Forming fragile families: Was the baby planned, unplanned, or in between?

THE BIRTH control pill prevents pregnancy 95 to 99 percent of the time, Depo-Provera and the patch are 99 percent effective, the IUD works 98 percent of the time, and condoms are 86 to 98 percent successful if used correctly (Federal Drug Administration 2005). Yet more than onethird of all recent pregnancies in the United States are unintended (Chandra et al. 2005; Henshaw 1998). Nonmarital conceptions are most likely to occur among those least able to bear the economic cost of children (Chandra et al. 2005). Why is this? Are some explicitly planned, or at least ambivalently desired in a way that quantitative studies are not capturing? Is it a lack of sex education? Are people just not thinking about the possibility of pregnancy when they have sex? Are the men indifferent, thinking they needn't be around if their sexual partner has a baby? Are contraceptives too hard to get or too expensive? Is birth control too much of a hassle?. Right after the birth of their child, interviewers for the Time, Love, and Cash among Couples with Children study asked both the mothers and fathers whether the baby was planned, unplanned, or in between. We asked similar questions for subsequent births. In the fourth wave of interviews, we asked parents in detail about the circumstances surrounding the conception of all their children, including those conceived with other partners. We also asked about miscarriages and abortions and the circumstances surrounding these conceptions. Our analysis here is based on fertility histories of seventy-six parents who were unmarried when our study began and remained in the study across the four waves (78 percent of the baseline sample of ninety-six unmarried parents). We look at the 202 pregnancies of these seventy-six parents that had occurred outside of marriage. We conduct both qualitative and quantitative analyses of these data, and propose a reconceptualization of the propensity to conceive, involving two continua. At either end of the first continuum are strong negative intentionality and strong positive intentionality with regard to pregnancy. The second continuum is efficacy, the ability or inclination to organize the complex set of behaviors required to avoid pregnancy, such as making and keeping doctor's appointments to get the pill or patch, going to the drug store to fill a prescription or purchase over-the-counter contraceptives, and using the pill or condoms regularly. We identify five primary types of conceptions: planned, between planned and unplanned, inconsistent contraception, unplanned conceptions to non-contraceptors, and contraceptive failures.1 We identify a sixth category as well: pregnancies to those who believe they were sterile. Because the last category is very small, we do not discuss it, though we include it in our tables. Categories vary along both continua. Intention and behavior are at least somewhat aligned in four of the five main types of pregnancy, and, in these, the stronger the intention (either to conceive or to avoid conception), the more behavior falls into line (Andrews and Kandel 1979). This is consistent with psychologists' theory of reasoned action (Fishbein and Ajzen 1975) as well as economic theory. A strong predictor of the strength of intention is the seriousness of the couple relationship. However, there is one category-capturing a quarter of the pregnancies-in which behavior and intentions are not aligned. In these cases, there was no expressed desire to conceive, yet no contraception was used, even inconsistently. Not surprisingly, those reporting pregnancies of this kind were the most unhappy when they learned of the pregnancy, and the most likely to consider abortion. It is for this group that the concept of efficacy seems especially relevant (Musick, England, and Edgington 2005; Rainwater 1960; Brown and Eisenberg 1995).