Rethinking the Pregnancy Planning Paradigm: Unintended Conceptions or Unrepresentative Concepts?

Approximately half of pregnancies occurring each year in the United States are unintended: They either occurred too soon or were not intended at any time. This commonly cited statistic is testament to the dominance of unintended pregnancy as a public health benchmark for measuring and improving women's reproductive health. In addition to its use as a public health metric, this timing-based definition of unintended pregnancy is reflected in pregnancy planning paradigms in clinical practice. According to these paradigms, women are expected to map out their intentions regarding whether and when to conceive, and to formulate specific plans to follow through on their intentions. What can researchers, public health practitioners and clinicians engaged in efforts to reduce unintended pregnancy and improve pregnancy outcomes do in response to these limitations? As a first step, we propose a conceptual model that integrates insights from recent research and provides a framework for informing women-centered approaches to preventing undesired pregnancies and improving outcomes