Abstract
Background
Unplanned pregnancy is associated with adverse consequences for women. Yet, these associations are typically based on women’s reports of pregnancy planning provided post birth. Therefore, women’s recollection of their pregnancy planning may be influenced by their adverse life circumstances following the pregnancy, artificially driving these associations.
Methods
To understand how post-birth experiences pattern women’s recall of their pregnancy planning, we conducted 17 in-depth interviews with young women (24–34 years old) enrolled in a longitudinal study in southern Malawi. Respondents who were pregnant at the time of data collection in 2015 answered close-ended questions about the planning of their pregnancy. During in-depth interviews three years later, women discussed their life experiences since the pregnancy and were re-asked a subset of the same questions about the planning of the 2015 pregnancy. We thematically coded respondents’ narratives about their relationships, parenting, and economic situations in the three years following their pregnancy and mapped these onto changes in women’s pre- and post-birth reports of their pregnancy planning.
Results
More than one-half of respondents recalled their pregnancy planning differently than they did pre-birth—some as more planned, others as less planned. The presence and direction of women’s changing reports were patterned by the quality of their relationship with the child’s father, the father’s involvement as a partner and parent, and their economic situation.
Conclusions
Women’s life experiences following a birth correspond with changes in their pregnancy planning reports, emphasizing the limitations of using retrospective measures to study the consequences of unplanned fertility.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Availability of data and material
Given the depth of information contained in the interviews for this study, the data have not been made publicly available to protect the confidentiality of respondents. The interview data that support the findings of this study are available from the corresponding author upon reasonable request. Details and data from Tsogolo la Thanzi are available at: https://doi.org/10.3886/ICPSR36863.v1.
Code Availability
The codebook, analytic memos, mapping of themes, and the analytic codes attached to interview quotations from NVIVO are available from the corresponding author upon reasonable request.
Notes
Note that the prompt for the timing question differed from the other two questions at both points in time, which could theoretically change the way that respondents recalled information. The questions of intendedness and desire prompted women to recall how they felt ‘just before the pregnancy’, whereas the timing question did not. Even so, these distinctions do not appear to pattern the extent to which women shifted their responses; instead, a comparable number of women revised their reports across each of the three domains.
References
Aiken, A. R. A., Dillaway, C., & Mevs-Korff, N. (2015). A blessing I can’t afford: Factors underlying the paradox of happiness about unintended pregnancy. Social Science & Medicine, 132, 149–155
Ameyaw, E. K., Budu, E., Sambah, F., Baatiema, L., Appiah, F., Seidu, A. A., & Ahinkorah, B. O. (2019). Prevalence and determinants of unintended pregnancy in sub-Saharan Africa: A multi-country analysis of demographic and health surveys. PloS One, 14(8), e0220970
Bankole, A., & Westoff, C. F. (1998). The consistency and validity of reproductive attitudes: evidence from Morocco. Journal of Biosocial Science, 30(04), 439–455
Barrett, G., Smith, S. C., & Wellings, K. (2004). Conceptualisation, development, and evaluation of a measure of unplanned pregnancy. Journal of Epidemiology & Community Health, 58(5), 426–433
Bearak, J., Popinchalk, A., Alkema, L., & Sedgh, G. (2018). Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: Estimates from a Bayesian hierarchical model. The Lancet Global Health, 6(4), e380–e389
Bertrand-Dansereau, A., & Clark, S. (2016). Pragmatic tradition or romantic aspiration? The causes of impulsive marriage and early divorce among women in rural Malawi. Demographic Research, 35, 47–80
Chin, B. (2010). Income, health, and well-being in rural Malawi. Demographic Research, 23(35), 997
Edin, K., & Kefalas, M. (2011). Promises I can keep: Why poor women put motherhood before marriage. University of California Press
Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Studies in Family Planning, 39(1), 18–38
Guzzo, K. B., & Hayford, S. R. (2014). Revisiting retrospective reporting of first-birth intendedness. Maternal and Child Health Journal, 18(9), 2141–2147
Guzzo, K. B., & Hayford, S. R. (2020). Pathways to parenthood in social and family contexts: Decade in review, 2020. Journal of Marriage and Family, 82(1), 117–144
Hall, J., Barrett, G., Copas, A., Phiri, T., Malata, A., & Stephenson, J. (2018). Reassessing pregnancy intention and its relation to maternal, perinatal and neonatal outcomes in a low-income setting: A cohort study. PloS One, 13(10), e0205487
Hall, K. S., Dalton, V. K., Zochowski, M., Johnson, T. R., & Harris, L. H. (2017). Stressful life events around the time of unplanned pregnancy and women’s health: Exploratory findings from a national sample. Maternal and Child Health Journal, 21(6), 1336–1348
Haug, R., & Westengen, O. T. (2020). Policy and Action for Food and Climate Uncertainties in Malawi. Climate Impacts on Agricultural and Natural Resource Sustainability in Africa (pp. 331–345). Springer
National Statistical Office (NSO) [Malawi] and ICF. (2017). Malawi Demographic Health Survey 2015–2016. Malawi and Rockville, Maryland, USA: Zomba
Johnson, J. A. (2017). After the mines: The changing social and economic landscape of Malawi–South Africa migration. Review of African Political Economy, 44(152), 237–251
Joyce, T., Kaestner, R., & Korenman, S. (2002). On the validity of retrospective assessments of pregnancy intention. Demography, 39(1), 199–213
Kavanaugh, M. L., Kost, K., Frohwirth, L., Maddow-Zimet, I., & Gor, V. (2017). Parents’ experience of unintended childbearing: A qualitative study of factors that mitigate or exacerbate effects. Social Science & Medicine, 174, 133–141
Koenig, M. A., Acharya, R., Singh, S., & Roy, T. K. (2006). Do current measurement approaches underestimate levels of unwanted childbearing? Evidence from rural India. Population Studies, 60(3), 243–256
Kost, K., & Zolna, M. (2019). Challenging unintended pregnancy as an indicator of reproductive autonomy: A response. Contraception, 100(1), 5–9
Lewinsohn, R., Crankshaw, T., Tomlinson, M., Gibbs, A., Butler, L., & Smit, J. (2018). This baby came up and then he said,“I give up!”: The interplay between unintended pregnancy, sexual partnership dynamics and social support and the impact on women’s well-being in KwaZulu-Natal, South Africa. Midwifery, 62, 29–35
Rackin, H. M., & Morgan, S. P. (2018). Prospective versus retrospective measurement of unwanted fertility: Strengths, weaknesses, and inconsistencies assessed for a cohort of US women. Demographic Research, 39, 61–94
Rosenzweig, M. R., & Wolpin, K. I. (1993). Maternal expectations and ex post rationalizations: The usefulness of survey information on the wantedness of children. Journal of Human Resources,205–229
Smith-Greenaway, E., & Sennott, C. (2016). Death and desirability: Retrospective reporting of unintended pregnancy after a child’s death. Demography, 53(3), 805–834
Wellings, K., Jones, K. G., Mercer, C. H., Tanton, C., Clifton, S., Datta, J., & Macdowall, W. (2013). The prevalence of unplanned pregnancy and associated factors in Britain: Rindings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). The Lancet, 382(9907), 1807–1816
White, A. L., Mann, E. S., & Larkan, F. (2018). ‘You just have to learn to keep moving on’: young women’s experiences with unplanned pregnancy in the Cook Islands. Culture, Health & Sexuality, 20(7), 731–745
Williams, L., & Abma, J. (2000). Birth wantedness reports: A look forward and a look back. Social Biology, 47(3–4), 147–163
Yeatman, S., & Sennott, C. (2015). The Sensitivity of Measures of Unwanted and Unintended Pregnancy Using Retrospective and Prospective Reporting: Evidence from Malawi. Maternal and Child Health Journal, 19(7), 1593-1600
Yeatman, S., Chilungo, A., Lungu, S., Namadingo, H., & Trinitapoli, J. (2019). Tsogolo la Thanzi: A longitudinal study of young adults living in Malawi’s HIV epidemic. Studies in Family Planning, 50(1), 71–84
Yeatman, S., & Smith-Greenaway, E. (2018). Birth Planning and Women’s and Men’s Health in Malawi. Studies in Family Planning, 49(3), 213–235
Acknowledgements
We are grateful to the women who shared their stories and life experiences with us. We also thank Leah Pauline who participated in the coding of these interviews.
Funding
This research uses data from Tsogolo la Thanzi, a research project designed by Jenny Trinitapoli and Sara Yeatman and funded by grants R01-HD058366 and R01‐HD077873 from the National Institute of Child Health and Human Development. The research was also supported by the population center at the University of Colorado (CUPC; P2C HD066613), grant R03-HD 097360 from the National Institute of Child Health and Human Development, and a gift from Facebook.
Author information
Authors and Affiliations
Contributions
Emily Smith-Greenaway and Sara Yeatman conceptualized the study, and, along with Synab Njerenga, designed the interview tools. Emily Smith-Greenaway and Synab Njerenga led the data collection process. Stephanie Chamberlin, Emily Smith-Greenaway, and Sara Yeatman conducted the analyses for this study. Stephanie Chamberlin led the manuscript development in collaboration with all authors who were involved in critically reviewing and editing this paper and approved the final draft.
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts of interest.
Ethics Approval
This study followed all appropriate ethical standards and was approved as part of the Tsogolo la Thanzi data collection by the Institutional Review Board (IRB) at the University of Chicago, as well as the national IRB for health research in Malawi, the National Health Research Council.
Consent to Participate
All study participants were provided with information about the purpose of the study, risks and benefits of the study, their voluntary participation, their right to stop the interview or withdraw from the study at any time and/or not to answer any questions, and the nature of the interview. Verbal consent was obtained from all respondents.
Consent for Publication
Not applicable.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chamberlin, S., Njerenga, S., Smith-Greenaway, E. et al. Women’s Life Experiences and Shifting Reports of Pregnancy Planning. Matern Child Health J 26, 1719–1726 (2022). https://doi.org/10.1007/s10995-022-03447-w
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-022-03447-w