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

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.