Moving Beyond Unintended Pregnancy
Development of a Person‐Centered Conceptual Framework and Measure of Self‐Assessed Pregnancy Acceptability
Bibliographic Data
Sexual and reproductive health (SRH) research, programming, policy, and services have long relied on the narrow paradigm of “pregnancy intendedness and planning,” including its “unintended pregnancy” measure. This framework is limited and problematic, overlooking diverse perspectives on pregnancy, structural factors, and non‐parenting outcomes such as abortion and adoption. In response, we developed the Self‐Assessed Pregnancy Acceptability (SAPA) framework and measure as a person‐centered alternative. The SAPA framework was developed by centering the lived experiences of pregnant people in Texas, Tennessee, Pennsylvania, and California through baseline interviews shortly after pregnancy confirmation (N = 31) and follow‐up post‐pregnancy interviews (N = 14). Development was also informed by a diverse Expert Panel (N = 19) including reproductive justice leaders, reproductive measurement experts, and lived experience experts. Using cognitive interviews (N = 13), we refined an 11‐item measure of SAPA that is currently being validated in a nationwide sample of nearly 600 people in early pregnancy. Following validation, SAPA could be integrated into national and state‐level epidemiological surveillance surveys such as the National Survey of Family Growth and the Pregnancy Risk Assessment Monitoring System. This novel framework and measure offer an alternative to unintended pregnancy and contribute to an ecosystem of person‐centered, rigorously developed measures of SRH equity
Abortion · Conceptual framework · Economic Justice · Fertility · Population · Pregnancy · Reproductive health · The Conceptual Framework · Unintended pregnancy · Adolescent Sexual and Reproductive Health · Reproductive Health and Contraception · Reproductive Health and Technologies
Challenging unintended pregnancy as an indicator of reproductive autonomy
“It just happens”
The Measurement and Meaning of Unintended Pregnancy
Defining Dimensions of Pregnancy Intendedness
I Just Don't Know”
It's Not Planned, But Is It Okay? The Acceptability of Unplanned Pregnancy Among Young People
The Effects of Unintended Pregnancy on Infant, Child, and Parental Health
Rethinking the Pregnancy Planning Paradigm
Social Norms and Stigma Regarding Unintended Pregnancy and Pregnancy Decisions
Comparing Prospective and Retrospective Reports of Pregnancy Intention in a Longitudinal Cohort of U.S. Women
Intimate Relationship Dynamics and Changing Desire for Pregnancy Among Young Women
Conceptualisation, development, and evaluation of a measure of unplanned pregnancy
Psychometric Evaluation of an Instrument to Measure Prospective Pregnancy Preferences
Framing Experience
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