Unintended conceptions leading to wanted pregnancies – an integral perspective on pregnancy acceptance from a mixed-methods study in Germany

Abstract

Objective

The study examines the differences within unintended first pregnancies in the life course of 20–44 year old women. Special attention is paid to response and pregnancy acceptance. Exploring determinants and dynamics, this study will contribute to a better understanding of ‘happiness with an unintended pregnancy’, as this is assumed to be indicative of fewer social problems and health risks.

Methods

Retrospective survey data on first unintended pregnancies carried to term (n = 2,306) were analysed using bivariate analysis. Qualitative analysis of the narrations of such pregnancies (n = 59) used the technique of comparing cases. Standardised and qualitative data are available for first intended or aborted pregnancies as comparison groups. All data were collected from the cross-sectional mixed-methods study of ‘Women’s Lives: Family Planning in the Life Course’ (2012–2018, Federal Centre of Health Education, Germany).

Results

Two-fifth of the unintended pregnancies carried to term were ‘(very) welcome’. Pregnancy intention, contraceptive use, living conditions, and attitudes had a significant impact. Five pathways of acceptance – sooner or later, more easy or hard to achieve – were identified in the qualitative data.

Conclusion

Unintended pregnancies form a continuum ranging from readily accepted ‘happy’ pregnancies to pregnancies hard to accept. A new measure should also include postconception acceptance, besides preconception desire.

摘要

目标：这项研究调查了20-44岁女性生命过程中首次意外怀孕的差异。特别关注女性的反应和妊娠接受度。探索决定因素和动力, 这项研究将有助于更好地理解“意外怀孕的幸福”, 因为这被认为是较少的社会问题和健康风险的指示。

方法：对2306例足月首次意外妊娠的回顾性调查数据进行双变量分析。对这种妊娠叙述的定性分析(n =59)使用了病例对比。标准化和定性数据可用于首次妊娠或流产作为比较组。所有数据均来自“女性生活:生命历程中的计划生育”(2012–2018, 德国联邦健康教育中心)的横断面混合方法研究。

结果：五分之二的意外怀孕是“非常受欢迎的”。怀孕意向、避孕药的使用、生活条件和态度都有显著影响。定性数据中确定了五种接受途径——早或晚, 更容易或更难实现。

结论：意外怀孕形成了一个连续范围, 从容易接受的“幸福”怀孕到难以接受的怀孕。除了孕前愿望之外, 新的衡量标准还应该包括孕后接受度。

Keywords:

• unintended pregnancy
• pregnancy intention
• pregnancy acceptance
• pregnancy happiness
• mixed methods
• qualitative research

Acknowledgment

We thank Julika Clausen for her support of the SoFFI-Team. The survey was conducted by KANTAR, Bielefeld.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Two narrations deal with pregnancies that were diagnosed too late for an abortion. The new evaluation and the emergence of acceptance follow the same pattern, focusing on how to cope with adverse living conditions.

Additional information

Funding

The research was funded by Federal Centre for Health Education, Cologne.