Understanding pregnancy intention is an important public health measure; it can be used to identify and monitor trends in reproductive health behaviours, to inform areas of need, and to design health care services both for pregnancy prevention and pregnancy preparation.

A recent paper (1) examined the range of tools available for measuring pregnancy intention, the timing of the use of tools in relation to pregnancy (before pregnancy, during pregnancy, or after the pregnancy has ended), their interpretation, and use for policy and practice. Traditionally, data on pregnancy intention has only really been collected during research or public health surveys, with little use of pregnancy intention measures in clinical services. Work from the P3 study and others is starting to change this.

Tools that measure pregnancy intention in a pregnancy that has already occurred are more advanced, with tools that have been in use for decades, and are known to work well, such as the London Measure of Unplanned Pregnancy (LMUP). The routine use of the LMUP is currently being piloted in antenatal care in the UK as part of the P3 Study. If used nationally, this would give us a way of knowing how common unplanned pregnancy is in the UK. This information can then be used to further the case for investment in contraception and preconception health services. On an individual level, the use of the LMUP can help midwives get to know the woman’s circumstances better allowing the midwife to personalise her care.

There has been less research conducted on how to measure what people are thinking with regard to a pregnancy in the future. The Desire to Avoid Pregnancy Scale (DAP) only become available in 2019 and was found to work well in the UK as part of the P3 Study (read more here). This will be a valuable research tool but is too long (14 questions) for a GP to ask in a consultation. For this, a shorter version of the DAP would be useful (read more here) and could be used by health care professionals to identify who needs contraception advice, preconception advice or both.

Overall, tools that measure pregnancy intention, if used routinely, could inform targeted delivery of services for a person before, during, and after pregnancy. This knowledge could also inform strategies at an individual, community, and population level as an indicator of access to sexual and reproductive health information and knowledge and uptake of preconception health.

1. Dorney E, Barrett G, Hall J, Black KI. Measures of Pregnancy Intention: Why Use Them and What Do They Tell Us? Seminars in Reproductive Medicine. 2022;40(5-06).