For years, a widely held assumption was that women of childbearing age fell neatly into two camps: those trying to have children, and those not trying to have children.
A new nationwide study suggests, however, that nearly a fourth of women consider themselves "OK either way" about getting pregnant - a wide swath of ambivalence that surprised researchers, and that could reshape how doctors approach many aspects of women's health care.
In a study of nearly 4,000 women ages 25 to 45 who are sexually active, about 71 percent said they were not trying to get pregnant, while 6 percent said they were. But nearly one in four, 23 percent, told researchers they were "OK either way" - they were neither trying to conceive, nor trying to prevent a pregnancy.
Among women who had no children, 60 percent said they were trying to not get pregnant, 14 percent were trying to get pregnant and 26 percent responded that they were "OK either way."
"This finding dramatically challenges the idea that women are always trying, one way or another, to either get pregnant or not get pregnant," said Julia McQuillan, professor of sociology at the University of Nebraska-Lincoln and the study's lead author. "It also shows that women who are OK either way should be assessed separately from women who are intentional about pregnancy."
The study also gave more accurate measures of women's pregnancy intentions, which are important for estimating unmet need for contraception, building more effective family planning programs, promoting infant health and helping maternal and infant well-being.
"If health-care providers only ask women if they are currently trying to get pregnant and women say no, then the assumption is that they are trying not to get pregnant," McQuillan said. "Clearly, many women are less intentional about pregnancy. Yet this group should be treated as if they will likely conceive and should therefore get recommendations such as ensuring adequate folic acid intake and limiting alcohol intake."
In addition, the study examined the attitudes and social pressures regarding pregnancy of the respondents, as well as their socioeconomic status.
Among the findings:
- Women who said they were OK either way reported the highest number when asked what the ideal number of children would be - 3.17 on average. They also tended to be slightly more religious than women who were either trying to get pregnant or not trying to get pregnant.
- Seventy-three percent of women who said they were OK either way said they would like a baby, compared with 34 percent of women who were not trying to get pregnant, and 95 percent of women who said they were trying to get pregnant.
- Those who were trying to get pregnant were more likely to report that having a child - or another child - was very important to their partner compared with women in the other two groups. Among women who had not yet had children and who said they were trying, 40 percent said it was important to their partner.
- Half of all women in the survey said their career was very important to them, while 45 percent said the same about having an adequate amount of leisure time. All three groups - women who were trying, women who weren't trying, and women who were OK either way - reported similar attitudes about work and leisure.
The study, which is forthcoming in Maternal and Child Health Journal, was authored by UNL's McQuillan along with Arthur L. Greil of Alfred University and Karina Shreffler of Oklahoma State University.