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The Dynamics of Intimate Relationships and Contraceptive Use During Early Emerging Adulthood

  • Published:
Demography

Abstract

We investigate the immediate social context of contraceptive behaviors: specifically, the intimate relationship. We use the Relationship Dynamics and Social Life (RDSL) study (2008–2012), based on a random sample of 1,003 women ages 18–19 residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18–22. We test three sets of hypotheses about change over time within a relationship, using relationship-level within-between models, which compare a couple’s contraceptive behaviors across different times in the relationship. First, we find that a couple is less likely to use contraception when the relationship is more intimate and/or committed and that a couple becomes less likely to use contraception over time, regardless of intimacy and commitment. Second, we find that a couple using contraception becomes increasingly likely to choose hormonal over coital methods, but this change occurs as a relationship endures and is unrelated to intimacy and/or commitment. Third, we find that a condom-using couple’s consistency does not decline when there is conflict; rather, consistency of condom use declines over time regardless of the relationship’s characteristics. We also demonstrate that conflict and power imbalance increase reliance on hormonal methods among those using contraception; conflict decreases consistency among withdrawal (but not condom) users; and nonmonogamy increases reliance on condoms and decreases withdrawal consistency. The strong and consistent link between duration and contraceptive behaviors—regardless of intimacy, commitment, conflict, or power imbalance—suggests that the continual vigilance required for long-term contraceptive use is difficult during early emerging adulthood.

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Data Availability

Barber, J. S., Kusunoki, Y., & Gatny, H. H. (2015). Relationship Dynamics and Social Life Study. Ann Arbor, MI: ICPSR. Available from https://www.icpsr.umich.edu/icpsrweb/ICPSR/studies/34626

Notes

  1. We focus here on contraceptive use to prevent pregnancy and thus analyze only heterosexual intercourse. Other research has documented lower levels of contraceptive use among nonheterosexual women (compared with heterosexual women) in their heterosexual sexual encounters (Ela and Budnick 2017).

  2. One important exception is Edin and Kefalas’ (2005) study of unmarried mothers, which documented their recollections of becoming less consistent coital contraceptive users over time as their relationship with the father reached “the next level of commitment.”

  3. One exception is the Continuity and Change in Contraceptive Use study, a four-wave, nationally representative longitudinal study (2012–2014) of ~4,500 women ages 18–39 (Jones 2018; Jones et al. 2015). Another is the Border Contraceptive Access Study, which selected ~1,000 women using two pharmacies for oral contraceptives and interviewed them four times over nine months (Potter et al. 2010). These data sets have not been used to study the links between changing intimate relationships and contraceptive use.

  4. Guttmacher (2018) reported that among current contraceptive users aged 15–19, 55% were using condoms, 35% used oral contraceptives, 20% used withdrawal, 8% used hormonal injectable/patch/ring, and only 3% used an IUD.

  5. When choosing the RDSL sample, the sampling statisticians at the University of Michigan’s Survey Research Center calculated that 95% of women ages 18–19 in the census were included in the sampling frame. We do not know the differences between women who were included in the sampling frame and those who were not, but we suspect that the excluded women are poorer and less stably housed than the included women. A driver’s license costs $25 in Michigan. However, one must have a driver’s license or personal ID card to receive public assistance in Michigan, and a personal ID card costs only $10. The fee is waived for those who receive public assistance or for other “good cause.” Thus, the financial barrier is fairly low for obtaining an ID card.

  6. The RDSL women are slightly more religious, more likely to have a mother who gave birth as a teen, and more likely to have experienced a teen pregnancy themselves. However, the proportion of the sample that is Black in RDSL is nearly double the proportion of Black respondents in the NSFG sample, which likely at least partially explains these discrepancies. Also, a slightly smaller proportion of the RDSL young women had first sexual intercourse before age 17, relative to the NSFG respondents.

  7. In other words, women who reported a desire for pregnancy at some point during the study are still included, but the weeks when they reported that desire are excluded from our analytic sample. In our main analyses, we define “want to get pregnant” (the excluded weeks) as those in which the woman gave a response of 5 to the question, “How much do you want to become pregnant in the upcoming month?,” where the response options were 0 (not at all) to 5 (extremely). We conducted sensitivity analyses with three additional definitions of wanting to get pregnant; see footnote 12.

  8. We also conducted sensitivity analyses including these 42 relationships, which are described in the Results section.

  9. In the 1% of weeks when a respondent had more than one partner, only the “most important or most serious” one was discussed in detail.

  10. A sensitivity analysis replacing this with an indicator of not growing up in a family with two biological parents (i.e., including a stepparent) is described in the Results section.

  11. Recall that we define “want a pregnancy” as giving a response of 5 (on a scale from 0 to 5) to the question, “How much do you want to get pregnant during the next month?” We reestimated our models three times, using three alternative definitions of wanting a pregnancy: (1) any nonzero response to the question about desire for pregnancy, (2) anything but the strongest antinatalism (a response of 0 for desire to get pregnant and 5 for a parallel question about wanting to avoid pregnancy), and (3) a response of 0 for desire to avoid pregnancy. Sensitivity analyses with these three sample restrictions produced very similar results. Coefficients that differed from those presented in Tables 2 and 3 are as follows: coefficients for engaged/married → any contraceptive were sometimes not statistically significant (although the p values increase to only ~ .13), cohabiting/stayover → hormonal versus coital method were marginally insignificant in one model (p = .08), cohabiting/stayover → withdrawal consistency and fighting → withdrawal consistency were significant with two of the three alternative specifications of pregnancy desire. These differences do not change our substantive conclusions.

  12. Recall that we exclude the 42 (5%) longest relationships. Sensitivity analyses including them produced very similar results, with one exception: the coefficients for duration and duration squared predicting withdrawal consistency. Rather than –0.17 (nonsignificant) and –0.03 (nonsignificant), respectively, they became 1.56 (significant at p < .01) and –0.09 (nonsignificant). Thus, the 42 longest relationships were particularly consistent in their use of withdrawal.

  13. The equation indicates that this increase would occur around four years, but few relationships in RDSL were observed at the four-year point. Our models should not be interpreted beyond the duration of the study (2.5 years).

  14. A sensitivity test replacing “did not grow up with two parents” with “did not grow up with two biological parents” produced results that were very similar in magnitude and statistical significance to the models shown in Tables 2 and 3.

  15. Alternatively, coital method use may appear to decline over time because couples shift from using only coital methods to using dual methods (coital and hormonal methods)—that is, they continue using coital methods but become increasingly likely to add a hormonal method—which would appear as shifting from coital to hormonal methods in our coding scheme. To test this, we estimated models of coital method use without a hormonal method separately from coital method use with a hormonal method. Both types of coital method use declined over time.

  16. The equation indicates that this decrease would occur around three years, but few relationships in the RDSL were observed at the three-year point. Our models should not be interpreted beyond the duration of the study (2.5 years).

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Acknowledgments

This research was supported by four grants from the National Institute of Child Health and Human Development (R01 HD050329, R01 HD050329-S1, U54 U54HD09354, PI Barber; R03 HD080775, PI Kusunoki) and a population center grant from the NICHD to the University of Michigan’s Population Studies Center (P2CHD041028). The authors gratefully acknowledge the Survey Research Operations (SRO) unit at the Survey Research Center of the Institute for Social Research for their help with the data collection, particularly Vivienne Outlaw, Sharon Parker, and Meg Stephenson. The authors also gratefully acknowledge the intellectual contributions of Heather Gatny, Lindsay Cannon, Kristin Bevilacqua, and Robert Melendez as well as the other members of the original RDSL project team, William Axinn, Mick Couper, and Steven Heeringa, and the National Advisory Committee for the project, Larry Bumpass, Elizabeth Cooksey, Kathie Harris, and Linda Waite.

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Authors and Affiliations

  1. School of Nursing, Department of Systems, Populations and Leadership, and Population Studies Center and Survey Research Center at the Institute for Social Research, University of Michigan, 400 North Ingalls Street, Room 4156, Ann Arbor, MI, 48109-4582, USA

    Yasamin Kusunoki

  2. Department of Sociology and Kinsey Institute, Indiana University, Bloomington, IN, 47405-7103, USA

    Jennifer S. Barber

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  1. Yasamin Kusunoki
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Both authors contributed to the study concept and design. Analyses were conducted by our programmer, Robert Melendez, who was supervised by Yasamin Kusunoki and Jennifer S. Barber. The first draft of the manuscript was written by Yasamin Kusunoki, and Yasamin Kusunoki and Jennifer S. Barber edited previous versions of the manuscript. Both authors read and approved the final manuscript.

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Correspondence to Yasamin Kusunoki.

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Kusunoki, Y., Barber, J.S. The Dynamics of Intimate Relationships and Contraceptive Use During Early Emerging Adulthood. Demography 57, 2003–2034 (2020). https://doi.org/10.1007/s13524-020-00916-1

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  • DOI: https://doi.org/10.1007/s13524-020-00916-1

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