Exploring key dimension of pregnancy intentions

Background: The conventional categorical measure of pregnancy intentions (intended, mistimed, or unwanted) found in most demographic surveys does not well represent the complexity of situational factors, attitudes, beliefs, and emotional reactions that women experience when they discover they are pregnant.

Method: Using multiple measures collected in the 2002 National Survey of Family Growth, factor analysis was employed to explore this complexity. We examined all pregnancies occurring in women 15-44 years between 1999 and 2002 (5033 women and 13593 pregnancies).

Results: Preliminary factor analyses revealed that these multiple measures of pregnancy experience did not load on a single factor. The factor which explained the greatest variance — termed “Wantedness” — included both affective and cognitive variables, as well as partner-specific factors. Measures that loaded on this initial factor include trying to get pregnant, wanting to get pregnant, happiness about the pregnancy, partner's response to the pregnancy, and relationship factors. Additional factors were identified that reflected pregnancy timing, including pregnancies occurring too soon, too late, or without a timing preference. Timing preferences of the woman and her partner often factored together. The degree of mistiming (less than one year, one to two years, 3 or more years) loaded separately, suggesting that mistiming is not a single linear variable. Age-stratified analyses suggested different factor solutions for adolescent and adult women.

Discussion: While unwanted and mistimed pregnancies are often combined as unintended, our analyses suggest that these represent differing underlying attitudes about a pregnancy that likely have differing implications for decisions about pregnancy outcomes.