Abstract
ObjectivesTo explore the association between changes in personal circumstances and shifts in pregnancy intentions.Study designNew start contraceptive clients, who desired to prevent pregnancy for at least one year enrolled in the survey arm of the HER Salt Lake Contraceptive Initiative (September 2015 –March 2017) and responded to the question “What are your future pregnancy plans?” at enrollment and 12-month follow-up. We estimated multivariable binary logistic fixed-effects regressions to examine the association between changes in personal circumstances and a change from never desiring a pregnancy at enrollment to considering one in the future at 12-month follow-up.ResultsThe majority of the 2825 participants (2246, 79%) maintained their pregnancy timing intention over the 12-month study period. Multivariable analyses of the 208 participants who changed from never desiring a pregnancy to considering pregnancy in the future at 12-month follow-up indicated that entering cohabitation (aOR 3.14, 95% CI 1.30–7.58), increased household income (aOR 1.06, 95% CI 1.00–1.13), and changes from unemployment to full-time employment (aOR 5.94, 95% CI 1.29–27.36) are associated with increased the odds of desiring a future pregnancy after never wanting one a year prior.ConclusionsPregnancy intentions are dynamic over twelve months and covary with partner status, household income, and employment status. Pregnancy intentions are linked to changes in life circumstances. Health care providers need to frequently assess pregnancy intentions and resulting contraceptive or preconception needs.
Highlights
IntroductionClinicians who provide contraception can increase person-centered family planning care by incorporating reproductive goal conversations into contraception counseling [3,4]
Pregnancy and parenting goals factor into contraceptive decision-making [1,2]
Multivariable analyses of the 208 participants who changed from never desiring a pregnancy to considering pregnancy in the future at 12month follow-up indicated that entering cohabitation, increased household income, and changes from unemployment to full-time employment are associated with increased the odds of desiring a future pregnancy after never wanting one a year prior
Summary
Clinicians who provide contraception can increase person-centered family planning care by incorporating reproductive goal conversations into contraception counseling [3,4]. From both a clinical and population health perspective, questions about desired timing of pregnancy hold relevance. These questions are often used to assess a client’s reproductive health needs and direct counseling on contraception or preconception care. The PATH framework is a patient-centered reproductive goals counseling approach and can be used clinically to discuss Parenting and Pregnancy Attitudes, Timing, and How important it is to prevent pregnancy [3,5,6]. A prospective assessment of pregnancy timing intentions reduces the bias resulting from asking whether a pregnancy was planned post-birth
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