Ambivalence towards Pregnancy: Is It a Singular or Multifaceted Concept?

250 words) CONTEXT: Ambivalence towards pregnancy is a widespread phenomenon with potential importance for understanding contraceptive behavior and measuring unintended pregnancy. Ambivalence may be operationalized as either a neutral attitude toward pregnancy or having conflicting attitudes. Previous research has focused on ambivalence as a neutral attitude, while conflicted ambivalence is less well understood. METHODS: We used data from a recent nationally representative survey of unmarried young adults, the “Fog Zone” survey (N=1,800; analytic sample, N=1,147). Based on two measures of attitudes toward becoming pregnant, the importance of avoiding pregnancy and predicted happiness about a pregnancy, we formed a categorical ambivalence measure considering both the presence and direction of conflicting attitudes: negative consistency, positive ambivalence (important to avoid pregnancy and happy about pregnancy), negative ambivalence (not important to avoid and unhappy), and positive consistency. Multinomial logit and logistic regression analyses were used to explore the characteristics associated with ambivalence and to examine whether ambivalence is associated with inconsistent use of contraceptives. RESULTS: Both consistency in attitudes toward pregnancy and ambivalence are patterned by race-ethnicity, age, education, and gender. Women with negative ambivalence were strongly less likely to use contraceptives consistently than those with negative consistency. In contrast, women with positive ambivalence do not differ from the majority of young women who want to avoid pregnancy. For males, ambivalence does not predict consistent use of contraceptives. CONCLUSION: Ambivalence is not a singular but multifaceted concept. Women with negative ambivalence rather than positive ambivalence should be a main target of prevention programs and related policies.