P068Navigating uncertainty: (In)fertility and reproductive planning

Abstract

<h3>Objectives</h3> Pregnancy planning is an important goal of sexual and reproductive health (SRH) programs, yet research focuses primarily on strategies to prevent pregnancy rather than strategies to achieve pregnancy when desired. This study examines how perceptions of (in)fertility influence how people make and pursue pregnancy/reproductive plans. <h3>Methods</h3> From February to April 2022, we conducted 17 focus groups and 17 in-depth interviews with female-identified people aged 18–35 living in Ohio. Interviews focused on reproductive planning and perceptions of (in)fertility, while focus groups focused on social/community norms. <h3>Results</h3> Participants wanted to make reproductive plans, but felt hindered by uncertainties regarding life circumstances (eg, relationships, career) and their ability to become pregnant. Three broad themes emerged: (1) women were concerned that they would not know if they could become pregnant until they tried, (2) healthcare providers focused only on immediate goals of pregnancy prevention, dismissing concerns about future fertility, and (3) perceptions that long-term impacts of contraception on fertility were not well-established, and so using contraception was both necessary and put their future fertility at risk. Women who experienced infertility reflected that they lacked information about infertility prior to experiencing it. With more information, many perceived they would have started trying for pregnancy earlier and/or made plans to pursue alternative pathways to pregnancy (eg, saving for infertility treatment) or parenthood (eg, planning for adoption). <h3>Conclusions</h3> Healthcare providers can support women by engaging in conversations about both current and future reproductive plans. Technologies that provide accurate information about women's fertility prior to pursuing pregnancy may be important tools in helping women plan their future.