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1. This is a project that Child Trends has done with funding from the Administration for Children and Families, but it has been updated with the support of OPA for this conference, to explore how HM and relationships are related to family planning. The original work involving conceptualizing HM and developing measures of HM was intended to be useful for evaluating the success of marriage intervention programs. Being here today brings me back to my long-term focus on fertility and family planning.
As you may, or may not, know, I have been involved in research on adolescent sex, contraception and parenthood for several decades. My research has focused on both adolescents and on the children born to adolescents. I have also done a lot of research on marriage, family formation, family structure and children more broadly.
Oddly, these research traditions have existed in separate silos. Today represents a rare opportunity to break down some silos and look across fields that you would think would be related to one another but which, surprisingly, have been rather disconnected.
Recently, I have spent a lot of time thinking about how to conceptualize and measure healthy marriage and healthy relationships. What does this mean?
This is a project that Child Trends has done with funding from the Administration for Children and Families, but it has been updated with the support of OPA for this conference, to explore how HM and relationships are related to family planning. The original work involving conceptualizing HM and developing measures of HM was intended to be useful for evaluating the success of marriage intervention programs. Being here today brings me back to my long-term focus on fertility and family planning.
As you may, or may not, know, I have been involved in research on adolescent sex, contraception and parenthood for several decades. My research has focused on both adolescents and on the children born to adolescents. I have also done a lot of research on marriage, family formation, family structure and children more broadly.
Oddly, these research traditions have existed in separate silos. Today represents a rare opportunity to break down some silos and look across fields that you would think would be related to one another but which, surprisingly, have been rather disconnected.
Recently, I have spent a lot of time thinking about how to conceptualize and measure healthy marriage and healthy relationships. What does this mean?
2. Goal One To create an index or scale with sub-scales that measures the elements of a healthy marriage or relationship for use in intervention evaluations. Our goal for the project to conceptualize and measure HM was READ
Note that, while our primary focus is on marriage, the work also covers relationships more broadly, to include, for example, unmarried couples that live together.
CLICKOur goal for the project to conceptualize and measure HM was READ
Note that, while our primary focus is on marriage, the work also covers relationships more broadly, to include, for example, unmarried couples that live together.
CLICK
3. Goal One To create an index or scale with sub-scales that measures the elements of a healthy marriage or relationship for use in intervention evaluations. Our second goal is READ
I just want to briefly summarize the original project, then discuss how HM might be related to family planning, and in the process try to cross over the silos that separate research work on these two topics.
First, HM. Our HM work was organized around a series of tasks that sought to review existing measures of marriage and relationship quality, review existing research studies of marital quality and stability, develop constructs that describe a healthy marriage, and then develop and test measures of the extent to which couples have a HM or a healthy relationship.
This was, needless to say, a challenging task, but a fascinating challenge at the same time.
We built our work on research conducted by dozens of scholars over many years. Also,
Our second goal is READ
I just want to briefly summarize the original project, then discuss how HM might be related to family planning, and in the process try to cross over the silos that separate research work on these two topics.
First, HM. Our HM work was organized around a series of tasks that sought to review existing measures of marriage and relationship quality, review existing research studies of marital quality and stability, develop constructs that describe a healthy marriage, and then develop and test measures of the extent to which couples have a HM or a healthy relationship.
This was, needless to say, a challenging task, but a fascinating challenge at the same time.
We built our work on research conducted by dozens of scholars over many years. Also,
4. I want to acknowledge my colleagues at Child Trends, and also acknowledge the funders of our work.I want to acknowledge my colleagues at Child Trends, and also acknowledge the funders of our work.
5. One of our first tasks was to develop a conceptual model, to clarify some of the assumptions underlying our work.
One assumption is that HM has multiple components, that it is a continuum (not a yes/no construct). Based on earlier research, the multiple constructs we have identified are shown in this column. READ
One of our first tasks was to develop a conceptual model, to clarify some of the assumptions underlying our work.
One assumption is that HM has multiple components, that it is a continuum (not a yes/no construct). Based on earlier research, the multiple constructs we have identified are shown in this column. READ
6. A second assumption is that it is crucial to distinguish the antecedents and consequences of HM from the definition of HM per se. The point is often made that HM is affected by factors such as employment and religiosity; but we want to distinguish these antecedents from the definition.
For example, just because a person is unemployed doesnt mean they cannot be in a HM or a healthy relationship, and being religious doesnt mean a person is, or is not, in a HM.
A second assumption is that it is crucial to distinguish the antecedents and consequences of HM from the definition of HM per se. The point is often made that HM is affected by factors such as employment and religiosity; but we want to distinguish these antecedents from the definition.
For example, just because a person is unemployed doesnt mean they cannot be in a HM or a healthy relationship, and being religious doesnt mean a person is, or is not, in a HM.
7. Similarly, outcomes for adults and for children are often linked with HM; but again we want to distinguish the definition of HM from the outcomes or consequences of HM.
For example, while acquiring wealth may be a consequence of HM, it is not part of the definition of HM.Similarly, outcomes for adults and for children are often linked with HM; but again we want to distinguish the definition of HM from the outcomes or consequences of HM.
For example, while acquiring wealth may be a consequence of HM, it is not part of the definition of HM.
8. To test the findings from our original literature review, we conducted several dozen qualitative interviews with married parents. Our sample was diverse in that we interviewed black, white, and Hispanic men and women, from a variety of income levels. These interviews were semi-structured and were conducted in person. We asked questions of our respondents and then asked them to tell us what they felt the question was asking about. Many offered additional comments as well.
Based on these cognitive interviews, I want to share feedback we have gotten on the meaning of constructs as we defined them; show an item or two for each construct; and share some of the comments from interview respondents.
Questions will be shown in black, with respondents comments shown in red.To test the findings from our original literature review, we conducted several dozen qualitative interviews with married parents. Our sample was diverse in that we interviewed black, white, and Hispanic men and women, from a variety of income levels. These interviews were semi-structured and were conducted in person. We asked questions of our respondents and then asked them to tell us what they felt the question was asking about. Many offered additional comments as well.
Based on these cognitive interviews, I want to share feedback we have gotten on the meaning of constructs as we defined them; show an item or two for each construct; and share some of the comments from interview respondents.
Questions will be shown in black, with respondents comments shown in red.
9. 1. Communication Quality and style:
Honesty, openness, respectful tone
Type and content:
Talking about each others days
Laughing together
Talking about the things that matter to the couple
The first construct is communication.
Based on our review, important elements of communication include the quality and style of communication (such as honesty, openness, or a respectful tone); the type and content of communication (such as talking about ones day, making joint decisions, laughing together, or talking about things that matter to the couple); and minimizing negative aspects, such as feeling inundated by attacks.
Quantity seems less critical than quality, although some minimal amount of communication is likely crucial. For couples who are separated because of military service or incarceration, such communication could involve telephone, letters, or e-mail. Communication is multidimensional in that it covers a broad range of topics, from simple chatting to decision making to sharing beliefs and concerns.
The first construct is communication.
Based on our review, important elements of communication include the quality and style of communication (such as honesty, openness, or a respectful tone); the type and content of communication (such as talking about ones day, making joint decisions, laughing together, or talking about things that matter to the couple); and minimizing negative aspects, such as feeling inundated by attacks.
Quantity seems less critical than quality, although some minimal amount of communication is likely crucial. For couples who are separated because of military service or incarceration, such communication could involve telephone, letters, or e-mail. Communication is multidimensional in that it covers a broad range of topics, from simple chatting to decision making to sharing beliefs and concerns.
10. 1. Communication Here is a quote from a 24 year-old African-American female from the qualitative interviews. READ
A couple of sample questions are: CLICK TO REVEAL QUESTIONS
READ
Here is a quote from a 24 year-old African-American female from the qualitative interviews. READ
A couple of sample questions are: CLICK TO REVEAL QUESTIONS
READ
11. 2. Interaction/Time Together Day-to-day activities
Social activities Second is Interaction and Time Together
Partner interaction includes day-to-day activities and social activities. To measure interaction, items should assess the amount and frequency of couple interaction, the quality of interactions, and the type and diversity of interactions.
Sample questions include:
CLICK TO REVEAL QUESTIONS
Second is Interaction and Time Together
Partner interaction includes day-to-day activities and social activities. To measure interaction, items should assess the amount and frequency of couple interaction, the quality of interactions, and the type and diversity of interactions.
Sample questions include:
CLICK TO REVEAL QUESTIONS
12. 2. Interaction/Time Together READ
Clearly, they got the idea.READ
Clearly, they got the idea.
13. 3. Commitment to the Couple A sense of we-ness
Obligation
Willingness to sacrifice for the other person
Expectations that relationship is long-term Third is Commitment to the Couple
A number of researchers have identified commitment among the constructs that compose marital health. Blaine Fowers views commitment as an essential individual contribution that partners must develop to maintain enduring relationships. This construct includes a number of elements, including a sense of we-ness and obligation, a feeling that there are costs and barriers to leaving the relationship, a willingness to sacrifice for the partner, minimal monitoring of alternatives to the relationship, and an expectation that the relationship is long-term.
Professors Stanley and Markman describe commitment as including both dedication and constraints, with dedication being the desire to invest, improve, and even to sacrifice for a relationship. Constraint, on the other hand, involve such aspects as standard of living or social relationships that may change for the worse as a result of divorce.
In his longitudinal study, Prof Steve Nock found that commitment is a stronger predictor of divorce than other indicators of marital quality. Commitment to the couple, therefore needs to be a central construct in the definition of a healthy marriage or relationship.
Questions include:
CLICK TO REVEAL QUESTIONSThird is Commitment to the Couple
A number of researchers have identified commitment among the constructs that compose marital health. Blaine Fowers views commitment as an essential individual contribution that partners must develop to maintain enduring relationships. This construct includes a number of elements, including a sense of we-ness and obligation, a feeling that there are costs and barriers to leaving the relationship, a willingness to sacrifice for the partner, minimal monitoring of alternatives to the relationship, and an expectation that the relationship is long-term.
Professors Stanley and Markman describe commitment as including both dedication and constraints, with dedication being the desire to invest, improve, and even to sacrifice for a relationship. Constraint, on the other hand, involve such aspects as standard of living or social relationships that may change for the worse as a result of divorce.
In his longitudinal study, Prof Steve Nock found that commitment is a stronger predictor of divorce than other indicators of marital quality. Commitment to the couple, therefore needs to be a central construct in the definition of a healthy marriage or relationship.
Questions include:
CLICK TO REVEAL QUESTIONS
14. I view our relationship as lifelong.
[To be committed means] being there spiritually, emotionally, mentally, and financially, no matter what.
I believe this relationship can stay strong even through the hard times.
I believe we can make it, doesnt matter how difficult things may become, it doesnt matter how challenging my life will turn out to be or obstacles. The more you go through them the more our love for each other is going to grow. 3. Commitment to the Couple READ
Again, they seemed to get the concept.READ
Again, they seemed to get the concept.
15. 4. Emotional Intimacy Feeling known
Closeness
Trust, counting on each other
Not feeling loneliness Next is Emotional Intimacy
Emotional Intimacy has been referred to by John Gottmam as the quality of the couples friendship. This includes the notion of feeling known, knowing each other, expressing interest in hearing what the other has to say, closeness, emotional support, and feelings of trust. This construct can also include negative aspects of intimacy, such as feelings of loneliness. We distinguish sexual intimacy as one aspect of emotional intimacy.
Some sample questions are: CLICK TO REVEAL QUESTIONS
Next is Emotional Intimacy
Emotional Intimacy has been referred to by John Gottmam as the quality of the couples friendship. This includes the notion of feeling known, knowing each other, expressing interest in hearing what the other has to say, closeness, emotional support, and feelings of trust. This construct can also include negative aspects of intimacy, such as feelings of loneliness. We distinguish sexual intimacy as one aspect of emotional intimacy.
Some sample questions are: CLICK TO REVEAL QUESTIONS
16. In your own words, what does it mean to be able to count on your partner?
If Im sick and need [to be] nursed, in a financial bind, or if I need to be more responsible, she gives me support to do that.
I know my partners worries.
Its hard to tell. Sometimes I think I know his worries, but I might not know everything.
I know I can count on my partner to be there if I need him/her.
This is a big thing. He will be there when I need him. 4. Emotional Intimacy READREAD
17. 5. Conflict/Conflict Resolution Sources of disagreements, such as chores, sex, time, money, family planning, drinking or drugs, friends, family, or other women or men
Conflict resolution styles, such as keeping opinions to yourself, calm discussions, heated arguments, compromise, etc. Conflict and Conflict Resolution
Conflict is a predictor of adult unhappiness and marital breakup and is associated with diminished child development. Conflict resolution skills are also changeable and therefore represent a reasonable target for a healthy marriage intervention.
Conflict and conflict resolution are elements that should be distinguished from violence. Any relationship, including family, work, and community relationships, involves some disagreement. The ability to resolve differences is a critical skill.
Questions assess both the type and amount of disagreement and also conflict resolution style
Our initial interview Rs dont seem to have much problem with understanding this construct
CLICK TO REVEAL QUESTIONS
Conflict and Conflict Resolution
Conflict is a predictor of adult unhappiness and marital breakup and is associated with diminished child development. Conflict resolution skills are also changeable and therefore represent a reasonable target for a healthy marriage intervention.
Conflict and conflict resolution are elements that should be distinguished from violence. Any relationship, including family, work, and community relationships, involves some disagreement. The ability to resolve differences is a critical skill.
Questions assess both the type and amount of disagreement and also conflict resolution style
Our initial interview Rs dont seem to have much problem with understanding this construct
CLICK TO REVEAL QUESTIONS
18. 5. Conflict/Conflict Resolution READ
READ
19. 6. Violence Physical and mental or psychological violence
Includes physical assaults, sexual abuse, psychological abuse, neglect 6. Violence
Violence (both mental and physical) goes beyond disagreement. Researchers find that spousal violence is often not an isolated event: men who are physically violent toward their partners are also likely to be violent toward their children.
Initial definitions of family violence focused on physical assaults against children, spouses, and other family members; over time, research has come to view family violence to also encompass sexual abuse, neglect, and psychological abuse.
An example is:
6. Violence
Violence (both mental and physical) goes beyond disagreement. Researchers find that spousal violence is often not an isolated event: men who are physically violent toward their partners are also likely to be violent toward their children.
Initial definitions of family violence focused on physical assaults against children, spouses, and other family members; over time, research has come to view family violence to also encompass sexual abuse, neglect, and psychological abuse.
An example is:
20. In your own words, what does it mean when someone is trying to keep someone else under their control?
Tell them what to do. Say who and who you cant see. Um, finances. [There are] different ways of controlling people.
It is okay to answer about it and I think it was okay to put down exactly what you meant, like slap, grab, whatever.
Theres a lot of people that dont want to say I smacked my girl if they did or I pulled out a gun. But they might be more likely to say yeah, it got physical a few times. 6. Violence READ 1ST COMMENT
We found that men and women had different suggestions for how to ask about violence.
This next comment was provided by a woman.
READ
However, a male respondent said about violence:
READREAD 1ST COMMENT
We found that men and women had different suggestions for how to ask about violence.
This next comment was provided by a woman.
READ
However, a male respondent said about violence:
READ
21. 7. Fidelity Infidelity is a dealbreaker
Respondents rate likelihood that partner is cheating
Ex-partners, especially those with children, are particularly testing for couples 7. Fidelity or faithfulness to the partner also looms large as a component of healthy relationships. Qualitative work by Smock and Manning indicates that infidelity is a deal breaker. In other words, when partners are unfaithful, relationships will likely end. Even the presence of a past romantic partner may threaten the current romantic relationship, and can be a concern, especially for those who have children with prior partners.
Ongoing involvement in co-parenting with an ex-partner is a reminder of a previous romantic relationship, and this can challenge trust and fidelity in ones current relationship. This may pose a particular challenge when the end of a past relationship is not clearly marked by a divorce (a common pattern among low-income couples), and yet that couple still must maintain contact owing to their children.
A sample Q is:
CLICK TO REVEAL QUESTIONS
7. Fidelity or faithfulness to the partner also looms large as a component of healthy relationships. Qualitative work by Smock and Manning indicates that infidelity is a deal breaker. In other words, when partners are unfaithful, relationships will likely end. Even the presence of a past romantic partner may threaten the current romantic relationship, and can be a concern, especially for those who have children with prior partners.
Ongoing involvement in co-parenting with an ex-partner is a reminder of a previous romantic relationship, and this can challenge trust and fidelity in ones current relationship. This may pose a particular challenge when the end of a past relationship is not clearly marked by a divorce (a common pattern among low-income couples), and yet that couple still must maintain contact owing to their children.
A sample Q is:
CLICK TO REVEAL QUESTIONS
22. 7. Fidelity READ
Clearly, we want to focus on positive aspects, like faithfulness, as well as negative behaviors, like cheating.READ
Clearly, we want to focus on positive aspects, like faithfulness, as well as negative behaviors, like cheating.
23. 8. Commitment to the Children 8 is Commitment to Children
Recall that a focus on childrens well-being underlies our work on HM. It also underlies, in part, the intervention efforts being undertaken, where all of the couples in the intervention have children.
For couples who live with only their biological children, commitment to children is a fairly straightforward construct.
For divorced or separated couples, the co-parental relationship ceases to be one of commitment to each other, but is one that allows parents to meet their childrearing responsibilities. Although some elements of co-parenting might remain similar for both intact and disrupted couples-for example, positive and supportive communication-the topics of communication might be different.
Also, children from previous relationships are often a source of conflict in new relationships, leading several researchers to recommend measuring couple communication about step-parenting. How money is spent on children from a prior relationship is another source of conflict in stepparent families.
A sample Q is:
CLICK TO REVEAL QUESTIONS8 is Commitment to Children
Recall that a focus on childrens well-being underlies our work on HM. It also underlies, in part, the intervention efforts being undertaken, where all of the couples in the intervention have children.
For couples who live with only their biological children, commitment to children is a fairly straightforward construct.
For divorced or separated couples, the co-parental relationship ceases to be one of commitment to each other, but is one that allows parents to meet their childrearing responsibilities. Although some elements of co-parenting might remain similar for both intact and disrupted couples-for example, positive and supportive communication-the topics of communication might be different.
Also, children from previous relationships are often a source of conflict in new relationships, leading several researchers to recommend measuring couple communication about step-parenting. How money is spent on children from a prior relationship is another source of conflict in stepparent families.
A sample Q is:
CLICK TO REVEAL QUESTIONS
24. 8. Commitment to the Children Do you have any children that behave in ways that put stress on your marriage?
Step-children can do that real easily. Youre not my father, I dont have to listen to you. But if you cant develop a relationship with the step-child and the step-parent then that could cause a lot of stress. Respect is earned, not given. READ
This quote demonstrates the unique and complicated issues that couples with step-children face.READ
This quote demonstrates the unique and complicated issues that couples with step-children face.
25. 9. Satisfaction Global satisfaction
Standard of living, time together Next is Marital Satisfaction
Measuring marital satisfaction is one of the most common approaches to assessing marital quality. Marital satisfaction is typically assessed as both global satisfaction and satisfaction with specific aspects of the marriage, such as a couples standard of living and time together.
Our review suggests that the satisfaction of individuals is an important but incomplete measure of HM and relationships but it is straightforward to measure!
Many surveys ask [DO NOT CLICK], READ Q, THEN CLICK
Next is Marital Satisfaction
Measuring marital satisfaction is one of the most common approaches to assessing marital quality. Marital satisfaction is typically assessed as both global satisfaction and satisfaction with specific aspects of the marriage, such as a couples standard of living and time together.
Our review suggests that the satisfaction of individuals is an important but incomplete measure of HM and relationships but it is straightforward to measure!
Many surveys ask [DO NOT CLICK], READ Q, THEN CLICK
26. 10. Duration and Marital Status Legal status of relationship
Duration of legal marriage
Duration of relationship before marriage Finally, there is, of course, marital status and duration of the relationship before marriage.
Thus, in addition to aspects of relationship quality, the hard facts on duration and legal status also matter for couples relationships.
Finally, there is, of course, marital status and duration of the relationship before marriage.
Thus, in addition to aspects of relationship quality, the hard facts on duration and legal status also matter for couples relationships.
27. How are the Elements of Healthy Marriages Related to Family Planning? Having completed the process of conceptualizing HM and developing measures of HM, we were asked by OPA to consider how our constructs are related to family planning. We did a search of recent literature to find out whether researchers have drawn any connections between a healthy marriage and relationship and family planning. Specifically, we looked for studies that focused on the components of healthy relationships and their effects on outcomes such as unintended pregnancy, teen pregnancy, contraceptive use, and abortion.
We found that, while some researchers have begun examining the links between relationship quality and family planning, many elements of a healthy relationship have not been the focus of research.
Having completed the process of conceptualizing HM and developing measures of HM, we were asked by OPA to consider how our constructs are related to family planning. We did a search of recent literature to find out whether researchers have drawn any connections between a healthy marriage and relationship and family planning. Specifically, we looked for studies that focused on the components of healthy relationships and their effects on outcomes such as unintended pregnancy, teen pregnancy, contraceptive use, and abortion.
We found that, while some researchers have begun examining the links between relationship quality and family planning, many elements of a healthy relationship have not been the focus of research.
28. Relationship Quality and Family Planning: Gaps in the Literature Most research focuses on teens
There are surprisingly few studies of married couples
Many studies use samples that are not nationally representative
Research is dated
Unintended pregnancy/births not commonly measured; contraceptive use and teen pregnancy are more common Some significant gaps exist in the literature on relationship quality and family planning.
For example, READ
Despite these limitations, I want to consider how each of the ten elements of a HM or relationship might be related to family planning. Where there is relevant research, I will also summarize what is know. We did our best to only include studies in our literature review that employed sound research methods and controlled for key socio-demographic characteristics. However, either way, the gaps in knowledge are pretty remarkable.Some significant gaps exist in the literature on relationship quality and family planning.
For example, READ
Despite these limitations, I want to consider how each of the ten elements of a HM or relationship might be related to family planning. Where there is relevant research, I will also summarize what is know. We did our best to only include studies in our literature review that employed sound research methods and controlled for key socio-demographic characteristics. However, either way, the gaps in knowledge are pretty remarkable.
29. 1 - Communication Communication:
I would expect that couples that communicate more and more effectively are more likely to have a healthy relationship and more likely to be successful users of contraception and less likely to experience an unintended pregnancy.
-The effect of communication has been examined in several studies, and these findings do consistently show that better communication is related to better family planning, over and above the effects of social and economic factors. For example, research shows that couples who discuss condoms or contraception prior to sex are more likely to use condoms or contraception than couples who do not have these discussions.
-On the other hand, general communication about sex may not be as useful. Two nonrepresentative studies of female subjects both found no influence of communication about sex in general on condom or contraceptive use. In other words, to affect contraceptive use, it appears that communication needs to focus on contraception.
- Would marriage or relationship education improve communication and thus family planning? Perhaps; it cant hurt, but it might need to specifically address issues of family planning.Communication:
I would expect that couples that communicate more and more effectively are more likely to have a healthy relationship and more likely to be successful users of contraception and less likely to experience an unintended pregnancy.
-The effect of communication has been examined in several studies, and these findings do consistently show that better communication is related to better family planning, over and above the effects of social and economic factors. For example, research shows that couples who discuss condoms or contraception prior to sex are more likely to use condoms or contraception than couples who do not have these discussions.
-On the other hand, general communication about sex may not be as useful. Two nonrepresentative studies of female subjects both found no influence of communication about sex in general on condom or contraceptive use. In other words, to affect contraceptive use, it appears that communication needs to focus on contraception.
- Would marriage or relationship education improve communication and thus family planning? Perhaps; it cant hurt, but it might need to specifically address issues of family planning.
30. 2 - Interaction/Time Together Interaction/Time together:
While there is not a lot of research on the effect of interaction time on couples family planning, it may simply be the case that couples who interact more and spend more time together are at greater risk, because they grow to trust each other, and use contraception inconsistently or not at all.
On the other hand, couples who know they will be together and expect to spend time together may be more able to plan and less likely to be caught by surprise. A one night-stand between two relative strangers can pose a risk of both pregnancy and STDs.
In other words, the implications of this element seem clear to me for a marriage or relationship, but unclear for family planning.
Interaction/Time together:
While there is not a lot of research on the effect of interaction time on couples family planning, it may simply be the case that couples who interact more and spend more time together are at greater risk, because they grow to trust each other, and use contraception inconsistently or not at all.
On the other hand, couples who know they will be together and expect to spend time together may be more able to plan and less likely to be caught by surprise. A one night-stand between two relative strangers can pose a risk of both pregnancy and STDs.
In other words, the implications of this element seem clear to me for a marriage or relationship, but unclear for family planning.
31. 3 - Commitment to the Couple Commitment to the couple:
Commitment to the couple is conceptualized very differently in studies of family planning and studies of marriage. Recall that commitment to the couple invokes a willingness to sacrifice for ones partner, a sense of we-ness, and the expectation of a long-term commitment. It seems likely that such a level of commitment would enhance cooperation and concern about unwanted pregnancy and disease. On the other hand, commitment in the family planning literature is often simply whether a couple considers their relationship as romantic or not.
Most studies on commitment defined as a romantic relationship have been done among teens, and this large and consistent body of research indicates that condom use is more common in less committed relationships (i.e. with casual sexual partners) than in more committed relationships (i.e. with more steady or serious partners). This relationship likely exists because casual partners are viewed as presenting a greater risk for contracting STIs.
The association between relationship commitment and broader contraceptive use (not only condoms) and the implication of commitment among older couples is less clear. Studies are needed that explore the commitment in unmarried versus married couples, since family planning and commitment are clearly quite distinct for these 2 groups. For married couples who are committed in their relationship, non-use of contraception may indicate that they wish to conceive. For unmarried couples, you hear about a desire for pregnancy to force commitment. And you hear a lot about how ineffective this is.
More research is needed.Commitment to the couple:
Commitment to the couple is conceptualized very differently in studies of family planning and studies of marriage. Recall that commitment to the couple invokes a willingness to sacrifice for ones partner, a sense of we-ness, and the expectation of a long-term commitment. It seems likely that such a level of commitment would enhance cooperation and concern about unwanted pregnancy and disease. On the other hand, commitment in the family planning literature is often simply whether a couple considers their relationship as romantic or not.
Most studies on commitment defined as a romantic relationship have been done among teens, and this large and consistent body of research indicates that condom use is more common in less committed relationships (i.e. with casual sexual partners) than in more committed relationships (i.e. with more steady or serious partners). This relationship likely exists because casual partners are viewed as presenting a greater risk for contracting STIs.
The association between relationship commitment and broader contraceptive use (not only condoms) and the implication of commitment among older couples is less clear. Studies are needed that explore the commitment in unmarried versus married couples, since family planning and commitment are clearly quite distinct for these 2 groups. For married couples who are committed in their relationship, non-use of contraception may indicate that they wish to conceive. For unmarried couples, you hear about a desire for pregnancy to force commitment. And you hear a lot about how ineffective this is.
More research is needed.
32. 4 - Emotional Intimacy Research shows that unmarried couples with a higher level of intimacy are more likely to use contraceptives and condoms the first time they have sex. For example, in a study of British students aged 16-18 reporting about their first sexual experience, researchers found that having an intimate reason for having sex (i.e. being in love) was related to a higher likelihood of using contraception for males. Furthermore, a study of teens involved in romantic relationships found that those couples who engage in more couple-like activities before having sex for the first time were more likely to use contraception at first sex.
It is difficult to reconcile these findings with the findings on commitment, but it appears that the use of condoms is higher with casual sexual partners, while contraceptive use in general may be more prevalent among more serious or intimate partners. Research also seems to indicate that the benefit of intimacy in a relationship on contraceptive use is more important for the first time a couple has sex, and is less relevant to consistent contraceptive use throughout the relationship.
Again, research on married couples is lacking. It may well be that more emotionally close and intimate couples, especially married couples, anticipate or are planning a pregnancy.
Research shows that unmarried couples with a higher level of intimacy are more likely to use contraceptives and condoms the first time they have sex. For example, in a study of British students aged 16-18 reporting about their first sexual experience, researchers found that having an intimate reason for having sex (i.e. being in love) was related to a higher likelihood of using contraception for males. Furthermore, a study of teens involved in romantic relationships found that those couples who engage in more couple-like activities before having sex for the first time were more likely to use contraception at first sex.
It is difficult to reconcile these findings with the findings on commitment, but it appears that the use of condoms is higher with casual sexual partners, while contraceptive use in general may be more prevalent among more serious or intimate partners. Research also seems to indicate that the benefit of intimacy in a relationship on contraceptive use is more important for the first time a couple has sex, and is less relevant to consistent contraceptive use throughout the relationship.
Again, research on married couples is lacking. It may well be that more emotionally close and intimate couples, especially married couples, anticipate or are planning a pregnancy.
33. 5 - Conflict/Conflict Resolution Astonishingly, we were unable to find any studies of conflict resolution and family planning.
Astonishingly, we were unable to find any studies of conflict resolution and family planning.
34. 6 - Violence Researchers studying the effects of intimate partner violence on pregnancy intendedness consistently find an association between increased risk of violence and unintended or mistimed births.
This association between violence and unintended pregnancy is noted in two U.S. studies using data from the Pregnancy Risk Assessment Monitoring Systems (PRAMS).
Also, studies of adolescents have found a positive association between experiencing physical or sexual abuse and engaging in risky sexual activities. One study analyzed a sample of sexually experienced male high school students and found that those who ever experienced forced sexual contact are 3.6 times as likely to have gotten a partner pregnant as those with no history of sexual abuse.
In the country of Columbia, researchers estimate that unintended pregnancies would decrease by 5% in the country if intimate partner violence were eliminated.
A variety of reasons have been posited to explain this connection. Victims of abuse may lack the power to negotiate healthy sexual behavior and contraceptive use within their relationships; on the other hand, unintended pregnancy may result directly from incidents of sexual abuse.
Clearly, marriage education and marriage therapy need to address violence; but this also seems like a topic that family planning professionals need to address as well. Researchers have offered some recommendations for programs, such as incorporating violence screening into reproductive health services for all women.Researchers studying the effects of intimate partner violence on pregnancy intendedness consistently find an association between increased risk of violence and unintended or mistimed births.
This association between violence and unintended pregnancy is noted in two U.S. studies using data from the Pregnancy Risk Assessment Monitoring Systems (PRAMS).
Also, studies of adolescents have found a positive association between experiencing physical or sexual abuse and engaging in risky sexual activities. One study analyzed a sample of sexually experienced male high school students and found that those who ever experienced forced sexual contact are 3.6 times as likely to have gotten a partner pregnant as those with no history of sexual abuse.
In the country of Columbia, researchers estimate that unintended pregnancies would decrease by 5% in the country if intimate partner violence were eliminated.
A variety of reasons have been posited to explain this connection. Victims of abuse may lack the power to negotiate healthy sexual behavior and contraceptive use within their relationships; on the other hand, unintended pregnancy may result directly from incidents of sexual abuse.
Clearly, marriage education and marriage therapy need to address violence; but this also seems like a topic that family planning professionals need to address as well. Researchers have offered some recommendations for programs, such as incorporating violence screening into reproductive health services for all women.
35. 7 - Fidelity Fidelity:
In studies of teens, infidelity in a relationship and having a greater number of sexual partners have been shown to lead to behaviors that may increase the risk of unintended pregnancy.
Teens who have more partners and/or are involved in concurrent relationships are, for example, less likely to use condoms and more likely to experience a teen pregnancy. However, findings are mixed. Some research has found an association between concurrent or non-monogamous relationships and reduced contraceptive use and condom use. Other work has suggested that, among those in concurrent relationships, the odds of condom use and condom use intentions are increased when having sex with a secondary, rather than the main, partner.
We found no literature looking at fidelity and family planning among adults. Obviously, infidelity is a risk factor for STDs. In addition, if pregnancy occurs, many risks exist for the child and family. Hence, addressing infidelity before children are conceived seems like a valuable goal. Fidelity:
In studies of teens, infidelity in a relationship and having a greater number of sexual partners have been shown to lead to behaviors that may increase the risk of unintended pregnancy.
Teens who have more partners and/or are involved in concurrent relationships are, for example, less likely to use condoms and more likely to experience a teen pregnancy. However, findings are mixed. Some research has found an association between concurrent or non-monogamous relationships and reduced contraceptive use and condom use. Other work has suggested that, among those in concurrent relationships, the odds of condom use and condom use intentions are increased when having sex with a secondary, rather than the main, partner.
We found no literature looking at fidelity and family planning among adults. Obviously, infidelity is a risk factor for STDs. In addition, if pregnancy occurs, many risks exist for the child and family. Hence, addressing infidelity before children are conceived seems like a valuable goal.
36. 8 - Commitment to the Children Despite the centrality of children in many marriages, we could not find any research on the relationship between commitment to children already in the household and subsequent fertility decisions.
Some research does indicate however, that having a child with a previous partner has an effect on family planning. One study found that couples in which the mother has children with a previous partner are less likely to marry or cohabit following the birth of another child. Men may be unwilling to assume responsibility for a new partners previous children, and women may be reluctant to marry a partner with financial obligations to children from other relationships. Having children from a past relationship may also lead to lower relationship quality, since having children with multiple partners can be a source of tension in a relationship.
Interestingly, the lens of the child and child well-being is uncommon in studies of family planning. This is another gap that should be addressed.Despite the centrality of children in many marriages, we could not find any research on the relationship between commitment to children already in the household and subsequent fertility decisions.
Some research does indicate however, that having a child with a previous partner has an effect on family planning. One study found that couples in which the mother has children with a previous partner are less likely to marry or cohabit following the birth of another child. Men may be unwilling to assume responsibility for a new partners previous children, and women may be reluctant to marry a partner with financial obligations to children from other relationships. Having children from a past relationship may also lead to lower relationship quality, since having children with multiple partners can be a source of tension in a relationship.
Interestingly, the lens of the child and child well-being is uncommon in studies of family planning. This is another gap that should be addressed.
37. 9 - Satisfaction Satisfaction is the most commonly studied marital quality element in studies of marriage, however, we were unable to find any research on how/whether marriage or relationship satisfaction helps predict a couples family planning decisions.Satisfaction is the most commonly studied marital quality element in studies of marriage, however, we were unable to find any research on how/whether marriage or relationship satisfaction helps predict a couples family planning decisions.
38. 10 - Relationship Duration RE: Duration-
Several studies of teens have found that condom use declines with relationship length, possibly because individuals feel more comfortable with their partners or because they switch to other methods of contraception later in the relationship. Analyses of contraceptive use more broadly defined suggest that the longer relationships last, the more likely couples are to ever use contraception, but the less likely they are to always use contraception.
Among married couples, studies have shown that reliance on sterilization as a contraception method increases with marital duration. This probably reflects the fact that these are older couples who have had all the children they want.
Regarding marital status-
Research indicates that married couples are less likely than unmarried couples to have an unintended birth, but are more likely to have a mistimed birth. For example, according to an analysis of data from the NSFG 2002, rates of unintended pregnancy are higher among unmarried women than married women, and are particularly high for cohabitating women. Unmarried women are also more likely to have an abortion than married women, another reflection of their higher risk of unintended pregnancy. RE: Duration-
Several studies of teens have found that condom use declines with relationship length, possibly because individuals feel more comfortable with their partners or because they switch to other methods of contraception later in the relationship. Analyses of contraceptive use more broadly defined suggest that the longer relationships last, the more likely couples are to ever use contraception, but the less likely they are to always use contraception.
Among married couples, studies have shown that reliance on sterilization as a contraception method increases with marital duration. This probably reflects the fact that these are older couples who have had all the children they want.
Regarding marital status-
Research indicates that married couples are less likely than unmarried couples to have an unintended birth, but are more likely to have a mistimed birth. For example, according to an analysis of data from the NSFG 2002, rates of unintended pregnancy are higher among unmarried women than married women, and are particularly high for cohabitating women. Unmarried women are also more likely to have an abortion than married women, another reflection of their higher risk of unintended pregnancy.
39. Summary There is little information on the effects of commitment to children, conflict resolution, and relationship satisfaction on family planning
More attention has been paid to how couple communication, violence, duration, and marital status are related to unintended pregnancy, teen pregnancy, abortion, and contraceptive use
Generally, research shows that being married, having higher levels of communication, greater intimacy or love, fidelity, and low levels of violence are associated with positive family planning outcomes for couples To summarize, there has been surprisingly little research attention on some potentially important topics READ ALL BULLETS
It was surprising to me, as a researcher, to have to recognize the limitations of current research. Since sex takes place within a relationship, and often that relationship is a marriage relationship, it is surprising that so little research has examined aspects of that couple relationship and how it might affect whether couples use contraception and how effectively and consistently they use it. To be clear, research on unmarried couples is also very important, not just married couples. Relationships more broadly require study.
Some recent research is taking a couples perspective on both relationships and the use of family planning methods; but our review suggests that work on healthy marriage and relationships and on family planning is still largely co-occuring in separate silos. There seem, however, to be some useful implications for both marriage educators and for family planners, and that both fields might benefit from some cross-fertilization, if you will.
To summarize, there has been surprisingly little research attention on some potentially important topics READ ALL BULLETS
It was surprising to me, as a researcher, to have to recognize the limitations of current research. Since sex takes place within a relationship, and often that relationship is a marriage relationship, it is surprising that so little research has examined aspects of that couple relationship and how it might affect whether couples use contraception and how effectively and consistently they use it. To be clear, research on unmarried couples is also very important, not just married couples. Relationships more broadly require study.
Some recent research is taking a couples perspective on both relationships and the use of family planning methods; but our review suggests that work on healthy marriage and relationships and on family planning is still largely co-occuring in separate silos. There seem, however, to be some useful implications for both marriage educators and for family planners, and that both fields might benefit from some cross-fertilization, if you will.
40. Implications For marriage educators, it seems that one of the last things a couple having challenges in their marriage or in their relationship as an unmarried couple is an unintended pregnancy. Therefore, it seems to me that marriage education programs, counseling and therapy might all consider READ BULLET
I am not necessarily suggesting that marriage education include a module on contraception, but it does seem that marriage educators might: READ BULLET
For family planning service providers, it might be useful to consider:
Providing screenings and referrals for marriage or relationship education or for therapy, for example, if there is domestic violence
Co-locating with marriage education or counseling services, or making sure that such services are a part of a comprehensive family services program
On a simpler level, just providing relevant videos or other materials in the waiting room, for example, a video on the value of a healthy marriage and where marriage education services might be obtained
And, finally, serving males and couples, as well as females, in recognition of the fact that effective use of family planning services often involves, either directly and explicitly or indirectly and implicitly, both partners in a relationship
One thing that has become increasingly clear to me over the last several years is how important relationships are to successful service provision, effective programs, and successful marriages and relationships. Human beings are a social species and healthy relationships are central to happiness and productivity. Therefore, consideration of healthy couples relationships seems like an important and promising direction for not only future research but for program service delivery.For marriage educators, it seems that one of the last things a couple having challenges in their marriage or in their relationship as an unmarried couple is an unintended pregnancy. Therefore, it seems to me that marriage education programs, counseling and therapy might all consider READ BULLET
I am not necessarily suggesting that marriage education include a module on contraception, but it does seem that marriage educators might: READ BULLET
For family planning service providers, it might be useful to consider:
Providing screenings and referrals for marriage or relationship education or for therapy, for example, if there is domestic violence
Co-locating with marriage education or counseling services, or making sure that such services are a part of a comprehensive family services program
On a simpler level, just providing relevant videos or other materials in the waiting room, for example, a video on the value of a healthy marriage and where marriage education services might be obtained
And, finally, serving males and couples, as well as females, in recognition of the fact that effective use of family planning services often involves, either directly and explicitly or indirectly and implicitly, both partners in a relationship
One thing that has become increasingly clear to me over the last several years is how important relationships are to successful service provision, effective programs, and successful marriages and relationships. Human beings are a social species and healthy relationships are central to happiness and productivity. Therefore, consideration of healthy couples relationships seems like an important and promising direction for not only future research but for program service delivery.
