243090 Defining pregnancy ambivalence: How different measures of ambivalence relate to socio-demographic factors and contraceptive use

Wednesday, November 2, 2011: 8:50 AM

Ronna Popkin, MS , Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
Jenny Higgins, PhD, MPH , Mailman School of Public Health, Columbia University, New York, NY
John S. Santelli, MD , Department of Population and Family Health, Columbia University, New York, NY
Context & Background: The psycho-social factor of pregnancy ambivalence has recently emerged in the literature as a strong correlate of contraceptive practices. However, definitions and operationalizations of pregnancy ambivalence vary across studies, making results difficult to interpret and compare. The reproductive health field needs research that compares different definitions of pregnancy ambivalence within the same sample.

Methods: Using a nationally representative dataset of 18-29 year-olds in current sexual relationships (N=388 men, 433 women), we created three different measures of pregnancy ambivalence consistent with those in prior research. We then 1) assessed the proportion of respondents corresponding with each respective ambivalence definition, and 2) analyzed the socio-demographic factors and reproductive health outcomes most strongly associated with each measure of ambivalence.

Results: Among the three measures of pregnancy ambivalence, the proportion of young adults who qualified as ambivalent ranged from 31% to 48%. The strength of associations between ambivalence, contraceptive practices, and socio-demographic factors also varied across the different measures. The measure of ambivalence that included feelings of indifference toward pregnancy seems most strongly related to contraceptive practices; measures that included only conflicted feelings appear more weakly related.

Conclusion: Within the same dataset, different operationalizations of pregnancy ambivalence can each have unique associations with socio-demographic factors and reproductive health outcomes. Findings suggest that the salience of pregnancy ambivalence to contraceptive practices depends on how the concept is measured. Researchers should seek consistency or at least be explicit about their operationalization of pregnancy ambivalence in future studies.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
At the end of this session, participants will be able to: 1) Explain the various ways in which pregnancy ambivalence has been defined and measured in prior research; 2) Assess the strengths and weaknesses of various approaches to operationalizing ambivalence; 3) Describe how the associations between ambivalence, socio-demographic factors, and reproductive health outcomes vary for different measures of ambivalence within a nationally representative dataset of young adults in current sexual relationships; 4) Discuss the implications of the inconsistent operationalization of pregnancy ambivalence for the field of sexual and reproductive health research; 5) Formulate clear and consistent definitions of pregnancy ambivalence for use in future studies.

Keywords: Reproductive Health Research, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am trained as a health educator and am conducting research on pregnancy ambivalence and contraceptive use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.