文章基本信息

标题：An Exploration of the Dimensions of Pregnancy Intentions Among Women Choosing to Terminate Pregnancy or to Initiate Prenatal Care in New Orleans, Louisiana
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作者：John S. Santelli ; Ilene S. Speizer ; Alexis Avery 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2006
卷号：96
期号：11
页码：2009-2015
DOI：10.2105/AJPH.2005.064584
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined pregnancy decisionmaking among women seeking abortion or prenatal care. Methods. Conventional measures of pregnancy intentions were compared with newer measures in 1017 women seeking abortion. A reduced sample of abortion patients (142 African American women from New Orleans) was compared with 464 similar women entering prenatal care. Results. Virtually all abortion patients reported the pregnancy as unintended; two thirds of prenatal patients reported the pregnancy as unintended. Reasons for seeking abortion related to life circumstances, including cost, readiness, not wanting any more children, marital status, relationship stability, and being too young. Abortion patients were more likely to report trying hard to avoid a pregnancy and not being in a relationship. They were less likely to report that their partner wanted a baby (odds ratio=0.10) or that they wanted a baby with their partner (odds ratio=0.13) than prenatal patients. Conclusions. Traditional measures of pregnancy intentions did not readily predict a woman’s choice to continue or abort the pregnancy. Relationship with male partners, desire for a baby with the partner, and life circumstances were critical dimensions in pregnancy decisionmaking. Unintended pregnancies include births that are unwanted and mistimed and pregnancies that end in abortion. 1 ^, 2 Almost half (49%) of pregnancies in the United States in 1994 were unintended and almost half of unintended pregnancies end in abortion. 1 Longitudinal European studies of women who had their abortion requests denied have found severe negative effects on the children’s long-term psychosocial development including effects on schooling, social adjustment, alcohol and drug abuse, criminal activity, and employment. 3 ^, 4 Where abortion is illegal and unsafe, unintended pregnancy is a major contributor to maternal morbidity and mortality. 5 ^, 6 Although the unfavorable consequences of unintended pregnancy are well delineated, unintended pregnancy itself is less well defined. Previous research suggested that pregnancy intentions are multidimensional, ambivalence about pregnancy is common, and the decision to carry a pregnancy to term or to abort is affected by life circumstances and social influences. 7 ^– 12 The complicated circumstances surrounding pregnancy decisionmaking have led to efforts to better measure pregnancy intentions. 13 ^– 17 A woman’s feelings about a specific pregnancy and her decision about abortion may be shaped by her relationship with her partner, medical conditions, social pressure from family members, physical abuse, emotional reactions, and prenatal diagnostic procedures. 18 ^– 24 Decisions about abortion are also driven by whether a woman accepts or rejects abortion as a solution for unwanted pregnancy. 18 ^, 25 Pregnancy intentions are seldom measured for women seeking abortion. A number of studies have directly compared abortion and prenatal patients on demographic and contraceptive factors; 24 ^– 26 however, these studies did not directly examine differences in pregnancy intentions between women who carry to term and women who abort. This study used data from the Determinants of Unintended Pregnancy Risk in New Orleans Study to answer 2 questions: What are the important cognitive, affective, and contextual dimensions of pregnancy intentions among women seeking abortion? How do abortion and prenatal patients differ in terms of these cognitive, affective, and contextual dimensions of pregnancy intentions? In this study we explored traditional demographic measures of pregnancy intentions as well as new measures that were developed in a previous qualitative research phase that involved African American women from New Orleans.