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