Development and exploration of a multidimensional measure of pregnancy desire from the national survey of family growth

In the United States, half of all pregnancies are classified as unintended. This measure fails to capture the complexity of cognitive and affective processes that result in conflicted or ambivalent attitudes toward pregnancy. Accurately measuring women's reproductive plans is essential for providing appropriate interventions to improve maternal-child health. The purpose of this study was to explore the concept of pregnancy ambivalence by estimating a multidimensional measure of pregnancy desire in the 2006-2010 National Survey of Family Growth data, and to examine the social and demographic characteristics associated with pregnancy ambivalence. For each female participant reporting exactly one live birth within a three-year time period (n = 2,298), a pregnancy desire score was calculated from five existing survey items. Weighted mean pregnancy desire scores were calculated for levels of the following covariates: maternal age, race, marital status, educational level, income, employment status, and birth order. Weighted multiple linear regression analysis was used to examine the associations between pregnancy desire and the same covariates. On a 0–100 scale, the mean pregnancy desire score was 68.7 (standard error 1.0). Pregnancy desire scores were highest for married, highly educated non-Hispanic White women between the ages of 35 and 39, with income greater than 300% of the federal poverty level, giving birth to their second child. After controlling for covariates, Hispanic women had a mean pregnancy desire score five points higher than non-Hispanic White women, and the difference in pregnancy desire score for a first birth versus a second birth was not statistically significant. The distribution of pregnancy desire score revealed that about one-quarter of pregnancies are highly desired, highlighting the large number of women with conflicting or ambivalent feelings about their pregnancies. Further research to explore alternatives to the traditional measure of pregnancy intention is warranted