A blessing I can't afford: Factors underlying the paradox of happiness about unintended pregnancy. (May 2015)

• Record Type: Journal Article
• Authors: Aiken, Abigail R.A.; Dillaway, Chloe; Mevs-Korff, Natasha
• Is Part Of: Social science & medicine. Volume 132(2015)
• Page Start: 149
• Page End: 155
• Publication Date: 2015-05
• Subjects: United states -- Unintended pregnancy -- Pregnancy intentions -- Pregnancy feelings -- Ambivalence -- Qualitative research -- Latina -- Non-Hispanic white; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2015.03.038
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: An unresolved paradox in the measurement and interpretation of unintended pregnancy is that women frequently report feeling happy about pregnancies they also classify as unintended ( i.e. they have incongruent intentions and feelings). This study explores the underlying reasons why women profess such happiness and how these relate to their motivations to avoid pregnancy. Between September 2013 and February 2014, semi-structured in-depth interviews were conducted with 27 women (8 white, 19 Latina) selected from a longitudinal study measuring prospective pregnancy intentions and feelings among 403 women in Austin, Texas. Women were selected for interview on the basis of wanting no more children and consistently professing either happiness (n = 17) or unhappiness (n = 10) at the prospect of pregnancy. Interviews were coded and analyzed following the principles of grounded theory. We found that it is possible for women to express happiness at the idea of pregnancy while simultaneously earnestly trying to prevent conception. Happiness at the idea of an unintended pregnancy was explained as the result of deep and heartfelt feelings about children taking precedence over practical considerations, the perception that the psychosocial stress resulting from another child would be low, and the ability to rationalize an unintended pregnancy as the result of fate or God's plan. The major exception to the sincerity of professed happiness was that conveyed as a result of social pressure despite truly negative feelings, predominantly expressed by foreign-born Latina women. Overall, equating incongruence with ambivalence about avoiding conception may undermine the sincerity of women's intentions and their desires for highly-effective contraception. At the same time, unintended pregnancies that are greeted with happiness may have different implications for maternal and child health outcomes compared to pregnancies that are greeted with unhappiness. Identifying which unintended pregnancies are most likely to result in adverse outcomes is a target for future research. Highlights: Happiness about pregnancy may coexist with sincere intent to avoid conception. Intent to avoid conception is influenced by perceived negative economic consequence. Happiness aligns with the perception of low psychosocial and emotional stress. For some women, happiness is a response resulting from sociocultural obligation. True happiness about unintended pregnancy may have implications for health outcomes.