DEFINING AND MEASURING INTENDED FERTILITY

There is no unambiguous definition of ''intended birth" that would apply to the different societies covered by this report, nor to all families within any society. "Intentions" fit actual decisions and behavior only imperfectly: the answers to standardized questions used in household surveys cannot fully capture the complexity of the process by which intentions are formed or their intensity. However, some measures, even imprecise ones, are needed to gauge the extent of the problem of unintended pregnancy, and survey data on fertility intentions have been found to predict subsequent fertility behavior well, at least at a population level (Westoff, 1990).1

The best recent source of comparable data for large populations in developing countries is the Demographic and Health Surveys (DHS). Using different items in the standard DHS questionnaires, there are two broad approaches to measuring intentions. One approach relies on answers to direct questions about the last birth or current pregnancy. In most DHS surveys, women are asked, for each live birth that occurred less than 5 years before the interview: "At the time you became pregnant with [Name], did you want to become pregnant then, did you want to wait until later, or did you want no more children at all?" Women who are pregnant at the time of the interview are asked analogous questions about their current pregnancy.

We use the term "unwanted" to refer to a pregnancy or birth to a woman who reports that she did not want any more children; "mistimed" for a pregnancy or birth to woman who wants more children, but not in the near future, and "unintended" to cover both.2

The second approach relies on hypothetical questions about all children. Most DHS surveys include this question: "If you could go back to the time when you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?" The answers can be averaged for a population, or a desired total

1  

The Technical Note at the end of this chapter discusses some of the problems of existing measures of the prevalence of unintended pregnancies and abortions.

2  

Other researchers use different terms. Some use "unplanned" to describe pregnancies that were not wanted at the time of conception or recognition of pregnancy, distinct from "unwanted," referring to the woman's wishes at the time of birth or interview. Asif and his colleagues (1994), analyzing data collected from pregnant women in Uttar Pradesh, India, distinguish between "unwanted," "unwanted but accepted," and "wanted" pregnancies; nearly half the pregnancies in his sample were classified unwanted but accepted. Brown and Eisenberg (1995) discuss the implications of various definitions of intention and wantedness.



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