Patient characteristics associated with pregnancy ambivalence

Background: The objective of our study was to determine demographic characteristics, health and sexual behaviors, and psychological health associated with pregnancy ambivalence. We used a cross-sectional design for our study. Methods: A self-administered cross-sectional survey was conducted among nonpregnant women 16-40 years old from southeast Texas from July 2010 to August 2011. The survey included questions pertaining to demographics, pregnancy intentions, health behaviors, sexual behaviors, violence exposure, pregnancy coercion, and psychological behaviors. Multivariate logistic regression analyses were performed to determine differences between ambivalent and nonambivalent females. Results: Of the 1,388 women included in this analysis, 529 (38%) were ambivalent toward pregnancy. Ambivalent women were younger (p=0.03), had fewer children living at home (p<0.01), and were less likely to have been previously pregnant (p=0.01). Multivariate analysis showed that ambivalent women were more likely to smoke (p<0.01), sleep poorly (p=0.02), have had more sexual partners in the past month (p<0.01) and in their lifetime (p=0.01), not used contraception at last sex (p=0.01), be a victim of violence (p=0.01), and have experienced pregnancy coercion (p<0.01). In addition, these women exhibited higher scores on scales measuring depressive symptoms (p=0.01) and perceived stress (p<0.01). Conclusions: Women ambivalent toward pregnancy are not only less likely to use contraception but also more likely to have unhealthy behaviors and psychological risk factors. As this combination of characteristics may put a future pregnancy and child at risk, awareness about the possible consequences of pregnancy ambivalence needs to increase among the public and medical community. Providers need to focus efforts on screening for this patient population and preventive education through contraceptive counseling.