Maternal and Child Health Journal

, Volume 4, Issue 3, pp 155–162 | Cite as

The Intendedness of Pregnancy: A Concept in Transition

  • Lorraine V. Klerman


Background: Although interest in the intendedness or the planning status of a pregnancy goes back many centuries, it is only since 1941 that questions about these issues have been asked systematically in large-scale surveys. More recently, questions about intendedness have become standard features of the National Survey of Family Growth and of the Pregnancy Risk Assessment Monitoring System (PRAMS). Interest in and concern about the large numbers of unintended pregnancies reported in those surveys resulted in an Institute of Medicine report on the subject and the inclusion of a national health objective for increasing the proportion of pregnancies that are intended in Healthy People 2000 and Healthy People 2010. Needs: The terms, “intended,” “unintended,” “mistimed,” “wanted,” “unwanted,” and “planned” are often used without significant attention being paid to their meaning or how they are derived from survey questions. There is a particular need to distinguish between terms that define attitudes and those that define behaviors. In addition, research has revealed that women are often happy despite experiencing an unintended pregnancy and that contraceptive failures do not always result in a report of an unintended pregnancy. Objectives: Researchers have begun to ask questions about the meaning of the intendedness concept and its relationship to what women express as their feelings about pregnancies and births. This article, and this entire issue, is an attempt to make the reader aware of the current issues in this area and to suggest additional research that is needed to enable policy makers and program planners to design programs that will better assist couples in meeting their fertility goals.

Pregnancy intendedness fertility family planning 


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  1. 1.
    Bumpass L, Westoff CF. The “perfect contraceptive” population. Science 1970;169:1177–82.Google Scholar
  2. 2.
    Centers for Disease Control. Achievements in public health, 1900-1999: Family planning. MMWR 1999;48(47):1073–80.Google Scholar
  3. 3.
    U.S. Commission on Population Growth and the American Future. Population and the American future. Washington, DC: U.S. Government Printing Office, 1972:145.Google Scholar
  4. 4.
    Pratt WF, Horn MC. Wanted and unwanted childbearing: United States, 1973–82. Advance data from vital and health statistics,No. 108. Hyattsville, MD: National Center for Health Statistics, 1985.Google Scholar
  5. 5.
    Williams LB, Pratt WF. Wanted and unwanted childbearing in the United States: 1973–88. Advance data from vital and health statistics, No. 189. Hyattsville, MD: National Center for Health Statistics, 1990.Google Scholar
  6. 6.
    Abma J, Chandra A, Mosher W, Peterson L, Piccinino L. Fertility, family planning, and women's health: New data from the 1995 National Survey of Family Growth. Vital and health statistics 23(19). Hyattsville, MD: National Center for Health Statistics, 1997.Google Scholar
  7. 7.
    Henshaw SK. Unintended pregnancy in the United States. Fam Plann Perspect 1998;30:24–9, 46.Google Scholar
  8. 8.
    Brown SS, Eisenberg L, editors. The best intentions. Unintended pregnancy and the well-being of children and families. Washington, DC: National Academy Press, 1995.Google Scholar
  9. 9.
    Piccinino L, Peterson LS. Ambivalent attitudes and unintended pregnancy. In: Severy LJ, Miller WB, editors. Advances in population: Psychological perspectives, Vol. 3. London: Jessica Kingsley, 1999:227–49.Google Scholar
  10. 10.
    Klerman LV, Pulley L. Mistimed: Is it a significant concept? Paper presented at the Annual Meeting of the American Public Health Association, Chicago, Nov 1999.Google Scholar
  11. 11.
    London K, Peterson L, Piccinino L. The National Survey of Family Growth: Principal source of statistics on unintended pregnancy: Supplement to Chapter 2. In: Brown SS, Eisenberg L (editors). The best intentions. Unintended pregnancy and the well-being of children and families. Washington, DC: National Academy Press, 1995:286–95.Google Scholar
  12. 12.
    Miller WB, Pasta DJ. Early family environment, reproductive strategy, and contraceptive behavior: Testing a genetic hypothesis. Genetic influences on human fertility and sexuality. Theoretical and empirical contributions from the biological and behavioral sciences. Boston, MA: Kluwer Academic, 2000:183–230.Google Scholar
  13. 13.
    Rosenzweig MR, Wolpin KI. Maternal expectations and ex post realizations. Hum Resources 1993;28:205–27.Google Scholar
  14. 14.
    Moos M-K, Petersen R, Meadows K, Melvin CL, Spitz AM. Pregnant women's perspectives on intendedness of pregnancy. Women's Health Issues 1997;7:385–92.Google Scholar
  15. 15.
    Fischer RC, Stanford JB, Jameson P, DeWitt MJ. Exploring the concepts of intended, planned, and wanted pregnancy. J Fam Pract 1999;48:117–22.Google Scholar
  16. 16.
    Trussell J, Vaughan B., Stanford J. Are all contraceptive failures unintended pregnancies? Evidence from the 1995 National Survey of Family Growth. Fam Plann Perspect 1999; 31:246–47, 260.Google Scholar
  17. 17.
    Luker KC. A reminder that human behavior frequently refuses to conform to models created by researchers. Fam Plann Perspect 1999;31:248–49.Google Scholar
  18. 18.
    Sable MR. Pregnancy intentions may not be a useful measure for research on maternal and child health outcomes. Fam Plann Perspect 1999;31:249–50.Google Scholar
  19. 19.
    Zabin LS. Ambivalent feelings about parenthood may lead to inconsistent contraceptive use and pregnancy. Fam Plann Perspect 1999;31:250–51.Google Scholar
  20. 20.
    Bachrach CA, Newcomer S. Intended pregnancies and unintended pregnancies: Distinct categories or opposite ends of a continuum? Fam. Plann Perspect 1999;31:251–52.Google Scholar
  21. 21.
    Peterson LS, Mosher WD. Options for measuring unintended pregnancy in Cycle 6 of the National Survey of Family Growth. Fam Plann Perspect 1999;31:252–53.Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Lorraine V. Klerman
    • 1
  1. 1.Department of Maternal and Child Health, School of Public HealthUniversity of Alabama at BirminghamBirmingham

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