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Member Research & Reports

Member Research & Reports

Columbia: Women With a Low Desire to Avoid Pregnancy Still Use Contraception

A study from Columbia Mailman School of Public Health and the University of California, San Francisco challenges assumptions that women with the highest preference against pregnancy use more effective contraceptive methods and women who might welcome pregnancy do not use contraception. Over half of the women who reported low preference to avoid pregnancy used a contraceptive method. The findings are in the journal Contraception.

Using the new 14-item Desire to Avoid Pregnancy (DAP) scale, researchers measured ranges of women’s preferences regarding a future pregnancy. The scale captures feelings about a potential pregnancy (within 3 months) and child (within a year), and allows for uncertainty in preferences; it also covers desires, emotions, and perceived consequences. This is the first study to test the measure of pregnancy preferences in an ethnically and geographically diverse sample.

The study showed that the odds of contraceptive use increased 64  for each increasing point on the DAP scale. Among women who had sex in the last 30 days, 21 percent reported not using any contraceptive method, 17 percent used IUDs, 31 percent used the Pill, and 20 percent used condoms. About 13 percent of women with a high preference to avoid pregnancy reported no use of contraception. Pregnancy preferences were not associated with the types of contraceptive methods women used.

“The finding tells us that women use contraception for all sorts of reasons, and contraceptive counseling shouldn’t be guided by pregnancy preferences alone, said Dr. Goleen Samari, Columbia University Mailman assistant professor of population and family health. “Even for women with strong preferences to avoid pregnancy, overemphasizing effectiveness in counseling may not lead to contraceptive uptake if other contraceptive features are not addressed.”

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