152849 Pleasures of pregnancy ambivalence: A qualitative analysis of intermittent contraceptive use and unintended pregnancy among U.S. women and men

Monday, November 5, 2007: 11:30 AM

Jenny Higgins, PhD, MPH , Mailman School of Public Health, Columbia University, New York, NY
Jennifer S. Hirsch, PhD , Department of Sociomedical Sciences, Columbia University, New York, NY
Background: Over half of all pregnancies in the U.S. are unintended, and exposure to unintended pregnancy (UP) also increases vulnerability to HIV and other STIs. The conceptualization and measurement of UP have evolved in recent years. However, gaps in the research remain. Furthermore, rates of UP among the most socially disadvantaged women have worsened rather than improved in the last decade. Objective: In this presentation, we use qualitative data to investigate an unexplored phenomenon that could contribute significantly to UP: that both women and men can want and not want a pregnancy at the same time, and this sometimes pleasurable ambivalence contributes to intermittent contraceptive use and UP. Methods: Data come from in-depth, sexual history interviews with 24 women and 12 men from Atlanta, 50% of whom had experienced at least one lifetime UP. Results: Over two-thirds of respondents had experienced pregnancy ambivalence with a partner at some point in their sexual history, which influenced their use of barrier methods. Men's pregnancy ambivalence was especially correlated with sporadic male condom use. A minority of women and men described fantasizing about pregnancy during sex, even though they did not want a child; this "eroticization of pregnancy risk" was strongly associated with misuse or non-use of barrier methods. Conclusions: Pregnancy ambivalence, as well as the eroticization of pregnancy risk, seem to influence both contraceptive/condom use and unintended pregnancy. Research and programs in UP prevention could be strengthened by addressing their existence and influence.

Learning Objectives:
At the end of this session, participants will be able to: 1. Understand how the current literature on unintended pregnancy fails to adequately explain the widespread intermittent use of contraceptive methods. 2. Articulate some of the sexual processes through which pregnancy ambivalence leads to inconsistent contraceptive use or abandonment of contraception. 3. Recognize the value of including men on research on unintended pregnancy and pregnancy ambivalence. 4. Indentify how future research and programming in prevention of unintended pregnancy could better address issues of pregnancy ambivalence.

Keywords: Contraception, Sexuality

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.