Attitudes toward unprotected intercourse and risk of pregnancy among women seeking abortion

Introduction: Many heterosexual couples have intercourse without using a method of contraception. This study examines attitudes towards unprotected intercourse (UI) among women at risk of unintended pregnancy.

Methods: Between April and September 2010, 602 women at 6 abortion clinics across the country completed an anonymous survey on laptops. We asked about frequency and motivations for UI in the three months prior to conception, current attitudes towards the risks and benefits of UI, likelihood of engaging in UI in the next three months and perceptions of the risk of conception.

Results: Women had an average of 18 acts of UI in the three months leading to conception. Women who had frequent UI (3 or more times) reported more problems with access to contraceptives, a history of side effects, partners who did not want to use birth control and pregnancy ambivalence. Women who overestimate the risk of conception from one act of UI (believe it is more than 50%) report being less likely to have future UI. Multivariable regression models found three factors to be significantly associated with future UI: holding a view that UI improves one's relationship with their partner (OR=2.24, 95% CI[1.38, 3.64]), underestimating the risk of conception in a year of UI(OR=1.58, 95% CI[1.00, 2.51]), and having an age under 20 (OR=2.59, 95% CI[1.30, 5.16]).

Conclusion: Couples have myriad reasons for engaging in UI. Public health interventions designed to reduce the incidence of unwanted pregnancy need to take account of the risks and benefits women see in having UI.