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Matern Child Health J. 2019 Nov;23(11):1547-1555. doi: 10.1007/s10995-019-02782-9.

Stability of Retrospective Pregnancy Intention Reporting Among Women with Unwanted Pregnancies in the United States.

Author information

1
Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, 1330 Broadway, 11th Floor, Oakland, CA, 94612, USA. corinne.rocca@ucsf.edu.
2
Graduate School of Education, University of California, Berkeley, 4415 Berkeley Way Building, Berkeley, CA, 94720, USA.
3
Graduate School of Education and Information Studies, University of California, Los Angeles, Moore Hall 3141, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.
4
Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, 1330 Broadway, 11th Floor, Oakland, CA, 94612, USA.

Abstract

Objectives Retrospective assessment of pregnancy intention may be unreliable as women's perceptions of a past conception can change over time. We compared the stability of retrospective pregnancy intention reporting over 5 years among women who sought and either received, or were denied, an abortion. Methods We recruited women from 30 abortion facilities across the United States in 2008-2010. Participants, some who received abortions and others who were denied care because they presented beyond facilities gestational limits, were followed prospectively for 5 years (n = 827). At enrollment and semiannually from year-2 to year-5, women completed the London Measure of Unplanned Pregnancy (LMUP), a six-item measure (scored 0-12), regarding the index pregnancy. We used multivariable mixed-effects models to assess the stability of retrospective reports of index pregnancy intendedness and compared trajectories by group, accounting for site and participant clustering. Our hypotheses were that intention would tend towards "more intended" over time among women denied abortions, who carried the pregnancies to term, and remain stable among women who received the abortion. Results Baseline LMUP scores were low (mean: 2.8) and similar by study group. Scores increased among women denied the abortion by year-2 (from 2.9 to 3.5; p < 0.001) and were steady through year-5. For women having near-limit abortions, reported intentions were steady between baseline (mean: 2.7) and year-2 (2.8), and declined thereafter through year-5 (to 2.5; p < 0.001). Conclusions Women somewhat shifted their perceptions of their intentions in correspondence with the pregnancy outcome. Retrospective estimates may underestimate the degree to which births result from unintended pregnancy.

KEYWORDS:

Abortion; Pregnancy intention; Reliability; Retrospective measurement; Stability; Unintended pregnancy

PMID:
31236825
PMCID:
PMC6786959
[Available on 2020-11-01]
DOI:
10.1007/s10995-019-02782-9

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