The relationship between attitudes towards pregnancy and contraceptive continuation: Results from a longitudinal study of married women in India

PLoS One. 2020 Feb 25;15(2):e0229333. doi: 10.1371/journal.pone.0229333. eCollection 2020.

Abstract

To understand the relationship between pregnancy intentions and contraceptive use, a growing body of research has begun to examine various domains of women's attitudes towards pregnancy, acknowledging that these attitudes may contradict one another, and women may be ambivalent. This study examines pregnancy ambivalence and assesses the relationship between attitudes towards pregnancy and contraceptive continuation after nine months among a sample of women in Odisha and Haryana, India. Data come from a longitudinal study of married women age 15-49 who began using a modern reversible method of contraception at the time of study enrollment. To assess their cognitive attitudes (beliefs/knowledge) towards pregnancy, women were asked "how important is it you to avoid a pregnancy now?" To assess their affective attitudes (feelings/emotions), women were asked about their agreement with the statement: "If I found out I was pregnant in the next several weeks, I would be happy." A joint, 4-category measure combining these cognitive and affective attitudes towards pregnancy was created to measure concordance and ambivalence in attitudes towards pregnancy. Multivariate random-effects logistic regression models were employed to examine the relationship of these two measures with method-specific contraceptive continuation nine months later. Two models were conducted, one with the two attitude variables included independently and the second with the joint, 4-category measure included. Results showed that affective and cognitive attitudes were both significantly associated with continuation, but that there were no significant differences between those that were ambivalent and those whose attitudes were concordantly anti-pregnancy. This study suggests that attitudes towards pregnancy are multifaceted and both cognitive and affective attitudes towards pregnancy may play an important role in contraceptive use in India.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Contraception Behavior / psychology*
  • Contraception Behavior / statistics & numerical data*
  • Emotions
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • India
  • Intention
  • Longitudinal Studies
  • Marriage / statistics & numerical data*
  • Middle Aged
  • Pregnancy
  • Reproductive Behavior / psychology*
  • Young Adult

Grants and funding

The Evidence Project is made possible by the generous support of the American people through the United States Agency for International Development (USAID, https://www.usaid.gov/) under the terms of cooperative agreement no. AIDOAA-A-13-00087. The contents of this manuscript are the sole responsibility of the Evidence Project and Population Council and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.