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The Enduring Case for Fertility Desires

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Demography

Abstract

Persistently high levels of unintended fertility, combined with evidence that over- and underachieved fertility are typical and not exceptional, have prompted researchers to question the utility of fertility desires writ large. In this study, we elaborate this paradox: widespread unintendedness and meaningful, highly predictive fertility desires can and do coexist. Using data from Malawi, we demonstrate the predictive validity of numeric fertility timing desires over both four-month and one-year periods. We find that fertility timing desires are highly predictive of pregnancy and that they follow a gradient wherein the likelihood of pregnancy decreases in correspondence with desired time to next birth. This finding holds despite the simultaneous observation of high levels of unintended pregnancy in our sample. Discordance between desires and behaviors reflects constraints to achieving one’s fertility and the fluidity of desires but not their irrelevance. Fertility desires remain an essential—if sometimes blunt—tool in the demographers’ toolkit.

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Data Availability

Tsogolo la Thanzi data are available through Data Sharing for Demographic Research within ICPSR at the University of Michigan (https://www.icpsr.umich.edu/web/DSDR/series/767).

Notes

  1. We refer to desires throughout the text despite frequently citing literature that uses the language of “intentions.” Although some surveys actually measure intentions, it is far more common for surveys (e.g., NSFG, DHS, PRAMS) to measure desires (e.g., “Did you yourself want to have a(nother) baby?”; “How long would you like to wait before the birth of a(nother) child?”). Responding to calls from fertility researchers, we endeavor to align our terminology with our measurement (Kost and Zolna 2019; Kost et al. 2018; Miller et al. 2004).

  2. Aspects of this debate parallel broader conversations about the “attitudinal fallacy” taking place across the social sciences, specifically those questioning the predictive power of attitudinal survey items (Jerolmack and Khan 2014; Vaisey 2014).

  3. Researchers have pointed out that questions on timing desires may be easier to answer for women who seek to space their births or who have yet to start childbearing than for women who seek to postpone their next birth indefinitely (Cleland et al. 2019; Hayford and Agadjanian 2019; Timaeus and Moultrie 2008). These women may introduce some noise into our measurement, although the exceedingly rare responses of “don’t know” or “no preference” and our focus on the short-term suggest the impact will be limited.

  4. Importantly, this allows us to examine the predictors of pregnancy, not just births, in a context where the health risks of abortion, largely illegal and unsafe, can be severe (Polis et al. 2017). Even with the close spacing of surveys within TLT, however, some early miscarriages and abortions may be missed, and thus the total number of pregnancies will still be underestimated. These missed pregnancies may introduce some bias (in both directions) to our results. As a sensitivity analysis, we include self-reported miscarriages and abortions during the intersurvey period; the findings do not change.

  5. Women who tested not pregnant or refused a test are considered not to be pregnant. As a sensitivity analysis, we rerun all analyses classifying refusers by their self-reported pregnancy status as well as dropping these women from analyses. The cumulative incidence of pregnancy increases with these approaches, but the key relationships do not change.

  6. In another sensitivity analysis, we include women who participated in any wave; the results do not change.

  7. Of the small set of prospective studies of unintended births, it is most common for researchers to allow a one-year grace period before labeling a birth as unintended (see, e.g., Koenig et al. 2006; Singh et al. 2013; Yeatman and Sennott 2015).

  8. Here, we revert to the terminology of intended and unintended pregnancy as widely used in the literature, with the acknowledgment that what we—and most researchers—actually measure is desires rather than intentions.

  9. Thus, for the four-month period, women who reported a desire for pregnancy as soon as possible are compared with women who reported a desire for any delay. For the one-year time frame, women who reported a desired birth within two years are compared with women who expressed a desire to delay a birth beyond two years.

  10. The TLT study focuses on a specific age range in a particular context. However, the gradient that we identify is similar to that found recently among postpartum women in urban Kenya slums (Machiyama et al. 2019).

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Acknowledgments

This research uses data from Tsogolo la Thanzi, a research project designed by Jenny Trinitapoli and Sara Yeatman and funded by Grants R01-HD058366, R01-HD077873, and R03-HD095690 from the National Institute of Child Health and Human Development. This research was also supported by the population centers at the University of Colorado (CUPC; P2C-HD066613) and the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Health and Behavioral Sciences, University of Colorado Denver, Campus Box 188, PO Box 173364, Denver, CO, 80217, USA

    Sara Yeatman

  2. University of Colorado Population Center, Boulder, CO, USA

    Sara Yeatman

  3. Sociology Department, University of Chicago, Chicago, IL, USA

    Jenny Trinitapoli & Sarah Garver

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  1. Sara Yeatman
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Contributions

Sara Yeatman developed the idea for the study and conducted the analyses with the assistance of Sarah Garver. Jenny Trinitapoli contributed heavily to the framing of the study, and the first draft of the manuscript was written by Sara Yeatman. All authors commented on previous versions of the manuscript and approved the final version.

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Correspondence to Sara Yeatman.

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The authors declare that they have no conflicts of interest.

Ethics and Consent

Ethical approval for the Tsogolo la Thanzi study was obtained in Malawi from the National Health Sciences Research Committee (NHSRC) and in the United States from the Office for Research Protections at The Pennsylvania State University and the Social and Behavioral Sciences Institutional Review Board at the University of Chicago. Respondents gave consent at the time they were recruited for the study, before each interview, and before biomarker collection. Unmarried women aged 15–17 in the core sample enrolled in the study only after the study team obtained informed consent from a parent or guardian and assent from the minors themselves.

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Yeatman, S., Trinitapoli, J. & Garver, S. The Enduring Case for Fertility Desires. Demography 57, 2047–2056 (2020). https://doi.org/10.1007/s13524-020-00921-4

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