The Measurement of Unintended Pregnancy in Rural India: A Comparison of Prospective versus Retrospective Assessment

Michael Koenig, Johns Hopkins University
Rajib Acharya, Johns Hopkins University
Tarun K. Roy, International Institute for Population Sciences (IIPS)
Sagri Singh, Johns Hopkins University

Estimates of unintended childbearing in developing countries have been almost exclusively derived from women’s retrospective responses. A 2003 follow-up survey of 6437 reproductive-aged women in four Indian states who were interviewed in the 1998-99 NFHS-2 provides a unique opportunity to assess prospective vs. retrospective assessments of unintended childbearing for 3900 births during the 1998-2003 period. In all four states, a pronounced shift is evident in births which were prospectively classified as unwanted to having been wanted based upon retrospective assessments. These results provide evidence of widespread rationalization by women of subsequent unwanted births to having been wanted, and suggest that retrospective assessments such as the DHS may lead to pronounced underestimations of the true extent of unintended childbearing. Our analysis subsequently explores the specific factors (demographic, socio-cultural, child, and husband) which explain this stability/shift in wantedness status among the 1075 births during this period which were prospectively defined as unwanted.