Factors Influencing the Formation and Achievement of Fertility Intentions: A Qualitative Study of Childbearing Decision Making Among Honduran Women

Fertility intentions—the desire for and desired timing of childbearing—are important drivers of reproductive health behaviors and outcomes such as unintended pregnancy. Predicting fertility is essential for family planning programs and researchers. Previous research has identified factors associated with fertility intentions however; prediction of pregnancy could be improved. Reproductive decision making processes and factors thought to influence fertility were explored through 8 focus groups and 25 in-depth interviews with Honduran women of reproductive age. Individual and community-level factors affecting intentions were identified. Results provide evidence that multiple factors influence plans for childbearing and suggest that the use of simple categorical measures is likely to be unsuccessful at accurately predicting pregnancy. Women's attitudes towards contraception, the locus of motivation for fertility decision making, the ability to pursue educational and occupational opportunities and the perceived ability to care for family were found to be key influences on intentions. The formation and achievement of fertility intentions were found to be distinct processes. Factors identified as influencing childbearing plans among study would could influence intentions in other developing country settings as well. Consideration of these factors is likely to strengthen measures of fertility intentions and facilitate the development of an improved, multidimensional measure which could enhance researchers' ability to predict pregnancy and ultimately contribute to the design of interventions to address unintended pregnancy.