Finding meaning in unintended pregnancy and motherhood: Exploring decision-making processes and the importance of prenatal attachment for postnatal mother-infant bonding and postpartum depressive symptomatology

The aim of this mixed-methods dissertation was to examine the experience of unintended pregnancy and motherhood; including relevant processes and outcomes associated with the event, in relation to pregnancy continuation vs. termination, prenatal attachment, postnatal mother-infant bonding, and levels of postpartum depressive symptomatology in a state that has notable issues with poor mother-infant outcomes. Two different data sets were used and both qualitative and quantitative data analysis were employed to provide a comprehensive overview of the experience of unintended motherhood. The qualitative portion of this dissertation sought to examine the meanings women attribute to their unintended pregnancies and how narratives differ for women who chose to continue their pregnancies versus those who opted for termination in a sample of women with at least some college education. The quantitative portions of this dissertation aimed to examine what happens after a woman decides to continue her unintended pregnancy as she may be faced with additional challenges, such as disrupted mother-infant bonding and a greater risk of postpartum depressive symptoms. Pregnancy and the postpartum period were investigated in union with one another to better understand the operation and development of constructs such as prenatal attachment, postnatal mother-infant bonding, and postpartum depression during the transition to motherhood; with special focus on multiple dimensions of pregnancy intentions (wantedness, timing, and happiness). Qualitative findings highlight the importance of cognitive appraisal of contextual factors, particularly that of perceived support, personality/attitudinal characteristics, and ability to visualize the future (ideal life vs. life as a mother), in the decisions women make regarding their unwanted or mistimed pregnancies. Quantitative findings indicate that pregnancy intentions are significantly associated with prenatal attachment, which is significantly associated with postnatal mother-infant bonding, as such we can infer that pregnancy intentions impact postnatal mother-infant bonding through prenatal attachment. Additionally, wanting a baby and higher levels of happiness about expecting a baby were predictive of lower levels of postpartum depressive symptoms and higher levels of depressive symptoms were predicted by mistimed pregnancy. Higher levels of prenatal attachment were also predictive of lesser postpartum depressive symptomatology; which was found to have a mediation effect on pregnancy wantedness and timing, suggesting a potential protective quality

Partner congruence on fertility intentions and values: Implications for birth outcomes

In heterosexual couples, both partners’ intentions to have a baby (or not) are associated with the likelihood of a subsequent birth, yet most studies only measure women’s intentions. Therefore, little is known about the potential association of couple agreement or disagreement on intentions or on such values as importance of parenthood, career, and leisure and the implications for childbearing. The goal of this article is to assess whether couple-level agreement or disagreement in fertility intentions and values are associated with the likelihood of a subsequent birth. Guided by the Theory of Conjunctural Action, we use couple data from two waves of the U.S. National Survey of Fertility Barriers for our analysis. Based on logistic regression analysis, we find that if either partner intends a child, the odds of having a baby within 3 years are higher than if neither partner intends and that the odds are substantially higher when both partners intend a child. Couples in whom both partners and couples in whom only the woman has a high value on career success are less likely to have a baby. Our findings suggest that agreement on fertility intentions is associated with considerably higher birth probability and that values about life domains matter as well. Couple disagreement on intentions and values are related in different ways to birth outcomes depending on which partner holds which value as important. Using data from both partners allows us to examine the patterns of couple agreement, values, and gendered influences related to birth outcomes

Infertility and fertility intentions, desires, and outcomes among US women

BACKGROUND AND OBJECTIVE Little is known about how the experience of infertility or identification as someone with infertility shapes women’s fertility intentions, desires, or birth outcomes. The purpose of this paper is to help fill this gap in knowledge for fertility-intentions research. METHODS Using data from the National Survey of Fertility Barriers (NSFB), we use linear and logistic regression methods to assess how infertility and parity statuses are associated with fertility intentions and desires, as well as how statuses at one point in time predict birth three years later. RESULTS We find that infertility is associated with lower fertility intentions. Women who have experienced infertility and/or identify as a person with infertility, however, express greater desires to have a baby and a higher ideal number of children. Women who meet the medical criteria for infertility are less likely than fecund women to give birth, despite greater desires

Tough Decisions: Exploring Women's Decisions Following Unintended Pregnancies

Approximately half of all pregnancies are unintended. Many (58%) are carried to term, but a substantial proportion of unintended pregnancies are terminated. In this paper, we draw from qualitative interviews with 33 women who experienced an unintended pregnancy in an effort to examine the meanings women attributed to their pregnancies and to explore how narratives differ for women who chose to continue their pregnancies vs. those who opted for termination. Findings from grounded-theory analysis highlight the importance of cognitive appraisal, ability to navigate resources, availability of support, individual values and beliefs, and situational context in women's decisions to terminate or continue with an unintended pregnancy

Partner congruence on fertility intentions and values: Implications for birth outcomes

In heterosexual couples, both partners’ intentions to have a baby (or not) are associated with the likelihood of a subsequent birth, yet most studies only measure women’s intentions. Therefore, little is known about the potential association of couple agreement or disagreement on intentions or on such values as importance of parenthood, career, and leisure and the implications for childbearing. The goal of this article is to assess whether couple-level agreement or disagreement in fertility intentions and values are associated with the likelihood of a subsequent birth. Guided by the Theory of Conjunctural Action, we use couple data from two waves of the U.S. National Survey of Fertility Barriers for our analysis. Based on logistic regression analysis, we find that if either partner intends a child, the odds of having a baby within 3 years are higher than if neither partner intends and that the odds are substantially higher when both partners intend a child. Couples in whom both partners and couples in whom only the woman has a high value on career success are less likely to have a baby. Our findings suggest that agreement on fertility intentions is associated with considerably higher birth probability and that values about life domains matter as well. Couple disagreement on intentions and values are related in different ways to birth outcomes depending on which partner holds which value as important. Using data from both partners allows us to examine the patterns of couple agreement, values, and gendered influences related to birth outcomes

Infertility and fertility intentions, desires, and outcomes among US women

BACKGROUND AND OBJECTIVE Little is known about how the experience of infertility or identification as someone with infertility shapes women’s fertility intentions, desires, or birth outcomes. The purpose of this paper is to help fill this gap in knowledge for fertility-intentions research. METHODS Using data from the National Survey of Fertility Barriers (NSFB), we use linear and logistic regression methods to assess how infertility and parity statuses are associated with fertility intentions and desires, as well as how statuses at one point in time predict birth three years later. RESULTS We find that infertility is associated with lower fertility intentions. Women who have experienced infertility and/or identify as a person with infertility, however, express greater desires to have a baby and a higher ideal number of children. Women who meet the medical criteria for infertility are less likely than fecund women to give birth, despite greater desires

Infertility and fertility intentions, desires, and outcomes among US women

Objective: Little is known about how the experience of infertility or identification as someone with infertility shapes women's fertility intentions, desires, or birth outcomes. The purpose of this paper is to help fill this gap in knowledge for fertility-intentions research. Methods: Using data from the National Survey of Fertility Barriers (NSFB), we use linear and logistic regression methods to assess how infertility and parity statuses are associated with fertility intentions and desires, as well as how statuses at one point in time predict birth three years later. Results: We find that infertility is associated with lower fertility intentions. Women who have experienced infertility and/or identify as a person with infertility, however, express greater desires to have a baby and a higher ideal number of children. Women who meet the medical criteria for infertility are less likely than fecund women to give birth, despite greater desires. Conclusions: These findings have important theoretical implications for our understanding of the meaning of fertility intentions for those who think their ability to achieve their intentions is uncertain, as well as for empirical research on fertility