Measuring pregnancy planning: A psychometric evaluation and comparison of two scales

J Adv Nurs. 2017 Nov;73(11):2765-2775. doi: 10.1111/jan.13364. Epub 2017 Jul 11.


Aims: To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale.

Background: The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level.

Design: Cross-sectional design.

Methods: In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation.

Results: All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability.

Conclusion: The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.

Keywords: antenatal care; confirmatory factor analysis; instrument development; midwives; nursing; pregnancy planning; psychometrics; reproducibility of results; reproductive health; unplanned pregnancy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Family Planning Services*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy, Unplanned
  • Psychometrics*
  • Surveys and Questionnaires
  • Sweden