Demographic diversity in the measurement and meaning of unintended pregnancy
Awarded 2013
Small Research Grants
Abigail Aiken, MD, MPH
University of Texas at Austin

Objectives: To explore the underlying reasons why women profess happiness about unintended pregnancies and how these reasons relate to their motivation to avoid pregnancy. Methods: 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 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. Results: We found that it is possible for women to express happiness at the idea of pregnancy while simultaneously earnestly trying to prevent conception. Happiness was explained as the result of deep and heartfelt feelings about children taking precedence over practical considerations, the perception of low psychosocial stress resulting from another child, and the ability to rationalize an unintended pregnancy as the result of fate or God’s plan. The major exception was happiness conveyed as a result of social pressure despite truly negative feelings, predominantly expressed by foreign-born Latinas. Conclusion: Equating incongruence with ambivalence may undermine women’s sincere intentions to prevent pregnancy and their desires for highly effective contraception. At the same time, it is possible that unintended pregnancies 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.