Unintended births among women in the United States: might some be “okay” instead?

Julia McQuillan, University of Nebraska-Lincoln
Stacy Tiemeyer, University of Nebraska-Lincoln
Michael S. Rendall, University of Maryland
Patricia Wonch Hill, University of Nebraska-Lincoln
Arthur Greil, Alfred University

Unintended births are important public health challenges that contribute to patterns of stratified reproduction in the United States. The standard measure of unintended births in the United States leaves no room for births that may appear to be unintended using a behavioral measure but were “okay either way” using an attitudinal measure. Guided by the Cognitive-Social Theory (CST) of fertility intentions, we use two large, nationally representative U.S. surveys to create a measure of birth intendedness that incorporates if women were trying to, trying not to, or “okay either way” about pregnancies. Comparisons of the attitudinal with the conventional measure shows that a substantial number of births that appear unintended and therefore problematic were actually unplanned but “okay”. We propose future analyses with cross-survey multiple imputation to assess if there are differences in psychosocial consequences from unintended compared to “okay” births. This research provides an important advance to efforts to improve understanding of truly problem unplanned pregnancies in the United States.