How Attitude Towards Pregnancy Matters When Women Select Contraception

To broaden understanding and knowledge about how women make decisions about contraception, a group of researchers at the University of Pittsburgh explored the relationship between pregnancy attitude, as well as intention, and contraceptive use in a large, diverse population with low-cost access to a range of contraceptive options.

Published in Women’s Health Issues, the study’s results showed that “pregnancy intention and attitude were associated, but not perfectly aligned,” and an attitude that pregnancy would be “the worst thing” was associated with use of highly effective contraception.

Tierney Wolgemuth of the University of Pittsburgh School of Medicine and her colleagues used data from the Examining Contraceptive Use and Unmet Need among Women Veterans (ECUUN) Study, which included a national sample of women veterans aged 18-44 years who received primary care from the Veterans Affairs Healthcare System. In addition to questioning the women about their plans to get pregnant (now, in the next year, or later in the future), interviewers asked how they would feel if they became pregnant in the next year (a seven-point scale from “it would be the worst thing” to “it would be the best thing”).

Out of 858 women who were sexually active and neither pregnant nor trying to become pregnant, 84% were using contraception. Overall, both pregnancy intention and attitude were associated with method effectiveness.  For White women, both intention and attitude were associated with method effectiveness; for Hispanic women, only attitude was associated; and for Black women, neither attitude nor intention was significantly associated with the effectiveness of the contraceptive method they used.

Traditional contraceptive counseling has typically focused on women’s pregnancy intentions and plans, Wolgemuth and her colleagues note, but a wider focus may enable providers to better assist their patients. “Understanding the factors that are most salient to women's contraceptive use is critical to best supporting women in their contraceptive decision making,” they comment. 

 “Associations between Pregnancy Intention, Attitudes, and Contraceptive Use among Women Veterans in the ECUUN Study” has been published in the November/December issue of Women’s Health Issues. Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.