The association of pregnancy control, emotions, and beliefs with pregnancy desires: A new perspective on pregnancy intentions

Abstract

Context Standard pregnancy intentions measures do not always align with how people approach pregnancy. Studies that have investigated beyond a binary framework found that those with “ambivalent” feelings towards pregnancy are less likely to use contraception consistently, but the reasons for this are unclear. We sought to gain a nuanced understanding of pregnancy desires, and how perceptions about pregnancy are associated with contraceptive use. Methods We used non-probability quota sampling based on sex, age, and geographic region for a web-based survey of heterosexual men and women, aged 21–44 years, who could become pregnant/impregnate and were not currently pregnant (n = 1,477; 51% female). The survey was created using unique items informed by recent literature. Bivariate and multivariable analyses explored relationships between various perceptions about pregnancy with pregnancy desires categorized as: wanting a pregnancy, not wanting a pregnancy, and not trying but would be okay with a pregnancy. We conducted a sub-group analysis of those who were not trying but would be okay with a pregnancy (n = 460), using descriptive statistics to examine how consistent contraceptive use was associated with emotions and beliefs about avoiding pregnancy. Results After adjustment, those who felt that pregnancy may not always be avoidable, but instead determined by fate/higher power, or a natural process that happens when it is meant to, were significantly more likely (aOR: 1.83, 95% CI: 1.05–3.36; aOR: 2.21, 95% CI: 1.29–3.76, respectively) to report not trying but being okay with pregnancy, whereas those with negative feelings about a pregnancy were less likely to feel okay about a pregnancy (aOR: 0.11, 95% CI: 0.08–0.15), versus not wanting a pregnancy. In the sub-group analysis, those who felt pregnancy was determined by fate/higher power or a natural process were more likely to report not using contraception consistently (70%, 68%, respectively). Conclusions Those who state they are not trying but would be okay with pregnancy may not use contraception consistently because of beliefs that pregnancy is predetermined. Our findings support less categorical and more multidimensional approaches to measuring fertility intentions, with important implications for reproductive health service provision.

Supply‐Side Versus Demand‐Side Unmet Need: Implications for Family Planning Programs

“…This research has shown that many people do not plan the timing of their pregnancies, their desired number of children, or other facets of their reproductive lives in the concrete and explicit ways in which researchers attempt to measure them ( Aiken et al 2016 ; Arteaga, Caton, and Gomez 2018 ; Rocca et al 2019 ). Qualitative and quantitative studies have both provided robust evidence that just because a person is not actively seeking a pregnancy does not mean that they would not welcome one ( Yeatman and Smith-Greenaway 2021 ; Huber et al 2017 ; Speizer 2006 ; Johnson-Hanks 2002 ; Gómez et al 2019 ; Manze et al 2021 ; Gomez et al 2018 ).…”

Longitudinal study of pregnancy intention and its association with pregnancy occurrence among female sex workers in Benin and Mali

“…The ambivalence with regards to parenthood may lead to inconsistent contraceptive use [ 71 ] and may explain the incidence rate that reaches 19 pregnancies per 100 person-years, which was higher than that observed among women with a negative intention. Women who are ambivalent may also have the impression that pregnancy is predetermined or the result of fate [ 72 ]. Women with such an attitude towards pregnancy are less likely to use contraception consistently.…”

Unintended Pregnancy and Abortion in the US Navy, 2016

“…1 Categorizing pregnancy desires is complex and current measurements of unintended pregnancy have limitations, which have led researchers to explore new ways of assessing pregnancy intention. [1][2][3][4] Regardless of these measurement limitations, births resulting from unintended pregnancies are associated with negative maternal and child health outcomes, 5,6 and unintended pregnancy remains a widely used metric for benchmarking health promotion and disease prevention. 7 Unintended pregnancy has been shown to be higher in the United States (US) military population compared to the civilian population.…”