOR]=.79, p = .000), whereas perceived physical benefits of sex and positive attitudes toward contraception were associated with earlier coital debut (AOR = 1.09, p = .049 and AOR = 1.17, p = .002, respectively). Worries about pregnancy were not associated with the timing of coital debut but did predict having oral sex before vaginal sex (AOR = 1.33, p = .007). Favorable birth control attitudes and positive attitudes toward sex also increased the odds of oral sex before vaginal sex (AOR = 1.38, p = .008 and AOR = 1.47, p = .000, respectively).

CONCLUSIONS

Teen girls' worries about the emotional and social consequences of sex may be a more salient predictor of the timing of coital debut than concerns about the risk of pregnancy or STIs. Teen girls' fears coexist with positive views about sex and contraception, which are associated with earlier sex and sexual sequencing.

Intimate Relationship Dynamics and Changing Desire for Pregnancy Among Young Women

CONTEXT

Although substantial research has focused on unintended pregnancy among young women, less is known about the circumstances under which pregnancy is desired. Whether a young woman's pregnancy desire changes across her different relationships, or over time within a relationship, has not been directly assessed.

METHODS

Data on intimate relationships and pregnancy desire were assessed weekly for 895 women aged 18-22 who participated in the Relationship Dynamics and Social Life study in a county in Michigan (2008-2012). Within-between logistic regression models were used to examine within-cluster and between-cluster differences-comparisons of a woman's pregnancy desire within a relationship over time as well as across a woman's different relationships.

RESULTS

Young women were more likely to desire pregnancy if they were in any relationship more intimate and committed than a casual relationship (odds ratios, 1.6-9.2); the odds of desiring pregnancy were also higher in long-term relationships rather than in short-term ones (2.1). In general, pregnancy desire increased over time as a relationship endured and became more serious. The odds of desiring pregnancy were lower among women with less educated, rather than equally educated, partners (0.7), while the odds were higher in nonmonogamous or violent relationships than in monogamous or nonviolent relationships (1.6 and 1.9, respectively).

CONCLUSIONS

Young women's pregnancy desire changes depending on their intimate relationship context, across the range of relationships they experience during the transition to adulthood.

Dimensions of Reproductive Attitudes and Knowledge Related to Unintended Childbearing Among U.S. Adolescents and Young Adults

Measures of attitudes and knowledge predict reproductive behavior, such as unintended fertility among adolescents and young adults. However, there is little consensus as to the underlying dimensions these measures represent, how to compare findings across surveys using different measures, or how to interpret the concepts captured by existing measures. To guide future research on reproductive behavior, we propose an organizing framework for existing measures. We suggest that two overarching multidimensional concepts-reproductive attitudes and reproductive knowledge-can be applied to understand existing research using various measures. We adapt psychometric analytic techniques to analyze two data sets: the National Longitudinal Survey of Adolescent to Adult Health (Add Health) and the Relationship Dynamics and Social Life study (RDSL). Although the specific survey measures and sample composition of the two data sets are different, the dimensionality of the concepts and the content of the items used to measure their latent factors are remarkably consistent across the two data sets, and the factors are predictive of subsequent contraceptive behavior. However, some survey items do not seem strongly related to any dimension of either construct, and some dimensions of the two concepts appear to be poorly measured with existing survey questions. Nonetheless, we argue that the concepts of reproductive attitudes and reproductive knowledge are useful for categorizing and analyzing social psychological measures related to unintended fertility. The results can be used to guide secondary data analyses to predict reproductive behavior, compare results across data sets, and structure future data collection efforts.

Spacing, Stopping, or Postponing? Fertility Desires in a Sub-Saharan Setting

A growing body of research has argued that the traditional categories of stopping and spacing are insufficient to understand why individuals want to control fertility. In a series of articles, Timæus, Moultrie, and colleagues defined a third type of fertility motivation-postponement-that reflects a desire to avoid childbearing in the short term without clear goals for long-term fertility. Although postponement is fundamentally a description of fertility desires, existing quantitative research has primarily studied fertility behavior in an effort to find evidence for the model. In this study, we use longitudinal survey data to consider whether postponement can be identified in standard measures of fertility desires among reproductive-age women in rural Mozambique. Findings show strong evidence for a postponement mindset in this population, but postponement coexists with stopping and spacing goals. We reflect on the difference between birth spacing and postponement and consider whether and how postponement is a distinctive sub-Saharan phenomenon.

Community Influences on Female Genital Mutilation/Cutting in Kenya: Norms, Opportunities, and Ethnic Diversity

Female genital mutilation/cutting (FGMC) is a human rights violation with adverse health consequences. Although prevalence is declining, the practice persists in many countries, and the individual and contextual risk factors associated with FGMC remain poorly understood. We propose an integrated theory about contextual factors and test it using multilevel discrete-time hazard models in a nationally representative sample of 7,535 women with daughters who participated in the 2014 Kenya Demographic and Health Survey. A daughter's adjusted hazard of FGMC was lower if she had an uncut mother who disfavored FGMC, lived in a community that was more opposed to FGMC, and lived in a more ethnically diverse community. Unexpectedly, a daughter's adjusted FGMC hazard was higher if she lived in a community with more extrafamilial opportunities for women. Other measures of women's opportunities warrant consideration, and interventions to shift FGMC norms in more ethnically diverse communities show promise to accelerate abandonment.

Adolescent Reproductive and Contraceptive Knowledge and Attitudes and Adult Contraceptive Behavior

Objectives Ineffective and inconsistent contraceptive use is common among adults, perhaps due to limited knowledge about reproduction and unfavorable attitudes toward contraception. Knowledge and attitudes are first developed in adolescence. We test whether adolescent knowledge and attitudes have long-term implications for adult contraceptive behavior. Methods Using the National Longitudinal Survey of Adolescent to Adult Health, our analytical sample (n = 6662) consists of those asked sex and contraception questions at Wave I (1995; students aged 15 and older) and who were sexually active and not pregnant at the time of the Wave IV (2007-2008) survey. We examined whether adolescent attitudes toward contraception, knowledge of condoms and reproduction, and confidence in contraceptive knowledge were predictive of adult contraceptive efficacy and consistency using logistic regression. Results In models adjusted for a range of socioeconomic, demographic, and life course factors, favorable attitudes toward contraception in adolescence increased the odds (aOR 1.21, CI 1.08-1.36) of using more effective methods rather than a less effective or no method of contraception in adulthood, as did more accurate condom knowledge (aOR 1.07, CI 1.00-1.14) and more accurate reproductive knowledge (aOR 1.07, CI 1.00-1.13). Adolescents with more favorable attitudes toward contraception also used contraception more consistently as adults (aOR 1.27, CI 1.14-1.43), as did those with more accurate condom knowledge (aOR 1.10, CI 1.03-1.18). Conclusions Attitudes towards contraception and knowledge about condoms and reproduction acquired during adolescence are predictive of adult contraceptive behavior. Results suggest that comprehensive sex education during adolescence could improve effective contraceptive behavior throughout the life course.

Adolescent Fertility Attitudes and Childbearing in Early Adulthood

Teens' attitudes about adolescent childbearing predict childbearing in the short term. If these attitudes reflect persistent goals and values, they may also be linked to later outcomes. To test long-term linkages, we analyze the association of adolescent fertility attitudes with actual and prospective fertility in adulthood using Waves I (1994-95) and IV (2007-08) of the National Longitudinal Study of Adolescent to Adult Health and focusing on men (N = 4,275) and women (N=4,418) without a teen birth. For women, we find that more negative teen attitudes predict lower hazards of a first birth up to around age 30 but that teens' attitudes are unrelated to planned childlessness among those who have not yet had children. Men's adolescent attitudes are unrelated to actual fertility or prospective intentions. For both men and women, more advantaged individuals are less likely to have had a child by around age 30; socioeconomic advantage is also related to postponement of childbearing rather than planned childlessness, though more so for women than men. We interpret the findings as evidence that, for girls, teens' attitudes toward adolescent childbearing capture an internalization of social schema about childbearing, childrearing, and sequencing with other life outcomes but do not reflect overall preferences about having children. More work is needed to understand the psychosocial factors that influence men's fertility.

Does Postpartum Contraceptive Use Vary By Birth Intendedness?

CONTEXT

Women with an unintended birth have an elevated risk of subsequent unintended pregnancy, and multiple unintended pregnancies could exacerbate any negative consequences of such births. It is therefore important to understand whether postpartum contraceptive use differs by birth intendedness.

METHODS

Data on 2,769 births reported in the 2011-2015 cycles of the National Survey of Family Growth were used to examine postpartum contraceptive use. Life-table estimates were employed to assess differences by birth intendedness in timing of postpartum contraceptive use, and multinomial logistic event history methods were used to model initial contraceptive uptake and efficacy by birth intendedness.

RESULTS

Compared with postpartum women whose births were on time or too late, those with seriously mistimed and those with unwanted births were more likely to first adopt a highly effective method (e.g., implant or IUD), rather than no method (relative risk ratios, 1.9 and 1.7, respectively); mothers with unwanted births were also more likely to first use least effective methods (e.g., condoms or withdrawal) instead of no method (1.5). Mothers with seriously mistimed births had a reduced likelihood of using either effective methods (e.g., the pill or injectable) or least effective methods, rather than highly effective ones (0.5 for each).

CONCLUSION

The elevated risk of repeat unintended fertility does not seem to be due to mothers' initial postpartum contraceptive behavior. Whether mothers with unintended births use contraceptives less consistently, discontinue use sooner or switch methods more often than those with intended births remains to be seen.

Trajectories of Unintended Fertility

Having an unintended birth is strongly associated with the likelihood of having later unintended births. We use detailed longitudinal data from the Add Health Study (N=8,300) to investigate whether a host of measured sociodemographic, personality, and psychosocial characteristics select women into this "trajectory" of unintended childbearing. While some measured characteristics and aspects of the unfolding life course are related to unintended childbearing, explicitly modeling these effects does not greatly attenuate the association of an unintended birth with a subsequent one. Next, we statistically control for unmeasured time invariant covariates that affect all birth intervals, and again find that the association of an unintended birth with subsequent ones remains strong. This persistent, strong association may be the direct result of experiencing an earlier unplanned birth. We propose several mechanisms that might explain this strong association.

Adults' Conceptualisations of Children's Social Competence in Nepal and Malawi

Adults in Nepal (N = 14) and Malawi (N = 12) were interviewed about their views regarding social competence of 5- to 17-year-old children in their societies. Both Nepali and Malawian adults discussed themes consistent with those expected in collectivistic societies with economic challenges (e.g., respect and obedience, family responsibilities, social relationships). There were also unique themes emphasized in each country, which may correspond with country-specific religious beliefs or social problems (e.g., rules and self-control, sexual restraint). Nepali adults described a wider variety of socialization strategies compared with Malawian adults. Results provide novel information regarding adults' perceptions of children's social competence in Nepal and Malawi and may help guide the development of measures of social competence.

Place, Time and Experience: Barriers to Universalization Of Institutional Child Delivery in Rural Mozambique

CONTEXT

Although institutional coverage of childbirth is increasing in the developing world, a substantial minority of births in rural Mozambique still occur outside of health facilities. Identifying the remaining barriers to safe professional delivery services can aid in achieving universal coverage.

METHODS

Survey data collected in 2009 from 1,373 women in Gaza, Mozambique, were used in combination with spatial, meteorological and health facility data to examine patterns in place of delivery. Geographic information system-based visualization and mapping and exploratory spatial data analysis were used to outline the spatial distribution of home deliveries. Multilevel logistic regression models were constructed to identify associations between individual, spatial and other characteristics and whether women's most recent delivery took place at home.

RESULTS

Spatial analysis revealed high- and low-prevalence clusters of home births. In multivariate analyses, women with a higher number of clinics within 10 kilometers of their home had a reduced likelihood of home delivery, but those living closer to urban centers had an increased likelihood. Giving birth during the rainy, high agricultural season was positively associated with home delivery, while household wealth was negatively associated with home birth. No associations were evident for measures of exposure to and experience with health institutions.

CONCLUSIONS

The results suggest the need for a comprehensive approach to expansion of professional delivery services. Such an approach should complement measures facilitating physical access to health institutions for residents of harder-to-reach areas with community-based interventions aimed at improving rural women's living conditions and opportunities, while also taking into account seasonal and other variables.

Prevalence and attitudes on female genital mutilation/cutting in Egypt since criminalisation in 2008

Female genital mutilation/cutting (FGM/C), which can result in severe pain, haemorrhage and poor birth outcomes, remains a major public health issue. The extent to which prevalence of and attitudes toward the practice have changed in Egypt since its criminalisation in 2008 is unknown. We analysed data from the 2005, 2008 and 2014 Egypt Demographic and Health Surveys to assess trends related to FGM/C. Specifically, we determined whether FGM/C prevalence among ever-married, 15-19-year-old women had changed from 2005 to 2014. We also assessed whether support for FGM/C continuation among ever-married reproductive-age (15-49 years) women had changed over this time period. The prevalence of FGM/C among adolescent women statistically significantly decreased from 94% in 2008 to 88% in 2014 (standard error [SE] = 1.5), after adjusting for education, residence and religion. Prevalence of support for the continuation of FGM/C also statistically significantly decreased from 62% in 2008 to 58% in 2014 (SE = 0.6). The prevalence of FGM/C among ever-married women aged 15-19 years in Egypt has decreased since its criminalisation in 2008, but continues to affect the majority of this subgroup. Likewise, support of FGM/C continuation has also decreased, but continues to be held by a majority of ever-married women of reproductive age.

Adults’ Conceptualisations of Children’s Social Competence in Nepal and Malawi

Adults in Nepal ( N = 14) and Malawi ( N = 12) were interviewed about their views regarding social competence of 5- to 17-year-old children in their societies. Both Nepali and Malawian adults discussed themes consistent with those expected in collectivistic societies with economic challenges (e.g., respect and obedience, family responsibilities, and social relationships). There were also unique themes emphasised in each country, which may correspond with country-specific religious beliefs or social problems (e.g., rules and self-control, and sexual restraint). Results provide novel information regarding adults’ perceptions of children’s social competence in Nepal and Malawi, and may help guide the development of measures of social competence.

Determined to stop? Longitudinal analysis of the desire to have no more children in rural Mozambique

Classic demographic theories conceptualize desired family size as a fixed goal that guides fertility intentions over the childbearing years. However, a growing body of research shows that fertility plans, even nominally long-term plans for completed childbearing, change in response to short-term conditions. Because of data limitations, much of this research has focused on low-fertility contexts, but short-term conditions are likely to be even more important in high-fertility contexts. This paper uses three waves of survey data collected in rural Mozambique to study predictors of the desire to stop childbearing in a context of relatively high fertility and high individual and social instability. We use fixed effects models to assess how women's desires to stop childbearing are shaped by demographic factors, household economic conditions, and health status, controlling for constant individual characteristics. Results provide evidence that fertility desires both reflect stable underlying goals and evolve in response to individual and social circumstances.

HIV status, fertility intentions, and contraception in the era of expanded access to antiretroviral therapy: A case study of rural Mozambique

Provision of effective contraception to HIV-positive women of reproductive age is critical to effective management of HIV infection and prevention of both vertical and horizontal HIV transmission in developing countries. This exploratory retrospective study examines contraceptive use during the prolonged post-partum period in a sample of 285 HIV-positive and HIV-negative women who gave birth at four rural maternity clinics in a high HIV-prevalence region in Mozambique. Multivariate analyses show no significant variations by HIV status in contraceptive timing (mean time to first contraceptive use of 7.1 months) or prevalence (31% at time of survey) but detect a moderating effect of fertility intentions: while HIV status makes no difference for women wishing to stop childbearing, among women who want to continue having children, or are unsure about their reproductive plans, HIV-positive status is associated with higher likelihood of contraceptive use. Regardless of HIV status, virtually no condom use is reported. These results are situated within the context of a rapidly widening access to post-partum antiretroviral therapy in the study site and similar sub-Saharan settings.

Father's Migration and Leaving the Parental Home in Rural Mozambique

Migration is an increasingly common demographic phenomenon and has important implications for the well-being of family members left behind. Although extensive research has examined the impact of parental labor migration on school-age children, less is known about its effect on adolescents. In this study, the authors used longitudinal survey data collected in rural Mozambique (N = 515) to assess the association between father's migration and adolescent children's leaving the parental home, an important component of the transition to adulthood. The results showed that father's migration delays home-leaving for adolescent girls and that these effects are not mediated by school enrollment. The results for boys were inconclusive. The authors also found that remittances and longer durations of paternal migration were negatively associated with the transition out of the home. On the basis of the findings, they argue that father's migration delays girls' marriage.

Perceived Costs and Benefits of Early Childbearing: New Dimensions and Predictive Power

CONTEXT

Understanding the causes of early childbearing is important for reducing the persistently high rates of early births in the United States. Perceptions of possible benefits may contribute to these rates, while high opportunity costs may dissuade women from early childbearing.

METHODS

Perceptions of costs and benefits of pregnancy, as well as later experiences of pregnancy, were assessed for 701 nulligravid women aged 18-22 who entered the Relationship Dynamics and Social Life study in 2008-2009 and were interviewed weekly for up to 30 months. Bivariate t tests, chi-square tests and multivariable discrete-time event history analyses were used to assess associations of perceived personal consequences of childbearing (e.g., predicted financial costs), goals in potentially competing domains (opportunity costs) and social norms with subsequent pregnancy.

RESULTS

Twenty percent of women reported that early childbearing would have more positive than negative personal consequences. Compared with other women, those who had a pregnancy during follow-up had, at baseline, more positive perceptions of the personal consequences of pregnancy and of their friends' approval of pregnancy, and greater desire for consumer goods. In multivariable analyses, only the scales assessing perceived personal consequences of childbearing and friends' approval of childbearing were associated with pregnancy (odds ratios, 2.0 and 1.2, respectively). Goals in potentially competing domains were not associated with pregnancy.

CONCLUSION

Young women's perceptions of consequences of early childbearing predict subsequent pregnancy. That these perceptions are distinct from childbearing desires and from other dimensions of costs and benefits illustrates the complex attitudinal underpinnings of reproductive behavior.

Bridging user and provider perspectives: family planning access and utilization in rural Mozambique

OBJECTIVES

To examine how the contraceptive behavior of women in rural southern Mozambique is shaped by their individual and household characteristics; community characteristics; access to family planning services; and characteristics of health facilities.

METHODS

Quantitative and qualitative data were collected mostly between January 20 and December 15, 2011, in rural areas of four districts in Gaza Province, Mozambique. The data included: a retrospective household-based survey of women of reproductive age (the analytical sample consisted of 1554 non-pregnant women in marital union); qualitative interviews with a subsample of surveyed women; a survey of communities where the women resided (n=56); and a survey of all health facilities in the study area (n=56). Binomial and multinomial logistic models were fitted to predict current use of modern contraceptive methods. Statistical analyses were complemented by insights from qualitative data.

RESULTS

Positive associations were detected between contraceptive use and education, household wealth, and perceived HIV infection status. Distance to the clinic was negatively associated with contraceptive use. These effects were additive, with some varying by type of contraceptive method. Examination of qualitative data highlighted frequent cognitive dissonance between service providers and users.

CONCLUSION

A simultaneous consideration of user-level and provider-level perspectives on contraceptive use improves our understanding of contraceptive dynamics and can usefully inform policy.

Revisiting retrospective reporting of first-birth intendedness

Because birth intendedness is typically measured retrospectively, researchers have raised concerns about the accuracy of reporting. Our objective was to assess the stability of intendedness reports for women asked about the same birth at different times. We used data from Wave III (2001-2002; ages 18-24) and Wave IV (2007-2008; ages 25-32) of the National Longitudinal Study of Adolescent Health, a nationally representative school-based sample first surveyed in 1995. For the 1,463 women who reported a first birth by Wave III that could be matched with the same birth reported at Wave IV, we examined whether intendedness was characterized consistently at both waves. We constructed descriptive measures of consistency in reporting and estimated logistic regression models predicting changes in reports. Nearly four-fifths of young mothers did not change their reports across waves, with about 60 % reporting their first birth as unintended. However, 22 % of women changed the intendedness categorization of their first birth between surveys. Women who initially reported the birth as intended were more likely to recategorize the birth as unintended than vice versa. With the exception of race and employment, most socioeconomic and demographic characteristics were unrelated to the likelihood of recategorizing first birth intendedness in multivariate models. Most reports of birth intentions are stable, but there is a nontrivial degree of inconsistency. Cross-sectional reports may either under- or overestimate the prevalence of unintended fertility. It remains to be seen whether, and how, consistency of reports is linked to maternal and child health and well-being.

The Decoupling of Marriage and Parenthood? Trends in the Timing of Marital First Births, 1945-2002

Family formation changed dramatically over the twentieth century in the United States. The impact of these changes on childbearing has primarily been studied in terms of nonmarital fertility. However, changes in family formation behavior also have implications for fertility within marriage. We use data from ten fertility surveys to describe changes in the timing of marital childbearing from the 1940s through the 21^st century for non-Hispanic white and non-Hispanic black women. Based on harmonized data from the Integrated Fertility Survey Series, our results suggest increasing divergence in fertility timing for white women. A growing proportion of marriages begin with a premarital conception; at the same time, an increasing proportion of white women are postponing fertility within marriage. For black women, marital fertility is increasingly postponed beyond the early years of marriage. Evaluating the sequencing of marriage and parenthood over time is critical to understanding the changing meaning of marriage.

FERTILITY AND THE STABILITY OF COHABITING UNIONS: VARIATION BY INTENDEDNESS

An extensive body of research demonstrates that children increase the stability of marriage. However, it is not clear whether the theories explaining greater marital stability among parents can be applied to the increasing number of cohabiting couples who have children, as cohabitation plays more varied roles in the family system than marriage. Furthermore, theories about children and marital stability often assume that births are intended, which is less likely to be the case for cohabiting than for marital births. Using data from the 2002 cycle of the National Survey of Family Growth, we find that intended and disagreed-upon pregnancies (but not unintended pregnancies) reduce the risk of dissolution relative to women who have no pregnancy or birth. Relative to non-fertile couples, all pregnancies increase the risk of marriage over staying cohabiting, but couples with a birth show little difference in the odds of stability or transitions once the child is born. However, relative to an intended birth, having an unintended or disagreed-upon birth increases the risk of dissolution. These findings suggest that normative pressures influence the union behaviors of cohabitors during pregnancy, while selection processes and rational choice considerations play a greater role after a birth.

Understanding the complexity of ambivalence toward pregnancy: does it predict inconsistent use of contraception?

Ambivalence towards future pregnancy is common and may increase the risk of unprotected sex and unintended pregnancy. We propose that ambivalent attitudes toward pregnancy consist of subtypes that are differentially associated with contraceptive use. Using data from a nationally representative survey of unmarried young adults (N = 1,147), we constructed four categories of ambivalence based on attitudes toward a hypothetical pregnancy. Multivariate analyses examined characteristics of ambivalence and the association between ambivalence and contraceptive use. Approximately one third of sexually active unmarried young adults are ambivalent about pregnancy. Having positive ambivalence (important to avoid a pregnancy but would be happy if it occurred) is associated with age, gender, education, and Hispanic origin. Although ambivalence toward pregnancy is associated with lower contraceptive use, this is true only among women with negative ambivalence (not important to avoid a pregnancy but would be unhappy if a pregnancy occurred). Attitudes toward pregnancy are multifaceted, and a more nuanced understanding of women's attitudes toward pregnancy can help target prevention programs and related policies for women at risk of unintended pregnancy.

Racial and ethnic variation in unmarried young adults' motivation to avoid pregnancy

CONTEXT

Racial and ethnic differences in unintended fertility are well documented, but mechanisms underlying these differences are poorly understood. To identify the factors that may contribute to such disparities, differences in distal characteristics theoretically linked to unintended fertility-such as the motivation to avoid a pregnancy-need to be identified.

METHODS

Data on sexual and reproductive attitudes and behavior among a sample of 1,573 unmarried men and women aged 18-29 came from the 2009 National Survey of Reproductive and Contraceptive Knowledge. Ordinal logistic regression analysis was conducted to examine two measures of motivation: one cognitive (perceived importance of avoiding pregnancy) and one affective (predicted feelings about experiencing an unplanned pregnancy).

RESULTS

Seventy-seven percent of young adults reported that avoiding pregnancy is very important, and 34% would be very upset if they were to experience an unplanned pregnancy. In multivariate analyses, the cognitive measure of motivation was not associated with race and ethnicity. The affective measure, however, was: Foreign-born Hispanics would be less upset than whites, and blacks would be more upset than whites, if they were to experience an unplanned pregnancy (coefficients, -1.7 and 0.5, respectively).

CONCLUSIONS

Differences in motivation to avoid pregnancy-particularly in predicted emotional responses to an unplanned pregnancy-should be further investigated as a potential factor in Hispanics' relatively high rates of unintended births. Future research should also examine connections between motivation to avoid pregnancy and reproductive behavior.

Now or never: perceived HIV status and fertility intentions in rural Mozambique

As the HIV epidemic evolves, researchers are devoting increased attention to the infection's effect on various life-course activities, including marriage and reproduction. The impact of HIV on decisions about childbearing is particularly important, given the role that vertical transmission plays in the persistence of the epidemic. Previous studies on HIV and fertility intentions have yielded inconsistent results. This article expands on prior research by taking into account preferred timing of childbearing. Using data from a population-based survey in rural Mozambique, we show that higher perceived risk of HIV is associated with greater likelihood of both wanting to speed up childbearing and wanting to stop having children. The "now or never" approach to childbearing is shown to be consistent with the widely held belief that HIV infection is incompatible with childbearing in the long term.

Race-Ethnic Differences in Sexual Health Knowledge

Despite extensive research examining the correlates of unintended fertility, it remains a puzzle as to why racial and ethnic minorities are more likely to experience an unintended birth than non-Hispanic whites. This paper focuses on sexual literacy, a potential precursor of unintended fertility. Analyses use a unique dataset of unmarried young adults aged 18-29, the 2009 Survey of Unmarried Young Adults' Contraceptive Knowledge and Practices, to examine beliefs regarding pregnancy risks, pregnancy fatalism, and contraceptive side effects. At the bivariate level, foreign-born Hispanics hold more erroneous beliefs about the risk of pregnancy than other groups, and non-Hispanic blacks are more likely to believe in contraceptive side effects than non-Hispanic whites. Both foreign-born Hispanics and non-Hispanic blacks are more likely than non-Hispanic whites to hold a fatalistic view towards pregnancy. Race-ethnic differences are attenuated for pregnancy misperceptions and fatalism in multivariate models controlling for sources of health information, sexual and fertility experiences, and sociodemographic characteristics. However, non-Hispanic blacks remain more likely than non-Hispanic whites to believe there is a high chance of reduced sexual desire and serious health consequences when using hormonal contraceptives. These differences may contribute to race-ethnic variation in contraceptive use and, ultimately, unintended fertility.

Unintended fertility and the stability of coresidential relationships

Having an unintended birth is associated with maternal and child health outcomes, the mother-child relationship, and subsequent fertility. Unintended fertility likely also increases the risk of union dissolution for parents, but it is unclear whether this association derives from a causal effect or selection processes and whether it differs by union type. This article uses data from the 2002 National Survey of Family Growth to compare union stability after intended and unintended births in coresidential relationships. Results show that coresidential couples are more likely to break up after an unintended first or higher-order birth than after an intended first or higher-order birth, even when accounting for stable unobserved characteristics using fixed-effects models. The negative association is stronger for marriages than cohabitations, despite the overall higher dissolution rate of cohabiting unions. We conclude that unintended fertility at any parity is disruptive for coresidential couples in ways that increase the risk of union dissolution.

Geographic influences on sexual and reproductive health service utilization in rural Mozambique

The HIV/AIDS epidemic remains a major public health issue across the globe, and it is of particular concern in sub-Saharan Africa. Utilization of sexual and reproductive health (SRH) services can significantly impact HIV prevention, transmission, and treatment. SRH service utilization may be determined by individual characteristics, such as education and economic status, but also by the location and accessibility of health care facilities. Using population-based survey data, this study applies exploratory spatial analysis techniques to examine spatial patterns of SRH service utilization among rural married women in southern Mozambique. Clustering among those using services is found as are spatial associations, indicating significant spatial variability in the utilization of health services. The findings provide valuable insights for current and future health care program planning and configuration.

Uncertain future, non-numeric preferences, and the fertility transition: A case study of rural Mozambique

In many high-fertility countries, and especially in sub-Saharan Africa, substantial proportions of women give non-numeric responses when asked about desired family size. Demographic transition theory has interpreted responses of "don't know" or "up to God" as evidence of fatalistic attitudes toward childbearing. Alternatively, these responses can be understood as meaningful reactions to uncertainty about the future. Following this latter approach, we use data from rural Mozambique to test the hypothesis that non-numeric responses are more common when uncertainty about the future is greater. We expand on previous research linking child mortality and non-numeric fertility preferences by testing the predictive power of economic conditions, marital instability, and adult mortality. Results show that uncertainty related to adult and child mortality and to economic conditions predicts non-numeric responses, while marital stability is less strongly related.

Religious differences in female genital cutting: a case study from Burkina Faso

The relationship between religious obligations and female genital cutting is explored using data from Burkina Faso, a religiously and ethnically diverse country where approximately three-quarters of adult women are circumcised. Data from the 2003 Burkina Faso Demographic and Health Survey are used to estimate multilevel models of religious variation in the intergenerational transmission of female genital cutting. Differences between Christians, Muslims, and adherents of traditional religions are reported, along with an assessment of the extent to which individual and community characteristics account for religious differences. Religious variation in the intergenerational transmission of female genital cutting is largely explained by specific religious beliefs and by contextual rather than individual characteristics. Although Muslim women are more likely to have their daughters circumcised, the findings suggest the importance of a collective rather than individual Muslim identity for the continuation of the practice.

Providers' views concerning family planning service delivery to HIV-positive women in Mozambique

This study explores challenges and obstacles in providing effective family planning services to HIV-positive women as described by staff of maternal and child health (MCH) clinics. It draws upon data from a survey of service providers carried out from late 2008 to early 2009 in 52 MCH clinics in southern Mozambique, some with and some without HIV services. In all clinics, surveyed providers reported that practical, financial, and social barriers made it difficult for HIV-positive clients to follow protocols to prevent mother-to-child transmission of the virus. Likewise, staff were skeptical of their seropositive clients' ability to adhere to recommendations to cease childbearing and to use condoms consistently. Providers' recommendations to HIV-positive clients and their assessment of barriers to adherence did not depend on availability of HIV services. Although integration of HIV and reproductive health services is advancing in Mozambique, service providers do not feel that they can influence the behaviors of HIV-positive women effectively.

Single Mothers, Single Fathers: Gender Differences in Fertility after a Nonmarital Birth

Research on nonmarital fertility has focused almost exclusively on unmarried mothers, due in part to a lack of fertility information for men. Cycle 6 of the National Survey of Family Growth allows exploration of nonmarital fertility for both genders. We compare the characteristics of unmarried first-time mothers (n = 2,455) and fathers (n = 797), use event history techniques to model second birth hazards, and examine the distribution of men's and women's second births across types of relationships. Our analysis is motivated by questions about how selection into nonmarital fertility relates to subsequent fertility behavior and by theories of mate selection and the "relationship" market. We find that unmarried mothers are more likely to have a second birth than unmarried fathers, driven largely by a higher hazard of having a noncoresidential second birth.

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 evolution of fertility expectations over the life course

In low-fertility contexts, how many children people have is largely a product of how many children they want. However, the social, institutional, and individual factors that influence how many children people want are not well understood. In particular, there is scant evidence about how fertility expectations change over the life course. This article provides an empirical description of changes in women's expected fertility over the entire span of childbearing years. Using data from the National Longitudinal Survey of Youth, 1979 cohort, group-based trajectory analysis illuminates common patterns in the evolution of fertility intentions and identifies individual characteristics associated with these patterns. Factors related to family formation, such as marriage and whether a woman has a child at an early age, are found to be the most consistent correlates of patterns of change in expected family size.