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Survey on Public Knowledge and Attitudes on Contraception and Unplanned Pregnancy in the U.S., Canada and the Netherlands

Kaiser Family Foundation Surveys on Public Knowledge and Attitudes on Contraception and Unplanned Pregnancy in the United States, Canada, and the Netherlands1995

Unplanned pregnancy is a major problem facing Americans today. Approximately 3.5 million unplanned pregnancies occur each year in the United States. Women in the United States are almost twice as likely as women in Great Britain and three times as likely as women in the Netherlands to face an unplanned pregnancy.

Research has explored public opinion on these issues, but none has measured public knowledge. Hoping to help explain some of the variation in unplanned pregnancy rates between the U.S. and other developed nations, the Kaiser Family Foundation commissioned telephone surveys with adults in Canada, the Netherlands, and the U.S. to assess differences in public knowledge, opinions, and practices related to pregnancy and birth control. Canada was selected for comparison because it represents a culture similar to that of the United States, but has an unplanned pregnancy rate two-thirds that of the U.S. The Netherlands was selected because its culture is considered very different in its attitudes toward sexuality than the U.S. and it has an extremely low unplanned pregnancy rate — only one-tenth of the U.S. rate.

The three national telephone surveys were designed and analyzed by the Kaiser Family Foundation and Louis Harris and Associates, Inc. and conducted by Louis Harris and Associates, Inc. (A complete methodology is on the opposite page.) The surveys examined public knowledge of and attitudes toward issues related to unplanned pregnancy and contraception, including emergency contraception. Survey respondents were asked, for example, about such things as their perceptions about the magnitude of the problem of unplanned pregnancy in their country and their awareness of different contraceptive options.

Press releases have been issued from the data collected in the U.S. survey on public knowledge and attitudes about emergency contraceptive pills, abortion rates, men and contraception, teen sexuality and pregnancy, and other aspects of contraception and reproduction. To obtain the press releases and additional information on these topics, call the Kaiser Family Foundation’s publications request line at 1-800-656-4533.

The Kaiser Family Foundation, based in Menlo Park, California, is a non-profit, independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries. The Foundation’s work is focused on four main areas: health policy, reproductive health, and HIV policy inthe United States, and health and development in South Africa.

Methodology

The Kaiser Surveys on Public Knowledge and Attitudes on Contraception and Unplanned Pregnancy are three separate random-sample telephone surveys of adults ages 18 and older living in the United States, Canada, and the Netherlands. The survey was designed by the Henry J. Kaiser Family Foundation in association with Louis Harris and Associates, Inc.

The sampling procedure was designed to produce representative samples of adults in telephone households in all three countries. Random digit selection was used to assure equal representation ofpeople in households that are listed and “unlisted” in telephone directories. An effort was made to match interviewers of the same sex as the randomly selected respondents. Interviews were conducted in English and Spanish in the United States. For the Canadian and Dutch surveys, the survey instrument was translated into French and Dutch, using culturally appropriate wording, and back-translated into English for verification.

The U.S. sample consisted of 2,002 adults in the 48 contiguous United States (excluding Alaska and Hawaii) and was conducted between October 12 and November 13, 1994. The margin of error in the nationwide U.S. sample is plus or minus 2 percent and plus or minus 3 percent for respondents of “reproductive age,” that is men and women age 18-44 (1,140 respondents). The Canadian sample consisted of 1,002 adults and interviews were conducted between December 9, 1994 and January 3, 1995. The margin of error for the Canadian sample is plus or minus 3 percent and plus or minus 4 percent for respondents of reproductive age (594 respondents). The Dutch sample consisted of 1,001 adults and interviews were conducted between December 15, 1994 and January 19, 1995. The margin of error for the Dutch sample is plus or minus 3 percent and plus or minus 4 percent for respondents of reproductive age (536 respondents).

Questionnaire and Toplines

I. Gender of Respondents

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 Male 50% 49% 51% 51% Female 50% 51% 49% 49%
II. Age of Respondents

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 18-29 21% 18-24 22% 20% 24% 30-49 43% 25-34 40% 42% 39% 50-64 18% 35-44 38% 39% 37% 65 and over 17%
A. Talking with Your Doctor

Now I’d like to ask you a few questions about your discussions with health care professionals. (If Necessary: If any question is not applicable to you, please say so, and we’ll move past it.)

A1. In the past two years, have you discussed birth control such as the use of condoms or birth control pills with your doctor or another health professional, or not?

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 Yes, discussed 21% 33% 34% 25% No, did not discuss 71% 63% 65% 73% Not applicable (Vol.) 9% 4% 1% 2% Not sure/Refused * * * *
A2. Have you ever discussed birth control with a doctor or another health professional, or not?

Based on those who did not discuss or were not sure whether they discussed birth control with a doctor in the past two years.

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 Yes, discussed 38% 40% 45% 36% No, never discussed 61% 60% 55% 62% Not applic. (Vol.) 1% * 2% * Not sure/Refused * * * *
A3. Has a doctor ever been the one to raise the subject of birth control, or not?

Based on those who have discussed birth control with a doctor. Asked only in the U.S.

USA
18+ Yes, doctor raised subject 32% No, doctor did not 67% Not sure/Refused 1%
B. Information Sources

B1. People can get information about birth control from a variety of sources. What sources would you say that you most typically rely on for information about birth control? What else? (Do Not Read List — Multiple Record)

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 1. Health care professionals 63% 64% 68% 79% 2. Magazines 20% 23% 15% 13% 3. Your friends or peers 12% 14% 6% 5% 4. Television 11% 13% 8% 9% 5. Your family 9% 10% 5% 5% 6. Health and sex education courses in school 8% 10% 5% 3% 7. Reference books/medical journals/library 5% 5% 5% 3% 8. Church, clergyman 2% 2% * * 9. Newspaper 2% 2% * * 10. Planned Parenthood/ family planning agencies 2% 2% * * 11. Your spouse or partner 2% 2% 1% 1% 12. Pamphlets 1% 2% 2% 2% 13. Nowhere — don’t want/need/get any information 1% * 2% * 14. Other 3% 5% 13% 16% 15. Not sure/Refused 13% 9% 3% 8%
C. Knowledge of Unplanned Pregnancy Problem

C1. Unplanned pregnancy is a pregnancy that a woman is not actively trying to have. It could be unintended, a mistake, unwanted, or not at the right time. Do you think unplanned pregnancies are a very big problem, a somewhat big problem, not a very big problem, or not a problem at all in your country?

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 Very big problem 60% 60% 36% 6% Somewhat big problem 30% 33% 45% 35% Not a very big problem 5% 4% 13% 49% Not a problem at all 2% 2% 3% 4% Not sure/Refused 3% 1% 3% 5%
C2. Compared with 10 years ago, do you feel the percentage of women in the your country who have unplanned pregnancies is now much higher, higher, about the same, lower or much lower?

USA
18+ USA
18-44 CAN
18-44 NETH
18-44 Much higher 27% 30% 14% 1% Higher 42% 42% 32% 13% About the same 20% 19% 28% 29% Lower 8% 7% 15% 45% Much lower 1% * 1% 5% Not sure/Refused 2% 1% 10% 6%
C3. Do you feel that (Rotate: married women or unmarried women) are more likely to haveunplanned pregnancies?

Asked only in the U.S.

USA
18+ Married women 9% Unmarried women 82% No difference (Vol.) 6% Not sure/Refused 2%
C4. Do you feel that (Rotote: teenagers or women over the age of 19) are more likely to haveunplanned pregnancies?

Asked only in the U.S.

USA
18+ Teenagers 86% Women over the age of 19 11% No difference (Vol.) 2% Not sure/Refused 2%
C5. Do you think that (Rotate: Women in the United States or women in other developed countries, such as Canada, Great Britain or Germany) are more likely to have unplanned pregnancies?

Asked only in the U.S.

USA
18+ United States 69% Other developed countries 11% Same (Vol.) 7% Not sure/Refused 13%
C6. Would you say that (read each item) contributes to unplanned pregnancies very much,somewhat, or not at all?

Very Much Somewhat Not At All Not Sure/
Refused a. A decline in moral standards USA 18+ 53% 36% 10% 1% USA 18-44 48% 40% 12% * CAN 18-44 29% 39% 28% 4% NETH 18-44 15% 33% 39% 12% b. Lack of education in general USA 18+ 48% 39% 12% 1% USA 18-44 46% 41% 13% * CAN 18-44 41% 38% 20% 1% NETH 18-44 16% 38% 44% 2% c. Lack of understanding about how to use birth control USA 18+ 27% 50% 22% 2% USA 18-44 26% 51% 22% * CAN 18-44 25% 45% 28% 2% NETH 18-44 14% 36% 47% 3% d. An inability to get birth control USA 18+ 21% 45% 33% 2% USA 18-44 21% 45% 34% * CAN 18-44 15% 36% 47% 2% NETH 18-44 13% 20% 64% 3% e. The cost of birth control USA 18+ 14% 40% 45% 2% USA 18-44 12% 40% 47% 1% CAN 18-44 14% 32% 49% 5% NETH 18-44 5% 29% 59% 7% f. A genuine desire to have children USA 18+ 12% 48% 37% 4% USA 18-44 11% 52% 36% 2% CAN 18-44 15% 37% 41% 7% NETH 18-44 8% 32% 42% 17%

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Surveys on Public Knowledge and Attitudes on Contraception and Unplanned Pregnancy:
Survey Part One Part Two Part Three

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.