Barrett, Geraldine;
(2002)
Developing a measure of unplanned pregnancy.
PhD thesis, London School of Hygiene & Tropical Medicine.
DOI: https://doi.org/10.17037/PUBS.00768479
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The incidence of unplanned pregnancy has long been used as an indicator of sexual and
reproductive health. However, because of dramatic social and demographic changes,
existing measures have become outdated and no satisfactory contemporary measure of this
status exists.
The aim of this study was to develop a measure of unplanned pregnancy which is valid,
reliable and appropriate in the context of contemporary demographic trends and social
mores, and can be used to establish population estimates of unplanned pregnancy. To
achieve this, a two-stage study design was employed: firstly, qualitative (inductive)
methods in order to delineate the construct of pregnancy planning/intention, and secondly
quantitative/psychometric methods to establish the means of measurement. At the
qualitative stage, 67 depth interviews were carried out with pregnant (continuing pregnancy
and abortion) and postnatal women. A conceptual model of pregnancy planning/intention
was developed from these data and used as the basis for item development in the
quantitative stage. Standard psychometric techniques were then employed to construct the
measure and test its reliability and validity (the qualitative findings informing judgements
about content and construct validity). Over 1000 women participated in the psychometric
field testing.
The result of the study is a six-item measure of unplanned pregnancy - the first
psychometric measure of this construct. Psychometric testing demonstrated the measure's
high reliability (Cronbach's alpha>0.90; test-retest reliability >0.90) and high face, content,
and construct validity. Women may occupy a range of positions in relation to pregnancy
planning, and these are represented in the measure by the spectrum of scores (zero to 12).
These scores provide a more sophisticated level of information about pregnancy planning
than was previously available. The measure is suitable for use with any pregnancy
regardless of outcome (i. e. birth, abortion, miscarriage) and is highly acceptable to women.