The Effects of Unintended Pregnancy on Children

摘要 在美国，近一半的怀孕是意外的，意外怀孕发生了五次 与富裕女性相比，更多的是在贫穷女性中。拟议的项目调查如何提供 获得免费避孕药具会影响意外怀孕，并最终影响儿童的生活--包括儿童 意外出生的人和可能失去资源(物质资源和时间)的大兄弟姐妹 作为母亲意外怀孕的结果。 拟议的项目极大地扩大了密歇根州避孕措施的获取、研究和 评估研究(M-CARE)，一项大规模的随机对照试验，提供免费的任何类型的访问 通过调查和丰富的行政数据对妇女进行纵向跟踪。拟议中的项目 旨在： (1)。将M-CARE招募期延长一倍，并增加在 1,000人参与研究的干预措施； (2)。开发和现场两份调查补充材料(注册后的第二年和第四年) 参与者询问(A)每次分娩的意愿(干预前和干预后)、(B)时间和 花在每个孩子身上的钱，(C)育儿实践，以及(D)儿童的健康，就学，额外的- 课程活动、行为和幸福感； (3)。使用调查(目标2)和行政记录汇编全面的纵向数据，以 在(A)短期(5年期)研究中记录参加儿童护理服务的儿童的结果 (B)长期(直到儿童年满18岁)；和 (4)。在调查数据中评估母亲获得免费避孕措施对儿童结局的因果影响 (目标2a-d)和行政记录(3a)，包括按收入、种族和 教育。 实现这些目标将有助于社会科学和公共卫生政策，通过提供新的实验 对妇女免费避孕的代际影响研究不足的证据 美国公共卫生系统。因此，这项研究将有助于对一种可行和 易于实施的生殖健康干预措施--这一干预措施可能有助于打破 消除贫困，改善儿童的终身机会。

ABSTRACT In the United States, nearly half of pregnancies are unintended, and unintended pregnancies occur five times more often among poor women compared to affluent women. The proposed project investigates how providing access to free contraceptives impacts unintended pregnancy and, ultimately, the lives of children—both children whose births are unintended and their older siblings who may lose resources (both material resources and time) as a result of a mother’s unintended pregnancy. The proposed project significantly expands the scope of Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES), a large-scale, randomized control trial that provides no-cost access to any type of contraception and tracks women longitudinally in surveys and rich, administrative data. The proposed project aims to: (1). Double the M-CARES recruitment period and increase the sample of children born before the intervention that are in the study by 1,000; (2). Develop and field two survey supplements (year 2 and year 4 post enrollment) of M-CARES participants to ask about (a) intendedness of each birth (pre- and post-intervention), (b) time and money spent on each child, (c) parenting practices, and (d) children’s health, schooling, extra- curricular activities, behavior and well-being; (3). Compile comprehensive longitudinal data using surveys (aim 2) and administrative records to document the outcomes of the children of M-CARES participants in (a) the short-term (5-year study period) and (b) long-term (until children reach age 18); and (4). Evaluate the causal effects of mothers’ access to free contraception on children’s outcomes in survey data (aims 2a-d) and administrative records (3a), including heterogeneity analyses by income, race, and education. Achieving these aims will contribute to social science and public health policy by providing novel experimental evidence on the understudied, intergenerational effects of making contraception free to women within the existing U.S. public health system. This study will, therefore, contribute to a larger cost-benefit analysis of a feasible and easy to implement reproductive health intervention—an intervention that potentially helps break the cycle of poverty and improve children’s life-time opportunities.