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Abstract
In 2014, it was estimated that 49% or nearly half of all U.S. pregnancies were unintended. The reproductive experiences of women aged 15-44 vary greatly and are often affected by various demographic characteristics such as age, race, religion, and income. There are approximately 580,000 new immigrants in the U.S. yearly, and more than half of them are females. The purpose of this study was to assess the association between nativity status (i.e., U.S. born or not) and the current use of contraception, and the use of family planning services in the last 12 months among women ages 18-40 in the U.S. interviewed for the latest National Survey of Family Growth (NSFG). This was a cross-sectional secondary data analysis of the 2013-2015 NSFG (n=3,635 for the current contraceptive use outcome and n=4,072 for the use of family planning services outcome). The NSFG is a periodic survey conducted by the Centers for Disease Control and Prevention (CDC) that collects data on family growth. Data were collected via in person interviews. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of the exposure-outcome associations while controlling for confounders. Nearly 82% of the study participants reported currently using some form of contraception while 18% reported having used family planning services in the last 12 months. After adjusting for age, race/ethnicity, primary language, income, marital status, insurance status, and religion there was no association between nativity status and current use of contraception (OR= 1.01; 95% CI: 0.66-1.55). After adjusting for age, race/ethnicity, primary language, income, marital status, insurance status, and age at first intercourse, women born outside of the U.S. had nearly 30% decreased odds of using family planning services in the last 12 months; however, this finding was not statistically significant (OR= 0.68; 95% CI: 0.43-1.09). Based on the study findings, nativity status does not appear to affect a woman’s ability to use contraception. However, nativity status is related to the use of family planning services. Although not statistically significant, there is a suggestion that foreign-born women are less likely to use these services. Further studies that examine the exposure in greater detail and provide a more comprehensive understanding of U.S. women’s use of family planning services are needed.