Measuring social inequalities in self-reported miscarriage experiences in the United Kingdom
Keywords:
miscarriage, United Kingdom, sexual and reproductive health, pregnancy, social inequalitiesAbstract
An estimated one in four pregnancies end in a miscarriage. Miscarriage may affect fertility intentions and worsen mental and physical health. Yet, we know little about how social inequalities affect the risk of experiencing miscarriage, and the few existing studies show mixed results. A social gradient in the risk of miscarriage may be related to societal structures shaping risk factors, such as stress, health behaviours, and age at pregnancy. We use the British Cohort Study (1970) to investigate whether individuals’ socioeconomic characteristics are associated with their likelihood of self-reporting a miscarriage over the reproductive life course. We apply a multi-level discrete-time event-history model to examine this likelihood according to occupational social class, income, and education. Our results are affected by the sub-population studied: among all women, those socioeconomically more disadvantaged have a higher risk of miscarriage at younger ages, but the direction of the association reverses towards the end of the reproductive life span. These differences disappear when analysing only those who self-reported a pregnancy. Methodological work tackling misreporting of miscarriage and other pregnancy outcomes is needed for more reliable estimates. A better understanding of this common reproductive event can help policy makers improve reproductive and population health.
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