A Multidimensional Approach to Pregnancy Intention

Pregnancy intention has been linked to poor pregnancy outcomes. Intention has been assessed in varying ways during and after pregnancy. High rates of unintended pregnancy, 49% (Freer & Henshaw, 2006) to 65% (Custer, Waller, Vernon, & O'Rourke, 2008) highlight the importance of understanding intention in order to improve pregnancy outcomes. We explore the multiple dimensions of pregnancy intention and their impacts on pregnancy outcomes. In addition, we explore how intention relates to risky behaviors such as STDs and substance use. At this time, 1169 pregnant women (812 NHB, 229 NHW, 100 H, and 45 Asian) have been recruited from Duke University Medical Center and Lincoln Community Health Center in Durham, NC, into an observational prospective pregnancy cohort study. Intention status and psychosocial correlates were obtained through prenatal surveys; electronic medical records were utilized to obtain pregnancy outcomes. Pregnancy intention was assessed with a general question about timing and desire for the pregnancy and six questions regarding specific dimensions of intention. Intention and its dimensions were significantly associated with risky behaviors, depression, perceived stress, social support, and personality measures. Pregnancy intention was related to gestational age at birth. Unintended pregnancy was associated with a negative constellation of psychosocial indices and risky behaviors. Considering the multiple dimensions of pregnancy intention offers clearer understanding of how intention relates to both psychosocial health and pregnancy outcomes. This in turn provides an opportunity to design and implement better public health interventions related to psychosocial health, preconception planning, and prenatal care.