High fertility norm among women was associated with greater likelihood of pregnancy intention, lower likelihood of delaying pregnancy and greater ambivalence on delaying pregnancy.
Authors
Nandita Bhan, Professor, Jindal School of Public Health & Human Development (JSPH), O.P. Jindal Global University, Sonipat, Haryana, India.
Nicole E. Johns, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
Sangeeta Chatterji, School of Social & Political Science, The University of Edinburgh, Edinburgh, UK.
Edwin E. Thomas, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
Namratha Rao, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
Mohan Ghule, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA.
Rebecka Lundgren, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA; Infectious Diseases & Global Public Health, University of California San Diego, San Diego, CA, USA.
Anita Raj, Center on Gender Equity and Health, University of California San Diego, San Diego, CA, USA; Department of Education Studies, School of Social Sciences, University of California San Diego, San Diego, CA, USA.
Summary
Social norms related to fertility may be driving pregnancy desire, timing and contraceptive use, but measurement has lagged. We validated a 10-item injunctive Fertility Norms Scale (FNS) and examined its associations with family planning outcomes among 1021 women and 1020 men in India.
FNS captured expectations around pronatalism, childbearing early in marriage and community pressure. We assessed reliability and construct validity through Cronbach’s alpha and exploratory factor analysis (EFA) respectively, examining associations with childbearing intention and contraceptive use. FNS demonstrated good reliability (α = 0.65–0.71) and differing sub-constructs by gender.
High fertility norm among women was associated with greater likelihood of pregnancy intention [RRR = 2.35 (95% CI: 1.25,4.39); ARRR = 1.53 (95% CI: 0.70,3.30)], lower likelihood of delaying pregnancy [RRR = 0.69 (95% CI: 0.50,0.96); ARRR = 0.72 (95% CI: 0.51,1.02)] and greater ambivalence on delaying pregnancy [RRR = 1.92 (95% CI: 1.18,3.14); ARRR = 1.99 (95% CI: 1.21,3.28)].
Women’s higher FNS scores were also associated with higher sterilization [RRR = 2.17 (95% CI: 1.28,3.66); ARRR = 2.24 (95% CI: 1.32,3.83)], but the reverse was noted for men [RRR = 0.61 (95% CI: 0.36,1.04); ARRR = 0.54 (95% CI: 0.32,0.94)]. FNS indicated better predictive value among women compared to men for key reproductive outcomes. This measure may be useful for social norms-focused evaluations in family planning and warrants cross-contextual study.
Published in: Studies in Family Planning
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