Abstract
Objectives
An understanding of the relationship between individuals’ pregnancy preferences and
contraceptive use is essential for appropriate patient-centered counseling and care.
We examined the relationship between women’s pregnancy preferences and contraceptive
use using a new prospective measure, the Desire to Avoid Pregnancy (DAP) scale.
Study Design
As part of a study examining women’s suspicion and confirmation of new pregnancies,
we recruited patients aged 15 – 45 from seven reproductive health and primary health
facilities in Arizona, New Jersey, New Mexico, South Carolina, and Texas in 2016–2017.
We used multivariable logistic, multinomial logistic, and linear regression models
to examine the associations among DAP scores (range: 0 – 4) and contraceptive use
outcomes and identify factors associated with discordance between DAP and use of contraception.
Results
Participants with a greater preference to avoid pregnancy had higher odds of contraceptive
use (aOR = 1.63, 95% CI: 1.31, 2.04) and used contraceptives more consistently (aβ = 8.9
percentage points, 95% CI: 5.2, 12.7). Nevertheless, 63% of women with low preference
to avoid pregnancy reported using a contraceptive method. Higher preference to avoid
pregnancy was not associated with type of contraceptive method used: women with the
full range of pregnancy preferences reported using all method types.
Conclusion
When measured using a rigorously developed instrument, pregnancy preferences were
associated with contraceptive use and consistency of use. However, our findings challenge
assumptions that women with the highest preference against pregnancy use more effective
methods and that women who might welcome pregnancy do not use contraception.
Implications
Women’s preferences about pregnancy contribute significantly to their use of contraception.
However, health care providers and researchers should consider that contraceptive
features besides effectiveness in preventing pregnancy shape contraceptive decision-making
and use.
Keywords
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Article info
Publication history
Published online: December 02, 2019
Accepted:
October 17,
2019
Received in revised form:
October 16,
2019
Received:
June 3,
2019
Footnotes
☆The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
☆☆This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Office of Research on Women’s Health, Building Interdisciplinary Research Careers in Women’s Health grant #2K12 HD052163 and funding from an anonymous private foundation.
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