Defining new categories of pregnancy intention in African-American women.
OBJECTIVE
Half of all U.S. pregnancies are categorized as unintended at conception, but concerns persist that existing measures of pregnancy intention do not adequately reflect the complexities of reproductive desires and preferences. We explored new strategies for categorizing viewpoints toward future pregnancy focusing on young, low-income, African-American women, and assessed the stability of these viewpoints over time. For pregnancies that occurred during the study, we examined the utility of the newly derived categories for predicting retrospective measures of intendedness.


METHODS
Data were collected using Q-methodology, a technique for eliciting subjective viewpoints and identifying shared patterns among individuals. African-American women ages 15 to 25 and at risk for pregnancy were recruited at clinics serving low-income populations. The women sorted statements reflecting attitudes and preferences regarding future pregnancy into a distribution on a continuum from "least true for me" to "most true for me." We used by-person factor analysis to derive latent viewpoints.


RESULTS
We identified six factors each reflecting a unique viewpoint about future pregnancy. These were a pregnancy seeking factor, one reflecting both ambivalence and low reproductive control, and four reflecting pregnancy avoidance, with distinctions around social support, reproductive control, and desired pregnancy timing. Distribution of factors differed by age group, as well as by retrospective categorization of pregnancy intention for those women who became pregnant during the study.


CONCLUSIONS
Our categories provide a nuanced reflection of women's points of view about future pregnancies, and, with further validation, may prove useful for predicting or preventing contraceptive nonuse, undesired conceptions, and associated adverse outcomes.
Schwartz
Alan
A
University of Illinois at Chicago, Department of Medical Education, Chicago, IL 60612, USA. alansz@uic.edu
Peacock
Nadine
N
McRae
Kenya
K
Seymour
Rachel
R
Gilliam
Melissa
M
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000367:Age Factors; D005163:Factor Analysis, Statistical; D005193:Family Planning Services; D005260:Female; D005544:Forecasting; D006801:Humans; D033182:Intention; D011203:Poverty; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D049168:Pregnancy, Unplanned / Q000208:ethnology / Q000523:psychology; D011446:Prospective Studies; D012189:Retrospective Studies; D012944:Social Support; D013997:Time Factors; D055815:Young Adult