Unintended conceptions leading to wanted pregnancies - an integral perspective on pregnancy acceptance from a mixed-methods study in Germany.

ABSTRACT

OBJECTIVE: The study examines the differences within unintended first pregnancies in the life course of 20-44 year old women. Special attention is paid to response and pregnancy acceptance. Exploring determinants and dynamics, this study will contribute to a better understanding of 'happiness with an unintended pregnancy', as this is assumed to be indicative of fewer social problems and health risks. METHODS: Retrospective survey data on first unintended pregnancies carried to term (n = 2,306) were analysed using bivariate analysis. Qualitative analysis of the narrations of such pregnancies (n = 59) used the technique of comparing cases. Standardised and qualitative data are available for first intended or aborted pregnancies as comparison groups. All data were collected from the cross-sectional mixed-methods study of 'Women's Lives Family Planning in the Life Course' (2012-2018, Federal Centre of Health Education, Germany). RESULTS: Two-fifth of the unintended pregnancies carried to term were '(very) welcome'. Pregnancy intention, contraceptive use, living conditions, and attitudes had a significant impact. Five pathways of acceptance - sooner or later, more easy or hard to achieve - were identified in the qualitative data. CONCLUSION: Unintended pregnancies form a continuum ranging from readily accepted 'happy' pregnancies to pregnancies hard to accept. A new measure should also include postconception acceptance, besides preconception desire.