Contraceptive Choices of Women 35–44 Years of Age: Findings From the Behavioral Risk Factor Surveillance System

Purpose

With an estimated 3.1 million unintended pregnancies in the United States each year, patterns of contraceptive use have significant public health importance. Little literature has focused on these patterns in women over age 35.

Methods

Using data from the 2004 Behavioral Risk Factor Surveillance System, we conducted a population-based analysis of 22,890 women between the ages of 35–44 years who completed information on family planning. Lifestyle, demographic, and medical history covariates were assessed and multinomial logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CI).

Results

Female sterilization was the most popular contraceptive method among women aged 35–44 years (28.5%). Relative to non-Hispanic white women, Hispanic and non-Hispanic black women were less likely to use effective methods of contraception such as male sterilization (OR = 0.33, 95% CI: 0.23, 0.46; and OR = 0.10, 95% CI: 0.06, 0.16, respectively) and oral contraceptives (OR = 0.55, 95% CI: 0.41, 0.73; and OR = 0.42, 95% CI: 0.31, 0.57, respectively) after adjustment for demographic, lifestyle, and medical factors.

Conclusions

Although fecundity is reduced in women of this age group, increased rates of maternal and fetal complications make unintended pregnancies riskier. This study demonstrates opportunities for targeted counseling and increased awareness of the diversity of contraceptive choices for older women.

Key Words: Contraception, Women's Health, Pregnancy, Unplanned

List of Abbreviations and Acronyms: BRFSS, Behavioral Risk Factor Surveillance System, BMI, body mass index, CI, confidence interval, NSFG, National Survey of Family Growth, OR, odds ratio, OCs, oral contraceptives, PRAMS, Pregnancy Risk Assessment Monitoring System