Unintended pregnancy in the Netherlands: An evaluation of a multidimensional and continuous construct

Abstract

Background. It is often unclear what constitutes an unintended pregnancy, and pregnancy intentions may be multidimensional, dynamic as well as context-specific. The London Measure of Unplanned Pregnancy (LMUP) measures pregnancy intentions in a manner close to the actual experience. The aim of this study is to establish a reliable adapted Dutch version of the LMUP (LMUP-NL). The second aim is to provide a more accurate understanding of unintended pregnancy in the Netherlands, by focusing on associated factors with unintended pregnancy of both pregnant people and their partners, irrespective of pregnancy outcome. The third aim is to give insight into agreement of pregnancy intentions within couples.Methods. The adapted LMUP-NL was translated based on the Flemish LMUP and the UK 2020 update. In a small validation sample, we evaluated the psychometric properties of the adapted LMUP-NL with regards to acceptability, readability, reliability, and construct validity. Further, we combined data from two studies on unintended pregnancy including both people who were pregnant and their partners. We tested several hypotheses, expecting people to report a more intended pregnancy if they were 1) continuing their pregnancy to term, 2) in a stable relationship, 3) older than 20 but younger than 40, and 4) pregnant for the first time. We additionally assessed consistency in pregnancy intentions of couples.Results. The evaluation (n = 101) demonstrated that the adapted LMUP-NL was acceptable, readable and reliable (Cronbach’s alpha = 0.75). There was good test-retest stability and acceptable construct validity. Subsequently, results from our hypothesis tests (n = 1172) showed that people who were younger, single, and nulliparous reported lower pregnancy intent. People who had an abortion reported lower pregnancy intent compared to people continuing their pregnancy to term. Lastly, results showed a high correlation of pregnancy intent in couples (n = 257).Conclusions. The current study evaluated the adapted LMUP-NL as reliable for the Dutch context. It offers researchers and policy makers an instrument suitable to measure pregnancy intention in a multidimensional manner, constituting a closer reflection of the actual experience of pregnancy intentions. Pregnancy intentions are context-specific and often consistent between partners.