Measurement of unmet need for family planning: longitudinal analysis of the impact of fertility desires on subsequent childbearing behaviors among urban women from Uttar Pradesh, India

Contraception. 2013 Oct;88(4):553-60. doi: 10.1016/j.contraception.2013.04.006. Epub 2013 Apr 26.


Background: The measure of unmet need relies on women's reported fertility desires; previous research has demonstrated that fertility desires may be fluid and not firm.

Study design: Our study uses recently collected longitudinal data from four cities in Uttar Pradesh, India, to examine whether women's fertility desires and family planning (FP) use at baseline predict pregnancy/birth experience in the 2-year follow-up period.

Results: Multivariate models demonstrate that women who were using any method of FP and reported an intention to stop childbearing were the least likely to experience a pregnancy/birth in the 2-year follow-up period. The stated desire to delay childbearing, whether or not the woman was using FP, did not distinguish pregnancy/birth experience. Ninety-two percent of pregnancies/births over the follow-up period were considered "wanted then" suggesting post-hoc rationalization of the pregnancy/birth even among those women who reported a desire to stop childbearing 2 years earlier.

Conclusions: More nuanced assessments of fertility intentions may be needed to adequately gauge latent FP needs. Non-users of FP may be ambivalent about future childbearing and the timing of future births; these women may not have an unmet need for FP as typically defined.

Keywords: Family planning; Fertility intentions; India; Unmet need.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / ethnology
  • Adult
  • Contraception Behavior / ethnology
  • Family Planning Services*
  • Female
  • Health Surveys
  • Humans
  • India
  • Longitudinal Studies
  • Multivariate Analysis
  • Needs Assessment
  • Reproductive Behavior* / ethnology
  • Spouses
  • Urban Health* / ethnology
  • Young Adult