Perfect storm of failing to plan and pregnancy ambivalence: Implications for health messages designed to decrease unintended pregnancies among 18-30 year old women

Unintended pregnancy rates among 18- to 30-year-olds in one rural, Midwestern state were 53.5% in 2006. In order to design a health communication campaign that targets a complex behavior like unintended pregnancy prevention, extensive formative research must be conducted. Two statewide surveys (N = 543, N = 796) were coupled with 18 focus groups (N =106) and 27 in-depth interviews with women ages18-30 to inform the campaign/message development. Results suggest that ambivalent feelings about becoming pregnant and perceptions of low susceptibility were common among these women. The major barrier to contraceptive use was a lack of planning, and factors such as alcohol consumption and having erratic schedules exacerbated this barrier. Other barriers were cost and concerns about side effects. Women also reported knowing little about methods other than the pill and condoms. Except for college women, there was excitement among participants about the opportunity to learn about other options. Campaign messages for 18-30 year olds will focus on the idea that sex can happen at any time, even when they do not plan on it, so they have to be prepared for the possibility. The risk of unintended pregnancy will be highlighted, since women believe unintended pregnancy does not happen often, particularly among adult women. Supporting messages will emphasize that there is a contraceptive that is appropriate for each woman, her body (addressing the concerns about side effects), her budget (addressing concerns about money), and her lifestyle (addressing erratic schedules). Three concepts were developed as options for conveying these messages.