Pregnancy Intention and Contraceptive Use Among Low Income Women

Objective:  About half of all pregnancies in the United States are unintended. Unintended pregnancy often results from lack of contraceptive use, inconsistent use or incorrect use of contraceptive methods.  Unintended pregnancies are highest among poor and minority women and are associated with increased health risks for the mother and infant.  There is limited research on pregnancy intention and proper contraceptive use in low income and minority women. The purpose of this study was to describe pregnancy intention and proper use of contraceptive methods among low income, mostly minority women living in underserved neighborhoods in order to provide appropriate contraceptive education. 

Design: A descriptive study using baseline survey data from an ongoing randomized controlled trial, the Preconception Reproductive Knowledge Promotion Project (PREKNOP). Social Cognitive Theory and the Health Promotion Model were used as the guiding frameworks for the study. 

Setting: Three racially diverse, low income underserved urban neighborhoods in a Midwestern state. 

Sample: Participants were women of childbearing age who were enrolled in PREKNOP. Women who had completed the baseline survey and reported not planning on getting pregnant in the next six months (n = 61) were included in the analysis.  

Methods: A descriptive design was used where baseline survey data was collected. Questions were asked about: (1) participants' plans to get pregnant in the next six months, and (2) incorrect use of contraception during sexual intercourse within the past month. Univariate and bivariate analyses were conducted using STATA 11. 

Results: Approximately 50% of the women had a household income of less than $10,000; 65% were not married; 44% were Hispanic and approximately 38% were black. Women’s ages ranged from 18 to 51 years (Mean = 30 years). More than one third of the women (34%) reported having sex without using contraceptives properly. Most black (70%) and Hispanic (89%) women definitely did not want to become pregnant but were more likely to have sexual intercourse without proper use of contraception (43% black, 30% Hispanic).  

Conclusion/Implications for nursing practice: The findings suggest there is a need for education on the importance of using contraceptives properly to prevent unintended pregnancies, especially in low income black and Hispanic women. In addition, there is a need to investigate further reasons why some low income and minority women fail to use contraceptives properly and put themselves at risk for unwanted pregnancies. 

Keywords: Pregnancy intention, contraceptive use, unintended pregnancies, Preconception Reproductive Knowledge Promotion Project