A qualitative investigation of women's choices about pregnancy

Background: About half of pregnancies in the United States are unintended, but fewer are unwanted. Purpose: The purpose of this study was to investigate concepts of intendedness of pregnancy and their social context, and the relevance these may have for women's choices to keep a baby, terminate a pregnancy, or adopt out a baby. Methods: We conducted in-depth semi-structured interviews with 33 women receiving prenatal care with intent to keep the baby, 19 women obtaining an abortion, and 15 women planning to adopt out the baby. Results: The women's ages ranged from 18 to 35 years, and 81% were white, non-Hispanic. Planning and wanting were distinctly different dimensions of pregnancy intendedness. Key components of planning were life preparation (including educational, financial, and emotional issues), sexual behavior, beliefs about susceptibility to pregnancy, and procreative intentions. Planning was related to proactivity, relationships, sexual attitudes, and attitudes about the male role. Key components of wanting were desire for pregnancy over lifetime and desire at specific time points prior to and following conception. Wanting was strongly related to partner, family, and other relationships; and also to personal beliefs and values about pregnancy and parenting. The decisions resulting in pregnancy about the pregnancy were driven by wanting rather than planning and were made in a context of pregnancy either stabilizing or destabilizing a woman's life. Discussion: The desire for pregnancy at the time is most relevant to a woman's choices about the pregnancy, and is influenced by many personal and social factors.