Almost half of all pregnancies in the United States are unintended. These pregnancies can result in worse health outcomes for both women and their babies, due to potentially poor health prior to pregnancy and delays in obtaining prenatal care and making changes such as quitting smoking.
For a new, small study published in the Journal of Midwifery & Women’s Health, researchers spoke to women in three Michigan neighborhoods characterized as low-income, urban, culturally/ethnically diverse, and medically underserved — basically the type of neighborhood where unintended pregnancy rates are higher than average.
The researchers conducted six focus groups with a total of 41 women, ages 18 to 44 years, who were either pregnant or had been pregnant within the last three years. They sought the women’s input on three important questions:
- What could be done to encourage women to recognize their pregnancies early (within six weeks from their last menstrual period)?
- What should be the primary action to help women recognize their pregnancy early?
- What are the most important things that could help women to be sure of their pregnancies early?
The women identified a few main themes and provided numerous suggestions for addressing these issues, including:
- Promoting knowledge of reproductive changes in the body: Teach women about their female reproductive system and its cyclic changes, such as timing of ovulation, number of days in a cycle, and how to keep a menstrual calendar.
- Promoting early testing or confirmation of pregnancy: Assist women to know symptoms of pregnancy and to recognize their pregnancies early through the use of home pregnancy test kits or going to the doctor or clinic to confirm a pregnancy.
- Providing informational support: Provide a list of locally available pregnancy-related resources, such as clinics, prenatal classes, and educational sessions on women’s health.
- Providing emotional support: Have a friend to talk with or have nurses, midwives, and other health professionals to go to for guidance during the preconception and prenatal periods.
While small, this type of study — and the prison health study we wrote about earlier in the week — are very much needed, because they ask the people most affected about their needs and experiences.
In this instance, community health workers (residents from each neighborhood employed to promote health and access to health care) were already familiar figures in these neighborhoods, and a participatory research model was employed that was sensitive to the residents’ needs. For example, the researchers provided transportation *and* childcare so the women could participate.
In their “implications for practice” section, the study’s authors urge future research along the themes the women identified. Teaching women about the menstrual cycle, along with the signs and symptoms of ovulation and pregnancy, can help women to take more control over their health and their lives.
As one woman in the study said, “I guess just being taught more in an individual sense of how to recognize things in your own body instead of being lumped, that it would be the standard, like I said earlier, 28-32 days. I mean, if women could really have that sense of, like, knowing how they are, it’s much easier to plan around that, or at least to be aware.”
The researchers also urge systemic approaches to reducing unintended pregnancy and the associated health effects, including comprehensive reproductive education (starting even before adolescence), policies that promote access to pregnancy-related resources and facilities, and access to early pregnancy testing.