A blessing I can't afford: Factors underlying the paradox of happiness about unintended pregnancy

Abstract

An unresolved paradox in the measurement and interpretation of unintended pregnancy is that women frequently report feeling happy about pregnancies they also classify as unintended (i.e. they have incongruent intentions and feelings). This study explores the underlying reasons why women profess such happiness and how these relate to their motivations to avoid pregnancy. Between September 2013 and February 2014, semi-structured in-depth interviews were conducted with 27 women (8 white, 19 Latina) selected from a longitudinal study measuring prospective pregnancy intentions and feelings among 403 women in Austin, Texas. Women were selected for interview on the basis of wanting no more children and consistently professing either happiness (n=17) or unhappiness (n=10) at the prospect of pregnancy. Interviews were coded and analyzed following the principles of grounded theory. We found that it is possible for women to express happiness at the idea of pregnancy while simultaneously earnestly trying to prevent conception. Happiness at the idea of an unintended pregnancy was explained as the result of deep and heartfelt feelings about children taking precedence over practical considerations, the perception that the psychosocial stress resulting from another child would be low, and the ability to rationalize an unintended pregnancy as the result of fate or God’s plan. The major exception to the sincerity of professed happiness was that conveyed as a result of social pressure despite truly negative feelings, predominantly expressed by foreign-born Latina women. Overall, equating incongruence with ambivalence about avoiding conception may undermine the sincerity of women’s intentions and their desires for highly-effective contraception. At the same time, unintended pregnancies that are greeted with happiness may have different implications for maternal and child health outcomes compared to pregnancies that are greeted with unhappiness. Identifying which unintended pregnancies are most likely to result in adverse outcomes is a target for future research.

Pregnancy intentions—a complex construct and call for new measures

“…Recent authors have called for new constructs that more fully capture the multidimensional nature of pregnancy intention (10, 12, 18, 38), especially as unintended pregnancies that are met with happiness may very well differ in terms of maternal and child health outcomes (9, 21, 50, 57–62). The London Measure of Unplanned Pregnancy is one such measure that has been validated in multiple populations (42, 63–67) that may offer promise for future studies.…”

Socioeconomic Variation in the Effect of Economic Conditions on Marriage and Nonmarital Fertility in the United States: Evidence From the Great Recession

“…For instance, a qualitative study of women in Texas found that even as they often used inconsistent or ineffective contraceptive practices, low-income respondents expressed financial concerns about the cost of having another child (Aiken et al 2015). Further, recent work based on interviews with low-SES men found substantial ambivalence about having a child and some evidence that economic resources play at least some role in their discussions of nonmarital fertility (Augustine et al 2009).…”

Happiness About Unintended Pregnancy And Its Relationship to Contraceptive Desires Among a Predominantly Latina Cohort

“…29 Findings indicated that women made a clear distinction between the questions on intentions and those on feelings, and understood that the former asked about the timing of their anticipated childbearing and the latter asked about their emotional response to a hypothetical future pregnancy.…”