Abstract

ObjectiveTo investigate the effect of question order on women’s responses to the London Measure of Unplanned Pregnancy (LMUP) or the pregnancy intention question of the Demographic and Health Survey (DHS) when both are asked in the same survey. We collected data on pregnancy intention from a cohort of 4244 pregnant women in Malawi who were re-interviewed at 1, 6 and 12 months postnatally. Women in Zone 1 were asked the LMUP, then antenatal questions, then the DHS pregnancy intention question, women in Zone 2 were asked the DHS pregnancy intention question, then antenatal questions, then the LMUP; women in Zone 3 were only asked the DHS pregnancy intention question. We used linear regression to compare the LMUP score and ordinal regression to compare DHS categorisations of pregnancy intention across Zones, adjusting for baseline socioeconomic differences between the Zones.ResultsWe found no effect of question order on the assessment of pregnancy intention by the LMUP. There were differences in the assessment of pregnancy intention when the pregnancy intention question in the DHS was used, however this seemed to be due to baseline sociodemographic differences between the groups of pregnant women being compared, and not due to question order.

Highlights

  • Questions about pregnancy intention have been asked in large scale surveys around the world for over 50 years [1]

  • We found no effect of question order on the assessment of pregnancy intention by the London Measure of Unplanned Pregnancy (LMUP)

  • There was no significant difference in the proportion of women who changed their LMUP score between either antenatal and 1–2 month postnatal (p = 0.733) or between 1 and 2 months and 6 months postnatally (p = 0.941) suggesting that there was no effect of question order on the stability of the LMUP

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Summary

Results

There were statistically significant differences between the Zones at baseline: socio-economic status (SES) (p < 0.001), education level (p = 0.006), age (p = 0.031), marital status (p = 0.018) and number of live children (p = 0.009) (see Additional file 1: Table S1). There was no significant difference in the proportion of women who changed their DHS categorisation between 1 and 2 months and 6 months postnatally (p = 0.488) suggesting that there was no effect of question order on the stability of the DHS

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