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 Both trends may reflect poorer access for rural teens and young
women to family planning options, researchers conclude in the
American Journal of Public Health.
The study team examined more than two decades of data on first
pregnancies for teens ages 15 to 19 and young women ages 20 to 24.
Overall, 25% of rural teens and 55% of rural young women planned
their first pregnancies, compared with 21% of urban teens and 47% of
urban young women.
Among teens with unintended first pregnancies, 74% in rural areas
had live births compared with 63% in urban areas, the study also
found. And among young women in their early 20s with unintended
first pregnancies, 73% of rural women had live births compared with
54% of urban women.
Unintended first pregnancies were terminated by 7% of rural teens
and 16% of urban teens, and by 6% of young women in rural areas,
compared with 15% in cities.
"Urban-rural disparities are perhaps less tied today than in the
past to individual sociodemographic factors," lead study author
April Sutton of the University of San Diego in La Jolla, California,
and colleagues write.
"Issues such as geographic access and isolation in health care -
including reproductive health care - may instead represent an
important dimension of the new geography of exclusion," Sutton and
colleagues write. "For rural women, the long-run costs of unintended
pregnancies seem most germane, especially because unintended
child-bearing has negative consequences for educational attainment,
earnings, and maternal and child health."
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Pregnancy outcomes also appeared to vary by race and location.
About 60% of rural black and Hispanic teens' first pregnancies were
unintended and ended with live births, compared with 45% of white
teens' pregnancies in cities, the study found.
Among rural black teens, just 4% of pregnancies were unintended and
resulted in abortions, compared with 20% among urban black
adolescents.
The proportion of unintended pregnancies ending in live births was
similar for black urban teens and white rural adolescents, at 51%
and 52%, respectively.
One limitation of the study is that it's possible that some survey
participants didn't disclose abortions, leading to an overcount of
the proportion of pregnancies resulting in live births, the study
authors note.
Even so, the results underscore that differences in pregnancy
outcomes and reproductive health options may contribute to health
disparities between rural and urban women, the researchers conclude.
SOURCE: https://bit.ly/2r9ukzv American Journal of Public Health,
online October 17, 2019.
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