Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Mar;52(1):39-48.
doi: 10.1363/psrh.12134. Epub 2020 Mar 18.

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Lauren J Ralph  1 , Diana Greene Foster  1 , Corinne H Rocca  1
Affiliations
Comparative Study

Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women

Lauren J Ralph et al. Perspect Sex Reprod Health. 2020 Mar.

Abstract

Context: Measurement of pregnancy intentions typically relies on retrospective reporting, an approach that may misrepresent the extent of unintended pregnancy. However, the degree of possible misreporting is unclear, as little research has compared prospective and retrospective reports of intention for the same pregnancies.

Methods: Longitudinal data collected between 2010 and 2015 on 174 pregnancies were used to analyze the magnitude and direction of changes in intendedness (intended, ambivalent or unintended) between prospective and retrospective measurements of intendedness using versions of the London Measure of Unplanned Pregnancy (LMUP). Changes were assessed both continuously and categorically. Differences in the degree of change-by pregnancy outcome and participant characteristics-were examined using mixed-effects linear and logistic regression models.

Results: Over two and one-half years of follow-up, 143 participants reported 174 pregnancies. Approximately half showed changes in intention between the prospective and retrospective assessments, with 38% of participants reporting increased intendedness and 10% decreased intendedness. Reported intendedness increased more among those who gave birth (mean change in continuous LMUP score, 2.2) than among those who obtained an abortion (0.7), as well as among individuals with a college degree (4.1) than among those with a high school diploma (1.2). Participants who reported recent depression or anxiety symptoms showed more stable intentions (0.02) than those who did not (2.1).

Conclusions: Retrospective measurement of pregnancy intentions may underestimate the frequency of unintended pregnancy, with such underestimation being greater among certain subgroups. Estimates based on retrospective reports thus may produce inaccurate impressions of intentionality. Further efforts to refine the measurement of pregnancy preferences are needed.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Distribution of scores on the prospective and retrospective London Measure of Unplanned Pregnancy Notes: Scores can range from 0 to 12; a higher score indicates a pregnancy that is more intended. The distributions of prospective and retrospective scores are shown as overlapping (i.e., bars are not additive); gray bars indicate prospective scores, and striped bars indicate retrospective scores.
FIGURE 2.
FIGURE 2.
Change in categorical scores on the prospective and retrospective London Measure of Unplanned Pregnancy
See this image and copyright information in PMC

References

    1. Finer LB and Zolna MR, Declines in unintended pregnancy in the United States, 2008–2011, New England Journal of Medicine, 2016, 374(9):843–852, 10.1056/NEJMsa1506575. - DOI - PMC - PubMed
    1. Joyce T, Kaestner R and Korenman S, On the validity of retrospective assessments of pregnancy intention, Demography, 2002, 39(1):199–213, 10.1353/dem.2002.0006. - DOI - PubMed
    1. Guzzo KB and Hayford SR, Revisiting retrospective reporting of first-birth intendedness, Maternal and Child Health Journal, 2014, 18(9):2141–2147, 10.1007/s10995-014-1462-7. - DOI - PMC - PubMed
    1. Poole VL et al., Changes in intendedness during pregnancy in a high-risk multiparous population, Maternal and Child Health Journal, 2000, 4(3):179–182, 10.1023/A:1009523430135. - DOI - PubMed
    1. Koenig MA et al., Do current measurement approaches underestimate levels of unwanted childbearing? Evidence from rural India, Population Studies, 2006, 60(3):243–256, 10.1080/0032472060089581. - DOI - PubMed

Publication types