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Pregnancy Intention

Pregnancy Intention. Wendy L. Hellerstedt, MPH, PhD Associate Professor MCH Program, Division of Epidemiology School of Public Health, University of Minnesota June, 2004. Outline. Healthy People 2010 goals How is pregnancy intention traditionally measured?

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Pregnancy Intention

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  1. Pregnancy Intention Wendy L. Hellerstedt, MPH, PhD Associate Professor MCH Program, Division of Epidemiology School of Public Health, University of Minnesota June, 2004

  2. Outline • Healthy People 2010 goals • How is pregnancy intention traditionally measured? • Magnitude of unintended pregnancy • Correlates of unintended pregnancy • Alternative measures

  3. Healthy People 2010 Reducing unintended pregnancy is an important public health goal in the U.S.

  4. Healthy People 2010 • Increase proportion of pregnancies that are intended to 70% • Baseline (1995): 51% intended • Goals: • Increase pregnancy spacing (target 6% births occurring within 24 mos of previous birth) • Increase contraception use to 100% for women and partners who do not intend to become pregnant • Several goals related to adolescent pregnancy risk

  5. Traditional Definition of Pregnancy Intention in the U.S.

  6. Unintended Pregnancy • The definition of unintended pregnancy is a combination of: • Abortion • Standard definition for non-terminated pregnancy: • At the time you became pregnant, did you, yourself, actually want to have a baby at that time? • IF YES, Did you become pregnant sooner than you wanted, later than you wanted, or at about the right time? • If response is either did not want to be pregnant or became pregnant sooner than wanted, then pregnancy is unintended • Unintended can be split into two categories: • Unwanted • Mistimed (I.e., pregnant sooner than wanted to be)

  7. Magnitude of Unintended Pregnancy

  8. Half of all pregnancies in the United States each year are unintended Intended pregnancies Unintended pregnancies Pregnancies (6.3 million) Source: www. Agi-usa.org

  9. . . . account for roughly half of all unintended pregnancies The small proportion of women who do not use contraceptives . . . Women at risk of unintended pregnancy (42 million) Women experiencing unintended pregnancies (3 million) Source: www. Agi-usa.org

  10. Distribution of pregnancies, by age at resolution, US, 1995, National Survey of Family Growth (Henshaw, 1998)

  11. Correlates of Pregnancy Intention

  12. In the U.S. women who are most likely to report an unintended pregnancy tend to be… • Younger than 20 yrs old • Black • Less well educated (I.e., less than 12 years of completed education) • Medicaid recipients

  13. Unintended pregnancy is associated with pregnancy risk • Poor pre-conceptional care • Less than adequate prenatal care • Low birthweight, preterm, and infant mortality may be higher • Pregnancy behaviors, like smoking and alcohol use, may be higher • Risk is highest for women with unwanted pregnancies compared with mistimed pregnancies

  14. Is Pregnancy Timing the Best Measure of “Intention”?

  15. Future Considerations in Measurement • Pregnancy feelings (e.g., happiness, perceived costs, worries, looking forward to pregnancy experience, looking forward to parenting experience) may be important--including ambivalence • Partner feelings (perceived by woman or reported by partner) or wanting a pregnancy with this partner • Pregnancy avoidance: how much did the woman try to avoid becoming pregnant? How much did the woman try to become pregnant?

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