contraception use in a community of international migration katie kessler, liliana quezada, shira...

Contraception Use in a Community of International Migration

Katie Kessler, Liliana Quezada, Shira Goldenberg

OutlineWhy study contraception in an

international migrant-sending community?

What methods did this study use?

What were the results?What are the implications?

BackgroundRural to urban migration

associated with changes in use of and access to effective contraceptive methods

Disparities in access to and use of contraception in Mexico and the U.S.

BackgroundUnmet need for contraception

◦Varies greatly by countryUnintended Pregnancy

Background: Theoretical FrameworkAdaptation HypothesisDisruption HypothesisSelection Hypothesis

MethodsTlacuitapa, Jalisco, MexicoData CollectionData Analysis

Research Questions and HypothesesDoes contraceptive use increase

with migration?◦Does migration increase the use of

efficacious contraceptive methods?◦Does migration reduce the unmet

need for contraception?◦Does migration reduce the rate of

unplanned pregnancies?

Findings: Migration and Efficacious Contraception Use

Hormonal Barrier Sterilization Fertility Awareness

No Method0

5

10

15

20

25

30

35

40

45

50

Never Attended School in U.S.Attended School in U.S.

Findings: Migration and the Unmet Need for Contraception27% of the Tlacuitapeño

population is currently experiencing an unmet need for contraception◦U.S. exposure: negative influence on

unmet need

Findings: Migration and Unintended Pregnancy30% who had children had

wanted to delay the pregnancy or had not wanted to conceive their last child at all

Local social norms◦“I think over here they’re more

conservative, more secretive, and over there they are more open about it, they don’t want to follow that tradition”

Stigma and Shame◦“People are around, you know,

looking and I just don’t want people to look at me like that” (about buying condoms at a store)

Access to Information◦“I thought if I used contraception I

couldn’t ever get pregnant”

DiscussionUse of Contraception: Migration

has positive influence on efficacious contraceptive use

Unmet Need for Contraception: Migration reduces the unmet need for contraception

Unintended Pregnancy: Migration does not reduce unintended pregnancies among Tlacuitapenses

ConclusionsSupports adaptation hypothesisIncreased efficacious

contraceptive use, but not necessarily fewer unintended pregnancies