Abstract
Objective
The objective was to use improved measures and methodology to investigate whether
race and ethnicity are associated with unintended pregnancy.
Study design
Cross-sectional study of English- or Spanish-speaking women, aged 16–44, with pregnancies
<24 weeks' gestation recruited from pregnancy testing and abortion care sites in New Haven,
CT, between June 2014 and June 2015. Participants completed self-assessments of race,
ethnicity and multidimensional measures of pregnancy “context,” including timing,
intention, wantedness, desirability, happiness and planning (measured with the London
Measure of Unplanned Pregnancy). Multivariable analysis was performed, adjusting for
maternal demographics, language, recruitment site, substance use and medical conditions
including history of depression.
Results
Among 161 participants (mean age=27.2±6.6 years), mean gestational age was 9±4.6 weeks. Overall, 14% self-identified as White non-Hispanic, 37% Black non-Hispanic,
42% Hispanic and 7% multiracial. Most (85%) were unmarried, and 75% had at least one
child. After adjustment, happiness about new pregnancies was more likely among Black
non-Hispanic than White non-Hispanic women OR=5.66 (95%CI: 1.51–21.20). Neither race
nor ethnicity was significantly associated with pregnancy intention, wantedness, planning,
timing or desirability.
Conclusion
In a diverse cohort with multiple, antenatal measures of pregnancy context, neither
race nor ethnicity is significantly associated with unintended pregnancy, as previous
studies reported. Black non-Hispanic women were more likely to report happiness about
new pregnancies than White non-Hispanic women. This study improves upon previous analyses
that used retrospective and limited assessments of pregnancy intention, excluded women
with miscarriages or abortions, and lacked adjustment for confounding.
Implications
Evaluation of multidimensional pregnancy contexts assessed antenatally is important
and may capture the experiences of women more accurately, especially Black and Hispanic
women.
Keywords
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Article info
Publication history
Published online: December 27, 2017
Accepted:
December 18,
2017
Received in revised form:
November 29,
2017
Received:
October 26,
2017
Footnotes
☆Funding: This work was supported by funding from NIH CTSA UL1 TR000142 and the Albert McKern Scholar Awards for Perinatal Research.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
