“I Just Don't Know”: An Exploration of Women's Ambivalence about a New Pregnancy

Cutler, Abigail S.; McNamara, Blair; Qasba, Neena; Kennedy, Holly Powell; Lundsberg, Lisbet S.; Gariepy, Aileen M.

doi:10.1016/j.whi.2017.09.009

Cited by 26 publications

(34 citation statements)

References 40 publications

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“…Our findings are consistent with previous research reporting increased odds of depression (defined as a major EDS score of 10 or higher, by selected characteristics, and unadjusted and adjusted odds ratios (and 95% confidence intervals) respondents with a low social support score (MKSSI≤3.2), by selected characteristics, and unadjusted and adjusted odds ratios (and 95% confidence intervals) depressive episode) among women with an unplanned or poorly timed pregnancy. 19 Further, we assessed "ambivalence"-identified as a distinct and important category within patient-centered pregnancy perspectives 42,43 -and demonstrated that women reporting ambivalence had increased odds of depression. This finding supports consideration of multiple pregnancy perspectives that include ambivalence, rather than relying on strictly dichotomous outcomes (i.e., planned versus unplanned).…”

Section: Discussionmentioning

confidence: 99%

Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy

Lundsberg

Cutler

Stanwood

et al. 2020

Perspect Sexual Reproductive

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Research into the relationship between pregnancy intention and perinatal depression or low social support is limited. Women's perspectives on pregnancy and their associations with perinatal depression could help in developing targeted efforts for screening and intervention. METHODS: In 2014-2015, 161 women seeking pregnancy testing or abortion care at clinics in New Haven, Connecticut, were surveyed. They were asked about pregnancy context (intentions, planning, wantedness, desirability, timing and happiness), and the Edinburgh Depression Screen (EDS) and the Modified Kendler Social Support Index (MKSSI) were used to identify possible antenatal depression and low social support, respectively. Multivariable logistic regression analysis was employed to examine associations between pregnancy context and these outcomes. RESULTS: On average, participants were 27 years old and at nine weeks' gestation. One-fifth reported a previous diagnosis of depression or anxiety, and 22% and 33% screened positive for depression (EDS scores of 13 or higher and 10 or higher, respectively); 52% received low social support (MKSSI score of 3.2 or less). Regression analysis found that pregnancies described as unintended, poorly timed or undesired were associated with depression at the higher cutoff (odds ratios, 3.2-4.5); all unfavorable pregnancy measures were associated with depression at the lower cutoff. Ambivalence regarding pregnancy timing, intention, wantedness and desirability was associated with increased odds of depression by either EDS score. Unplanned pregnancies and those about which the woman was ambivalent were associated with low social support. CONCLUSIONS: Findings support the need to screen women for depression early in pregnancy and to integrate assessments of pregnancy context into the evaluation of potential risk factors.

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Section: Discussionmentioning

confidence: 99%

Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy

Lundsberg

Cutler

Stanwood

et al. 2020

Perspect Sexual Reproductive

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“…Sources of uncertainty include previous experience with fertility and pregnancy, maternal‐foetal health, and the dynamics of the current family. Women are also concerned about the way pregnancy could influence their lives, goals, and dreams . Furthermore, this ambivalence is associated with poor pregnancy outcomes, such as an increased likelihood of premature membrane rupture, preterm delivery, and delivering a low birthweight infant .…”

Section: Discussionmentioning

confidence: 99%

“…Women are also concerned about the way pregnancy could influence their lives, goals, and dreams. 16 Furthermore, this ambivalence is associated with poor pregnancy outcomes, such as an increased likelihood of premature membrane rupture, preterm delivery, and delivering a low birthweight infant. 17 In the current study, the proportions of women who were in the third decade of their lives had average educational levels, and the proportions of women who were married indicated that ambivalence could have been involved in their decision to undergo an abortion.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the decision to undergo abortion in Romania: Experiences at our clinic

Pleș

Popescu

Margarit

et al. 2019

Evaluation Clinical Practice

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Rationale, aims, and objectives It is estimated that 25% of pregnancies worldwide end in induced abortion. In Romania, the abortion situation shows a specific pattern. Following the fall of the communist regime, first‐trimester abortions were legalized, and between 1990 and 1992, the country's abortion rate was the highest in the world, with 182 abortions per 1000 women of reproductive age. However, there are currently no statistically reliable data, as some abortions are not reported. The purpose of this study was to identify the main circumstances that determine the choice to undergo abortion with all related potential risks, rather than using contraception. Method We conducted a prospective type 1 cohort study based on a Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement that included women who presented at Bucur Maternity, Saint John Hospital, Bucharest, for abortion during the first trimester, between July and December 2018. The patients were asked to complete a 21‐item questionnaire based on psychosocial data. Results The study included 119 patients, with a mean age of 29.57 years. Their educational level was average (ie, 51.3%, 4.2%, and 8.4% had completed high school, elementary school, and college or university, respectively). Most women were married (46.2%), and 47.9% were unemployed. The main reason for deciding to undergo an abortion was poverty (P = .014), and guilt was correlated with this decision (P = .004). Conclusion The profiles of the women who chose to undergo an abortion as a family planning method were as follows: in the third decade of life, resident of urban areas, married, unemployed, and with a low family income. The main reasons for abortion were financial status, advanced maternal age, incompatibility of pregnancy with future plans, and the desire to postpone conception.

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“…The sample size was too small in these categories to enable us to carry out statistical analyses of their characteristics and behaviors. Ambivalence and uncertainty are important components of fertility decision-making (Aiken et al, 2016; Bernardi, Mynarska, & Rossier, 2015; Cutler et al, 2018) and are areas for continued research. Relatedly, we found that much of the literature on fertility preferences is atheoretical.…”

Section: Discussionmentioning

confidence: 99%

Exploring Multiple Dimensions of Young Women’s Fertility Preferences in Malawi

Gibby

Luke

2019

Matern Child Health J

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Introduction-Standard survey measures of fertility preferences, such as the desire for and preferred timing of future births, do not capture the complexity of individuals' preferences. New research focuses on additional dimensions of emotions and expectations surrounding childbearing. Few quantitative studies, however, consider the influence of all three dimensions of fertility preferences concurrently. Methods-Using longitudinal survey data from the Tsogolo la Thanzi project (2009-2012) in Malawi, this study employed logistic regression analysis to investigate the influence of young women's emotions, expectations, and a standard measure of fertility preferences on pregnancy and modern contraceptive use. Results-Young women experienced high unmet need; across survey waves, over three-quarters of women who desired a child in more than two years were not currently using modern contraceptives and over three-quarters of women who thought a pregnancy in the next month would be bad news (garnered from a measure of emotions surrounding pregnancy) were not currently using modern contraceptives. In regression models including all three measures of fertility preferences, each was significantly associated with the likelihood of a future pregnancy. The standard measure and emotions measure were significantly associated with modern contraceptive use. Discussion-Emotions and expectations surrounding pregnancy and childbirth appear to be distinct and salient aspects of fertility preferences in addition to the standard measure. A better understanding of the multidimensional nature of fertility preferences will help individuals define and achieve their reproductive goals and obtain appropriate services. Furthermore, future research should incorporate new measures of fertility preferences into surveys internationally.

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“I Just Don't Know”: An Exploration of Women's Ambivalence about a New Pregnancy

Cited by 26 publications

References 40 publications

Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy

Association of Pregnancy Contexts with Depression and Low Social Support in Early Pregnancy

Factors affecting the decision to undergo abortion in Romania: Experiences at our clinic

Exploring Multiple Dimensions of Young Women’s Fertility Preferences in Malawi

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