Study shows possible changes in pregnancy intentions after 12 months
Deciding when to start or grow a family is deeply personal and complex. When someone starts using contraception, it may seem obvious that they have no plans to become pregnant anytime soon. But a recently published study in PLUS ONE found that pregnancy intentions often only change within a 12-month period and that they vary according to partner status, household income and employment status.
When we think about whether or when someone wants to get pregnant, it is often assumed that there is a big life plan out there. However, we know that things change over the course of a lifetime. “
Claudia Geist, Head of Studies, Associate Professor and Associate Dean for Research, School for Cultural and Social Transformation, University of Utah
While some studies have identified potential factors that influence pregnancy decisions, few studies have looked at how those decisions can change or postpone over time and what personal circumstances are associated with the change. This study aimed to help providers be more flexible and respond to the needs of contraceptive customers. Understanding how much pregnancy intentions can change in just one year adds to the ongoing effort to de-stigmatize and support the common practices of switching and stopping different birth control methods.
Researchers followed a cohort of people participating in the HER Salt Lake Contraceptive Initiative, a prospective study that recruited participants from four family planning clinics in Salt Lake County, Utah, between September 2015 and March 2017. Eligible participants were between 18 and 45 years old and were either starting a new contraceptive or switching to a different method of contraception. In addition, they had to intend to prevent pregnancy for at least a year.
The analysis includes 2,825 participants who provided data on pregnancy intent both at the time of admission and at the 12-month follow-up examination. Participants were asked to answer the question, “What are your future pregnancy plans?” Answer options include:
- “I am currently trying to get pregnant” (only available with 12 month follow-up)
- “I want to get pregnant next year”
- “I want to get pregnant in the next 2-5 years, but not the next year”
- “I want to get pregnant in the next 5-10 years, but not before”
- “I’m not sure if or when I want to get pregnant” (only available at registration)
- I have no plans to become pregnant in the future
At the 12-month follow-up, the majority (79%) of participants retained their intention of timing pregnancy, while just under 20% reported a change. Of those who initially said they never wanted to conceive, 22% changed their minds over the course of a year. About 10% of the participants postponed their pregnancy to wish a pregnancy earlier than when they enrolled.
“I expected a change, but I didn’t expect as much change as we found,” said Geist. “We found that economic stability, including higher household incomes and / or full-time employment, seems to put people in a mood to consider pregnancy after previously declaring they never want to conceive . “
In addition to economic stability, the researchers looked at relationship status, sexual identity, and educational status and aspiration for education. By examining the relationships between changes in personal circumstances and changes in pregnancy intentions, the researchers hope to provide insight into clinicians who offer contraception.
“The rapid changes we found over 12 months are a strong reminder that healthcare providers often have to ask about their patients’ pregnancy wishes,” said Geist.
Geist, C., et al. (2021) Life Changing, Dynamic Plans: Prospective Assessment of 12 Month Changes in Pregnancy Timing Intentions and Personal Circumstances Using Data from HER Salt Lake. PLUS ONE. doi.org/10.1371/journal.pone.0257411.