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.
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
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).
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.