Pregnancy intentionality in relation to non-planning impulsivity

Abstract

Background: Half of US pregnancies are unintended. Understanding risk factors is important for reducing unintended pregnancy rates.

Aim: We examined a novel risk factor for unintended pregnancies, impulsivity. We hypothesized that non-planning impulsivity, but not motor or attentional impulsivity, would be related to pregnancy intention.

Methods: Pregnant women (N = 116) completed self-report measures during their second or third trimester. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS-15); subscales measured motor, attentional and non-planning impulsivity (subscale range: 5–20). On each subscale, high impulsivity was indicated by a score of ≥11. Pregnancy intention was assessed by asking women whether they were trying to become pregnant at the time of conception (yes or no). Crude and multivariable-adjusted logistic regression models estimated the cross-sectional association between impulsivity and unplanned pregnancy.

Results: Thirty-four percent of women reported that their current pregnancy was unplanned, and 32% had high non-planning impulsivity. Fifty-one percent of women with high non-planning impulsivity reported an unplanned pregnancy versus 25% of women with low impulsivity. Women with high non-planning impulsivity had 3.53 times the odds of unplanned pregnancy compared to women with low non-planning impulsivity (adjusted OR =3.53, 95% CI: 1.23–10.14). Neither motor (adjusted OR =0.55, 95% CI: 0.10–2.90) nor attentional (adjusted OR =0.84, 95% CI: 0.25–2.84) impulsivity were related to pregnancy intentionality.

Conclusions: High non-planning impulsivity may be a risk factor for unplanned pregnancy. Further research should explore whether increasing the use of long-acting reversible contraceptives or integrating if-then planning into contraceptive counseling among women with higher non-planning impulsivity can lower unplanned pregnancy rates.

Keywords:

• Impulsivity
• long-active reversible contraceptives
• pregnancy intention

Current knowledge on the subject

• Half of US pregnancies are unintended

• Many unintended pregnancies are due to lack of access to or use of contraception or contraceptive failure

• Little is known about behavioral factors associated with unplanned pregnancy, and no previous studies have used quantitative methods to examine trait impulsivity in relation to pregnancy intention

What this study adds

• We examined pregnancy intentionality in relation to impulsivity among pregnant women using a quantitative measure of impulsivity

• We found that pregnant women with high non-planning impulsivity were significantly more likely to report that the current pregnancy was unplanned

• Long-acting reversible contraceptives are likely to be appropriate contraceptive choices to prevent unplanned pregnancy in women with high non-planning impulsivity