Abstract
Objective Unintended pregnancy is common and disproportionately occurs among low-income women. We conducted a qualitative study with low-income women to better typologize pregnancy intention, understand the relationship between pregnancy intention and contraceptive use, and identify the contextual factors that shape pregnancy intention and contraceptive behavior. Study design Semistructured interviews were conducted with low-income, African-American and white women aged 18-45 recruited from reproductive health clinics in Pittsburgh, PA, to explore factors that influence women's pregnancy-related behaviors. Narratives were analyzed using content analysis and the constant comparison method. Results Among the 66 participants (36 African-American and 30 white), we identified several factors that may impede our public health goal of increasing the proportion of pregnancies that are consciously desired and planned. First, women do not always perceive that they have reproductive control and therefore do not necessarily formulate clear pregnancy intentions. Second, the benefits of a planned pregnancy may not be evident. Third, because preconception intention and planning do not necessarily occur, decisions about the acceptability of a pregnancy are often determined after the pregnancy has already occurred. Finally, even when women express a desire to avoid pregnancy, their contraceptive behaviors are not necessarily congruent with their desires. We also identified several clinically relevant and potentially modifiable factors that help to explain this intention-behavior discrepancy, including women's perceptions of low fecundity and their experiences with male partner contraceptive sabotage. Conclusion Our findings suggest that the current conceptual framework that views pregnancy-related behaviors from a strict planned behavior perspective may be limited, particularly among low-income populations. Implications This study identified several cognitive and interpersonal pathways to unintended pregnancy among low-income women in Pittsburgh, PA, including perceptions of low reproductive control, perceptions of low fecundity and male partner reproductive coercion.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 150-156 |
| Number of pages | 7 |
| Journal | Contraception |
| Volume | 91 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 2015 |
Fingerprint
Keywords
- Pregnancy intention
- Pregnancy planning
- Race
- Reproductive coercion
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynecology
Cite this
It just happens : A qualitative study exploring low-income women's perspectives on pregnancy intention and planning. / Borrero, Sonya; Nikolajski, Cara; Steinberg, Julia R.; Freedman, Lori; Akers, Aletha Y.; Ibrahim, Said; Schwarz, Eleanor.
In: Contraception, Vol. 91, No. 2, 01.01.2015, p. 150-156.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - It just happens
T2 - A qualitative study exploring low-income women's perspectives on pregnancy intention and planning
AU - Borrero, Sonya
AU - Nikolajski, Cara
AU - Steinberg, Julia R.
AU - Freedman, Lori
AU - Akers, Aletha Y.
AU - Ibrahim, Said
AU - Schwarz, Eleanor
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Objective Unintended pregnancy is common and disproportionately occurs among low-income women. We conducted a qualitative study with low-income women to better typologize pregnancy intention, understand the relationship between pregnancy intention and contraceptive use, and identify the contextual factors that shape pregnancy intention and contraceptive behavior. Study design Semistructured interviews were conducted with low-income, African-American and white women aged 18-45 recruited from reproductive health clinics in Pittsburgh, PA, to explore factors that influence women's pregnancy-related behaviors. Narratives were analyzed using content analysis and the constant comparison method. Results Among the 66 participants (36 African-American and 30 white), we identified several factors that may impede our public health goal of increasing the proportion of pregnancies that are consciously desired and planned. First, women do not always perceive that they have reproductive control and therefore do not necessarily formulate clear pregnancy intentions. Second, the benefits of a planned pregnancy may not be evident. Third, because preconception intention and planning do not necessarily occur, decisions about the acceptability of a pregnancy are often determined after the pregnancy has already occurred. Finally, even when women express a desire to avoid pregnancy, their contraceptive behaviors are not necessarily congruent with their desires. We also identified several clinically relevant and potentially modifiable factors that help to explain this intention-behavior discrepancy, including women's perceptions of low fecundity and their experiences with male partner contraceptive sabotage. Conclusion Our findings suggest that the current conceptual framework that views pregnancy-related behaviors from a strict planned behavior perspective may be limited, particularly among low-income populations. Implications This study identified several cognitive and interpersonal pathways to unintended pregnancy among low-income women in Pittsburgh, PA, including perceptions of low reproductive control, perceptions of low fecundity and male partner reproductive coercion.
AB - Objective Unintended pregnancy is common and disproportionately occurs among low-income women. We conducted a qualitative study with low-income women to better typologize pregnancy intention, understand the relationship between pregnancy intention and contraceptive use, and identify the contextual factors that shape pregnancy intention and contraceptive behavior. Study design Semistructured interviews were conducted with low-income, African-American and white women aged 18-45 recruited from reproductive health clinics in Pittsburgh, PA, to explore factors that influence women's pregnancy-related behaviors. Narratives were analyzed using content analysis and the constant comparison method. Results Among the 66 participants (36 African-American and 30 white), we identified several factors that may impede our public health goal of increasing the proportion of pregnancies that are consciously desired and planned. First, women do not always perceive that they have reproductive control and therefore do not necessarily formulate clear pregnancy intentions. Second, the benefits of a planned pregnancy may not be evident. Third, because preconception intention and planning do not necessarily occur, decisions about the acceptability of a pregnancy are often determined after the pregnancy has already occurred. Finally, even when women express a desire to avoid pregnancy, their contraceptive behaviors are not necessarily congruent with their desires. We also identified several clinically relevant and potentially modifiable factors that help to explain this intention-behavior discrepancy, including women's perceptions of low fecundity and their experiences with male partner contraceptive sabotage. Conclusion Our findings suggest that the current conceptual framework that views pregnancy-related behaviors from a strict planned behavior perspective may be limited, particularly among low-income populations. Implications This study identified several cognitive and interpersonal pathways to unintended pregnancy among low-income women in Pittsburgh, PA, including perceptions of low reproductive control, perceptions of low fecundity and male partner reproductive coercion.
KW - Pregnancy intention
KW - Pregnancy planning
KW - Race
KW - Reproductive coercion
UR - http://www.scopus.com/inward/record.url?scp=84921288583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921288583&partnerID=8YFLogxK
U2 - 10.1016/j.contraception.2014.09.014
DO - 10.1016/j.contraception.2014.09.014
M3 - Article
VL - 91
SP - 150
EP - 156
JO - Contraception
JF - Contraception
SN - 0010-7824
IS - 2
ER -