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Background Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods A nationally representative sample of publicly funded clinics was surveyed in 2013–2014 (n = 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PR) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42–1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01–1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01–1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40–0.74) and primary care services (aPR, 0.74; 95% CI, 0.68–0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway.

Materials and Methods:  Using data on 245 women who were attending an urban hospital abortion clinic, we assessed whether women had ever experienced emotional, physical, or sexual IPV. Effectiveness of women's post-abortion contraceptive method selection was categorized into high (intrauterine device [IUD] and implant), moderate (pill, patch, ring, and shot), and low (condoms, emergency contraception, and none) effectiveness. Using multinomial logistic regression, we examined the relationship between number of types of IPV experienced and post-abortion contraceptive method effectiveness, adjusting for sociodemographics, prior abortion, having children, abortion trimester, importance of avoiding pregnancy in the next year, pre-abortion psychological distress, and effectiveness level of the contraceptive method women were planning to use before contraceptive counseling. Results:  Twenty-seven percent (27%) of women experienced two or three types of IPV, 35% experienced one IPV type, and 38% experienced no IPV. Compared to women with no histories of IPV, women who experienced two or more types of IPV during their lifetimes were more likely to choose contraceptive methods with moderate effectiveness (adjusted odds ratio [AOR] = 5.23, 95% confidence interval [CI]: 1.13–24.23, p = 0.035) and high effectiveness (AOR = 5.01, 95% CI: 1.12–22.39, p = 0.035) than those with low effectiveness. Conclusion:  Women who experienced two or more types of lifetime IPV selected more effective contraceptive methods post-abortion. Access to contraceptives that are not partner dependent, including long-acting reversible contraceptives (LARC), may be particularly important for women who have experienced multiple types of IPV.

Purpose This study aimed to examine whether the timing of depression onset relative to age at sexual debut is associated with teenage pregnancy. Methods Using data from 1,025 adolescent girls who reported having had sex in the National Comorbidity Survey—Adolescent Supplement, we applied cox proportional hazards models to test whether depression onset before first sex, at the same age as first sex, or after first sex compared with no depression onset was associated with experiencing a first teenage pregnancy. We examined the unadjusted risk by depression status as well as risk adjusted for adolescents' race/ethnicity, marital status, poverty level, whether the adolescent lived in a metropolitan area, living status, age at first sex, parental education, and age of mother when the adolescent was born. Results In both unadjusted and adjusted models, we found that adolescents with depression onset at the same age as having initiated sex were at an increased risk of experiencing a teenage pregnancy (unadjusted hazard ratio [HR] = 2.5, 95% confidence interval [CI]: 1.08–5.96; adjusted HR = 2.7, 95% CI: 1.15–6.34) compared with those with no depression onset. Moreover, compared with those with no depression onset, the risk of pregnancy for girls experiencing depression onset before first sex also increased but was not significant (adjusted HR = 1.5, 95% CI: .82–2.76). Conclusions Timing of first depressive episode relative to age at first sexual intercourse plays a critical role in determining the risk of teenage pregnancy. Timely diagnosis and treatment of depression may not only help adolescents' mental well-being but may also help them prevent teenage pregnancy.

The majority of research on African American adolescents raised in single-mother homes has focused on externalizing problems, with less attention to other facets of socio-emotional functioning. Using a compensatory resilience approach, the current study examined risk and protective factors at the family (maternal warmth, monitoring, psychological control) and youth (ethnic identity and religiosity) levels as predictors of depressive symptoms, hopelessness, and self-esteem among African American adolescents from single-mother homes ( n  = 193). Lower levels of psychological control, higher levels of monitoring, and higher levels of youth ethnic identity were associated with at least one of the outcomes, depressive symptoms, hopelessness, and self-esteem. In addition, self-esteem, but not hopelessness, mediated the associations between the family- and youth-level factors and youth depressive symptoms. The importance of targeting maternal psychological control and youth ethnic identity, as well as self-esteem, in intervention programs for African American youth from single-mother families is discussed.

Research has documented a negative association between women’s educational attainment and early sexual intercourse, union formation, and pregnancy. However, the implications that school progression relative to age may have for the timing and order of such transitions are poorly understood. In this article, I argue that educational attainment has different implications depending on a student’s progression through school grades relative to her age. Using month of birth and age-at-school-entry policies to estimate the effect of advanced school progression by age, I show that it accelerates the occurrence of family formation and sexual onset among teenage women in Mexico. Focusing on girls aged 15–17 interviewed by a national survey, I find that those who progress through school ahead of their birth cohort have a higher probability of having had sex, been pregnant, and cohabited by the time of interview. I argue that this pattern of behaviors is explained by experiences that lead them to accelerate their transition to adulthood compared with same-age students with fewer completed school grades, such as exposure to relatively older peers in school and completing academic milestones earlier in life. Among girls who got pregnant, those with an advanced school progression by age are more likely to engage in drug use, alcohol consumption, and smoking before conception; more likely to have pregnancy-related health complications; and less likely to attend prenatal care visits. Thus, an advanced school progression by age has substantial implications for the health and well-being of young women, with potential intergenerational consequences.

We examine change across U.S. cohorts born between 1920 and 2000 in their probability of having had sex with same-sex partners in the last year and since age 18. Using data from the 1988–2018 General Social Surveys, we explore how trends differ by gender, race, and class background. We find steep increases across birth cohorts in the proportion of women who have had sex with both men and women since age 18, whereas increases for men are less steep. We suggest that the trends reflect an increasingly accepting social climate, and that women’s steeper trend is rooted in a long-term asymmetry in gender change, in which nonconformity to gender norms is more acceptable for women than men. We also find evidence that, among men, the increase in having had sex with both men and women was steeper for black than for white men, and for men of lower socioeconomic status; we speculate that the rise of mass incarceration among less privileged men may have influenced this trend.

We advance current knowledge of school punishment by examining (1) the prevalence of exclusionary discipline in elementary school, (2) racial disparities in exclusionary discipline in elementary school, and (3) the association between exclusionary discipline and aggressive behavior in elementary school. Using child and parent reports from the Fragile Families Study, we estimate that more than one in ten children born between 1998 and 2000 in large US cities were suspended or expelled by age nine, when most were in third grade. We also find extreme racial disparity; about 40 percent of non-Hispanic black boys were suspended or expelled, compared to 8 percent of non-Hispanic white or other-race boys. Disparities are largely due to differences in children’s school and home environments rather than to behavior problems. Next, consistent with social stress and strain theories, we find suspension or expulsion associated with increased aggressive behavior in elementary school. This association does not vary by race but is robust to a rich set of covariates, within-individual fixed effects, and matching methods. In conjunction with what we find for racial disparities, our results imply that school discipline policies relying heavily on exclusionary punishment may be fostering childhood inequality.

Objectives: I extend the life-course theory of cumulative disadvantage to focus on continuity in punishment across generations. Specifically, I examine (1) the association between paternal incarceration and elementary school suspension or expulsion and (2) the extent to which behavior problems and weakened social bonds explain this association. Method: Analyses rely on logistic regression, propensity score matching, and mediation methods with data from the Fragile Families and Child Wellbeing Study (N = 3,201), a birth cohort of children born in large U.S. cities between 1998 and 2000. Results: The odds of school punishment among children who had a residential father incarcerated by age 5 are 75 percent greater than the odds for children in a matched control group. About one third of this association is accounted for by behavior problems and weakened social bonds. Even after accounting for behavior problems and social bonds, children whose fathers were incarcerated are at greater risk of school punishment. Conclusions: I find evidence of an intergenerational stability of punishment and mixed support for an intergenerational extension to cumulative disadvantage theory. Paternal incarceration is associated with children’s likelihood of experiencing formal punishment in elementary school, and behavior problems and weakened social bonds explain part of this association

Adolescent girls and young women (AGYW) in Uganda are at risk of early sexual debut, unwanted pregnancy, violence, and disproportionally high HIV infection rates, driven in part by transactional sex. This paper examines the extent to which AGYW’s participation in transactional sex is perceived to be coerced. We conducted 19 focus group discussions and 44 in-depth interviews using semi-structured tools. Interviews were audio recorded, and transcribed verbatim. Data were analysed using a thematic analysis. While AGYW did not necessarily use the language of coercion, their narratives describe a number of coercive aspects in their relationships. First, coercion by force as a result of “de-toothing” a man (whereby they received money or resources but did not wish to provide sex as “obligated” under the implicit “terms” of the relationships). Second, they described the coercive role that receiving resources played in their decision to have sex in the face of men’s verbal insistence. Finally, they discussed having sex as a result of coercive economic circumstances including poverty, and because of peer pressure to uphold modern lifestyles. Support for income-generation activities, microfinance and social protection programmes may help reduce AGYW’s vulnerability to sexual coercion in transactional sex relationships. Targeting gender norms that contribute to unequal power dynamics and social expectations that obligate AGYW to provide sex in return for resources, critically assessing the meaning of consensual sex, and normative interventions building on parents’ efforts to ascertain the source of their daughters’ resources may also reduce AGYW’s vulnerability to coercion.

We offer a new strategy to identify the distribution of treatment effects using data from the Infant Health and Development Program (IHDP), a relatively understudied early-childhood intervention for low birth-weight infants. We introduce a new policy parameter, QCD, which denotes quantiles of the effect distribution conditional on latent neonatal health. The dependence between potential outcomes originates from a new class of factor models where latent health can affect the location and shape of distributions. We first show that QCD depends on quantiles of marginal outcome distributions given latent health. We then achieve identification of these marginal distributions and QCD by proxying latent health with neonatal anthropometrics and accounting for measurement error in these proxies. The effects of enrolling in IHDP are widely distributed across children and depend on neonatal health. Moreover, the large average effects documented in past work for close to normal birth weight children from low-income families are driven by a minority of children in this group.