Expecting someone
Experimentally Induced Stress Decreases Ideal Female Reproductive Timing
Abby Chipman & Edward Morrison
Psychoneuroendocrinology, December 2015, Pages 89–95
Abstract:
Previous correlational research shows that childhood adversity is associated with earlier age of reproduction in humans and other species. Such studies, however, cannot show that stressful conditions cause earlier reproduction. Using the cold-pressor task, we built on previous work to test the idea that acute stress influences human reproductive and marital ideals, and that individual stress responses depend on adaptive life history strategies shaped by exposure to adversity during childhood. Acute stress shifted ideal ages of first birth and marriage to earlier ages. We also tested a competing hypothesis, whether stress had a more general impact on time preference, but found no evidence that it did. Furthermore, there was an interaction between childhood adversity and acute stress. Individuals who reported more exposure to childhood adversity responded to acute stress by reporting even earlier reproductive ideals. These findings offer experimental evidence that physiological stress can alter reproductive decision making in humans.
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The Association between High-Deductible Health Plan Transition and Contraception and Birth Rates
Amy Graves et al.
Health Services Research, forthcoming
Objective: To evaluate the association between employer-mandated enrollment into high-deductible health plans (HDHPs) and contraception and birth rates among reproductive-age women.
Data Sources/Study Setting: Using data from 2002 to 2008, we examined 1,559 women continuously enrolled in a Massachusetts health plan for 1 year before and after an employer-mandated switch from an HMO to a HDHP, compared with 2,793 matched women contemporaneously enrolled in an HMO.
Principal Findings: Monthly contraception rates were 19.0–24.0 percent at baseline. Level and trend changes did not differ between groups (p = .92 and p = .36, respectively). Annual birth rates declined from 57.1/1,000 to 32.7/1,000 among HDHP members and from 61.9/1,000 to 56.2/1,000 among HMO controls, a 40 percent relative reduction in odds of childbirth (odds ratio = 0.60; p = .02).
Conclusions: Women who switched to HDHPs experienced a lower birth rate, which might reflect strategies to avoid childbirth-related out-of-pocket costs under HDHPs.
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Contraception Use, Abortions, and Births: The Effect of Insurance Mandates
Karen Mulligan
Demography, August 2015, Pages 1195-1217
Abstract:
Beginning August, 2012, the U.S. Patient Protection and Affordable Care Act (ACA) required new private health insurance plans to cover contraceptive methods and counseling without requiring an insured’s copay. The ACA represents the first instance of federally mandated contraception insurance coverage, but 30 U.S. states had already mandated contraceptive insurance coverage through state-level legislation prior to the ACA. This study examines whether mandated insurance coverage of contraception affects contraception use, abortions, and births. I find that mandates increase the likelihood of contraception use by 2.1 percentage points, decrease the abortion rate by 3 %, and have an insignificant impact on the birth rate. The results imply a lower-bound estimate that the ACA will result in approximately 25,000 fewer abortions.
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Regulation, Imperfect Competition, and the U.S. Abortion Market
Andrew Beauchamp
International Economic Review, August 2015, Pages 963–996
Abstract:
The U.S. abortion market has grown increasingly concentrated recently, while many states tightened abortion laws. Using data on abortion providers, I estimate an equilibrium model of demand, price competition, entry and exit, to capture the effect of regulation on industry dynamics. Estimates show regulations played an important role in determining the abortion market structure and evolution. Counterfactual simulations reveal increases in demand-aimed regulation were the most important observed factor in explaining recent abortion declines. Simulating Utah's regulatory regime nationally shows tightening abortion restrictions can increase abortions in equilibrium, mainly through tilting the competitive landscape toward low-price providers.
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The Effect of Statutory Rape Laws on Teen Birth Rates
Michael Frakes & Matthew Harding
American Law and Economics Review, forthcoming
Abstract:
Policymakers have often been explicit in expanding statutory rape laws to reduce teenage pregnancies and live births by teenage mothers, often with the goal of reducing associated welfare outlays. In this paper, we explore whether expansions in such laws are indeed associated with reductions in teen birth rates. In order to codify statutory-rape-law expansions, we use a national micro-level sample of sexual encounters to simulate the degree to which such encounters generally implicate the relevant laws. By codifying statutory rape laws in terms of their potential reach into sexual encounters, as opposed to using crude binary treatment variables, this simulation approach facilitates the use of multi-state difference-in-difference designs in the face of highly heterogeneous legal structures. Our results suggest that live birth rates for teenage mothers fall by roughly 4.5% (or 0.1 percentage points) upon a 1 standard-deviation increase in the share of sexual activity among a given age group that triggers a felony for the elder party to the encounter. This response, however, is highly heterogeneous across ages and weakens notably in the case of the older teen years. Furthermore, we do not find strong results suggesting a further decline in birth rates upon increases in punishment severities.
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Career and Family Choices Among Elite Liberal Arts Graduates
Heather Antecol
Demography, August 2015, Pages 1089-1120
Abstract:
This study describes how the career and family choices of female graduates of the Claremont Colleges within 15 years of undergraduate graduation (unless otherwise specified) have changed across the graduation years of 1960 to 1994. Specifically, I show that female graduates of the Claremont Colleges have clearly shifted away from having their family first (i.e., having at least one biological child) and a job second (i.e., having a job after 15 years of receiving their undergraduate degree but having very weak labor force attachment prior to that) toward simultaneously having both a career (i.e., very strong labor force attachment) and a family for those that graduated after 1979. Finally, I find that the primary mechanisms that allowed for the observed shift toward “career and family” for those that graduated post-1979 appear to be increased access to paid parental leave and childcare.
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Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality
Cristian Meghea et al.
Pediatrics, August 2015, Pages 334-342
Objective: To evaluate whether participation in a statewide enhanced prenatal and postnatal care program, the Maternal Infant Health Program (MIHP), reduced infant mortality risk.
Methods: Data included birth and death records, Medicaid claims, and program participation. The study population consisted of Medicaid-insured singleton infants born between January 1, 2009, and December 31, 2012, in Michigan (n = 248 059). The MIHP participants were propensity score–matched with nonparticipants based on demographics, previous pregnancies, socioeconomic status, and chronic disease. Infant mortality, neonatal mortality, and postneonatal mortality analyses were presented by race.
Results: Infants with any MIHP participation had reduced odds of death in the first year of life compared with matched nonparticipants (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.63–0.84). Infant death odds were reduced both among black infants (OR 0.71, 95% CI 0.58–0.87) and infants of other races (OR 0.74, 95% CI 0.61–0.91). Neonatal death (OR 0.70, 95% CI 0.57–0.86) and postneonatal death odds (OR 0.78, 95% CI 0.63–0.96) were also reduced. Enrollment and screening in MIHP by the end of the second pregnancy trimester and at least 3 additional prenatal MIHP contacts reduced infant mortality odds further (OR 0.70, 95% CI 0.58–0.85; neonatal: OR 0.67, 95% CI 0.51–0.89; postneonatal: OR 0.74, 95% CI 0.56–0.98).
Conclusions: A state Medicaid-sponsored population-based home-visitation program can be a successful approach to reduce mortality risk in a diverse, disadvantaged population. A likely mechanism is the reduction in the risk of adverse birth outcomes, consistent with previous findings on the effects of the program.
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Nora Becker & Daniel Polsky
Health Affairs, July 2015, Pages 1204-1211
Abstract:
The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance.
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Kerri Raissian & Leonard Lopoo
Population Research and Policy Review, August 2015, Pages 481-510
Abstract:
While recent national discussions of the Affordable Care Act (ACA) made the introduction of mandated contraceptive coverage within health insurance policies seem like a novel idea, it is not new at all. Since the late 1990s, 29 states have mandated that insurance providers include prescription contraceptive supplies and, in some instances, associated contraceptive services in their coverage. We use state-level policy variation to generate both difference-in-differences and triple difference estimates to determine if women in states with state-level contraception supply or contraception supply and services insurance mandates experienced changes in their utilization of contraception and preventive health care services. We find a positive relationship between these policies and prescription contraception use for those with low educational attainment, but the results are not robust to a variety of specifications. Our results also show an increase in the consumption of preventive health services for women with low educational attainment as a result of these health insurance mandates. We conclude by discussing the implications for the ACA.
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Liran Hiersch et al.
Journal of Maternal-Fetal & Neonatal Medicine, forthcoming
Objective: To determine the association between single previous abortion and pregnancy outcome in nulliparous women.
Methods: A retrospective cohort study of all nulliparous women who delivered in a university-affiliated tertiary hospital (2009–2014). Pregnancy outcome of women with single previous first trimester abortion (study group) was compared to those of primigravida (control group).
Results: Of the 44 371 deliveries during the study period, 14 498 (32.6%) were of nulliparous women, of them 1501 (10.3%) had single previous abortion (<13 weeks). Except for a higher rate of diabetes mellitus in the study group (6.1 versus 4.4%, p = 0.003), no differences were found between the groups regarding pregnancy complications. In multivariate analysis, previous single abortion was independently associated with induction of labor (OR = 1.31, 95%C.I 1.04–1.63, p = 0.01), cesarean section (OR = 1.38, 95%C.I 1.18–1.60, p < 0.001) and retained placenta (OR = 1.29, 95%C.I 1.03–1.61, p = 0.02). Among nulliparous women with previous single abortion no difference in pregnancy outcome was observed between those with previous induced termination of pregnancy and spontaneous abortion, except for increased risk for retained placenta in those with previous spontaneous abortion.
Conclusion: Single early previous abortion in nulliparous women was associated with higher rate of induction of labor, cesarean section and retained placenta compared to primigravida women.
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Decision Rightness and Emotional Responses to Abortion in the United States: A Longitudinal Study
Corinne Rocca et al.
PLoS ONE, July 2015
Background: Arguments that abortion causes women emotional harm are used to regulate abortion, particularly later procedures, in the United States. However, existing research is inconclusive. We examined women’s emotions and reports of whether the abortion decision was the right one for them over the three years after having an induced abortion.
Methods: We recruited a cohort of women seeking abortions between 2008-2010 at 30 facilities across the United States, selected based on having the latest gestational age limit within 150 miles. Two groups of women (n=667) were followed prospectively for three years: women having first-trimester procedures and women terminating pregnancies within two weeks under facilities’ gestational age limits at the same facilities. Participants completed semiannual phone surveys to assess whether they felt that having the abortion was the right decision for them; negative emotions (regret, anger, guilt, sadness) about the abortion; and positive emotions (relief, happiness). Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.
Results: The predicted probability of reporting that abortion was the right decision was over 99% at all time points over three years. Women with more planned pregnancies and who had more difficulty deciding to terminate the pregnancy had lower odds of reporting the abortion was the right decision (aOR=0.71 [0.60, 0.85] and 0.46 [0.36, 0.64], respectively). Both negative and positive emotions declined over time, with no differences between women having procedures near gestational age limits versus first-trimester abortions. Higher perceived community abortion stigma and lower social support were associated with more negative emotions (b=0.45 [0.31, 0.58] and b=-0.61 [-0.93, -0.29], respectively).
Conclusions: Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.
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Gender Composition of Children and the Third Birth in the United States
Felicia Tian & Philip Morgan
Journal of Marriage and Family, forthcoming
Abstract:
Pollard and Morgan (2002) argued that the parental mixed-gender preference (i.e., parents' preference to have at least one son and one daughter) will weaken in the United States as aspects of gender become increasingly deinstitutionalized. They presented evidence that mixed-gender preference weakened in the 1986–1995 period compared to earlier and coined this change as emerging gender indifference. On the other hand, credible claims and evidence suggest that after 1985, the “gender revolution” has stalled. Such arguments suggest that weakened mixed-gender preference will persist. In this study, the authors replicated and extended Pollard and Morgan using 4 waves of data from the National Survey of Family Growth that allow examination of the 1966–2009 period. The results show that the effect of same-gender children on intending/having another child declined in the 1986–1995 period; however, no evidence that this effect has continued to weaken was found. Thus, these data show evidence consistent with a “stalled revolution.”
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V. Jadva et al.
Human Reproduction, August 2015, Pages 1896-1906
Study question: What are the characteristics, motivations and expectations of men and women who search for a co-parent online?
Study design, size and duration: An online survey was completed by 102 participants (61 men, 41 women) who were members of Pride Angel, an online connection website that facilitates contact between people looking for someone with whom to have a child. The survey was live for 7 weeks.
Main results and the role of chance: Approximately one-third of men and one half of women seeking co-parenting arrangements were heterosexual. The majority (69, 68%) of participants were single, although significantly more gay and bisexual men (15, 36%) and lesbian and bisexual women (11, 55%) had a partner compared with heterosexual men (4, 20%) and heterosexual women (2, 12%), respectively. Overall, the most important motivation for seeking co-parenting arrangements was in order for both biological parents to be involved in the child's upbringing. Co-parents were looking for someone with a good medical history. Most female co-parents expected the child to live with them, whereas male co-parents either wished the child to reside with the mother or to live equally in both households. A higher proportion of gay and bisexual men than heterosexual men wanted daily contact with the child.
Wider implications of the findings: This study provides important insights into the new phenomenon of elective co-parenting. With the increasing use of assisted reproductive technologies and the diversification of family forms, a growing number of people are seeking co-parenting arrangements to have children. While up until now, elective co-parenting has been principally associated with the gay and lesbian community, this study shows that, with the rise of co-parenting websites, increasing numbers of heterosexual men and women are seeking these types of parenting arrangements. This study generates the first findings on the expectations and motivations of those who seek co-parents online and examines whether these differ according to gender and sexual orientation. Future studies are needed to assess the impact of this new form of parenting on all involved, particularly the children.
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Directional dominance on stature and cognition in diverse human populations
Peter Joshi et al.
Nature, 23 July 2015, Pages 459–462
Abstract:
Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power. Here we use runs of homozygosity to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts, and find statistically significant associations between summed runs of homozygosity and four complex traits: height, forced expiratory lung volume in one second, general cognitive ability and educational attainment (P < 1 × 10−300, 2.1 × 10−6, 2.5 × 10−10 and 1.8 × 10−10, respectively). In each case, increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months’ less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing evidence that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been.
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Sperm and simulacra: Emotional capitalism and sperm donation industry
Ya'arit Bokek-Cohen & Limor Dina Gonen
New Genetics and Society, Summer 2015, Pages 243-273
Abstract:
The article proposes sociological insights into the sperm banking industry, derived from a qualitative study of extended sperm donor profiles in six large American sperm banks. We content analyzed the extended profiles and baby photos of 120 randomly selected donors who appear in the catalogues. Inspired by Baudrillard's and Illouz's writings on the postmodern era, we show how sperm banks de-commodify sperm, personify donations, facilitate the romanticization of the donor–recipient bond, and add an emotional context to the economic transaction. The donors’ extended profiles constitute a simulacrum of a living male partner and fulfill recipients’ fantasies. This creates a powerful reenchantment mechanism counterbalancing the anonymity and disenchantment characterizing donor insemination technology in particular and the postmodern spirit in general.