For some individuals, the perceived emotional and sexual benefits of becoming pregnant may outweigh their goal of preventing a pregnancy through contraceptive use, even when the pregnancy is not wholly intended, according to “Pleasure, Prophylaxis and Procreation: A Qualitative Analysis of Intermittent Contraceptive Use and Unintended Pregnancy,” by Jenny A. Higgins et al., published in the September 2008 issue of Perspectives on Sexual and Reproductive Health.

Recent studies have found that women’s ambivalence toward pregnancy can result in inconsistent or nonuse of contraceptives. In a new analysis of qualitative interviews with 36 men and women, half of whom had experienced at least one unintended pregnancy, the study authors explore the relationships between pleasure, pregnancy ambivalence and contraceptive use, and identify three categories of pleasure related to ambivalence that are associated with the misuse or nonuse of contraceptive methods.

The first category is defined as active eroticization of pregnancy risk, in which participants described increased sexual arousal at the prospect of a pregnancy, even when they did not actually desire a child or the responsibilities of parenthood. In the second, defined as passive romanticization of procreation, respondents, usually in the context of a long-term relationship, flirted with the romantic fantasy of pregnancy with a particular partner. The third category, escapist pleasures, was most common among socially disadvantaged women. For these women, even when they were not planning or hoping for a baby, respondents embraced unintended pregnancy as a way to foster a relationship, cultivate a new family and potentially escape the hardships of their lives. All of these scenarios resulted in decreased contraceptive use.

Because ambivalence about pregnancy seems to play such a prominent role in women’s consistent use of contraceptives and their ability to prevent unintended pregnancies, the authors suggest that future behavioral studies consider how flirting with the idea of procreation may decrease the motivation to use contraceptives, and that more research be done around developing reasonable programmatic and clinical guidelines that address this ambivalence directly.

Also in this issue:

Prior Pill Experiences and Current Continuation Among Pill Restarters, by Debra Kalmuss et al.;

Recent Evaluations of the Peer-Led Approach in Adolescent Sexual Health Education: A Systematic Review, by Caron R. Kim and Caroline Free;

Timing of Sexual Debut and Initiation of Postsecondary Education by Early Adulthood, by Aubrey L. Spriggs and Carolyn Tucker Halpern;

Implementing an Advance Emergency Contraception Policy: What Happens in the Real World? by Paul G. Whittaker et al.; and

Associations Between Low-Income Women’s Relationship Characteristics and Their Contraceptive Use, by Ellen K. Wilson and Helen P. Koo.