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. 2004 May;58(5):426–433. doi: 10.1136/jech.2003.014787

Conceptualisation, development, and evaluation of a measure of unplanned pregnancy

G Barrett 1, S Smith 1, K Wellings 1
PMCID: PMC1732751  PMID: 15082745

Abstract

Study objective: To develop a measure of unplanned pregnancy that is valid, reliable, and appropriate in the context of contemporary demographic trends and social mores and can be used in a variety of situations, including the production of population prevalence estimates.

Design: A two stage study design: qualitative (inductive) methods to delineate the construct of pregnancy planning, and quantitative/psychometric methods to establish the means of measurement.

Setting: Eight health service providers (comprising 14 clinics, including antenatal, abortion, and one general practitioner) across London, Edinburgh, Hertfordshire, Salisbury, and Southampton in the UK.

Participants: Samples comprised a mixture of pregnant (continuing pregnancy and opting for abortion) and recently pregnant (post-abortion and postnatal) women. At the qualitative stage, 47 women took part in depth interviews (20 of whom were re-interviewed after the birth of their baby). Items were pre-tested with 26 women, and two psychometric field tests were carried out with, respectively, 390 and 651 women.

Main results: A six item measure of unplanned pregnancy was produced. Psychometric testing demonstrated the measure's high reliability (Cronbach's α = 0.92; test-retest reliability = 0.97) and high face, content, and construct validity. Women's positions in relation to pregnancy planning are represented by the range of scores (0–12).

Conclusions: A psychometric measure of unplanned pregnancy, the development of which was informed by lay views, is now available. The measure is suitable for use with any pregnancy regardless of outcome (that is, birth, abortion, miscarriage) and is highly acceptable to women.

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Selected References

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  1. Adams M. M., Shulman H. B., Bruce C., Hogue C., Brogan D. The Pregnancy Risk Assessment Monitoring System: design, questionnaire, data collection and response rates. PRAMS Working Group. Paediatr Perinat Epidemiol. 1991 Jul;5(3):333–346. doi: 10.1111/j.1365-3016.1991.tb00718.x. [DOI] [PubMed] [Google Scholar]
  2. Barrett Geraldine, Wellings Kaye. What is a 'planned' pregnancy? Empirical data from a British study. Soc Sci Med. 2002 Aug;55(4):545–557. doi: 10.1016/s0277-9536(01)00187-3. [DOI] [PubMed] [Google Scholar]
  3. Donner A., Eliasziw M. Sample size requirements for reliability studies. Stat Med. 1987 Jun;6(4):441–448. doi: 10.1002/sim.4780060404. [DOI] [PubMed] [Google Scholar]
  4. Fleissig A. Unintended pregnancies and the use of contraception: changes from 1984 to 1989. BMJ. 1991 Jan 19;302(6769):147–147. doi: 10.1136/bmj.302.6769.147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Harris K., Campbell E. The plans in unplanned pregnancy: secondary gain and the partnership. Br J Med Psychol. 1999 Mar;72(Pt 1):105–120. doi: 10.1348/000711299159853. [DOI] [PubMed] [Google Scholar]
  6. Joyce Ted, Kaestner Robert, Korenman Sanders. On the validity of retrospective assessments of pregnancy intention. Demography. 2002 Feb;39(1):199–213. doi: 10.1353/dem.2002.0006. [DOI] [PubMed] [Google Scholar]
  7. Jurich J. The relationship of modernity of sex roles to pregnancy planning. Sociol Focus. 1984 Aug;17(3):223–242. doi: 10.1080/00380237.1984.10570476. [DOI] [PubMed] [Google Scholar]
  8. Kaufmann R. B., Morris L., Spitz A. M. Comparison of two question sequences for assessing pregnancy intentions. Am J Epidemiol. 1997 May 1;145(9):810–816. doi: 10.1093/oxfordjournals.aje.a009174. [DOI] [PubMed] [Google Scholar]
  9. Kost K., Forrest J. D. Intention status of U.S. births in 1988: differences by mothers' socioeconomic and demographic characteristics. Fam Plann Perspect. 1995 Jan-Feb;27(1):11–17. [PubMed] [Google Scholar]
  10. Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
  11. Luker K. C. A reminder that human behavior frequently refuses to conform to models created by researchers. Fam Plann Perspect. 1999 Sep-Oct;31(5):248–249. [PubMed] [Google Scholar]
  12. Miller W. B. Reproductive decisions: how we make them and how they make us. Adv Popul. 1994;2:1–27. [PubMed] [Google Scholar]
  13. Morin Pascale, Payette Hélène, Moos Merry-K, St-Cyr-Tribble Denise, Niyonsenga Théophile, De Wals Philippe. Measuring the intensity of pregnancy planning effort. Paediatr Perinat Epidemiol. 2003 Jan;17(1):97–105. doi: 10.1046/j.1365-3016.2003.00461.x. [DOI] [PubMed] [Google Scholar]
  14. Najman J. M., Morrison J., Williams G., Andersen M., Keeping J. D. The mental health of women 6 months after they give birth to an unwanted baby: a longitudinal study. Soc Sci Med. 1991;32(3):241–247. doi: 10.1016/0277-9536(91)90100-q. [DOI] [PubMed] [Google Scholar]
  16. Petersen R., Moos M. K. Defining and measuring unintended pregnancy: issues and concerns. Womens Health Issues. 1997 Jul-Aug;7(4):234–240. doi: 10.1016/S1049-3867(97)00009-1. [DOI] [PubMed] [Google Scholar]
  17. Peterson L. S., Mosher W. D. Options for measuring unintended pregnancy in cycle 6 of the National Survey of Family Growth. Fam Plann Perspect. 1999 Sep-Oct;31(5):252–253. [PubMed] [Google Scholar]
  18. Sable M. R., Spencer J. C., Stockbauer J. W., Schramm W. F., Howell V., Herman A. A. Pregnancy wantedness and adverse pregnancy outcomes: differences by race and Medicaid status. Fam Plann Perspect. 1997 Mar-Apr;29(2):76–81. [PubMed] [Google Scholar]
  19. Santelli John, Rochat Roger, Hatfield-Timajchy Kendra, Gilbert Brenda Colley, Curtis Kathryn, Cabral Rebecca, Hirsch Jennifer S., Schieve Laura, Unintended Pregnancy Working Group The measurement and meaning of unintended pregnancy. Perspect Sex Reprod Health. 2003 Mar-Apr;35(2):94–101. doi: 10.1363/3509403. [DOI] [PubMed] [Google Scholar]
  20. Stanford J. B., Hobbs R., Jameson P., DeWitt M. J., Fischer R. C. Defining dimensions of pregnancy intendedness. Matern Child Health J. 2000 Sep;4(3):183–189. doi: 10.1023/a:1009575514205. [DOI] [PubMed] [Google Scholar]
  21. Trussell J., Vaughan B., Stanford J. Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth. Fam Plann Perspect. 1999 Sep-Oct;31(5):246-7, 260. [PubMed] [Google Scholar]

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