Wanted and Unwanted Pregnancies: A Fertility Decision‐Making Model

Criticisms are offered of the measures of family‐size desires and unwanted pregnancies most often employed in U.S. fertility surveys and KAP surveys. This paper offers a reconceptualization of attitudes toward pregnancy as a set of perceived advantages and disadvantages to childbearing and as a dynamic decision‐making process. A model is suggested which recognizes that attitudes toward pregnancy and fertility goals can differ in the preconception, pregnancy, and postnatal periods. It is hypothesized that within each stage, decision‐making on fertility goals and birth planning depends on the couple's perceived susceptibility to pregnancy, the perceived significant advantages and disadvantages to childbearing, the knowledge, availability, and acceptability of birth‐planning measures, and couple communication on these topics.