Having a baby would give me someone to love: Perceived benefits of childbearing and risk of pregnancy among young women

High unintended pregnancy rates, along with inconsistencies between reported pregnancy intentions and contraceptive behaviors, have been well-documented among young women in the US. Women's beliefs about the benefits of childbearing and motherhood may help to explain these patterns. We assessed childbearing attitudes and feelings about becoming pregnant among 1,377 adolescents and young women participating in a one-year longitudinal cohort study in the San Francisco Bay area. All participants were initiating hormonal contraception and did not want to become pregnant for one year. The psychometric properties of a multi-item measure of childbearing attitudes were examined using item response theory-based methods. Cox proportional hazard regression was used to investigate the independent, prospective association of childbearing attitudes and feelings about pregnancy with both contraceptive discontinuation and pregnancy. The Benefits of Childbearing scale performed well, exhibiting high reliability (0.82) and strong internal structure validity. Childbearing attitudes were more favorable among younger women, non-white women, and those with lower maternal education. Even among those who would feel “very upset” if they became pregnant (44%), many had positive childbearing attitudes. Women with more positive childbearing attitudes were more likely to become pregnant over a year (HR=1.16, p<0.05), controlling for stated feelings about becoming pregnant and demographics. Use of the Benefits of Childbearing measure in conjunction with traditional pregnancy intentions questions may help capture risk for unintended pregnancy. Research should address how the scale can be incorporated into clinical settings to better help young women, particularly adolescents, to achieve their goals of delayed or prevented pregnancy.