Family Planning

National Data Sources

National Survey of Family Growth (NSFG), CDC, NCHS; National Vital Statistics System (NVSS), CDC, NCHS; Abortion Provider Survey, The Alan Guttmacher Institute (AGI); Abortion Surveillance Data, CDC, NCCDPHP.

State Data Source

Not identified.

Healthy People 2000 Objective

Adapted from 5.2 (Family Planning).

Measure

Percent.

Baseline

51 (1995).

Numerator

Number of intended births among females aged 15 to 44 years.

Denominator

Number of live births plus abortions among females aged 15 to 44 years.

Population Targeted

U.S. resident population; U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       Before you became pregnant this time, was the reason you did not use any birth control methods because you, yourself wanted to become pregnant?

Ø       At the time you became pregnant, did you, yourself actually want to have a baby at some time?

Ø       So would you say you became pregnant too soon, at about the right time, or later than you wanted?

1) Too soon            
2) Right time                       
3) Later                              
4) Didn’t care

Expected Periodicity

Periodic.

Comments

Intended pregnancies include births that were wanted at the time of conception. Births that were wanted at the time of conception are those resulting from pregnancies that happened at the right time, later than wanted or those answering didn’t care. All abortions are considered unintended pregnancies.

Estimates of pregnancies that were intended are derived from the following sources: (1) live births to U.S. residents in 1994; (2) the proportion of recent births that were intended according to the 1995 NSFG; and (3) estimates of induced abortions based on reports by CDC and The Alan Guttmacher Institute (AGI). AGI’s national estimates of abortions, based on surveys it conducts of all known abortion providers, are distributed by age, race, marital status, and ethnicity according to estimates prepared by CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), which are based on reports from State health departments.

The proportion of births intended (females who wanted to become pregnant and wanted to have a baby at sometime and became pregnant at the right time, later, or didn’t care) from NSFG are applied to all resident live births, divided by all births and abortions combined.

Information about potential sources of error in the data sources have been published.1, 2, 3

Known pregnancies that ended in fetal loss (for example, miscarriage, stillbirth, or ectopic pregnancy) are excluded. However, it was found that incorporating information on the planning status of pregnancies resulting in fetal loss, as reported in the 1995 NSFG, had very little impact on the proportions shown.

This objective is adapted from a measure in Healthy People 2000 objective 5.2, which tracked the proportion of pregnancies that were unintended. This measure tracks the proportion of pregnancies that are intended.

See Part C for a description of NSFG and NVSS and Appendix A for focus area contact information.

National Data Source

National Survey of Family Growth (NSFG), CDC, NCHS.

State Data Source

Not identified.

Healthy People 2000 Objective

Not applicable.

Measure

Percent.

Baseline

11 (1995).

Numerator

Number of females aged 15 to 44 years whose most recent live birth occurred within 24 months of a previous live birth.

Denominator

Number of females aged 15 to 44 years with at least one live birth.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       How many times have you been pregnant altogether?

[For each pregnancy:]

Ø       In which of the ways did the pregnancy end?

(a)  Miscarriage
(b)  Still birth
(c)  Abortion
(d)  Ectopic or tubal pregnancy
(e)  Live birth by Cesarean section
(f)   Live birth by vaginal delivery

[For each live birth:]

Ø       On what date was (baby’s name) born?

Expected Periodicity

Periodic.

Comments

A female is considered to have had a birth within 24 months of a previous birth if she had consecutive pregnancies ending in a live birth by Cesarean section or live birth by vaginal delivery.

The interval between consecutive live births is derived from the date of birth.

Vaginal delivery includes delivery through natural or induced labor.

Questions addressing how the pregnancy ended and date baby was born are repeated based on the number of pregnancies.

See Part C for a description of NSFG and Appendix A for focus area contact information.

National Data Source

National Survey of Family Growth (NSFG), CDC, NCHS.

State Data Source

Not identified.

Healthy People 2000 Objective

5.12 (Family Planning).

Measure

Percent.

Baseline

93 (1995).

Numerator

Number of at-risk females aged 15 to 44 years who currently use a method of contraception other than withdrawal.

Denominator

Number of at-risk females aged 15 to 44 years.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

[NUMERATOR:]

Ø       Please write the methods you used each month on the calendar. I need to know about all the methods you used, so if you used more than one method, please write down all methods you used that month.

1)  Birth control pills
2)  Condom
3)  Partner’s vasectomy
4)  Diaphragm
5)  Foam
6)  Jelly or cream     
7)  Cervical cap       
8)  Suppository, insert
9)  Today sponge
10) Female condom, vaginal pouch
11) IUD, Coil, Loop
12) Norplant
13) Depo-provera, Injectables           
14) Morning after pill
15) Rhythm or safe period by calendar                      
16) Safe period by temperature, or cervical mucus test, or natural family planning
17) Withdrawal, pulling out
18) Respondent sterile    
19) Partner sterile
20) Other method (specify)        

[DENOMINATOR:]

Ø       Is the reason you are not using a method of birth control now because you, yourself, want to become pregnant as soon as possible?

Ø       Many women have times when they are not having intercourse at all, for example, because of pregnancy, separation, not dating anyone, illness, or other reasons. Since (Date), have there been any times when you were not having intercourse at all for one month or more?

Ø       What months and years were those?

Expected Periodicity

Periodic.

Comments

A female (and her partner) is considered to be at risk of unintended pregnancy if there is a negative response to the denominator questions above on wanting to become pregnant (first question) or not having intercourse (second question).

“At risk” females are those who had intercourse in the 3 months prior to the survey who were not pregnant, nor seeking pregnancy, nor post partum, nor (themselves or partners) surgically or nonsurgically sterile.

“Currently using” refers to having used any contraceptive method (categories 1, 2, 4 through 16 above) other than sterilization or withdrawal in the month of the interview.

An unintended pregnancy is one that was not wanted at the time of conception or not wanted at all.

See Part C for a description of NSFG and Appendix A for focus area contact information.

National Data Sources

National Survey of Family Growth (NSFG), CDC, NCHS; Abortion Patient Survey, The Alan Guttmacher Institute (AGI).

State Data Source

Not identified.

Healthy People 2000 Objective

5.7 (Family Planning).

Measure

Percent.

Baseline

13 (1995).

Numerator

Number of pregnancies that occur within the first 12 months of reported continuous use of a reversible contraceptive method among females aged 15 to 44 years, and their partners.

Denominator

Number of consecutive months that a reversible contraceptive method was used by females aged 15 to 44 years, and their partners.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       Please write the methods you used each month on the calendar. I need to know about all the methods you used, so if you used more than one method, please write down all methods you used that month.

1)  Birth control pills
2)  Condom
3)  Partner’s vasectomy
4)  Diaphragm
5)  Foam
6)  Jelly or cream                
7)  Cervical cap       
8)  Suppository, insert           
9)  Today sponge
10) Female condom, vaginal pouch
11) IUD, Coil, Loop
12) Norplant
13) Depo-provera, Injectables
14) Morning after pill
15) Rhythm or safe period by  calendar
16) Safe period by temperature, cervical mucus test, natural family planning                     
17) Withdrawal, pulling out                           
18) Respondent sterile            
19) Partner sterile
20) Other method (specify)

Ø       How many months or weeks had you been pregnant when the baby was born/that pregnancy ended? (Note: this yields date pregnancy began.)

From the 1994 Abortion Patient Survey:

Ø       Before you found out you were pregnant, what was the LAST contraceptive method that you used to prevent pregnancy, including rhythm, withdrawal or condoms?

(a)  Pill
(b)  Condom, rubber (for males)
(c)  Female condom, vaginal pouch
(d)  Diaphragm with or without jelly or cream
(e)  Sponge (TODAY)
(f)   Foam/cream/jelly
(g)  Suppository, insert (Semicid, Encara Oval)
(h)  IUD, coil, loop
(i)   Rhythm/natural family planning
(j)   Withdrawal
(k)  Norplant, implants in the arm
(l)   Depo-Prevera, injectables, shot
(m)Emergency contraception/morning-after pill
(n)  Other method (specify)
(o)  Never used a method before this pregnancy

Ø       In what month and year did you stop using that method?
______/______Month Year

Ø       For about how many months in a row had you been using that method?

Less than 1 month                                     
1 month
2 months                                                                      
3 months
4 months                                                                      
5 months
6 months                                                                      
7 months
8 months                                                                      
9 months
10 months                                                                    
11 months
12 months
13 months
14 months
15 months
16 months
17 months                                                                    
18-24 months
25-26 months
27-28 months
29-36 months
37 or more months (3 or more years)

Ø       Had you ever used that method before the months specified above?     

Ø       Had you stopped using all methods to prevent pregnancy before you became pregnant this time?

Expected Periodicity

Periodic.

Comments

Pregnancies include live births, miscarriages, or induced abortions.

Females are considered to have experienced pregnancy despite use of a reversible method if there was continuous method use (in 12-month intervals) and they became pregnant during a month of use of one or more of the following methods: birth control pills, condom (rubber), diaphragm, foam/jelly/cream, cervical cap, suppository, insert, TodayTM sponge, female condom (vaginal pouch), IUD, coil, loop, Norplant, Depo-provera, injectables, withdrawal (pulling out), rhythm/natural family planning, or emergency contraception/morning-after pill.

NSFG data are adjusted for underreporting of abortions according to AGI’s Abortion Patient Survey. Detailed information on adjustment procedure, contraceptive methods and failure rates have been published by AGI.4

See Part C for a description of NSFG and Appendix A for focus area contact information.

National Data Sources

Abortion Provider Survey, The Alan Guttmacher Institute (AGI); Abortion Surveillance Data, CDC, NCCDPHP; National Vital Statistics System (NVSS), CDC, NCHS; National Survey of Family Growth (NSFG), CDC, NCHS.

State Data Source

Not identified.

Healthy People 2000 Objective

5.1 (Family Planning).

Measure

Rate.

Baseline

68 (1996).

Numerator

Number of pregnancies among females aged 15 to 17 years.

Denominator

Number of adolescent females aged 15 to 17 years.

Population Targeted

U.S. civilian, noninstitutionalized population; U.S. resident population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       (For fetal losses) In which of the ways did your pregnancy end?

1)   Miscarriage
2)   Stillbirth
3)   Abortion
4)   Ectopic or tubal pregnancy
5)   Live birth by Cesarean section
6)   Live birth by vaginal delivery
[Responses 1 and 2 are used as indicators of fetal loss.]

Expected Periodicity

Periodic.

Comments

Adolescent pregnancies are the sum of all U.S. resident live births, induced abortions, and fetal losses to females aged 15 to 17 years.

Data on live births are counts of all births to U.S. residents occurring in the United States. Estimates of induced abortion are based on reports by CDC and The Alan Guttmacher Institute (AGI). AGI’s national estimates of abortions, based on surveys it conducts of all known abortion providers, are distributed by age and race according to estimates prepared by CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), based on reports of induced abortions from selected State health departments.

Estimates of fetal losses are estimates from the 1995 NSFG. Females participating in this survey were asked to report the dates and outcomes of each of their pregnancies in the past 5 years, including spontaneous fetal losses (miscarriages, stillbirths) from recognized pregnancies.

Fetal losses refer to pregnancies that end in miscarriage or stillbirth.

See Part C for a description of NSFG and NVSS and Appendix A for focus area contact information.

9-8a.      Females.

National Data Source

National Survey of Family Growth (NSFG), CDC, NCHS.

State Data Source

Not identified.

Healthy People 2000 Objective

Adapted from 5.4 (Family Planning) (also 18.3 and 19.9).

Measure

Percent.

Baseline

81 (1995).

Numerator

Number of females aged 15 to 19 years who had no sexual intercourse with a male before age 15.

Denominator

Number of females aged 15 to 19 years.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       At any time in your life, have you ever had sexual intercourse with a man, that is, made love, had sex, or gone all the way?

[If yes:]

o        Please look at the calendar and think back to the very first time in your life that you ever had sexual intercourse with a man. In what month and year was that?
____Month  ____Year

Expected Periodicity

Periodic.

Comments

Females are considered to have never had sexual intercourse before age 15 if they report that they either never had sexual intercourse with a male or their age at first intercourse was greater than 15 years.

This objective is adapted from Healthy People 2000 objective 5.4, which tracked the proportion of adolescents aged 15 to 17 years who engaged in sexual intercourse. This measure tracks the proportion of females aged 15 to 19 years who have never engaged in sexual intercourse.

See Part C for a description of NSFG and Appendix A for focus area contact information.

9-8b.      Males.

National Data Source

National Survey of Adolescent Males (NSAM), Urban Institute.

State Data Source

Not identified.

Healthy People 2000 Objective

Adapted from 5.4 (Family Planning) (also 18.3 and 19.9).

Measure

Percent.

Baseline

79 (1995).

Numerator

Number of males aged 15 to 19 years who had no sexual intercourse with a female before age 15.

Denominator

Number of males aged 15 to 19 years.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Adolescent Males:

Ø       Have you ever had sexual intercourse with a female (sometimes this is called “making love,” “having sex” or “going all the way”)?

[Followed by a question of when the intercourse occurred, similar to that used in objective 9.8a]

Expected Periodicity

Periodic.

Comments

Males are considered to have never had sexual intercourse before age 15 if they report that they either never had sexual intercourse with a female or their age at first intercourse was greater than 15 years.

This objective is adapted from Healthy People 2000 objective 5.4, which tracked the proportion of adolescents aged 15 to 17 years who engaged in sexual intercourse. This measure tracks the proportion of males aged 15 to 19 years who have never engaged in sexual intercourse.

NSFG will collect comparable data on males aged 15 to 49 years starting with data collected in 2001 and will thereby replace NSAM for tracking of this measure.

See Appendix A for focus area contact information.

9-9b.      Males.

National Data Source

National Survey of Adolescent Males (NSAM), Urban Institute.

State Data Source

Not identified.

Healthy People 2000 Objective

Adapted from 5.4 (Family Planning) (also 18.3 and 19.9).

Measure

Percent.

Baseline

57 (1995).

Numerator

Number of males aged 15 to 17 years who had never had sexual intercourse with a female.

Denominator

Number of males aged 15 to 17 years.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Adolescent Males:

Ø       Have you ever had sexual intercourse with a female (sometimes this is called “making love,” “having sex” or “going all the way”)?

Expected Periodicity

Periodic.

Comments

This objective is adapted from Healthy People 2000 objective 5.4, which tracked the proportion of adolescents aged 15 to 17 years who engaged in sexual intercourse. This measure tracks the proportion of males aged 15 to 17 years who have never engaged in sexual intercourse.

NSFG will collect comparable data on males aged 15 to 49 years starting with data collected in 2001 and will thereby replace NSAM for tracking of this measure.

See Appendix A for focus area contact information.

9-10a.    Condom at first intercourse: Females.

National Data Source

National Survey of Family Growth (NSFG), CDC, NCHS.

State Data Source

Not identified.

Healthy People 2000 Objective

Adapted from 5.6 (Family Planning).

Measure

Percent.

Baseline

67 (1995).

Numerator

Number of sexually experienced, unmarried females aged 15 to 17 years who used a condom at first intercourse.

Denominator

Number of sexually experienced, unmarried females aged 15 to 17 years.

Population Targeted

U.S. civilian, noninstitutionalized population.

Questions Used To Obtain the National Data

From the 1995 National Survey of Family Growth:

Ø       What is your current marital status?  Are you...

1)   Married
2)   Widowed 
3)   Divorced 
4)   Separated, because you and your husband are not getting along
5)   Have you never been married?

[Following a series of questions on when sexual intercourse with a man occurred and whether or not the sexual intercourse was voluntary:]

Ø       The very first time you ever used a birth control method, which method did you use?  If you used more than one method that first time, please tell me about it.

1) Birth control pills             
2) Condom                         
3) Partner’s vasectomy        
4) Diaphragm                                  
5) Foam                                         
6) Jelly or cream                             
7) Cervical cap                                
8) Suppository, insert                      
9) Today sponge                             
10) Female condom, vaginal pouch               
11) IUD, Coil, Loop
12) Norplant
13) Depo-provera, Injectables
14) Morning after pill
15) Rhythm or safe period by calendar
16) Safe period by temperature, or cervical mucus test, natural family planning
17) Withdrawal, pulling out               
18) Respondent sterile
19) Partner sterile
20) Other method (specify)

Ø       Thinking again of the very first time you used a method of birth control, was it the first time you had intercourse?

Expected Periodicity

Periodic.

Comments

Unmarried females are considered to have used a condom at first intercourse if they reported they were sexually active and partner used a condom (rubber) at their first intercourse.

Sexually experienced refers to females who had their first premarital voluntary intercourse in the past 5 years.

This objective is adapted from a measure in Healthy People 2000 objective 5.6, which tracked the proportion of sexually active, unmarried people aged 15 to 19 years who used contraception at first intercourse. This measure tracks the proportion of females aged 15 to 17 years who used a condom at first intercourse.

See Part C for a description of NSFG and Appendix A for focus area contact information.