Revisiting a contraceptive risk-taking model: Results and implications from a study of Midwestern women

Luker (1977) formulated a theory of contraceptive risk taking that described women's decisions to use contraceptives as a four step process: assignment of utilities to contraceptive use (cost and benefit of contraceptive use); assignment of utilities to pregnancies (cost and benefit for pregnancy); assignment of probabilities to becoming pregnant (perceived susceptibility); and assignment of probabilities to reversibility of pregnancy (perceptions of abortion). This study was an attempt to update Luker's model and to determine which constructs are still relevant for women today. A telephone survey of 18-30 year old women (N = 696) was conducted to investigate women's sexual and reproductive health, including what factors influenced women's contraceptive behavioral intentions. Hierarchical, multivariate linear regression was used to assess the impact of past use and the variables outlined by Luker with the exception of abortion, controlling for age and education level. The R2 for this model was .599. How women would feel if they had an unintended pregnancy now was negatively related to intention; women who believed an unintended pregnancy would be bad were more likely to intend to use contraceptives in the future. Perceived benefits of using contraceptives, fear of an unintended pregnancy, and past use were positively associated with intention. The model was consistent with Luker, but the inclusion of past use significantly strengthened the mode. Implications for interventions designed to improve contraceptive use and prevent unintended pregnancies will be discussed.