Abstract
BackgroundValid and reliable measures such as London Measure of Unplanned Pregnancy (LMUP) are imperative for understanding fertility-related behaviors and estimating unintended pregnancy. The aim of this study was to validate the LMUP in the Hindi language for a wider reach in India.MethodsAn interviewer administered version of the LMUP was translated and pretested in Hindi. The LMUP was field tested with married women in the reproductive age group across forty informal settlements in Mumbai in the post intervention census of a cluster randomized control trial to improve the health of women and children. Analyses involved the full sample and sub-groups according to time-from-conception. Reliability (internal consistency) was assessed using Cronbach’s alpha, inter-item correlations, and item-rest correlations. Construct validity was assessed by hypothesis testing and confirmatory factor analysis.Results4991 women were included in the study (1180 were pregnant, 2126 in their first- and 1685 in their second postnatal year). LMUP item completion rates were 100 % and the full range of LMUP scores was captured. Reliability: the scale was internally consistent (Cronbach’s α = 0.84), inter-item correlations were positive, and item-rest correlations were above 0.2 for all items except item six (0.07). Construct validity: hypotheses were met, and confirmatory factor analysis showed that a one-factor model was a good fit for the data, confirming unidimensional measurement. The sub-group analysis (by pregnant, first-, and second postnatal year) showed that the psychometric properties of the LMUP were similar across the groups. In terms of LMUP scores, the women in the postnatal groups were very slightly, but significantly, more likely to have an LMUP score of 10 + compared to pregnant women; the difference between the first and second postnatal year was not significant.ConclusionsThe Hindi LMUP is valid and reliable measure of pregnancy intention that may be used in India.Trial RegistrationThis study is registered with ISRCTN, number ISRCTN56183183, and Clinical Trials Registry of India, number CTRI/2012/09/003004.
Highlights
Valid and reliable measures such as London Measure of Unplanned Pregnancy (LMUP) are imperative for understanding fertility-related behaviors and estimating unintended pregnancy
The LMUP, which was administered to women who were pregnant at the time of census or had a child under two years of age, was completed by 4991 women
Our results indicate that the Hindi version of LMUP is reliable and valid in terms of acceptability, targeting, internal consistency and construct validity according to internationally accepted psychometric criteria, and can be used for measuring pregnancy intention in Hindi speakers in India
Summary
Valid and reliable measures such as London Measure of Unplanned Pregnancy (LMUP) are imperative for understanding fertility-related behaviors and estimating unintended pregnancy. Recent estimates suggest that 214 million women were not using any modern method of contraception irrespective of their intention to avoid any future pregnancy Satisfying these unmet needs would have prevented 67 million unintended pregnancies, 36 million induced abortions, and 23 million unplanned births in 2017 [1]. Women with unintended pregnancies are at higher risk of developing complications such as high blood pressure, anemia, and gestational diabetes [5, 6]. These conditions, if not managed, can lead to severe obstetric complications like hemorrhage, pre-eclampsia, pre-term birth, and maternal mortality [7,8,9]. Preventing unintended pregnancies can lead to substantial improvement in maternal and child health outcomes [2, 13]
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